PATH 370 - W7 Check Your Understanding

Proton pump inhibitors may be used in the management of peptic ulcer disease to increase gastric motility. inhibit secretion of pepsinogen. neutralize gastric acid. decrease hydrochloric acid (HCl) secretion.

decrease hydrochloric acid (HCl) secretion.

A patient who should be routinely evaluated for peptic ulcer disease is one who is taking six to eight tablets of acetaminophen per day. being treated with high-dose oral glucocorticoids. experiencing chronic diarrhea. routinely drinking alcoholic beverages.

being treated with high-dose oral glucocorticoids.

In the United States, nearly ________ people have diabetes mellitus. 7 million 29.1 million 366 million 176 billion

29.1 million

A biliary cause of acute pancreatitis is suggested by an elevation in which serum laboratory results? Lipase Amylase Glucose Alkaline phosphatase

Alkaline phosphatase

What finding should prompt further diagnostic testing in a child presenting with diarrhea? Periumbilical discomfort Greenish, watery diarrhea Frequent, large-volume diarrhea Blood and mucus in the stools

Blood and mucus in the stools

What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? Negative stool leukocytes Intermittent constipation Abdominal pain and distention Bloody stools

Bloody stools

What clinical finding would suggest an esophageal cause of a client's report of dysphagia? Nasal regurgitation Airway obstruction with swallowing Chest pain during meals Coughing when swallowing

Chest pain during meals

What laboratory data would support a diagnosis of hemochromatosis? Deficient protease inhibitor Elevated ferritin Elevated urine copper Positive antinuclear antibody

Elevated ferritin

What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus? Blood glucose levels Urine glucose levels Glycosylated hemoglobin levels (HbA1c) Clinical manifestations of hyperglycemia

Glycosylated hemoglobin levels (HbA1c)

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of Addison disease. Cushing syndrome. myxedema. Graves disease.

Graves disease.

Which symptom suggests the presence of a hiatal hernia? Nausea Heartburn Diarrhea Abdominal cramps

Heartburn

A patient with chronic gastritis would likely be tested for Helicobacter pylori. occult blood. lymphocytes. herpes simplex.

Helicobacter pylori.

What form of viral hepatitis is likely to be transmitted sexually? Hepatitis A Hepatitis B Hepatitis C Hepatitis E

Hepatitis B

What effect would adrenocortical insufficiency have on an individual's response to surgical stress? More prone to hyperglycemia Decreased sensitivity to anesthesia More susceptible to hypertensive crisis More prone to hypotension

More prone to hypotension

Which response to an injection of ACTH indicates a primary adrenal insufficiency? No change in serum glucocorticoid level An increase in serum glucocorticoid level A decrease in serum glucose level An increase in serum ACTH level

No change in serum glucocorticoid level

An early indicator of colon cancer is rectal pain. bloody diarrhea. a change in bowel habits. jaundice.

a change in bowel habits.

________ is the most powerful predictor of developing type 2 diabetes mellitus. Aging Obesity Sedentary lifestyle Cardiovascular disease

Obesity

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver. Kayser-Fleischer Wilson Reye Byler

Wilson

A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ________ hepatitis B. recovered from immunity to chronic active acute

acute

Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of viral hepatitis. alcohol-induced injury. cirrhosis. acetaminophen toxicity.

alcohol-induced injury.

More than half of the initial cases of pancreatitis are associated with trauma. stones. alcoholism. high cholesterol.

alcoholism.

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of appendicitis. peritonitis. cholecystitis. gastritis.

appendicitis.

It is true that Graves disease is a secondary endocrine disorder. associated with autoantibodies to TSH receptors. characterized by high serum TSH levels. untreatable.

associated with autoantibodies to TSH receptors.

Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is hepatitis D. autoimmune hepatitis. hepatitis A. hepatitis B.

autoimmune hepatitis.

Congenital adrenal hyperplasia (adrenogenital syndrome) results from cortisol excess. testosterone-secreting tumor. exogenous androgens. blocked cortisol production.

blocked cortisol production.

Ulcerative colitis is commonly associated with bloody diarrhea. malabsorption of nutrients. fistula formation between loops of bowel. inflammation and scarring of the submucosal layer of the bowel.

bloody diarrhea.

An infusion of mannitol would be prescribed to treat varices. encephalopathy. peritonitis. cerebral edema.

cerebral edema.

The definitive treatment for cholecystitis is lithotripsy of stones. chemical dissolution of stones. antibiotics and anti-inflammatories. cholecystectomy.

cholecystectomy.

Most gallstones are composed of bile. cholesterol. calcium. uric acid salts.

cholesterol.

An increase in ADH secretion occurs in response to decreased serum osmolality. dehydration. hypervolemia. hyponatremia.

dehydration.

Chronic pancreatitis may lead to diabetes mellitus. Crohn disease. gallstones. celiac sprue.

diabetes mellitus.

Fecal leukocyte screening would be indicated in a patient with suspected lactose intolerance. enterocolitis. laxative abuse. giardiasis.

enterocolitis.

Steatohepatitis is caused by an accumulation of ________ in the liver cells. fat bile acetaminophen ferritin

fat

A silent abdomen 3 hours after bowel surgery most likely indicates peritonitis. mechanical bowel obstruction. perforated bowel. functional bowel obstruction.

functional bowel obstruction.

Untreated acute cholecystitis may lead to ________ of the gallbladder wall. gangrene infection distention inflammation

gangrene

Dumping syndrome is commonly seen after __________ procedures. appendectomy intestinal biopsy colonoscopy gastric bypass

gastric bypass

Epigastric pain that is relieved by food is suggestive of pancreatitis. cardiac angina. gastric ulcer. dysphagia.

gastric ulcer.

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is ascites. cerebral edema. hepatic encephalopathy. gastroesophageal varices.

gastroesophageal varices.

The breakdown of stored glycogen in the liver and muscles is called glycolysis. glycogenesis. glycogenolysis. gluconeogenesis.

glycogenolysis.

A thyroid gland that grows larger than normal is known as cretinism. myxedema. goiter. colloidosis.

goiter.

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis. hemolysis metabolism fibrosis canalicular bilirubin transport

hemolysis

An increased urine bilirubin is associated with an increased indirect serum bilirubin. hemolytic reactions. Gilbert syndrome. hepatitis.

hepatitis.

The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder. A symptom associated with primary Cushing syndrome is hyperpigmentation. hypotension. hyperglycemia. hyperkalemia.

hyperglycemia.

A patient with pancreatitis may experience muscle cramps secondary to alkalosis. hyperglycemia. hypocalcemia. hypermagnesemia.

hypocalcemia.

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is hypokalemia. hypoglycemia. hypertension. moon face.

hypoglycemia.

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is hypernatremia. hyperkalemia. hypokalemia. hyperglycemia.

hypokalemia.

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is hypovolemia. hyponatremia. decreased osmolality. dehydration.

hyponatremia.

Constipation in an elderly patient can be best treated by maintaining a low-fiber diet. maintaining the current level of activity. fecal disimpaction. increasing fiber in the diet.

increasing fiber in the diet.

The underlying pathogenic mechanism for type 2 diabetes is pancreatic β-cell destruction. insulin resistance and β-cell dysfunction. lack of exercise and chronic overeating. impaired glucose transport into cells.

insulin resistance and β-cell dysfunction.

Surgical removal of a gland may result in hypersecretion. hyposecretion. hyporesponsiveness. tissue resistance.

hyposecretion.

Myxedema coma is a severe condition associated with hypothyroidism. hyperthermia. acute cortisol insufficiency. pheochromocytoma.

hypothyroidism.

Diabetes insipidus is a condition that results from inadequate ADH secretion. is characterized by oliguria. is associated with anterior pituitary dysfunction. leads to glycosuria.

inadequate ADH secretion.

Hepatic encephalopathy is associated with hyperbilirubinemia. hyperuricemia. toxic effects of alcohol on brain cells. increased blood ammonia levels.

increased blood ammonia levels.

Insulin binding to its receptor on target cells results in increased active transport of glucose into the cell. glycogen breakdown within target cells. increased facilitated cellular diffusion of glucose. gluconeogenesis.

increased facilitated cellular diffusion of glucose.

The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis is an expected finding and requires no specific intervention. indicates peritonitis with substantial risk for sepsis and shock. requires immediate surgical intervention. is an unusual finding in pancreatitis and indicates misdiagnosis.

indicates peritonitis with substantial risk for sepsis and shock.

Celiac sprue is a malabsorptive disorder associated with inflammatory reaction to gluten-containing foods. megacolon at regions of autonomic denervation. ulceration of the distal colon and rectum. deficient production of pancreatic enzymes.

inflammatory reaction to gluten-containing foods.

Propylthiouracil may be used to treat hyperthyroidism, because it destroys thyroid gland cells. inhibits the release of TSH. suppresses production of autoantibodies. inhibits thyroid hormone synthesis.

inhibits thyroid hormone synthesis.

The formation of active vitamin D occurs in the skin. is impaired in renal failure. is dependent on oral intake of vitamin D. is necessary for normal potassium metabolism.

is impaired in renal failure.

It is true that the synthesis of thyroid hormones is increased by thyrotropin-inhibiting factor. occurs in perifollicular C cells. is stimulated by ACTH. is inhibited by iodine deficiency.

is inhibited by iodine deficiency.

Brain injury secondary to high serum bilirubin is called hepatic encephalopathy. hepatic meningitis. kernicterus. encephalitis.

kernicterus.

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes. less than 180 more than 180 70 130

less than 180

Jaundice is a common manifestation of malabsorption syndromes. anemia. liver disease. cholecystitis.

liver disease.

A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________ diet. low-protein and high-fiber high-protein and high-carbohydrate high-sodium unrestricted

low-protein and high-fiber

It is true that gallstones are a minimal risk for Native Americans. more common in women. more common in men. at highest risk among Asians.

more common in women.

Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate. cure morbidity insurance mortality

mortality

Premature infants are at greater risk for developing necrotizing enterocolitis. pseudomembranous colitis. appendicitis. diverticular disease.

necrotizing enterocolitis.

Radioactive iodine treatment is the therapy of choice in patients with Graves disease. The patient should be expected to achieve full recovery after treatment. need short-term thyroid replacement therapy. need lifelong thyroid replacement therapy. receive lifelong iodine treatment.

need lifelong thyroid replacement therapy.

Type 2 diabetes mellitus is often associated with nonketotic hyperosmolality. childhood. autoimmune destruction of the pancreas. ketoacidosis.

nonketotic hyperosmolality.

Growth hormone-deficient infants would display low birth length and weight. normal birth length and weight. high birth length and weight. normal length and low weight.

normal birth length and weight.

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of glucose. octreotide acetate. anticoagulants. proton pump inhibitors.

octreotide acetate.

Calcitonin is produced by thyroid parafollicular cells and increases bone formation by homeostasis. osteoclasts. reabsorption. osteoblasts.

osteoblasts.

The most challenging aspect of treatment for chronic pancreatitis is pancreatectomy. strict dietary avoidance of fats. abstinence from alcohol. pain control.

pain control.

The underlying pathogenic mechanism for type 1 diabetes is pancreatic β-cell destruction. lack of insulin receptors. lack of exercise and chronic overeating. impaired glucose transport into cells.

pancreatic β-cell destruction.

Elevated serum lipase and amylase levels are indicative of gallbladder disease. appendicitis. pancreatitis. peritonitis.

pancreatitis.

A tumor which results in excessive production and release of catecholamines is goiter. pheochromocytoma. Conn syndrome. Cushing disease.

pheochromocytoma.

Pathophysiologically, esophageal varices can be attributed to elevated bilirubin. diminished protein metabolism. fluid accumulation. portal hypertension.

portal hypertension.

A type of insulin that would be most appropriate for acute management of hyperglycemia is NPH. Semilente. regular. Ultralente.

regular.

Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to prevent abdominal distention. remove the usual stimuli for pancreatic secretion. prevent hyperglycemia associated with loss of insulin secretion. prevent mechanical obstruction of the intestine.

remove the usual stimuli for pancreatic secretion.

In type I diabetes, respiratory compensation may occur through a process of respiratory alkalosis. respiratory acidosis. metabolic acidosis. metabolic alkalosis.

respiratory alkalosis.

It is true that growth hormone excess in adults results in the condition of acromegaly. leads to abnormally tall stature. is associated with hypoglycemia. is usually asymptomatic.

results in the condition of acromegaly.

Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States. first second fourth seventh

seventh

Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for respiratory depression. narcotic dependency. sphincter of Oddi dysfunction. allergic reaction.

sphincter of Oddi dysfunction.

The pain associated with chronic pancreatitis is generally described as ________ in nature. sharp and constant steady and boring intermittent and burning intermittent and stabbing

steady and boring

A patient receiving chemotherapy may be at greater risk for development of gastroesophageal reflux. stomatitis. esophageal varices. Mallory-Weiss syndrome.

stomatitis.

It is true that biliary cancer is most often cured by surgery. respond well to chemotherapy. are identifiable and treatable when diagnosed early. tend to be asymptomatic and progress insidiously.

tend to be asymptomatic and progress insidiously.

Clinical manifestations of Graves disease may include tremor. cold intolerance. lethargy. weight gain.

tremor.

A clinical finding consistent with a hypoglycemic reaction is acetone breath. warm, dry skin. tremors. hyperventilation.

tremors.

Antidiuretic hormone (ADH) increases sodium reabsorption in the distal tubule of the kidney. potassium secretion in the distal tubule of the kidney. water reabsorption in the collecting tubule of the kidney. urinary output.

water reabsorption in the collecting tubule of the kidney.