question

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?

answer

Secretory Response Feedback: Infections lead to secretory diarrhea.

question

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.

answer

Osmotic Response Feedback: A nonabsorbable substance in the intestine leads to osmotic diarrhea.

question

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:

answer

Visceral Response Feedback: Visceral pain arises from a stimulus (distention, inflammation, ischemia) acting on an abdominal organ.

question

The most common disorder associated with upper GI bleeding is:

answer

Esophageal varices Response Feedback: Esophageal varices is the most common disorder associated with upper GI bleeding.

question

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

answer

Hematochezia Response Feedback: Hematochezia is bleeding from the rectum.

question

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

answer

Loss of muscle tone at the lower esophageal sphincter Response Feedback: Gastroesophageal reflux is due to loss of muscle tone at the lower esophageal sphincter.

question

Reflux esophagitis is defined as a(n)

answer

Inflammatory response to gastroesophageal reflux Response Feedback: When gastroesophageal reflux leads to an inflammatory response, it is termed reflux esophagitis.

question

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

answer

Hiatal hernia Response Feedback: Regurgitation, dysphagia, and substernal discomfort after eating are common in individuals with hiatal hernia.

question

A serious complication of paraesophageal hiatal hernia is:

answer

Strangulation Response Feedback: Strangulation of the hernia is a major complication.

question

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:

answer

Pyloric obstruction Response Feedback: The pylorus is the opening between the esophagus and the duodenum; the obstruction is pyloric.

question

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

answer

Vomiting The cardinal sign of pyloric stenosis is vomiting

question

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?

answer

Intussusception Response Feedback: Telescoping of one part of the intestine into another; this usually causes strangulation of the blood supply and is more common in infants 10 to 15 months of age than in adults.

question

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:

answer

A hernia Response Feedback: A hernia is a protrusion of the intestine through a weakness in the abdominal muscles or through the inguinal ring.

question

Chronic gastritis is classified according to the:

answer

Location of lesions Response Feedback: Chronic gastritis is classified as type A (fundal) or type B (antral), depending on the pathogenesis and location of the lesions.

question

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?

answer

Pernicious anemia Response Feedback: Pernicious anemia can develop because the damage to the mucosa makes the intrinsic factor less available to facilitate

question

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

answer

Breaks in the mucosa and presence of corrosive secretions Response Feedback: Peptic ulcer disease is caused by breaks in the mucosa and the presence of corrosive substances.

question

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:

answer

Inhibiting mucosal prostaglandin synthesis Response Feedback: Use of NSAIDs inhibit prostaglandins and maintenance of the mucosal barrier and decrease bicarbonate secretion.

question

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?

answer

Cigarette smoking Response Feedback: Acid production is stimulated by cigarette smoking. Caffeinated beverages do not contribute to ulcer formation.

question

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.

answer

Cushing Response Feedback: A Cushing ulcer is a stress ulcer associated with severe head trauma or brain surgery that results from decreased mucosal blood flow and hypersecretion of acid caused by overstimulation of the vagal nerve.

question

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:

answer

Bleeding Response Feedback: The most common clinical manifestation is bleeding.

question

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

answer

Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility Response Feedback: Undigested lactose increases the osmotic gradient in the intestine, causing irritation and osmotic diarrhea.

question

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

answer

Fats and fat-soluble vitamins Response Feedback: Clinical manifestations of bile salt deficiency are related to poor intestinal absorption of fat and fat-soluble vitamins (A, D, E, K).

question

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

answer

Anemia Response Feedback: One of the complications is anemia due to iron malabsorption, which may result from decreased acid secretion.

question

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

answer

Ulcerative colitis Response Feedback: Ulcerative colitis is manifested by fever, elevated pulse rate, frequent diarrhea (10 to 20 stools/day), urgency, obviously bloody stools, and continuous lesions present in the colon.

question

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

answer

Malabsorption Response Feedback: Malabsorption is common in Crohn disease and is rare in ulcerative colitis.

question

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:

answer

Appendicitis Response Feedback: Appendicitis is manifested by right lower quadrant pain with rebound tenderness.

question

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

answer

Atherosclerosis Response Feedback: The most common cause of chronic vascular insufficiency is atherosclerosis, especially in the elderly.

question

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

answer

Often precipitated by an embolism Response Feedback: Occlusion of blood flow is often precipitated by embolism.

question

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

answer

Ischemia alters mucosal membrane permeability, and fluid is shifted to the bowel wall and peritoneum. Response Feedback: Fluid shifts lead to hypovolemia.

question

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

answer

Leptin resistance Response Feedback: Leptin resistance disrupts hypothalamic satiety signaling and promotes overeating and excessive weight gain and is a factor in the development of obesity.

question

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:

answer

Bulimia nervosa Response Feedback: Binge eating and vomiting is characteristic of bulimia nervosa. Anorexia nervosa is starvation eating.

question

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?

answer

Cirrhosis of the liver Response Feedback: Portal hypertension occurs secondarily to cirrhosis of the liver.

question

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

answer

Esophageal Response Feedback: Vomiting of blood from bleeding esophageal varices is the most common clinical manifestation of portal hypertension.

question

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:

answer

Albumin and lack of cellular integrity Response Feedback: Ascites is due to decreased albumin and lack of cellular integrity.

question

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

answer

Impaired ammonia metabolism Response Feedback: Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy.

question

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

answer

Hemolytic Response Feedback: Excessive hemolysis (breakdown) of red blood cells can cause hemolytic jaundice (prehepatic jaundice).

question

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

answer

Clay-colored stools Response Feedback: Complete obstruction of bile flow leads to clay-colored stools.

question

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

answer

Jaundice, dark urine, enlarged liver Response Feedback: The icteric phase is manifested by jaundice, dark urine, and clay-colored stools. The liver is enlarged, smooth, and tender, and percussion causes pain; this is the actual phase of illness.

question

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:

answer

Alcoholism Response Feedback: The most common cause of cirrhosis is alcoholism.

question

In alcoholic cirrhosis, hepatocellular damage is caused by:

answer

Acetaldehyde accumulation Response Feedback: Alcoholic cirrhosis is caused by the toxic effects of alcohol metabolism on the liver. Alcohol is transformed to acetaldehyde, and excessive amounts significantly alter hepatocyte function and activate hepatic stellate cells, a primary cell involved in liver fibrosis.

question

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:

answer

Cholesterol Response Feedback: The majority of gallstones are composed of cholesterol.

question

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:

answer

Common bile duct Response Feedback: Jaundice is due to obstruction of the common bile duct.

question

Cholecystitis is inflammation of the gallbladder wall usually caused by:

answer

Obstruction of the cystic duct by a gallstone Response Feedback: Cholecystitis can be acute or chronic, but both forms are almost always caused by a gallstone lodged in the cystic duct.

question

Tissue damage in pancreatitis is caused by:

answer

Leakage of pancreatic enzymes Response Feedback: Leaked enzymes become activated, initiating autodigestion, inflammation, oxidative stress, and acute pancreatitis.

question

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

answer

Obstruction of the biliary tract by a gallstone Response Feedback: Biliary tract obstruction by gallstones is one of the known causes of pancreatitis.

question

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

answer

Epigastric Response Feedback: Epigastric or midabdominal pain ranging from mild abdominal discomfort to severe, incapacitating pain is one of the manifestations of pancreatitis.

question

Pancreatic insufficiency is manifested by deficient production of:

answer

Lipase Response Feedback: Pancreatic insufficiency is the deficient production of lipase by the pancreas.

question

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

answer

Reflux esophagitis Response Feedback: Reflux is a factor in the development of esophageal cancer.

question

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

answer

Colorectal Response Feedback: Colorectal cancer (CRC) is the third most common cause of cancer and cancer death in the United States for both men and women.

question

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

answer

CRC Response Feedback: CRC is associated with dietary intake, primarily lack of fiber and high fat content.

question

The cardinal signs of small bowel obstruction are:

answer

Vomiting and distention Response Feedback: Colicky pains followed by vomiting and distention are the cardinal symptoms of small bowel obstruction.

question

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

answer

Anorexia Nausea Response Feedback: Anorexia is lack of the desire for food intake and is a subjective experience. Nausea is a subjective experience. Retching is a forceful form of vomiting and is observable. Vomiting and diarrhea are observable.

question

A patient presents to the physician with complaints of constipation. Which of the following could be the cause?

answer

Neurogenic disorder of the large intestine Sedentary lifestyle Low residue diet Aging Use of antacids Constipation can be caused by neurogenic disorders of the large intestine in which neural pathways or neurotransmitters are altered and colon transit time delayed. A low-residue diet (the habitual consumption of highly refined foods) decreases the volume and number of stools and causes constipation. A sedentary lifestyle and lack of regular exercise are other common causes of constipation. Lack of access to toilet facilities and consistent suppression of the urge to empty the bowel are other causes. Excessive use of antacids containing calcium carbonate or aluminum hydroxide often results in constipation. Opiates, particularly codeine, tend to inhibit bowel motility. Conditions associated with constipation include congenital megacolon, hypothyroidism, pelvic hiatal hernia, multiple sclerosis, spinal cord trauma, cancer, cerebrovascular disease, and irritable bowel syndrome-constipation predominant. Aging may result in changes in neuromuscular function, causing constipation.

question

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.)

answer

Parkinson disease Cerebrovascular accident Achalasia Functional dysphasia is caused by neural or muscular disorders that interfere with voluntary swallowing or peristalsis. Disorders that affect the striated muscles of the upper esophagus interfere with the oropharyngeal (voluntary) phase of swallowing. Typical causes are dermatomyositis (a muscle disease) and neurologic impairments caused by cerebrovascular accidents, Parkinson disease, or achalasia. Peptic ulcer disease or pyloric stenosis would not cause functional dysphasia.

question

Complications obstruction in the lower bowel include

answer

Metabolic acidosis Tachycardia Hypovolemia Peritonitis With obstruction lower in the intestine, metabolic acidosis is more likely to occur because bicarbonate from pancreatic secretions and bile cannot be reabsorbed. Hypokalemia can be extreme. Continued intestinal secretion and decreased absorption lead to decreased blood volume and elevates hematocrit, decreases central venous pressure, and causes tachycardia. Severe dehydration leads to hypovolemic shock. Bacteria also proliferate and may cross the mucosal barrier and cause peritonitis or sepsis.

question

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

answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) H. pylori infection Infection with H. pylori and chronic use of NSAIDs are the major causes of duodenal ulcer. Consuming spicy foods, trauma, and antibiotics do not lead to duodenal ulcer disease.

question

A 46-year-old female is diagnosed with gastric ulcers. Which of the following characterizes the disorder?

answer

Pain occurs immediately after eating. Duration of treatment is extended. The pattern of pain is different from that of duodenal ulcers as it frequently occurs immediately after eating. Gastric ulcers cause more anorexia, vomiting, and weight loss than duodenal ulcers. Gastric ulcers also tend to be chronic rather than alternating between periods of remission and exacerbation. The evaluation and treatment of gastric ulcers are similar to the evaluation and treatment of duodenal ulcers, although duration of treatment is longer than with duodenal ulcers.

question

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?

answer

Oliguria Jaundice Ascites Anorexia Oliguria and complications of advanced liver disease, including jaundice, ascites, and GI bleeding, are usually present. Systolic blood pressure is usually below 100 mm Hg. Nonspecific symptoms of hepatorenal syndrome include anorexia, weakness, and fatigue.

question

Which of the following type(s) of hepatitis has an incubation period of up to 180 days?

answer

A D Both hepatitis A and D have incubation periods of up to 180 days.

question

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.)

answer

Narcotic analgesics Restriction of food intake Nasogastric suctioning Antibiotics IV fluids Narcotic medications may be needed to relieve pain. To decrease pancreatic secretions and "rest the gland," oral food and fluids may be withheld, and continuous gastric suction is instituted. Nasogastric suction may not be necessary with mild pancreatitis, but it helps to relieve pain and prevent paralytic ileus in individuals who are nauseated and vomiting. Parenteral fluids are essential to restore blood volume and prevent hypotension and shock. Antibiotics may control infection. The risk of mortality increases significantly with the development of infection or pulmonary, cardiac, and renal complications.

question

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.)

answer

Peptic ulcer disease Trauma Smoking Pancreatitis can be acute or chronic, and risk factors include alcoholism, obstructive biliary tract disease (particularly cholelithiasis), peptic ulcers, trauma, hyperlipidemia, and smoking, as well as certain drugs.

question

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

answer

9

question

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

answer

30

question

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

answer

15

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