Deck 3: Gastrointestinal (Gi)

Question 1

A patient presents with left lower quadrant abdominal pain that increases with coughing and straining, fever, flatulence, and abdominal distention. Altered bowel habits are also reported. Physical examination reveals a palpable tender rectal mass. CT scan reveals inflammation of outpouchings of the sigmoid colon's intestinal mucosa. The patient is most likely diagnosed with:

A)Crohn's disease
B)Diverticulitis
C)Ulcerative colitis
D)Appendicitis

Answer 1

Diverticulitis

Question 2

A 38-year-old woman presents with melena and a burning pain in the mid-epigastric area two to four hours after eating. Abdominal pain is also reported during night time. Pain is usually relieved by food intake. The patient has a diagnosis of:

A)Dumping syndrome
B)Gastric ulcer
C)Duodenal ulcer
D)Chronic gastritis

Answer 2

Duodenal ulcer

Question 3

An elderly patient is prescribed with docusate sodium. The therapeutic action of the drug is achieved if the client is experiencing:

A)Softer stools during bowel movements
B)Reduction of steatorrhea
C)Relief of abdominal pain
D)Relief of diarrhea

Answer 3

Softer stools during bowel movements

Question 4

A patient presents with anorexia, jaundice, hepatomegaly, ascites, and abdominal pain. A diagnosis of Laennec's cirrhosis is given. Which of the following information is most likely indicated in the patient's history?

A)The patient has a history of alcoholism
B)The patient had a massive liver necrosis due to exposure to hepatotoxins
C)The patient has a history of chronic biliary obstruction
D)The patient has a history of severe, right-sided congestive heart failure

Question 5

A man suspected of acute pancreatitis is ordered to have a series of laboratory work ups, including fluid and electrolyte tests. Which of the following findings support the diagnosis?

A)Hypercalcemia, hyperglycemia, hypokalemia
B)Hypercalcemia, hypoglycemia, hyperkalemia.
C)Hypocalcemia, hyperglycemia, hypokalemia
D)Hypocalcemia, hyperglycemia, hypokalemia.

Question 6

A 55-year-old man comes to the office complaining of pain in the epigastric and left upper abdominal pain that radiates to the back. These symptoms started about three days ago. Anorexia, nausea, vomiting, and flatulence are also reported. The patient says that his stool has been fatty, frothy, and foul-smelling. Blood chemistry shows increased amylase, lipase, AST, and lipid levels. Calcium and potassium are both low. Based on these findings, the patient is diagnosed with:

A)Pancreatitis
B)Cholecystitis
C)Cholelithiasis
D)Cirrhosis

Question 7

A 50-year-old man with a history of alcoholism is suspected of pancreatitis. Which of the following laboratory test is ordered to verify the diagnosis?

A)Alkaline phosphatase
B)Lipase
C)Bilirubin
D)Insulin

Question 8

When performing an abdominal assessment, which technique is done first?

A)Inspection
B)Percussion
C)Palpation
D)Auscultation

Question 9

A patient came in with clinical features of esophageal achalsia. Which of the following clinical findings is primarily seen in this patient?

A)Fever
B)Dysphagia to both liquid and solid foods
C)Food regurgitation
D)Epigastric pain

Question 10

A male patient with liver cirrhosis has a serum ammonia level of 80 mcg/dL. Which of the following dietary recommendations is appropriate for the patient?

A)Maintain current dietary instructions
B)Increase intake of foods high in protein
C)Limit intake of foods high in vitamin K
D)Limit intake of foods high in protein

Question 11

A newborn is diagnosed with Hirschsprung disease. The following characteristics are expected in older infants or children with the condition except:

A)Abdominal distention
B)Chronic constipation
C)Projectile vomiting
D)Failure to thrive

Question 12

A woman presents symptoms of a typical duodenal ulcer. Which of the following is not a characteristic of this condition?

A)Primarily affects males
B)Occasional malignancy
C)Can lead to weight gain
D)Affects people over 65

Question 13

____________ cancer has the highest incidence in men.

A)Colorectal
B)Urinary tract
C)Prostate
D)Lung

Question 14

A 50-year-old woman presents with symptoms of heartburn due to a weak lower esophageal sphincter. Which of the following conditions causes this?

A)Achalasia
B)Mallory-Weiss syndrome
C)Hiatal hernia
D)Gastroesophageal reflux disease

Question 15

A 23-year-old woman is complaining of colicky pain in the right lower abdomen after meals and continuous diarrhea. Stools are liquid or semi-formed, with mucus and pus, but without blood. Physical assessment findings include tenderness and mass in the right lower quadrant of the abdomen. The patient is suspected to have Crohn's disease. Which of the following laboratory and diagnostic findings would support the diagnosis?

A)A cobblestone appearance is recognized on the mucosa of the affected bowel
B)The mucosa and submucosa of the large intestine is affected
C)The distribution of the lesions is continuous
D)Normal levels of folic acid and vitamins A, B complex, and C are detected

Question 16

Which of the following foods should be avoided by a patient diagnosed with Gout to prevent complications?

A)Anchovies
B)Organ meats
C)Sardines
D)All of the above

Question 17

The following statements about pyloric stenosis are true except:

A)It is more commonly seen in male infants.
B)It is commonly detected between one and six months.
C)It is more common in white infants.
D)It is more likely to affect a pre-term infant than a full-term infant.

Question 18

A 23-year-old woman comes to the office complaining of nausea and vomiting, anorexia, and belching. The patient has chronic gastritis. The patient is at risk of what vitamin deficiency?

A)Vitamin A
B)Vitamin B12
C)Vitamin C
D)Vitamin D

Question 19

A patient is scheduled for a barium enema. Pre-procedure instructions and actions include the following except:

A)Cleansing enemas on the morning of the examination
B)NPO after midnight before the day of the examination
C)A soft diet for 1 to 2 days before the test
D)A clear liquid diet and laxative on the evening before the test

Question 20

A patient diagnosed with a peptic ulcer is prescribed with sucralfate. Which of the following instructions should be given to the patient to ensure that the medication is taken appropriately?

A)Sucralfate is taken with meals
B)Sucralfate should be administered together with an antacid
C)Sucralfate should be administered two hours apart from warfarin sodium
D)Sucralfate can cause diarrhea; increased fiber intake is recommended

Question 21

A patient diagnosed with hepatic encephalopathy is prescribed with lactulose. The medication treats liver cirrhosis by the following actions except:

A)It decreases the pH of the bowel
B)It decreases ammonia production by the bacteria
C)It promotes ammonia excretion.
D)It reduces the number of colonic bacteria that convert urea and amino acids into ammonia.