Deck 30: Gastrointestinal Diseases

Question 1

Where does colon carcinoma most commonly occur?

A) Rectosigmoid colon
B) Cecum
C) Transverse colon
D) Ascending colon

Answer 1

Rectosigmoid colon

Question 2

On barium enema, a "napkin ring" lesion is evident within the colon. The most likely diagnosis is __________.

A) adenomatous polyposis
B) Crohn disease
C) colon carcinoma
D) intussusception

Answer 2

colon carcinoma

Question 3

A 45-year-old male patient presents with constipation, weight loss, and hemoccult positive stools. Which of the following is the most appropriate diagnostic imaging follow-up?

A) Colonoscopy
B) Upper GI barium exam
C) Conventional radiography of the abdomen
D) Computed tomography of the abdomen

Answer 3

Colonoscopy

Question 4

Which of the following terms describes an acute infection of the gallbladder caused by gas-forming organisms?

A) Emphysematous cholecystitis
B) Gallstone ileus
C) Calcification of gallbladder wall
D) Milk of calcium

Question 5

Radiographic examination of the lumbopelvic spine reveals numerous calcifications overlying the L1 and L2 vertebrae with extension to the left upper quadrant. In a patient with a history of chronic high alcohol intake, this most likely represents __________.

A) nephrolithiasis
B) old adrenal hemorrhage
C) splenic artery aneurysm
D) pancreatic lithiasis

Question 6

Which of the following is not a complication seen with gallstone disease?

A) Cholecystitis
B) Gallstone ileus
C) Pancreatitis
D) Emphysematous cholecystitis

Question 7

An air-fluid level in the posterior mediastinum on a plain film chest radiograph most likely represents __________.

A) sliding hiatal hernia
B) paraesophageal hernia
C) abscess
D) cavitated lung neoplasm

Question 8

Small bowel obstruction, biliary tract air, and an opaque concretion in the small bowel compose the classic plain film triad for __________.

A) pneumobilia
B) appendix perforation
C) gallstone ileus
D) chronic pancreatitis

Question 9

Which part of the gastrointestinal tract is normally fixed in position?

A) Jejunum
B) Ileum
C) Appendix
D) Duodenum

Question 10

Which of the following statements is true regarding colon polyps?

A) Adenomatous polyps are not precursors to colon cancer
B) Polyps measuring 1 cm or larger should be excised
C) The incidence of malignancy decreases with increased polyp size
D) 98% of colon polyps are missed on barium enema

Question 11

Which of the following statements is consistent with the clinical presentation of cholelithiasis?

A) 5:1 male to female predominance
B) Colicky pain
C) Pain radiation to the lower back or tip of the right scapula
D) Obesity is uncommon

Question 12

Which of the following is associated with a porcelain gallbladder presentation?

A) Cholelithiasis
B) Hepatitis
C) Echinococcus granulosis
D) Adenocarcinoma

Question 13

Accumulations of calcium carbonate in viscous intraluminal bile, mimicking the appearance of an oral cholecystogram is representative of __________.

A) porcelain gallbladder
B) milk of calcium
C) gallbladder carcinoma
D) gallstone ileus

Question 14

Small bowel barium enteroclysis examination of a young adult patient with intermittent low-grade fever, diarrhea, and right lower quadrant pain reveals bowel wall ulcerations, separation of bowel loops, strictures, and fistulas. Which of the following is the most likely diagnosis?

A) Ulcerative colitis
B) Familial polyposis
C) Crohn's disease
D) Gardener syndrome

Question 15

Which of the following is the preferred diagnostic imaging modality for evaluating patients with possible gallstones or biliary duct obstruction?

A) Conventional abdomen radiography
B) Ultrasonography
C) Magnetic resonance imaging
D) Oral cholecystography

Question 16

Approximately 10% to 15% of cases of Crohn's disease cannot be differentiated from __________.

A) ulcerative colitis
B) colorectal carcinoma
C) diverticulitis
D) Peutz-Jeghers disease

Question 17

Which of the following is an indication for CT colonography?

A) Incomplete optical colonoscopy
B) Complete conventional colonoscopy
C) Normal bowel gas pattern on conventional radiography
D) Abdominal pain with referral to the sacrum

Question 18

Diverticulae are most commonly located in the __________.

A) rectum
B) sigmoid colon
C) descending colon
D) ascending colon

Question 19

The most important diagnostic imaging methods for detecting colon polyps are __________ and __________.

A) conventional abdomen radiograph, conventional colonoscopy
B) conventional colonoscopy, barium enema
C) optical colonoscopy, CT colonography
D) diagnostic ultrasonography, optical colonoscopy

Question 20

Which percentage of the time do gallstones appear calcified?

A) 0% to 5%
B) 10% to 15%
C) 50% to 75%
D) 35% to 50%

Question 21

Which of the following examinations is the best screening method for detection of gallstones?

A) Plain film radiography
B) Ultrasonography
C) Computed tomography
D) Magnetic resonance imaging

Question 22

What percentage of gallstones are missed on CT examination?

A) 2%
B) 5%
C) 10%
D) 20%

Question 23

Barium enema reveals loss of haustral pattern with coarse granular appearance of the mucosa in a patient with episodic bloody diarrhea. Which of the following is the most likely diagnosis?

A) Colon carcinoma
B) Familial polyposis
C) Crohn's disease
D) Ulcerative colitis

Question 24

Dilatation of the small bowel is evident when the transverse dimension of the small bowel lumen initially exceeds __________ cm.

A) 1
B) 2
C) 3
D) 4

Question 25

Concretions within the pancreas associated with chronic alcoholism usually appear after __________ years of episodic abdominal pain onset.

A) 1-4
B) 5-10
C) 11-14
D) 15-20

Question 26

Approximately 50% of patients with ulcerative colitis will have the disease isolated to the __________.

A) ileocecal junction
B) duodenum
C) transverse colon
D) rectosigmoid colon

Question 27

What percentage of gastric ulcers are associated with malignancies?

A) 5%
B) 15%
C) 20%
D) 90%

Question 28

Radiographs of the skull of a patient with precancerous colorectal polyps demonstrate osteomas within the sinuses. This constellation of findings is consistent with __________.

A) Gardner syndrome
B) familial polyposis
C) Peutz-Jehgers syndrome
D) Crohn's disease

Question 29

Widely spaced, thick mucosal folds, known as haustra, are observed within the __________.

A) small bowel
B) stomach
C) descending colon
D) esophagus

Question 30

Muccocutaneous pigmented macules appearing on the lips, buccal mucosa, and skin are characteristic of which of the following polyposis syndromes?

A) Nonfamilial adenomatous polyposis
B) Peutz-Jehgers syndrome
C) Turcot syndrome
D) Familial juvenile polyposis

Question 31

Which of the following high-risk groups for colorectal carcinoma has a 100% risk of cancer development if left untreated?

A) Ulcerative colitis
B) Family history
C) Gardner syndrome
D) Familial polyposis

Question 32

Which of the following infectious organisms is associated with development of peptic ulcer disease?

A) Staphylococcus aureus
B) Haemophilus influenza
C) Helicobacter pylori
D) Histoplasma capsulatum

Question 33

Which of the following diagnoses is associated with increased risk of gallstone formation due to increased bilirubin excretion?

A) Crohn's disease
B) sickle-cell disease
C) pregnancy
D) obesity

Question 34

Which of the following is associated with an increased biliary output of cholesterol and reduction of synthesis of bile acid in women?

A) Oral contraceptive use
B) Obesity
C) Northern European ethnicity
D) Pregnancy

Question 35

Which of the following polyposis syndromes is autosomal dominant, appears between the ages of 10 and 35 years, and leads to development of colon cancer usually by the age of 50?

A) Familial adenomatous polyposis
B) Gardner syndrome
C) Familial juvenile polyposis
D) Turcot syndrome

Question 36

A 1-millimeter thin lucent line traversing the orifice of the ulcer crater viewed on profile is known as the __________.

A) ulcer collar
B) Hampton line
C) ulcer mound
D) incisura

Question 37

Toxic megacolon should be suspected in a patient with ulcerative colitis whose abdominal radiographs reveal chronic dilatation of the colon exceeding __________ cm.

A) 4.5
B) 5
C) 5.5
D) 6.5

Question 38

Adenomatous polyps in the colon measuring larger than 2 cm in diameter are associated with a __________ percent incidence of malignancy.

A) 0.5
B) 1-2.5
C) 10
D) 46

Question 39

A "Cobblestone" coastal pattern on a barium examination is characteristic of advanced __________.

A) peptic ulcer disease
B) Crohn's disease
C) granulomatous colitis
D) diverticulosis

Question 40

Which segment of the bowel generally contains fluid feces and gas bubbles intermixed?

A) Jejunum
B) Ileum
C) Cecum
D) Rectum

Question 41

In the presence of splenomegaly, where is the stomach most likely displaced?

A) Laterally
B) Superiorly
C) Medially
D) Inferiorly

Question 42

Which of the following structures is least likely to be displaced due to hepatomegaly?

A) Stomach
B) Right hemidiaphragm
C) Right kidney
D) Spleen

Question 43

Gas-filled intestine interposed between the liver and the diaphragm is known as which term?

A) Extraperitoneal air
B) Situs inversus
C) Chilaiditi syndrome
D) Double-wall finding