Deck 39: Alterations of Digestive Function

Question 1

The action of antiemetics, such as domperidone, and haloperidol is to _____ the effects of _____.

A)block; 5-HT serotonin
B)block; histamine-2 (H₂)
C)stimulate; acetylcholine
D)stimulate; dopamine (D₂)

Answer 1

stimulate; dopamine (D₂)

Question 2

Individuals with chronic hepatitis C are at increased risk for chronic liver disease.

Answer 2

True

Question 3

The chemoreceptor trigger zone (CTZ) for vomiting is located in the:

A)hypothalamus.
B)medulla oblongata.
C)pons.
D)midbrain.

Answer 3

medulla oblongata.

Question 4

Ammonia formation may increase hepatic encephalopathy.

Question 5

Hepatitis A is transmitted through infected blood and other body fluids.

Question 6

_____ vomiting is caused by direct stimulation of the vomiting center by neurologic lesions involving the brainstem.

A)Retch
B)Periodic
C)Duodenal
D)Projectile

Question 7

Chronic gastritis of the fundus occurs more frequently than chronic gastritis of the antrum.

Question 8

With losses of more than 1000 ml or more, the heart rate is greater than 100 beats per minute and systolic blood pressure is less than 100 mm Hg.

Question 9

Hepatitis D virus (HDV) occurs in individuals with hepatitis B.

Question 10

Because patterns of bowel evacuation differ greatly among individuals, constipation must be individually defined.

Question 11

Obesity is defined as a body mass index (BMI) greater than 40.

Question 12

Chronic gastritis tends to occur in older adults and causes thinning and degeneration of the stomach wall.

Question 13

Endoscopy and biopsy may show long-standing inflammatory process and gastric atrophy indicating chronic gastritis in an individual with no history of abdominal distress.

Question 14

After a gastrectomy, individuals develop anemia from deficiencies in iron, folate, and vitamin B₁₂.

Question 15

More than _____ stools per day is considered abnormal.

A)two
B)three
C)five
D)seven

Question 16

Parietal pain is diffuse because nerve endings in abdominal organs are sparse and multisegmented.

Question 17

Hepatitis B is a sexually transmitted disease.

Question 18

Anorexia is the lack of desire to eat despite physiologic stimuli that would normally produce hunger.

Question 19

Primary biliary cirrhosis can be a result of gallstones.

Question 20

Normal bowel habits range from two or three evacuations per day to one per:

A)day.
B)2 days.
C)week.
D)month.

Question 21

Which statement is false regarding the contributing factors of duodenal ulcers?

A)There are a greater than usual number of parietal cells in the gastric mucosa.
B)Gastric emptying is slowed causing greater exposure of the mucosa to acid.
C)High serum gastrin levels remain high longer than normal after eating.
D)Failure of the feedback mechanism occurs, whereas acid in the gastric antrum inhibits gastrin release.

Question 22

An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis by causing the:

A)gain of bicarbonate from pancreatic secretions that cannot be absorbed.
B)excessive loss of hydrogen ions normally absorbed from gastric juice.
C)excessive loss of potassium promoting atony of the intestinal wall.
D)loss of bile acid secretions that cannot be absorbed.

Question 23

The cardinal symptoms of small intestinal obstruction include:

A)constant, dull pain in the lower abdomen relieved by defecation.
B)acute, intermittent pain 30 minutes to 2 hours after eating.
C)colicky pain caused by distention followed by vomiting.
D)excruciating pain in the hypogastric area caused by ischemia.

Question 24

Which statement is false about how abdominal pain is produced?

A)Chemical mediators, such as histamine, bradykinin, and serotonin produce abdominal pain.
B)Edema and vascular congestion produce abdominal pain by stretching.
C)Ischemia caused by distention of bowel obstruction or mesenteric vessel thrombosis produces abdominal pain.
D)Low concentrations of anaerobes, such as streptococci, lactobacilli, staphylococci, enterobacteria, and Bacteroides, produce abdominal pain.

Question 25

A person who has cholera would be expected to have which type of diarrhea?

A)Osmotic
B)Secretory
C)Small volume
D)Motility

Question 26

Intussusception causes intestinal obstruction by:

A)telescoping of part of the intestine into another usually causing strangulation of the blood supply.
B)twisting the intestine on its mesenteric pedicle causing occlusion of the blood supply.
C)the loss of peristaltic motor activity in the intestine, causing an adynamic ileus.
D)forming fibrin and scar tissue that attach to intestinal omentum and cause obstruction.

Question 27

The type of diarrhea that is a result of unhydrolyzed lactose is referred to as:

A)motility.
B)osmotic.
C)secretory.
D)small-volume.

Question 28

After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are a result of:

A)an anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles causing shock.
B)hemorrhage postoperatively in which a large volume of blood is lost, causing hypotension with compensatory tachycardia.
C)a concentrated bolus that moves from the stomach into the small intestine, which causes hyperglycemia, resulting in polyuria and eventually hypovolemic shock.
D)a rapid gastric emptying and creation of a high osmotic gradient in the small intestine that causes a sudden shift of fluid from the blood vessels to the intestinal lumen.

Question 29

A peptic ulcer may occur in all of the following areas except the:

A)stomach.
B)duodenum.
C)jejunum.
D)esophagus.

Question 30

Reflux esophagitis may be defined as a(n):

A)immune response to gastroesophageal reflux.
B)inflammatory response to gastroesophageal reflux.
C)congenital anomaly.
D)secretory response to gastroesophageal reflux.

Question 31

The most commonly occurring small intestinal obstruction is:

A)diverticulosis.
B)tumor.
C)volvulus.
D)adhesions.

Question 32

Which of the following is consistent with dumping syndrome?

A)Usually responds well to dietary management
B)Occurs 1 to 2 hours after eating
C)Is seen following intestinal surgery
D)Can result in alkaline reflux gastritis

Question 33

Which inflammatory cytokines are released in chronic gastritis?

A)TNF-a, IL-6, IL-8, IL-10, and leukotrienes
B)Colony-stimulating factor (CSF), IL-1, IL-5, IL-7, and prostaglandins
C)INF-a, IL-2, IL-12, IL-18, and serotonin
D)Gastric-stimulating factor (GSF), IL-4, IL-9, IL-11, and bradykinin

Question 34

Frank bleeding of the rectum is called:

A)melena.
B)hematochezia.
C)occult bleeding.
D)hematemesis.

Question 35

Functional dysphagia is caused by:

A)intrinsic mechanical obstruction.
B)extrinsic mechanical obstruction.
C)a tumor.
D)a neural or muscular disorder.

Question 36

The desire to eat is stimulated by:

A)agouti-related protein (AgRP).
B)alpha-melanocyte-stimulating hormone (a-MSH).
C)cocaine- and amphetamine-regulated transcript (CART).
D)peptide YY (PYY).

Question 37

The primary cause of duodenal ulcers is:

A)hypersecretion of gastric acid.
B)hyposecretion of pepsin.
C)Helicobacter pylori.
D)Escherichia coli.

Question 38

The adult intestine processes approximately _____ L of luminal content per day.

A)3
B)6
C)9
D)12

Question 39

Gastroesophageal reflux disease (GERD) is a result of:

A)excessive production of hydrochloric acid.
B)a zone of low pressure of the lower esophageal sphincter (LES).
C)presence of Helicobacter pylori in the esophagus.
D)reverse muscular peristalsis of the esophagus.

Question 40

Abdominal pain is best described as visceral pain that:

A)is diffused, vague, poorly localized, and dull.
B)travels from a specific organ to the spinal cord.
C)lateralizes from only one side of the nervous system.
D)is in concert with the peristalsis of the gastrointestinal tract.

Question 41

Which are the early (prodromal) clinical manifestations of hepatitis?

A)Fatigue, fever, hyperalgia, and vomiting
B)Light-colored stools, dark-colored urine
C)Large, tender liver; itching; jaundice
D)Pain in the left upper quadrant, splenomegaly

Question 42

The most common manifestation of portal hypertension induced splenomegaly is:

A)leukopenia.
B)thrombocytopenia.
C)erythrocytopenia.
D)pancytopenia.

Question 43

Eating behavior, energy metabolism, and body fat mass are regulated by the:

A)anterior pituitary.
B)hypothalamus.
C)posterior pituitary.
D)parietal lobe.

Question 44

Which statement is false regarding the pathophysiology of acute pancreatitis?

A)Pancreatic acinar cells metabolize ethanol, which generates toxic metabolites.
B)Injury to the pancreatic acinar cells permits leakage of pancreatic enzymes that digest pancreatic tissue.
C)Acute pancreatitis is an autoimmune disease in which IgG coats the pancreatic acinar cells so they are destroyed by the pancreatic enzymes.
D)When gallstones are present, bile flows into the pancreas, contributing to attacks.

Question 45

Hepatic fat accumulation is seen in which form of cirrhosis?

A)Biliary
B)Metabolic
C)Postnecrotic
D)Alcoholic

Question 46

Which clinical manifestation is not consistent with cancer of the cecum and ascending colon?

A)Mahogany-colored blood mixed with stool
B)Anemia
C)Pain
D)Constipation

Question 47

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

A)rectal
B)duodenal
C)esophageal
D)intestinal

Question 48

Which statement is false about the pathophysiology of alcoholic cirrhosis?

A)Inflammation and damage leading to cirrhosis begin in the bile canaliculi.
B)Alcohol is transformed to acetaldehyde, which promotes liver fibrosis.
C)Mitochondrial function is impaired, decreasing oxidation of fatty acids.
D)Acetaldehyde inhibits export of proteins from the liver.

Question 49

Which of the following is false regarding the sources of increased ammonia that contribute to hepatic encephalopathy?

A)End products of intestinal protein digestion
B)Digested blood leaking from ruptured varices
C)Accumulation of short-chain fatty acids attaches to ammonia
D)Ammonia-forming bacteria in the colon

Question 50

Match the descriptions with the corresponding terms.
Inflammation develops in crypts of Lieberkühn in the large intestine.

A)Ulcerative colitis
B)Crohn disease

Question 51

Match the descriptions with the corresponding terms.
Alterations in immunoglobulin G production have been found in individuals with this disorder.

A)Ulcerative colitis
B)Crohn disease

Question 52

Which statement is false concerning the accumulation of fluid in the peritoneal cavity?

A)Impaired excretion of sodium by the kidneys promotes water retention.
B)Decreased oncotic pressure and increased hepatic sinusoidal hydrostatic pressure cause movement of fluid into the peritoneal cavity.
C)Decreased blood flow to the kidneys activates aldosterone, which retains sodium.
D)Circulating nitric oxide causes vasoconstriction, which forces fluid from the capillaries into the peritoneal cavity.

Question 53

Symptoms characteristic of bulimia nervosa include:

A)recurrent episodes of binge eating with fears of not being able to stop eating.
B)a fear of becoming obese despite progressive weight loss.
C)a perception that the body is fat when it is actually underweight.
D)absence of three consecutive menstrual periods.

Question 54

The mutation of which gene occurs in cancers of the stomach, colon, liver, gallbladder, and pancreas?

A)K-ras mutation
B)TP53 tumor-suppressor gene
C)myc
D)HER2