Deck 9: Gastrointestinal Function

Question 1

Which cranial nerve controls intestinal motility?

A) Trigeminal
B) Glossopharyngeal
C) Hypoglossal
D) Vagus

Answer 1

D

Question 2

Which of the following statements describes the function of Escherichia coli in the intestine?

A) These organisms feed off undigested food.
B) They synthesize vitamins (e.g., B vitamins).
C) They produce mucus so that feces will pass.
D) They aid with water absorption.
E) Both these organisms feed off undigested food, and they synthesize vitamins (e.g., B vitamins).

Answer 2

E

Question 3

__________ emulsifies fat soluble vitamins (A, D, E, and K) so that they can be absorbed.

A) Amylase
B) Lipase
C) Bile salts
D) Bilirubin

Answer 3

C

Question 4

Changes in the gastrointestinal system associated with aging include:

A) increased stomach acid secretion leading to susceptibility of ulcer formation.
B) increased peristalsis thereby causing diarrhea.
C) reduced liver blood flow and drug clearance.
D) increased intrinsic factor production.

Question 5

An infant is born with an esophageal atresia with a tracheoesophageal fistula. A complication that can occur is:

A) aspiration pneumonia.
B) inability to suck.
C) bowel obstruction.
D) anal atresia.

Question 6

A 3-week-old male infant is brought to the ER with projectile vomiting and irritability. The mother said that he seems to be hungry a lot but vomits after, and it has gotten worse over 2-3 days. She also notes he is constipated. The most likely diagnosis is:

A) intestinal malrotation.
B) Meckel diverticulum.
C) pyloric stenosis.
D) esophageal atresia

Question 7

In which of these scenarios is liver injury most likely?

A) A 55-year-old with a low alanine aminotransferase (ALT)
B) A 45-year-old with an elevated aspartate aminotransferase (AST)
C) A 60-year-old with an elevated alkaline phosphatase and elevated γ-glutamyl transpeptidase (GGT)
D) A 70-year-old with an elevated alkaline phosphatase and normal γ-glutamyl transpeptidase (GGT)

Question 8

A 50-year-old man is diagnosed with gastroesophageal reflux disease. He smokes and drinks a lot of coffee. What is a likely reason for the development of reflux in this man?

A) Impaired gastric motility
B) Abnormalities in the lower esophageal sphincter
C) Increased sympathetic stimulation
D) Decreased hydrochloric acid inhibition

Question 9

Clinical manifestations of new onset, uncomplicated gastroesophageal reflux disease include:

A) heartburn.
B) sour taste in mouth.
C) odynophagia.
D) melena.
E) heartburn and sour taste in mouth.

Question 10

When the normal esophageal squamous epithelium becomes metaplastic columnar epithelium (a precursor to adenocarcinoma), it is referred to as:

A) esophagitis.
B) ulcer.
C) Barrett esophagus.
D) erosive disease.

Question 11

Diagnostic evaluation for causes of gastritis includes:

A) colonoscopy.
B) Helicobacter pylori testing.
C) barium swallow.
D) blood alcohol level.

Question 12

The bacterium Helicobacter pylori causes mucosal lining issues by:

A) producing urease, which allows bacterial colonization.
B) producing urea, which increases stomach acid.
C) eliminating protective cytotoxins.
D) destroying normal flora.

Question 13

Epigastric pain that is relieved by food is suggestive of:

A) cholecystitis.
B) peptic ulcer.
C) pancreatitis.
D) gastroesophageal reflux disease.

Question 14

Which of the following is a common cause of peptic ulcer development?

A) Gastrinoma
B) Nonsteroidal anti-inflammatory drug use
C) Stress
D) Chronic kidney disease

Question 15

A woman is diagnosed with cholelithiasis. Which finding from the history and physical examination may have contributed to the development of the condition?

A) The patient's body mass index (BMI) is 40.
B) The patient is a vegetarian.
C) The patient drinks 4 ounces of red wine nightly.
D) The patient takes 81 mg of aspirin every morning.

Question 16

Gallstones in the common bile duct in comparison to those in the cystic duct are more likely to result in:

A) right upper quadrant pain.
B) jaundice.
C) ascites.
D) low bilirubin levels.

Question 17

Which of the following types of viral hepatitis is not associated with the potential development of chronic hepatitis?

A) Type A
B) Type B
C) Type C
D) All of these are correct.

Question 18

A man is seropositive for viral hepatitis type D, which means:

A) he most likely contracted it from eating contaminated food.
B) he has a coinfection with viral hepatitis type B.
C) chronic infection will not develop with this type.
D) he has an asymptomatic type.

Question 19

A 60-year-old man was screened for hepatitis C, and the results of the anti-HCV was positive. This finding means:

A) he was vaccinated, and immunity is present.
B) he has a current infection.
C) he has a previous infection.
D) he has a previous or current infection.

Question 20

Changes in the liver that occur as a result of cirrhosis include:

A) extracellular matrix degradation due to proteolytic activity.
B) decrease in collagen synthesis.
C) inhibition of specialized stellate cells, which depress chemokine release.
D) increased blood flow resulting in liver hypertrophy.

Question 21

A patient who is an alcoholic for more than 15 years develops acute hematemesis. Esophageal varices are suspected as the cause. How do these varices develop?

A) Increased vasodilation and decreased vasoconstriction (decreased norepinephrine)
B) Fluid backing up into the abdominal cavity
C) High pressure in the portal system vasculature that leads to engorgement
D) Increased platelets

Question 22

Which of the following causes a patient with advanced cirrhosis to have dark-colored urine?

A) Red blood cell hemolysis
B) Increased renal excretion of bile
C) Renal thrombosis
D) Impaired clotting factors

Question 23

A man with cirrhosis has high ammonia levels. This will cause common clinical manifestations including:

A) cognitive and mental status changes.
B) cardiac arrhythmias and constipation.
C) abdominal pain and ulcers.
D) hypogonadism and impotence.

Question 24

A woman comes in for her annual physical, and she has no concerns. She recently went to the urgent care with epigastric pain and an upper abdominal ultrasound was normal except for the finding of a fatty liver. She was diagnosed with gastroesophageal reflux disease and prescribed an antacid. She denies further episodes of reflux after taking the antacids for 2 weeks. She is a nonsmoker and has one glass of red wine about 5 times a week. Her past medical includes hypertension, which is well controlled and type 2 diabetes mellitus for which she takes metformin and insulin. She has a history of gout and her last flare was 1 year ago. Her physical examination is unremarkable except for a BMI of 35. What are likely reasons for the fatty liver?

A) Gout
B) Her BMI of 35
C) Type 2 diabetes mellitus
D) Gastroesophageal reflux disease
E) Both her BMI of 35 and type 2 diabetes mellitus

Question 25

Which of the following is a common cause of chronic pancreatitis, portal hypertension, and cirrhosis?

A) Smoking
B) Obesity
C) Alcoholism
D) Unsafe sex

Question 26

Clostridium difficile infection will cause diarrhea that is:

A) small in quantity and frequent.
B) large and loose and provoked by eating.
C) large with melena present.
D) continuous and foul smelling.

Question 27

The presence of mucus and blood ("currant jelly") stool is present in which intestinal obstruction mostly seen in children?

A) Hirschsprung disease
B) Intussusception
C) Volvulus
D) Anorectal malformation