Midterm – Flashcard Test Questions
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Which of the following is the primary site for absorption of nutrients
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Ileum
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Which of the following stimulates increased peristalsis and secretions in the digestive tract
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Vagus nerve
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What does the term gluconeogenesis refer to
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Formations of glucose from protein and fat (Happens in liver)
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Which of the following statements applies to bile salts
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Emulsify lipids and lipid soluble vitamins
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The visceral peritoneum
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Forms the outer covering of the stomach and intestines
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Which of the following part of the stomach is the most proximal to the esophagus
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Fundus
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Blank is associated with progressive hypertrophy of the circular muscles in the pyloric sphincter found 3-5 weeks after birth
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Pyloric stenosis
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Blank may occur when the vagus nerve is damaged
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Gastroparesis
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Blank decreases stomach motility
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Gastroperesis
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Blank presents with symptoms of early satiety, bloating, emesis of undigested food a few hours after eating
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Gastroperesis
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Blank is a breach in epithelium of the mucosa
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Erosion
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Blank is a breach in the mucosa with extension into the submucosa or deeper
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Ulcer
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Blank is spitting up blood
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Hematemesis
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Blank is a dark colored stool
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Melena
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Blank is a type of atrophic gastritis associated with fundus and body of the stomach
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Type A
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Blank is a type of atrophic gastritis associated with Antrum and pylorus
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Type B
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Blank is a type of atrophic Gastritis associated with pernicious anemia and the patient would be at an increased risk for adenocarcinoma and macrocytic anemia due to vitamin b12 deficiency
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Type A
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Hematuria
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Blood in urine
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Uremia
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High urea level in blood
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Blank is a type of atrophic gastritis caused most commonly due to H. Pylori infection and can be diagnosed with the help of urea breath test and stool antigen test to detect the gram negative rod (H. Pylori)
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Type B
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Peptic ulcer disease is most often caused by which of the following
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H. Pylori
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Blank ulcers are never malignant
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Duodenal
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Blank ulcers present with epigastric pain exacerbated by eating
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Gastric
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Blank ulcers present with epigastric pain relieved by eating
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Duodenal
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Primary stomach adenocarcinoma has increased incidence in blood group blank people
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A
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Blank is a type of primary stomach carcinoma that has diffuse infiltration of malignant cells in the stomach wall sometimes called linitis plastica "plastic bottle"
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Diffuse gastric adenocarcinoma
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What is the common cause of hiatal hernia
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Increased intra- abdominal pressure
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What is a common sign of acute gastritis
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Vomiting and epigastric tenderness
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What does the pathophysiology of chronic gastritis include
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Atrophy of the gastric mucosa with decreased secretions
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Which of the following individuals is likely to develop acute gastritis
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An individual with an allergy to shellfish
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What does congenital pyloric stenosis involve
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Hypertrophy and hyperplasia of smooth muscle in the pylorus
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A patient with acquired pyloric stenosis would likely
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Vomit undigested food from previous meals
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Prolonged or severe stress predisposed to peptic ulcer disease because
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Of reduced blood flow to the gastric wall and mucous glands
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The pathophysiology of peptic ulcer disease may involve any of the following except
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Increased stimulation of mucous producing glands
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Which of the following would a perforated gastric ulcer likely cause
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Chemical peritonitis
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What is frequently the first manifestation of stress ulcers
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Hematemesis and hypotension
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What would be the result of chronic bleeding from gastric carcinoma
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Occult blood in stool and anemia
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Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates
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A large volume of chyme has entered the intestines, causing distention
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Which of the following is the most frequent location of peptic ulcers
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Proximal duodenum
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An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate
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Erosion of a large blood vessel
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Which of the following is not a common predisposing factor to gastric carcinoma
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Anti-inflammatory medications such as ASA
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When a portion of the proximal stomach and the para esophageal junction move above the diaphragm, this is called a
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Sliding hernia (Hiatal hernia)
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Which of the following applies to gastric cancer
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Most cases involve an adenocarcinoma of the mucous glands
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Why does mild hyperbilirubinemia occur in newborns
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The immature liver cannot process bilirubin quickly enoigh
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Which of the following applies to hepatitis A infection
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It is transmitted by fecal-oral route
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What can be concluded if the hepatitis B antigen level remains high in the serum
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Chronic infection has developed
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What is the most common type of hepatitis transmitted by blood transfusion
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HCV
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What is the likely effect of long term exposure to hepatotoxic
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Gradual irreversible damage to the liver and cirrhosis
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A primary factor causing encephalopathy with cirrhosis is the elevated
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Serum ammonia
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What is the primary cause of increased bleeding tendencies associated with cirrhosis
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Deficit of vitamin k and prothrombin
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Which factors contribute to ascites in patients with cirrhosis
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Increased aldosterone and deficit of albumin
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Which of the following is a major cause of primary hepatocellular cancer
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Long term exposure to certain chemicals
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Which of the following statements about jaundice is true
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Jaundice usually develops with hepatocellular carcinoma
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Which types of hepatitis increases the risk of hepatocellular carcinoma
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HBV HCV
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Which of the following are related to post hepatic jaundice
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Pruritic skin and light colored stools
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Which of the following occurs with hepatitis B
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The liver is inflamed and enlarged
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Identify a major reason making it difficult to prevent the spread of hepatitis B
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Infection is often asymptomatic
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What is the initial pathological change in alcoholic liver disease
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Accumulation of fat in hepatocytes with hepatomegaly (Fatty liver)
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How does serum bilirubin change with cirrhosis
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Increased conjugated and unconjugated bilirubin
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Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate
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HDV
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Deficiencies of vitamins A, D and K occur in patients with cirrhosis primarily because of decreased
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Production of bile for absorption
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Which one of the following is not a prodrome for viral hepatitis
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Increased UCB and CB
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Blank is a viral hepatitis that is transmitted via fecal-oral route, most commonly associated with travelers and males who have sex with other males
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Hepatitis A
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Blank is a viral hepatitis that is spread most commonly via parenteral, oral routes, commonly associated with intra venous drug abusers and causes fever, painful hepatomegaly and malaise
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Hepatitis B
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Which one of the following can be prevented via immunization with recombinant vaccine
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Hepatitis B
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Blank is the most common blood borne infection in the United States that has no preventive vaccine and is responsible for most cases of liver transplant, usually found in intra venous drug abusers
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Hepatitis C
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Blank can be transmitted parenterally or sexually, co-infection with hepatitis B virus infection could result in a chronic condition
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Hepatitis D
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Blank is an indicator in hepatitis B serology that appears within 2-8 weeks after exposure to the virus
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HBsAg
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Which of the following is a marker of immunization after hepatitis B vaccination
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Anti-HBV surface AB (anti-HBs)
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Persistence of HBsAg longer then blank indicates of chronic hepatitis B infection
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6 months
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Fulminant hepatic failure is defined as acute liver failure and blank within 8 weeks of hepatic dysfunction in adults
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Encephalopathy
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Irreversible diffuse fibrosis with formation of regenerative liver nodules is a description for which of the following
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Cirrhosis
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In a patient that consumes alcohol every day and has a family history for Wilson's disease is most likely to have which of the following
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Cirrhosis
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Which of the following is not a symptom caused due to hypertension as
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Hypoalbuminemia
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Which of the following is not a symptom caused to portal hypertension as a complication of liver cirrhosis
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Female distribution of hair
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Predisposing factors to cholelithiasis include excessive
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Bilirubin or cholesterol concentration in bile
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What is the major effect when a gallstone obstructs the cystic duct
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Severe colicky pain in RUQ
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Which of the following describes the supply of bile following s cholecystectomy
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Small amounts of bile are continuously secreted and flow into the duodenum
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How do body defenses respond immediately after the gallbladder ruptures
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Blood clots seal the perforation
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Which of the following is the function of cystic duct
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Drain the gallbladder
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Common bile duct is formed by merging
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Cystic duct and common hepatic duct
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The 3rd part of the common bile duct lies in
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Lies Ina groove on the posterior surface of the head of the pancreas
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The common bile duct is joined by the main pancreatic duct; together they open through
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Ampulla of vater
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What is a correct statement
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Cholelthiasis causes cholecystitis
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Other fluid collections in the right upper quadrant should be observed by the sonographer for signs of change or peristalsis
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Acute cholecystitis
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Cholelithiasis
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Formations of gallstones
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Cholecystitis
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Inflammation of the gallbladder
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Cholangitis
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Inflammation of the bile Duct
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Patients often fall under the category of the 5 f's; fat, female, forty, fertile, fair for which of the following
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Cholelithiasis
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Is a serious, painful complication of acute cholecystitis that may lead to perforation that occurs after a prolonged infection, which causes the gallbladder to undergo necrosis
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Gangrenous cholecystitis
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Most common form of gallbladder inflammation. Clinically, patients may have some transient RUQ pain but not tenderness
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Chronic cholecystitis
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What causes massive inflammation and necrosis in acute pancreatitis
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Activation and spread of proteolytic enzymes
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How does chemical peritonitis and shock frequently result from acute pancreatitis
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Inflammation and increased vascular permeability of the peritoneum affect fluid balance
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What causes characteristic rigid abdomen found in the patient with peritonitis
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Inflamed peritoneum resulting in reflex abdominal muscle spasm
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What would be the likely outcome from chemical peritonitis related to a perforated gallbladder
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Leakage of intestinal bacteria into blood and the peritoneal cavity
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Tetany may develop in patients with acute pancreatitis because
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Calcium ions bind with fatty acids in necrotic tissue
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Pancreatic cancer may be diagnosed early if obstruction of bile or pancreatic secretions develops when the tumor is located
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At the head of the pancreas
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The pancreas is a large long gland that
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Secretes both hormones and digestive enzymes
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Which of the following secretes insulin
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Beta cells
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Which of the following is most commonly caused by alcohol abuse in adults and cystic fibrosis in children
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Pancreatic insufficiency
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Which refers to obstruction of the biliary tract by gallstones
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Choleclolithiasis
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In which of the following the dorsal and ventral buds form a ring around the duodenum
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Annular pancreas
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In which of the following the activation of the pancreatic pro enzymes leads to autodigestion
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Acute pancreatitis
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Severe, boring (knife like) mid epigastric pain that radiates to the back, grey turner sign are one of the symptoms indicating
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Acute pancreatitis
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Blank causes the following complications such as legal blindness, peripheral neuropathy, chronic renal failure, below the knee amputation
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Diabetes mellitus
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Which of the following has the usual presentation such as a 15 year patient with thin body habitus, polyuria, polydipsia, Polyphagia
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Diabetes mellitus type 1 (Juvenile, insulin dependent)
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Which of the following had the usual presentation such as a 50 year patient with obese body type, recurrent blurry vision
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Diabetes mellitus type 2 (Maturity onset diabetes)
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Which of the following is a common complication of diabetes mellitus 2 where plasma glucose could be more than 600
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Diabetic keto acidosis
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Blank is a malignant tumor of the alpha cells
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Glucagonoma
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Which of the following conditions could have clinical signs such as hyperglycemia 250-1000 mg/dl , HbAlc more than 6, hyperkalemia and hyonatremia
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Hyper osmolar non-ketotic coma
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Which of the following hereditary disorder could cause hematuria and abdominal pain
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Adult polycystic kidney disease
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Which of the following best describes steatorrhea
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Bully, fatty, foul-smelling stool Floating
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What are the typical changes occurring with chrons disease
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Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
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Stools that are more liquid and contain mucous, frank blood and pus are typical of
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Ulcerative colitis
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How does iron deficiency anemia frequently develop with ulcerative colitis
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Chronic blood loss in stools
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What is the cause of inflammatory bowel disease
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Idiopathic
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What pain is typical of diverticulitis
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LLQ
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What usually indicates acute appendicitis
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Obstruction of the lumen of the appendix
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With acute appendicitis, localized pain and tenderness in the lower right quadrant result from
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Local inflammation of the parietal peritoneum
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How does localized peritonitis develop from acute appendicitis before rupture
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Intestinal bacteria escape through the necrotic appendeceal wall
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What is a typical early sign of cancer in the ascending colon
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Occult blood in the stool
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To which site does the colon cancer usually first metastasize
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Liver
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Partial obstruction of the sigmoid colon resulting from diverticular disease would likely
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Result in a small, hard stool
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What causes hypovolemic shock to develop with intestinal obstruction
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Continued vomiting and fluid shift into the intestine
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What does the term Melena mean
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Blood in dark colored stool
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Which factors appear to have a role in the etiology of inflammatory bowel diseases
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Genetic and immunologic factors
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The telescoping of one section of bowel inside another section is called
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Intussusceptions
