Deck 38: Gastrointestinal and Pancreatic Diseases

Question 1

Which one of the following statements concerning secretin is correct?

A) Secretin is produced by the parietal cells in the stomach.
B) The release of secretin is controlled by the presence of glucose in the blood.
C) The function of secretin is to relax smooth muscle of the gut.
D) Secretin stimulates release of pancreatic hormones.

Answer 1

Secretin stimulates release of pancreatic hormones.

Question 2

Which one of the following substances is not synthesized by the pancreas?

A) Gastrin
B) Somatostatin
C) Vasoactive intestinal polypeptide (VIP)
D) Insulin

Answer 2

Vasoactive intestinal polypeptide (VIP)

Question 3

Which one of the following statements concerning insulin is incorrect?

A) Insulin release from the pancreas is stimulated by gastrin.
B) Glucose-dependent insulinotropic peptide (GIP)inhibits insulin release.
C) An insulinoma belongs to a group of tumors arising from pancreatic islet cells.
D) Secretion of insulin is one of the principal actions of CCK.

Answer 3

Glucose-dependent insulinotropic peptide (GIP)inhibits insulin release.

Question 4

Mucosal inflammation of the stomach that is associated with peptic ulcer disease or gastric carcinoma is referred to as:

A) celiac disease.
B) Zollinger-Ellison syndrome.
C) nonerosive gastritis.
D) erosive gastritis.

Question 5

Fecal osmotic gap measurements are done to:

A) assess the functional mass of pancreatic tissue.
B) distinguish between osmotic and secretory diarrhea.
C) determine lactose tolerance.
D) assess the amount of protein lost in stool.

Question 6

Gastrointestinal neuroendocrine tumors are either carcinoid tumors of enterochromaffin cells or,as in the case of somatostatinoma,tumors of the:

A) gastric parietal cells.
B) cells in the brush border of the small intestine.
C) small bowel mucosal cells.
D) pancreatic endocrine cells.

Question 7

A problem with the use of noninvasive testing for assessing pancreatic exocrine function is that this type of testing:

A) is uncomfortable for the patient compared with invasive testing.
B) is expensive and time-consuming for the patient and provider.
C) is only useful for adults with early pancreatic disease.
D) lacks the clinical sensitivity and specificity for early disease detection.

Question 8

A consequence of Crohn disease is bacterial overgrowth of the small bowel that normally contains few bacteria.Bacterial overgrowth further leads to:

A) bile salt deficiency and fat malabsorption.
B) excess hydrogen in the intestine and acid reflux disease.
C) lactase deficiency.
D) chronic pancreatitis and pancreatic islet destruction.

Question 9

A test that is considered diagnostic for cystic fibrosis in infants over the age of 2 weeks and for other assessment of pancreatic insufficiency is:

A) fecal elastase-1.
B) an invasive test,such as the secretin stimulation test.
C) a pancreatic enzyme test,such as amylase or lipase.
D) gastrin analysis.

Question 10

What special specimen requirements must be met when collecting and preparing a sample for gastrin analysis?

A) Whole blood is the specimen of choice,collected in EDTA-containing tubes,placed on ice,and then refrigerated immediately upon receipt in the lab.
B) Blood must be collected into a heparin-containing tube,separated in a refrigerated centrifuge,and frozen within 15 minutes of collection.
C) Serum is the specimen of choice and must be collected into non-anticoagulant-containing tubes and kept warm until analysis is complete.
D) A 12-hour overnight collection of gastric juice must be assessed for gastrin.

Question 11

A peptide secreted by the upper intestinal mucosa that causes gallbladder contraction and release of digestive enzymes from the pancreas,and is also localized in the nervous system,is:

A) secretin.
B) VIP.
C) insulin.
D) CCK.

Question 12

Extremely elevated serum levels of gastrin are typically indicative of:

A) insulinoma.
B) diabetes mellitus.
C) Zollinger-Ellison syndrome.
D) cystic fibrosis.

Question 13

Which one of the following peptide hormones acts to increase intestinal motility and stimulate gallbladder contractions?

A) Secretin
B) Glucagon
C) Insulin
D) Cholecystokinin (CCK)

Question 14

A 23-year-old man visits his physician with symptoms of abdominal discomfort and diarrhea.The man states that the diarrhea has been present off and on for approximately 6 weeks.He especially notes symptoms after a breakfast of wheat cereal and milk.His physician considers the possibility of two disorders,celiac disease and lactose intolerance.Which of the following pairs of laboratory tests would provide a definitive answer?

A) Analysis of tissue transglutaminase IgA antibodies and breath hydrogen testing
B) Serum gastrin and fecal alpha₁-antitrypsin analysis
C) Breath hydrogen testing and fecal osmotic gap determination
D) Fecal elastase-1 and tissue transglutaminase IgA antibody analysis

Question 15

Chronic pancreatic damage leads to pancreatic insufficiency.In children,this is most commonly associated with:

A) accidental alcohol ingestion.
B) cystic fibrosis.
C) gallstones.
D) pancreatic tumors.

Question 16

The use of the urea breath test for detection of H.pylori involves:

A) titration of bacterial free acid in breath with sodium hydroxide to a pH end point of 3.5 compared with a urea standard.
B) immunoassay measurement of deficiency of IgA-class transglutaminase in breath using tissue transglutaminase as an antigen.
C) bacterial hydrolysis of ingested labeled urea producing labeled bicarbonate,which is absorbed into the blood and exhaled as ¹⁴CO₂ or ¹³CO₂.
D) production of hydrogen by bacterial metabolism that is absorbed into the systemic circulation and exhaled in the breath as urea.

Question 17

During the gastric phase of the digestive process,HCl will be released from parietal cells following the _____ of gastrin from the mucosal endocrine cells in the stomach.

A) release
B) inhibition

Question 18

Regarding the gastrointestinal (GI)tract,the function of gastrin is to:

A) stimulate release of GI hormones,such as secretin and insulin.
B) regulate contraction of the gallbladder.
C) stimulate intestinal motility.
D) induce absorption of digested food products across the intestinal wall.

Question 19

Secondary acquired lactose intolerance can occur from reduced lactase activity following diffuse intestinal damage caused by,for example,inflammatory bowel disease (IBD).Which one of the following IBDs affects the large bowel in particular?

A) Celiac disease
B) Ulcerative colitis
C) Crohn disease
D) Peptic ulcer disease

Question 20

An autoimmune disorder produced by ingestion of gluten and characterized by inflammatory damage to intestinal lining cells and malabsorption is:

A) Crohn disease.
B) ulcerative colitis.
C) lactose intolerance.
D) celiac disease.