Question 1

Celiac sprue is a malabsorptive disorder associated with&#10;A) inflammatory reaction to gluten-containing foods.&#10;B) megacolon at regions of autonomic denervation.&#10;C) ulceration of the distal colon and rectum.&#10;D) deficient production of pancreatic enzymes.

Accepted Answer

Celiac disease (also called celiac sprue)is characterized by intolerance of gluten, a protein in wheat and wheat products.Current research suggests that celiac sprue is an immune disorder.The main pathologic finding is villus atrophy, with a decrease in the activity and amount of surface epithelial enzymes.Celiac sprue is not associated with ulceration of the distal colon and rectum.Celiac disease is an intolerance of gluten.

Question 2

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of&#10;A) appendicitis.&#10;B) peritonitis.&#10;C) cholecystitis.&#10;D) gastritis.

Accepted Answer

The earliest manifestation of appendicitis is generalized periumbilical pain accompanied by nausea and, occasionally, diarrhea.The pain is often described as "migrating" or localizing to the lower right abdomen (McBurney's point)due to distention of the serosa from inflammatory edema, at which time fever usually manifests.Acute localized pain with rebound tenderness is not associated with peritonitis.Cholecystitis is not manifested by lower quadrant pain.Gastritis is not associated with symptoms of right lower quadrant pain and systemic inflammation.

Question 3

Esophageal varices represent a complication of ________ hypertension.&#10;A) primary&#10;B) pregnancy-induced&#10;C) portal&#10;D) secondary

Accepted Answer

Esophageal varices represent a complication of portal hypertension, which in Western society is generally the result of cirrhosis due to alcoholism or viral hepatitis.Primary hypertension is not manifested by esophageal varices.Pregnancy-induced hypertension is unrelated to esophageal varices.Esophageal varices is not a complication of secondary hypertension.

Question 4

Barrett esophagus is a&#10;A) gastrin secreting lesion.&#10;B) preneoplastic lesion.&#10;C) benign condition.&#10;D) gastrin-secreting tumor.

Accepted Answer

Barrett esophagus is a complication of chronic GERD and represents columnar tissue replacing the normal squamous epithelium of the distal esophagus.It carries a significant risk for esophageal cancer.Patients with Barrett esophagus should undergo regular endoscopic screening for cancer, along with pharmacologic control of their reflux.Barrett esophagus carries a significant risk for esophageal cancer and does not secrete gastrin.

Question 5

What clinical finding would suggest an esophageal cause of a client's report of dysphagia?&#10;A) Nasal regurgitation&#10;B) Airway obstruction with swallowing&#10;C) Chest pain during meals&#10;D) Coughing when swallowing

Accepted Answer

Two types of pain occur in the esophagus: (1)heartburn (also called pyrosis)and (2)pain located in the middle of the chest, which may mimic the pain of angina pectoris.Heartburn is caused by the reflux of gastric contents into the esophagus and is a substernal burning sensation that may radiate to the neck or throat.A person experiencing pharyngeal contractions may cough and expel the ingested food or fluids through their mouth and nose or aspirate when they attempt to swallow.Airway obstruction with swallowing would be an oropharyngeal cause of dysphagia.A person experiencing pharyngeal contractions may cough and expel the ingested food or fluids through his or her mouth and nose or aspirate when he or she attempts to swallow.

Question 6

A silent abdomen 3 hours after bowel surgery most likely indicates&#10;A) peritonitis.&#10;B) mechanical bowel obstruction.&#10;C) perforated bowel.&#10;D) functional bowel obstruction.

Accepted Answer

Functional obstruction or ileus refers to the loss of propulsive ability by the bowel and may occur after abdominal surgery or in association with hypokalemia, peritonitis, severe trauma, spinal fractures, ureteral distention, and the administration of medications such as narcotics.Peritonitis may be associated with functional obstruction.Mechanical obstructions are due to adhesions, hernia, tumors, impacted feces, volvulus (twisting), or intussusception (telescoping).Perforated bowel is a rare condition sometimes associated with Crohn disease.

Question 7

An early indicator of colon cancer is&#10;A) rectal pain.&#10;B) bloody diarrhea.&#10;C) a change in bowel habits.&#10;D) jaundice.

Accepted Answer

The manifestations of colon cancer depend on the anatomic location and function of the bowel segment containing the tumor.Early manifestations may include a change in bowel habits.Later in the progression of tumor growth, a sensation of rectal fullness and a dull ache may be felt in the rectum or sacral region.Although no signs of obstruction are present, black, tarry stools, which signify bleeding into the intestinal lumen, are a significant finding.Jaundice is not an early indicator of colon cancer.

Question 8

What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea?&#10;A) Negative stool leukocytes&#10;B) Intermittent constipation&#10;C) Abdominal pain and distention&#10;D) Bloody stools

Accepted Answer

Bloody stools are not a symptom of irritable bowel syndrome.A person with irritable bowel syndrome would have negative stool leukocytes.The manifestations of IBS may vary greatly, with some persons experiencing only diarrhea or constipation and others experiencing an alternating pattern of both.In addition to cramping abdominal pain, manifestations such as nausea and mucus in the stool may also be present.

Question 9

Ulcerative colitis is commonly associated with&#10;A) bloody diarrhea.&#10;B) malabsorption of nutrients.&#10;C) fistula formation between loops of bowel.&#10;D) inflammation and scarring of the submucosal layer of the bowel.

Accepted Answer

Ulcerative colitis (inflammation and ulceration of the colon and rectal mucosa)is manifested as bloody diarrhea and abdominal pain.Ulcerative colitis is not associated with malabsorption of nutrients.Fistula formation in the bowel is related to Crohn disease.Acute inflammation of the intestinal wall may manifest as pseudomembranous enterocolitis or necrotizing enterocolitis.

Question 10

Fecal leukocyte screening would be indicated in a patient with suspected&#10;A) lactose intolerance.&#10;B) enterocolitis.&#10;C) laxative abuse.&#10;D) giardiasis.

Accepted Answer

Enterocolitis is manifested by diarrhea (often bloody), abdominal pain, fever, leukocytosis, and rarely, colonic perforation.Lactose intolerance would not be a cause of leukocytosis.Leukocyte screening would not be a factor in laxative use or abuse.Suspected giardiasis would not be a reason to screen fecal leukocytes.

Question 11

What finding should prompt further diagnostic testing in a child presenting with diarrhea?&#10;A) Periumbilical discomfort&#10;B) Greenish, watery diarrhea&#10;C) Frequent, large-volume diarrhea&#10;D) Blood and mucus in the stools

Accepted Answer

The answer of What finding should prompt further diagnostic testing...

Question 12

A patient receiving chemotherapy may be at greater risk for development of&#10;A) gastroesophageal reflux.&#10;B) stomatitis.&#10;C) esophageal varices.&#10;D) Mallory-Weiss syndrome.

Accepted Answer

The answer of A patient receiving chemotherapy may be at...

Question 13

Epigastric pain that is relieved by food is suggestive of&#10;A) pancreatitis.&#10;B) cardiac angina.&#10;C) gastric ulcer.&#10;D) dysphagia.

Accepted Answer

The answer of Epigastric pain that is relieved by food...

Question 14

An urgent surgical consult is indicated for the patient with acute abdominal pain and&#10;A) vomiting.&#10;B) CVA tenderness.&#10;C) absent bowel sounds.&#10;D) borborygmi.

Accepted Answer

The answer of An urgent surgical consult is indicated for...

Question 15

A patient who should be routinely evaluated for peptic ulcer disease is one who is&#10;A) taking 6 to 8 tablets of acetaminophen per day.&#10;B) being treated with high-dose oral glucocorticoids.&#10;C) experiencing chronic diarrhea.&#10;D) routinely drinking alcoholic beverages.

Accepted Answer

The answer of A patient who should be routinely evaluated...

Question 16

Which symptom suggests the presence of a hiatal hernia?&#10;A) Nausea&#10;B) Heartburn&#10;C) Diarrhea&#10;D) Abdominal cramps

Accepted Answer

The answer of Which symptom suggests the presence of a...

Question 17

The most common cause of mechanical bowel obstruction is&#10;A) volvulus.&#10;B) intussusception.&#10;C) adhesions.&#10;D) fecal impaction.

Accepted Answer

The answer of The most common cause of mechanical bowel...

Question 18

Proton pump inhibitors may be used in the management of peptic ulcer disease to&#10;A) increase gastric motility.&#10;B) inhibit secretion of pepsinogen.&#10;C) neutralize gastric acid.&#10;D) decrease hydrochloric acid (HCl) secretion.

Accepted Answer

The answer of Proton pump inhibitors may be used in...

Question 19

Constipation in an elderly patient can be best treated by&#10;A) maintaining a low-fiber diet.&#10;B) maintaining the current level of activity.&#10;C) fecal disimpaction.&#10;D) increasing fiber in the diet.

Accepted Answer

The answer of Constipation in an elderly patient can be...

Question 20

A patient with chronic gastritis would likely be tested for&#10;A) Helicobacter pylori.&#10;B) occult blood.&#10;C) lymphocytes.&#10;D) herpes simplex.

Accepted Answer

The answer of A patient with chronic gastritis would likely...

Question 21

Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate.&#10;A) cure&#10;B) morbidity&#10;C) insurance&#10;D) mortality

Accepted Answer

The answer of Rupture of esophageal varices is a complication...

Question 22

Dumping syndrome is commonly seen after __________ procedures.&#10;A) appendectomy&#10;B) intestinal biopsy&#10;C) colonoscopy&#10;D) gastric bypass

Accepted Answer

The answer of Dumping syndrome is commonly seen after __________...

Question 23

Crohn disease is associated with what complications?&#10;A) Perianal fissures&#10;B) Fistulae&#10;C) Green stool&#10;D) Abscesses&#10;E) Rectal pain

Accepted Answer

The answer of Crohn disease is associated with what complications?&#10;A)...

Question 24

A disorder of the esophageal smooth muscle function where dysphagia is a symptom is&#10;A) esophageal stricture.&#10;B) achalasia.&#10;C) esophageal tumors.&#10;D) Mallory-Weiss syndrome.&#10;E) hiatal hernia.

Accepted Answer

The answer of A disorder of the esophageal smooth muscle...

Question 25

Premature infants are at greater risk for developing&#10;A) necrotizing enterocolitis.&#10;B) pseudomembranous colitis.&#10;C) appendicitis.&#10;D) diverticular disease.

Accepted Answer

The answer of Premature infants are at greater risk for...

Question 26

What is a pathophysiologic mechanism involved in the development of diarrhea?&#10;A) Osmotic diarrhea&#10;B) Excessive flatus&#10;C) Secretory diarrhea&#10;D) Exudative diarrhea&#10;E) Motility disturbances

Accepted Answer

The answer of What is a pathophysiologic mechanism involved in...

Deck 36: Gastrointestinal Disorders