Deck 34: Alterations of Digestive Function

Question 1

A 10-month-old is brought to the pediatrician by the mother who states the baby has been experiencing colicky pain followed by vomiting,sweating,nausea,and irritability.Testing reveals a condition in which one part of the intestine telescopes into another.From which type of intestinal obstruction is he suffering?

A) Hernia
B) Ileus
C) Torsion
D) Intussusception

Answer 1

Intussusception

Question 2

A 45-year-old male complains of heartburn after eating and difficulty swallowing.He probably has:

A) Pyloric stenosis
B) Gastric cancer
C) Achalasia
D) Hiatal hernia

Answer 2

Hiatal hernia

Question 3

A serious complication of paraesophageal hiatal hernia is:

A) Hemorrhage
B) Strangulation
C) Peritonitis
D) Ascites

Answer 3

Strangulation

Question 4

A 50-year-old male is experiencing reflux of chyme from the stomach.He is diagnosed with gastroesophageal reflux.This condition is caused by:

A) Fibrosis of the lower third of the esophagus
B) Sympathetic nerve stimulation
C) Loss of muscle tone at the lower esophageal sphincter
D) Reverse peristalsis of the stomach

Question 5

A 22-year-old male underwent brain surgery to remove a tumor.Following surgery,he experienced a peptic ulcer.His ulcer is referred to as a(n)_____ ulcer.

A) Infectious
B) Cushing
C) Ischemic
D) Curling

Question 6

A 38-year-old female complains of epigastric fullness following a meal,nausea,and epigastric pain.Tests reveal narrowing of the opening between the stomach and the duodenum.This condition is referred to as:

A) Ileocecal obstruction
B) Hiatal hernia
C) Pyloric obstruction
D) Hiatal obstruction

Question 7

A 40-year-old female presents complaining of pain near the midline in the epigastrium.Assuming the pain is caused by a stimulus acting on an abdominal organ,the pain felt is classified as:

A) Visceral
B) Somatic
C) Parietal
D) Referred

Question 8

A 54-year-old male is diagnosed with peptic ulcer disease.This condition is most likely caused by:

A) Hereditary hormonal imbalances with high gastrin levels
B) Breaks in the mucosa and presence of corrosive secretions
C) Decreased vagal activity and vascular engorgement
D) Gastric erosions related to high ammonia levels and bile reflux

Question 9

Reflux esophagitis is defined as a(n):

A) Immune response to gastroesophageal reflux
B) Inflammatory response to gastroesophageal reflux
C) Congenital anomaly
D) Secretory response to hiatal hernia

Question 10

The most common disorder associated with upper GI bleeding is:

A) Diverticulosis
B) Hemorrhoids
C) Esophageal varices
D) Cancer

Question 11

A 20-year-old male was recently diagnosed with lactose intolerance.He eats an ice cream cone and develops diarrhea.His diarrhea can be classified as _____ diarrhea.

A) Osmotic
B) Secretory
C) Hypotonic
D) Motility

Question 12

A 40-year-old male develops an intestinal obstruction related to protrusion of the intestine through the inguinal ring.This condition is referred to as:

A) Intussusception
B) A volvulus
C) A hernia
D) Adhesions

Question 13

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

A) Constipation
B) Diarrhea
C) Vomiting
D) Heartburn

Question 14

A 34-year-old male was diagnosed with a bacterial GI infection.Which of the following types of diarrhea would most likely occur with his condition?

A) Osmotic
B) Secretory
C) Hypotonic
D) Motility

Question 15

Chronic gastritis is classified according to the:

A) Severity
B) Location of lesions
C) Patient's age
D) Signs and symptoms

Question 16

A 42-year-old female presents with abdominal discomfort,epigastric tenderness,and bleeding.Gastroscopy reveals degeneration of the gastric mucosa in the body and fundus of the stomach.Which of the following would most likely follow?

A) Pernicious anemia
B) Osmotic diarrhea
C) Increased acid secretion
D) Decreased gastrin secretion

Question 17

A 24-year-old male who sustained a head injury and fractured femur develops a stress ulcer.A common clinical manifestation of this ulcer is:

A) Bowel obstruction
B) Bleeding
C) Pulmonary embolism
D) Hepatomegaly

Question 18

A 39-year-old female with chronic intermittent pain in the epigastric area 2 to 3 hours after eating is diagnosed with a duodenal ulcer.Which of the following behaviors may have contributed to the development of the ulcer?

A) Cigarette smoking
B) Drinking caffeinated beverages
C) Consuming limited fiber
D) Antacid consumption

Question 19

A 60-year-old male presents with GI bleeding and abdominal pain.He reports that he takes NSAIDs daily to prevent heart attack.Tests reveal that he has a peptic ulcer.The most likely cause of this disease is:

A) Increasing subepithelial bicarbonate production
B) Accelerating the H+ (proton) pump in parietal cells
C) Inhibiting mucosal prostaglandin synthesis
D) Stimulating a shunt of mucosal blood flow

Question 20

A 52-year-old presents with bleeding from the rectum.This condition is referred to as:

A) Melena
B) Occult bleeding
C) Hematochezia
D) Hematemesis

Question 21

A 55-year-old male died in a motor vehicle accident.Autopsy revealed an enlarged liver caused by fatty infiltration,testicular atrophy,and mild jaundice secondary to cirrhosis.The most likely cause of his condition is:

A) Bacterial infection
B) Viral infection
C) Alcoholism
D) Drug overdose

Question 22

The most common cause of chronic vascular insufficiency among the elderly is:

A) Anemia
B) Aneurysm
C) Lack of nutrition in gut lumen
D) Atherosclerosis

Question 23

Complete obstruction of bile flow to the liver would be manifested by:

A) Elevated hemoglobin and hematocrit
B) Lower-leg edema
C) Clay-colored stools
D) Hypotension

Question 24

A 3-month-old female develops colicky pain,abdominal distention,and diarrhea after drinking cow's milk.The best explanation for her symptoms is:

A) Deficiency of bile that stimulates digestive secretions and bowel motility
B) Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea
C) Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and decreased bowel motility
D) Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Question 25

Clinical manifestations of bile salt deficiencies are related to poor absorption of:

A) Fats and fat-soluble vitamins
B) Water-soluble vitamins
C) Proteins
D) Minerals

Question 26

A 16-year-old female presents with abdominal pain in the right lower quadrant.Physical examination reveals rebound tenderness and a low-grade fever.A possible diagnosis would be:

A) Colon cancer
B) Pancreatitis
C) Appendicitis
D) Hepatitis

Question 27

A 54-year-old male complains that he has been vomiting blood.Tests reveal portal hypertension.Which of the following is the most likely cause of his condition?

A) Thrombosis in the spleen
B) Cirrhosis of the liver
C) Left ventricular failure
D) Renal stenosis

Question 28

A 13-year-old female confides to her mother that she binge eats and induces vomiting to prevent weight gain.This disease is referred to as:

A) Anorexia nervosa
B) Bulimia nervosa
C) Long-term starvation
D) Laxative abuse

Question 29

The most common clinical manifestation of portal hypertension is _____ bleeding.

A) Rectal
B) Duodenal
C) Esophageal
D) Intestinal

Question 30

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

A) Hyperbilirubinemia and jaundice
B) Fluid and electrolyte imbalances
C) Impaired ammonia metabolism
D) Decreased cerebral blood flow

Question 31

The icteric phase of hepatitis is characterized by which of the following clinical manifestations?

A) Fatigue, malaise, vomiting
B) Jaundice, dark urine, enlarged liver
C) Resolution of jaundice, liver function returns to normal
D) Fulminant liver failure, hepatorenal syndrome

Question 32

In alcoholic cirrhosis,hepatocellular damage is caused by:

A) Acetaldehyde accumulation
B) Bile toxicity
C) Acidosis
D) Fatty infiltrations

Question 33

An increase in the rate of red blood cell breakdown causes which form of jaundice?

A) Obstructive
B) Hemolytic
C) Hepatocellular
D) Metabolic

Question 34

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

A) Abdominal pain
B) Pattern of remission/exacerbations
C) Diarrhea
D) Malabsorption

Question 35

The risk of hypovolemic shock is high with acute mesenteric arterial insufficiency because:

A) The resulting liver failure causes a deficit of plasma proteins and a loss of oncotic pressure.
B) Ischemia alters mucosal membrane permeability, and fluid is shifted to the bowel wall and peritoneum.
C) Massive bleeding occurs in the GI tract.
D) Overstimulation of the parasympathetic nervous system results in ischemic injury to the intestinal wall.

Question 36

Which of the following conditions is thought to contribute to the development of obesity?

A) Insulin excess
B) Leptin resistance
C) Adipocyte failure
D) Malabsorption

Question 37

A 50-year-old male complains of frequently recurring abdominal pain,diarrhea,and bloody stools.A possible diagnosis would be:

A) Ulcerative colitis
B) Hiatal hernia
C) Pyloric obstruction
D) Achalasia

Question 38

A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain.Physical examination reveals severe ascites.This condition is caused by decreased:

A) Albumin and lack of cellular integrity
B) Capillary filtration pressure
C) Capillary permeability
D) Antidiuretic hormone secretion

Question 39

Which of the following characteristics is associated with an acute occlusion of mesenteric blood flow to the small intestine?

A) Often precipitated by an embolism
B) Commonly associated with disease such as pancreatitis and gallstones
C) Caused by chronic malnutrition and mucosal atrophy
D) Often a complication of hypovolemic shock

Question 40

A 30-year-old obese female underwent gastric resection in an attempt to lose weight.Which of the following complications could the surgery cause?

A) Constipation
B) Acid reflux gastritis
C) Anemia
D) Hiccups

Question 41

The primary causes of duodenal ulcers include (select all that apply):

A) Consumption of spicy foods
B) Nonsteroidal anti-inflammatory drugs (NSAIDs)
C) H. pylori infection
D) Trauma
E) Side effects of antibiotics

Question 42

A patient presents to the physician with complaints of constipation.Which of the following could be the cause? (Select all that apply.)

A) Neurogenic disorder of the large intestine
B) Sedentary lifestyle
C) Low residue diet
D) Aging
E) Use of antacids
F) None of above

Question 43

Acute pancreatitis often manifests with pain to which of the following regions?

A) Right lower quadrant
B) Right upper quadrant
C) Epigastric
D) Suprapubic

Question 44

A 39-year-old female presents with abdominal pain and jaundice.She is diagnosed with gallstones and undergoes cholecystectomy.An analysis of her gallstones would most likely reveal a high concentration of:

A) Phosphate
B) Bilirubin
C) Urate
D) Cholesterol

Question 45

Which of the following type(s)of hepatitis has an incubation period of up to 180 days? (Select al that apply.)

A) A
B) B
C) C
D) D
E) E

Question 46

The cardinal signs of small bowel obstruction are:

A) Vomiting and distention
B) Diarrhea and excessive thirst
C) Dehydration and epigastric pain
D) Abdominal pain and rectal bleeding

Question 47

Which of the following gastrointestinal (GI)clinical manifestations is subjective? (Select all that apply.)

A) Retching
B) Anorexia
C) Nausea
D) Vomiting
E) Diarrhea

Question 48

Complications obstruction in the lower bowel include (select all that apply):

A) Metabolic acidosis
B) Hypokalemia
C) Tachycardia
D) Hypovolemia
E) Peritonitis

Question 49

A 46-year-old female is diagnosed with gastric ulcers.Which of the following characterizes the disorder? (Select all that apply.)

A) Pain occurs immediately after eating.
B) Weight gain occurs.
C) Bile is regurgitated.
D) Occurrence is typically a single event.
E) Duration of treatment is extended.

Question 50

A 60-year-old male is diagnosed with cancer of the esophagus.Which of the following factors most likely contributed to his disease?

A) Reflux esophagitis
B) Intestinal parasites
C) Ingestion of salty foods
D) Frequent use of antacids

Question 51

A 55-year-old female has general symptoms of gallstones but is also jaundiced.IV cholangiography would most likely reveal that the gallstones are obstructing the:

A) Intrahepatic bile canaliculi
B) Gallbladder
C) Cystic duct
D) Common bile duct

Question 52

A 31-year-old female presents with midabdominal pain.She is expected to have acute pancreatitis.Which of the will be part of the treatment plan? (Select all that apply.)

A) Narcotic analgesics
B) Restriction of food intake
C) Nasogastric suctioning
D) Antibiotics
E) IV fluids
F) None of above

Question 53

A 62-year-old male presents with difficulty swallowing.Tests reveal a loss of esophageal peristalsis and failure of the lower esophageal sphincter to relax.Functional dysphasia is the diagnosis.A history of which of the following could be the most likely cause? (Select all that apply.)

A) Parkinson disease
B) Cerebrovascular accident
C) Achalasia
D) Peptic ulcer disease
E) Pyloric stenosis

Question 54

A 40-year-old male presents with epigastric pain.Tests reveal acute pancreatitis.The most likely cause of his condition is:

A) Pancreatic duct obstruction by a malignant tumor
B) Surgical trauma to the pancreas
C) Obstruction of the biliary tract by a gallstone
D) Toxic injury to the pancreas from nonprescription medications

Question 55

Cholecystitis is inflammation of the gallbladder wall usually caused by:

A) Accumulation of bile in the hepatic duct
B) Obstruction of the cystic duct by a gallstone
C) Accumulation of fat in the wall of the gallbladder
D) Viral infection of the gallbladder

Question 56

A 40-year-old male who consumes a diet high in fat and low in fiber is at risk for:

A) Cancer of the stomach
B) Cancer of the liver and biliary ducts
C) Cancer of the small intestine
D) CRC

Question 57

Which of the GI cancers has the highest rate of incidence and is responsible for the highest number of deaths?

A) Esophageal
B) Stomach
C) Pancreatic
D) Colorectal

Question 58

Pancreatic insufficiency is manifested by deficient production of:

A) Insulin
B) Amylase
C) Lipase
D) Bile

Question 59

A 55-year-old male intravenous (IV)drug user with a history of advanced liver disease is diagnosed with hepatorenal syndrome.Which of the following clinical manifestations would be expected? (Select all that apply.)

A) Oliguria
B) Jaundice
C) Ascites
D) Hypertension
E) Anorexia

Question 60

Tissue damage in pancreatitis is caused by:

A) Insulin toxicity
B) Autoimmune destruction of the pancreas
C) Leakage of pancreatic enzymes
D) Hydrochloric acid reflux into the pancreatic duct

Question 61

Obesity is define as a body mass index (BMI)greater than _____.

Question 62

A 16-year-old female is diagnosed with anorexia nervosa.By definition,the patient would weigh ____% less than normal for age and height:

Question 63

A 52-year-old female presents with continuous abdominal pain that intensifies after eating.She is diagnosed with chronic pancreatitis.Contributing factors include: (Select all that apply.)

A) Alcohol abuse
B) Peptic ulcer disease
C) Trauma
D) Smoking
E) Bulimia

Question 64

The adult intestine processes approximately _____ liters of luminal content per day,of which 99% of the fluid is normally reabsorbed.