Pathophysiology Homework – Digestive

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Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
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Parietal cells
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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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When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?
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secretin
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Which of the following breaks protein down into peptides?
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peptidase
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In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?
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liver
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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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Which of the following is contained in pancreatic exocrine secretions?
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Bicarbonate ion
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An alkaline environment is required in the duodenum to:
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activate intestinal and pancreatic enzymes
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What does the term gluconeogenesis refer to?
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Formation of glucose through protein and fat
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Normally, proteins or amino acids are required to produce all of the following EXCEPT:
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cellular energy
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Which of the following statements applies to bile salts?
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They 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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The early stage of vomiting causes:
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metabolic alkalosis
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Prolonged vomiting cause a state of acidosis due to:
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catabolism of proteins and lipids
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What is the first change in arterial blood gases with diarrhea?
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Decreased bicarbonate ion
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Which of the following applies to the act of swallowing?
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Requires coordination of cranial nerves five, nine, ten and twelve
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What does the defecation reflex require?
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Coordination through the sacral spinal cord
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What is the definition of achalasia?
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Lack of a nerve plexus to relax the lower esophageal sphincter
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What does esophageal atresia cause?
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No fluid or food entering the stomach
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Which of the following applies to cleft palate?
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The hard and soft palates do not fuse during the first trimester of pregnancy
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Oral candidiasis is considered to:
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be an opportunistic fungal infection of the mouth
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What is/are common location(s) for oral cancer?
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Increased intra-abdominal pressure
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What is a common cause of hiatal hernia?
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Increased intra-abdominal pressure
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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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What is a common cause of gastroenteritis due to Salmonella?
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Raw or undercooked poultry or eggs
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Which of the following individuals is likely to develop acute gastritis?
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An individual with 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 predisposes to peptic ulcer disease because:
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of reduced blood flow
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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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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 the 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 chime has entered the intestines, causing distention
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Which of the following is/are (a) manifestation(s) of hemolytic jaundice?
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Increased unconjugated bilirubin in the blood
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Why does mild hyperbilirubinemia occur in newborns?
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The immature liver cannot process bilirubin quickly enough
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Predisposing factors to cholelithiasis include excessive:
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bilirubin or cholesterol concentration in the 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 upper right quadrant
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Which of the following describes the supply of bile following a cholecystectomy?
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Small amounts of bile are continuously secreted and flow into the duodenum.
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Which of the following applies to hepatitis A infection?
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It is transmitted by the 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 causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis?
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Necrosis of liver cells
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What is the likely effect of long-term exposure to a hepatotoxin?
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Gradual irreversible damage to the liver and cirrhosis
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What indicates the presence of third-stage alcohol hepatitis?
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Accumulation of fat in the hepatocytes and hepatomegaly
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A primary factor causing encephalopathy with cirrhosis is the elevated:
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serum ammonia
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In patients with cirrhosis, serum ammonia may increase when:
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bleeding occurs in the digestive tract
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What is the primary cause of esophageal varices?
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Portal hypertension
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What is the primary cause of increased bleeding tendencies associated with cirrhosis?
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Deficit in 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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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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Malnutrition may develop in children with celiac disease because of:
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damage to the intestinal villi
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Which of the following best describes steatorrhea?
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Bulky, fatty, foul-smelling stools
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What is the dietary requirement for a child with celiac disease?
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Gluten-free
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What are the typical changes occurring with Crohn’s 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 mucus, frank blood, and pus are typical of:
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ulcerative colitis
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How may a fistula form with Crohn’s disease?
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recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops
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How does iron-deficiency anemia frequently develop with ulcerative colitis?
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Chronic blood loss in stool
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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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Lower left quadrant. Llq.
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With acute appendicitis, localized pain and tenderness in the lower right quadrant results 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 appendiceal 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 colon cancer usually first metastasize?
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liver
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How does a volvulus cause localized gangrene in the intestine?
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The mesenteric arteries are compressed in the twisted section of intestine
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Which of the following is a typical indicator of an intestinal obstruction caused by paralytic ileus?
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Severe steady abdominal pain
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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 causes the 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 gall bladder?
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Leakage of intestinal bacteria into the blood and the peritoneal cavity.
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How does pelvic inflammatory disease frequently lead to bacterial peritonitis?
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Infection spreads through the fallopian tubes directly into the peritoneal cavity
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Choose the significant change in arterial blood gases expected with prolonged severe vomiting:
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decreased bicarbonate ion, decreased PCO2, serum pH 7.35
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When dehydration reduces the compensation possible for acidosis resulting from prolonged diarrhea, what significant change in arterial blood gases indicates this?
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Serum bicarbonate levels would decrease, serum pH would drop below 7.35
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How do body defenses respond immediately after the gall bladder ruptures?
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Blood clots seal the perforation
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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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In peptic ulcer disease, which of the following does NOT decrease the resistance of the mucosal barrier?
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Decreased vagal stimulation
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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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What does the term melena mean?
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Blood in a dark-colored stool
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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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Which of the following frequently occurs 2-3 hours after meals in post-gastrectomy patients?
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hypoglycemia
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Which term refers to obstruction of the biliary tract by gallstones?
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choledocholithiasis
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Which of the following is NOT usually present during the icteric stage of viral hepatitis?
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Esophageal varicies
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Which of the following statements about jaundice is/are true?
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Four only. Jaundice usually develops with hepatocellular carcinoma.
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Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
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HBV and 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
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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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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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In which condition is a deficit of protein and vitamins most likely to occur?
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Regional ileitis
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When a portion of the proximal stomach and the paraesophageal junction move above the diaphragm, this is called a:
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sliding 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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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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“A gluten-free diet as required” for the client with celiac disease means avoiding:
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certain grains
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The telescoping of one section of bowel inside another section is called:
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intussusceptions
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Hirschsprung’s disease refers to:
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congenital lack of PNS innervations in a segment of the colon

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