Deck 41: Alterations of Digestive Function

Question 1

What term is used to identify frank bleeding of the rectum?

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

Answer 1

Hematochezia

Question 2

What is the most immediate result of a small intestinal obstruction?

A) Vomiting
B) Dehydration
C) Electrolyte imbalances
D) Distention

Answer 2

Distention

Question 3

What is the cause of gastroesophageal reflux disease?

A) Excessive production of hydrochloric acid
B) Zone of low pressure of the lower esophageal sphincter
C) Presence of Helicobacter pylori in the esophagus
D) Reverse muscular peristalsis of the esophagus

Answer 3

Zone of low pressure of the lower esophageal sphincter

Question 4

Where in the brain is the vomiting center located?

A) Hypothalamus
B) Medulla oblongata
C) Pons
D) Midbrain

Question 5

What type of diarrhea is a result of lactase deficiency?

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

Question 6

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

A) Gain of bicarbonate from pancreatic secretions that cannot be absorbed
B) Excessive loss of hydrogen ions normally absorbed from gastric juices
C) Excessive loss of potassium, promoting atony of the intestinal wall
D) Loss of bile acid secretions that cannot be absorbed

Question 7

How can abdominal pain that is visceral in nature best be described?

A) Abdominal pain that is visceral in nature is diffused, vague, poorly localized, and dull.
B) It travels from a specific organ to the spinal cord.
C) The pain lateralizes from only one side of the nervous system.
D) Abdominal pain is associated with the peristalsis of the gastrointestinal tract.

Question 8

Considering the normal frequency of bowel evacuation,how infrequently can evacuation occur and still be considered within normal range?

A) Once a day
B) Once every 2 days
C) Once a week
D) Once every 2 weeks

Question 9

What are the cardinal symptoms of small intestinal obstruction?

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 10

What type of vomiting is caused by the direct stimulation of the vomiting center by neurologic lesions involving the brainstem?

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

Question 11

What is a cause of chronic antral gastritis?

A) Helicobacter pylori bacteria
B) Development of autoantibodies to gastric H+/K+ ATPase
C) Pernicious anemia
D) Reflux of bile and alkaline pancreatic secretions

Question 12

What is the primary cause of peptic ulcers?

A) Hypersecretion of gastric acid
B) Hyposecretion of pepsin
C) Helicobacter pylori
D) Escherichia coli

Question 13

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

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

Question 14

What is the cause of reflux esophagitis?

A) Immune response to gastroesophageal reflux
B) Delayed gastric emptying
C) Congenital anomaly
D) Secretory response to gastroesophageal reflux

Question 15

The adult intestine processes approximately how many liters of luminal content per day?

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

Question 16

How many stools per day are considered the upper limits of normal?

A) Two
B) Three
C) Five
D) Seven

Question 17

By what mechanism does intussusception cause an intestinal obstruction?

A) Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply
B) Twisting the intestine on its mesenteric pedicle, causing occlusion of the blood supply
C) Loss of peristaltic motor activity in the intestine, causing an adynamic ileus
D) Forming fibrin and scar tissue that attach to the intestinal omentum, causing obstruction

Question 18

Which statement is false concerning 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 19

What is the cause of functional dysphagia?

A) Intrinsic mechanical obstruction
B) Extrinsic mechanical obstruction
C) Tumor
D) Neural or muscular disorders

Question 20

Antiemetic agents,such as domperidone and haloperidol,are antagonists for which receptors?

A) 5-Hydroxytryptamine (5-HT) serotonin
B) Histamine-2
C) Acetylcholine
D) Dopamine

Question 21

Which symptom is characteristic of bulimia nervosa?

A) Recurrent episodes of binge eating with fears of not being able to stop eating.
B) Fear of becoming obese, despite progressive weight loss.
C) Perception that the body is fat when it is actually underweight.
D) Absence of three consecutive menstrual periods.

Question 22

After a partial gastrectomy or pyloroplasty,clinical manifestations that include increased pulse,hypotension,weakness,pallor,sweating,and dizziness are the results of which mechanism?

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

Question 23

Which statements are true regarding parietal pain? (Select all that apply.)

A) Parietal pain arises from the parietal peritoneum.
B) It is generally more localized than visceral pain.
C) Parietal pain is usually less intense than visceral pain.
D) Nerve fibers that travel to the spinal cord are involved in parietal pain.
E) Parietal pain corresponds to dermatomes T6 and L1.

Question 24

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

A) Stomach
B) Duodenum
C) Jejunum
D) Esophagus

Question 25

Which statement is consistent with dumping syndrome?

A) Dumping syndrome usually responds well to dietary management.
B) It occurs 1 to 2 hours after eating.
C) Constipation is often a result of the dumping syndrome.
D) It can result in alkaline reflux gastritis.

Question 26

Which statement is false concerning the pathophysiologic process 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 27

The most common clinical manifestation of portal hypertension is what type of bleeding?

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

Question 28

The mutation of which gene is an early event associated with the pathogenetic origin of esophageal cancer?

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

Question 29

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 the 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 30

What is the most common manifestation of portal hypertension-induced splenomegaly?

A) Leukopenia
B) Thrombocytopenia
C) Erythrocytopenia
D) Pancytopenia

Question 31

Which statements are true regarding chronic gastritis? (Select all that apply.)

A) Chronic gastritis tends to occur in older adults.
B) It causes thinning and degeneration of the stomach wall.
C) Chronic gastritis results in chronic inflammation and mucosal atrophy.
D) Mucosal atrophy is a common outcome of chronic gastritis.
E) Epithelial metaplasia is often observed with chronic gastritis.

Question 32

Hepatic fat accumulation is observed in which form of cirrhosis?

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

Question 33

Which statement is false regarding the pathophysiologic process of acute pancreatitis?

A) Bile duct or pancreatic duct obstruction blocks the outflow of pancreatic digestive enzymes.
B) Acute pancreatitis can also result from direct cellular injury from drugs or viral infection.
C) Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells.
D) Acute pancreatitis is usually mild and spontaneously resolves.

Question 34

Which structure regulates eating behavior and energy metabolism?

A) Anterior pituitary
B) Hypothalamus
C) Posterior pituitary
D) Parietal lobe

Question 35

Which hormones are natural appetite suppressants? (Select all that apply.)

A) Insulin
B) Cortisol
C) Galanin
D) Calcitonin
E) Serotonin

Question 36

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

A) Bleeding from duodenal ulcers causes hematemesis or melena.
B) Gastric emptying is slowed, causing greater exposure of the mucosa to acid.
C) The characteristic pain begins 30 minutes to 2 hours after eating when the stomach is empty.
D) Duodenal ulcers occur with greater frequency than other types of peptic ulcers.

Question 37

Which are the early (prodromal)clinical manifestations of hepatitis? (Select all that apply.)

A) Fatigue
B) Vomiting
C) Itching
D) Splenomegaly
E) Hyperalgia

Question 38

Obesity is defined as a body mass index (BMI)greater than what measurement?

A) 22
B) 25
C) 28
D) 30

Question 39

What stimulates the desire to eat?

A) Agouti-related protein (AgRP)
B) Alpha-melanocyte-stimulating hormone (a-MSH)
C) Cocaine- and amphetamine-regulated transcript (CART)
D) Peptide YY (PYY)

Question 40

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

A) End products of intestinal protein digestion are sources of increased ammonia.
B) Digested blood leaking from ruptured varices is a source of increased ammonia.
C) Accumulation of short-chain fatty acids that is attached to ammonia is a source of increased ammonia.
D) Ammonia-forming bacteria in the colon are sources of increased ammonia.

Question 41

Which clinical manifestations are consistent with cancer of the cecum and ascending colon? (Select all that apply.)

A) Mahogany-colored blood mixed with stool
B) Anemia
C) Pain
D) Constipation
E) Palpable mass in the lower right quadrant

Question 42

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

A)Ulcerative colitis
B)Crohn disease

Question 43

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

A)Ulcerative colitis
B)Crohn disease