Patho Final

An early indicator of colon cancer is

a change in bowel habits

A Barrett esophagus is

a preneoplastic lesion

Achalasia

absence of peristalsis in a portion of the esophagus

An urgent surgical consult is indicated for the patient with acute abdominal pain and

absent bowel tones

Combined dysphagia with both solids and liquids is typical of

achalasia

A viral hepatitis screen with positive hepatitis B surface antigen, positive anti-HB core IgM, and negative anti-HB surface IgG should be interpreted as _____ hepatitis B.

acute

The most common cause of mechanical bowel obstruction is

adhesions

Liver transaminase elevations in which aspartate aminotransferase (AST) is greater than alanine aminotransferase (ALT) by a 2:1 ratio is characteristic of

alcohol-induced injury

Which of the following enzymes is proteolytic?

chymotrypsin

In which of the following cases would it be inappropriate to manage dyspepsia with an empiric trial of an H2 blocke

concomitant dysphagia

Histamine antagonists may be used in the management of peptic ulcer disease to

decrease hydrochloric acid (HCl) secretion

An increase in ADH secretion occurs in response to

dehydration

Dysphagia

difficulty swallowing

Which of the following is a characteristic of lipid-soluble hormones?

diffuse through cell membranes to activate intracellular receptors

The release of prolactin is normally inhibited by

dopamine

Hemochromatosis is a common genetic disorder that may lead to chronic liver failure. Which of the following laboratory data would support a diagnosis of hemochromatosis?

elevated ferritin

The structure and secretions of the salivary gland most closely resemble those of the

exocrine pancreas

A reduction in lower esophageal sphincter tone helps reduce gastroesophageal reflux.

false

Crohn disease and ulcerative colitis are two types of irritable bowel syndrome.

false

Distention of the cecum results in relaxation of the ileocecal sphincter.

false

Diverticulitis usually is asymptomatic.

false

Hepatitis A and hepatitis C are transmitted through contaminated food and water.

false

In general, activation of sympathetic nerves to the GI tract increases motility and secretion.

false

Liver cancer usually is a primary cancer arising from hepatic cells.

false

Most pituitary hormones are carried in the bloodstream bound to protein carrier molecules.

false

Oxytocin and ADH are secreted in response to hypothalamic releasing hormones.

false

Secondary adrenocortical insufficiency is characterized by hyperpigmentation due to excessive secretion of melanocyte-stimulating hormones.

false

TSH passes directly through the cell membrane and binds to intracellular receptors.

false

The longitudinal layer is composed of striated muscle, whereas the circular layer is composed of smooth muscle.

false

A silent abdomen 3 hours after bowel surgery most likely indicates

functional bowel obstruction

Epigastric pain that is relieved by food is suggestive of

gastric ulcer

Most endocrine hormones are water soluble and exert their effects on target cells by

generating second messengers

Which of the following can be absorbed through the intestinal epithelia without further digestion?

glucose

Which of the following symptoms suggests the presence of a hiatal hernia?

heartburn

An increased urine bilirubin is associated with

hepatitis

Bile is manufactured by

hepatocytes

Diverticulosis

herniations in the bowel wall

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is

hypoatremia

Normally secretion of growth hormone is suppressed by all of the following except

hypoglycemia

Myxedema coma is a severe condition associated with

hypothyroidism

An increase in serum osmolality would be expected to _____ secretion.

increase vasopressin

Hepatic encephalopathy is associated with

increased blood ammonia levels

Up-regulation of target cell receptors results in

increased target cell responsiveness to hormone

Growth hormone has several effects on the body, including

increasing lean body mass

Esophageal varices may develop as a complication of liver disease. Pathophysiologically, this condition can be attributed to

portal hypertension

A patient receiving thyroid replacement hormone for primary hypothyroidism who has a low TSH should have a(n)

reduction in hormone replacement dose

Clinical manifestations of hypoparathyroidism

result from decreased serum ionized calcium

Diabetes insipidus is a condition

resulting from inadequate ADH secretion

Growth hormone excess in adults

results in the condition of acromegaly

The primary stimulus for pancreatic secretion is

secretin

Most nutrient digestion and absorption occurs in the

small intestine

Clinical manifestations of Graves disease may include

tremor

A patient with primary adrenal insufficiency would have a high serum ACTH.

true

Esophagitis pain is similar in location and pattern to myocardial chest pain.

true

Gastric emptying is inhibited by high fat concentrations in the duodenum.

true

Hepatitis A is a self-limiting infection that does not have a chronic carrier state.

true

Hepatitis C is a chronic condition in about 85% of cases.

true

Hypoglycemia is a potent stimulus for growth hormone secretion.

true

Liver transaminases are increased in the serum when hepatocytes are injured.

true

Long-term administration of glucocorticoids leads to adrenocortical atrophy.

true

Long-term use of nonsteroidal antiinflammatory medications and infection with Helicobacter pylori are causative factors in peptic ulcer disease.

true

Releasing and inhibiting hormones travel from the hypothalamus to the anterior pituitary gland through portal veins.

true

Secretion of most hormones is regulated by negative feedback mechanisms

true

The finding of exophthalmos is indicative of Graves disease.

true

The myenteric plexus lies between the longitudinal and circular muscle layers of the gastrointestinal (GI) tract.

true

Which of the following hormones is regulated by releasing and inhibiting factors from the hypothalamus?

ACTH

Which of the following forms of viral hepatitis is likely to be transmitted sexually?

Hepatitis b

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of

appendicitis

Graves disease is

associated with autoantibodies to TSH receptors

A patient who should be routinely evaluated for peptic ulcer disease is one who is

being treated with high-dose oral glucocorticoids

Pancreatic secretions are high in

bicarbonate ions

Which of the following findings should prompt further diagnostic testing in a child presenting with diarrhea?

blood and mucus in the stools

Hepatitis B is usually transmitted by exposure to

blood or semen

Ulcerative colitis is commonly associated with

bloody diarrhea

Which of the following findings would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea?

bloody stools

Which of the following clinical findings would suggest an esophageal rather than an oropharyngeal cause of dysphagia?

chest pain during meals

Which of the following is associated with relaxation of the sphincter of Oddi?

cholecystokinin

Fecal leukocyte screening would be indicated in a patient with suspected

inflammatory bowel disease

Celiac sprue is a malabsorptive disorder associated with

inflammatory reaction to gluten-containing foods

Propylthiouracil may be used to treat hyperthyroidism because it

inhibits thyroid hormone synthesis

Brush-border enzymes are produced by _____ cells.

intestinal epithelial

Synthesis of thyroid hormones

is inhibited by iodine deficiency

In comparison to triiodothyronine (T3), thyroxine (T4)

is more abundant in circulation

Which of the following statements regarding pepsin is true?

it is secreted as an inactive proenzyme

Brain injury secondary to high serum bilirubin is called

kernicterus

Jaundice is a common manifestation of

liver disease

All of the following would stimulate secretion from gastric parietal cells except

norepinephrine

Which of the following hormones is not released from the anterior pituitary gland?

oxytocin

Odynophagia

painful swallowing

Chief cells secrete

pepsinogen

An example of a secondary endocrine disorder is

pituitary hyper secretion of TSH

Absorption of glucose and amino acids across the intestinal epithelium occurs by

sodium-dependent carriers

Growth hormone stimulates the liver to release

somatomedins

Encopresis

stasis and involuntary leakage of stool

Parasympathetic stimulation of the stomach would

stimulate motility

A primary endocrine disorder occurs when

the target gland is unresponsive to pituitary regulation.

An example of a lipid-soluble hormone is

thyroid hormone

Which of the following hormones is highly bound to carrier proteins in the bloodstream?

thyroid hormones

Most of the parasympathetic innervation of the GI tract is supplied by the

vagus nerves

Antidiuretic hormone (ADH) increases

water reabsorption in the collecting tubule of the kidney