Question 1

The definitive treatment for cholecystitis is&#10;A) lithotripsy of stones.&#10;B) chemical dissolution of stones.&#10;C) antibiotics and antiinflammatories.&#10;D) cholecystectomy.

Accepted Answer

The definitive treatment for cholecystitis is cholecystectomy, which involves the removal of the gallbladder. This is typically done laparoscopically and is a very safe and effective procedure. Lithotripsy and chemical dissolution of stones are options for gallstones, but they are not appropriate for treating the underlying inflammation and infection of the gallbladder. Antibiotics and anti-inflammatories may be used to treat the acute symptoms of cholecystitis, but they are not curative and do not address the underlying issue of a damaged gallbladder.

Question 2

The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis&#10;A) is an expected finding and requires no specific intervention.&#10;B) indicates peritonitis with substantial risk for sepsis and shock.&#10;C) requires immediate surgical intervention.&#10;D) is an unusual finding in pancreatitis and indicates misdiagnosis.

Accepted Answer

Hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis indicate peritonitis, which is a serious complication that can lead to sepsis and shock. Immediate medical attention is required to manage this condition. Surgery may be necessary in severe cases to remove infected or damaged tissue.

Question 3

Patients with acute pancreatitis are generally not allowed to eat and may require continuous gastric suctioning to&#10;A) prevent abdominal distention.&#10;B) remove the usual stimuli for pancreatic secretion.&#10;C) prevent hyperglycemia associated with loss of insulin secretion.&#10;D) prevent mechanical obstruction of the intestine.

Accepted Answer

Patients with acute pancreatitis are not allowed to eat to remove the usual stimuli for pancreatic secretion. This helps to reduce the inflammation and damage to the pancreas. Continuous gastric suctioning may also be used to remove any remaining food or stomach contents and prevent further stimulation of the pancreas. The other options (preventing abdominal distention, preventing hyperglycemia associated with loss of insulin secretion, preventing mechanical obstruction of the intestine) are not the primary reasons for these interventions in acute pancreatitis.

Question 4

The pain of cholecystitis commonly radiates to the left upper quadrant and left shoulder.

Accepted Answer

The pain of cholecystitis commonly radiates to the right upper quadrant and right shoulder, not the left side.

Question 5

Alcohol abuse is the primary risk factor for chronic pancreatitis.

Accepted Answer

Chronic pancreatitis is a long-term inflammation of the pancreas that impairs its ability to function properly. Alcohol abuse is the most common cause of chronic pancreatitis, accounting for approximately 70% of cases. Other risk factors include smoking, genetic predisposition, and certain types of medical conditions such as cystic fibrosis.

Question 6

A deficiency of lipid digestion or absorption commonly results in&#10;A) steatorrhea.&#10;B) constipation.&#10;C) hyperlipidemia.&#10;D) cholelithiasis.

Accepted Answer

A deficiency of lipid digestion or absorption commonly results in steatorrhea, which is the presence of excess fat in the stool. This can be due to various reasons such as pancreatic insufficiency, celiac disease, or other malabsorption disorders. B, C, and D are not commonly associated with lipid digestion or absorption deficiencies.

Question 7

Most gallstones are composed of&#10;A) bile.&#10;B) cholesterol.&#10;C) calcium.&#10;D) uric acid salts.

Accepted Answer

Most gallstones are composed of cholesterol, which can either be from excess cholesterol in the bile or poor functioning of the gallbladder in removing excess bile salts.

Question 8

Bile salts enzymatically digest lipids in the small intestine.

Accepted Answer

Bile salts do not enzymatically digest lipids; they emulsify fats, increasing their surface area for lipase enzymes to act upon.

Question 9

A patient with pancreatitis may experience muscle cramps and laryngospasm secondary to&#10;A) alkalosis.&#10;B) hyperglycemia.&#10;C) hypocalcemia.&#10;D) hypermagnesemia.

Accepted Answer

Hypocalcemia is a common complication of pancreatitis due to inadequate absorption of calcium from the intestine and the deposition of calcium crystals in the inflamed pancreatic tissue. Hypocalcemia can cause muscle cramps and laryngospasm, among other symptoms. Alkalosis, hyperglycemia, and hypermagnesemia are not typically associated with pancreatitis or its complications.

Question 10

The usual treatment for chronic pancreatitis includes&#10;A) pancreatectomy.&#10;B) strict dietary avoidance of fats.&#10;C) abstinence from alcohol.&#10;D) long-term narcotic administration for pain.

Accepted Answer

Abstinence from alcohol is crucial to prevent further damage to the pancreas in chronic pancreatitis. A, B, and D may be options in certain cases, but they are not the usual treatments for chronic pancreatitis. Pancreatectomy (A) may be considered for severe cases of chronic pancreatitis where other treatments have failed, but this is not a first-line treatment. Strict dietary avoidance of fats (B) may help manage symptoms, but it does not address the underlying cause of chronic pancreatitis. Long-term narcotic administration for pain (D) may be necessary for some patients, but it is not a treatment for the disease itself.

Question 11

Elevated serum lipase and amylase levels are indicative of&#10;A) gallbladder disease.&#10;B) appendicitis.&#10;C) pancreatitis.&#10;D) peritonitis.

Accepted Answer

The answer of Elevated serum lipase and amylase levels are...

Question 12

The exocrine pancreas is stimulated to secrete in response to secretin and cholecystokinin.

Accepted Answer

The answer of The exocrine pancreas is stimulated to secrete...

Question 13

Cholelithiasis is present in 90% of patients who have acute cholecystitis.

Accepted Answer

The answer of Cholelithiasis is present in 90% of patients...

Question 14

Chronic pancreatitis may lead to&#10;A) diabetes mellitus.&#10;B) Crohn disease.&#10;C) gallstones.&#10;D) celiac sprue.

Accepted Answer

The answer of Chronic pancreatitis may lead to&#10;A) diabetes mellitus.&#10;B)...

Question 15

A biliary cause of acute pancreatitis is suggested by which of the following laboratory results?&#10;A) Elevated serum lipase&#10;B) Elevated serum amylase&#10;C) Elevated serum glucose&#10;D) Elevated serum alkaline phosphatase

Accepted Answer

The answer of A biliary cause of acute pancreatitis is...

Deck 37: Alterations in Function of the Gallbladder and Exocrine Pancreas