Deck 19: Gastroenterology

Question 1

A black bowel movement is most likely to indicate which of the following?

A) Upper gastrointestinal bleeding
B) A diet rich in fruits and vegetables
C) A parasitic infection of the gastrointestinal tract
D) Gallstones

Answer 1

Upper gastrointestinal bleeding

Question 2

Tenderness under the right side of the rib cage (Murphy's sign) is indicative of:

A) Cholecystitis (inflammation of the gallbladder)
B) Appendicitis (inflammation of the appendix)
C) Diverticulitis (inflammation of the colon)
D) Pneumonia (infection of the lung)

Answer 2

Cholecystitis (inflammation of the gallbladder)

Question 3

A nasogastric tube:

A) Can be used to provide enteral nutrition to a patient
B) Enters the mouth, passes through the esophagus, and can be positioned, ideally, in the proximal small intestine
C) Can be used to aspirate fluid from, or pour liquids into, the stomach
D) All of the above
E) None of the above

Answer 3

All of the above

Question 4

A useful blood test to perform in a patient who has repeated episodes of bleeding is:

A) A urinalysis
B) A sputum analysis
C) A serum lactate level
D) A hematocrit

Question 5

Bowel transit time increases:

A) In constipation
B) Post-operatively, while recuperating from intestinal surgery
C) In patients with malabsorption
D) In patients at bedrest

Question 6

Which of the following pairs of laboratory tests are not "liver function tests?"

A) AST and ALT
B) BUN and Cr
C) Total bilirubin and direct bilirubin
D) GGT

Question 7

Pain that occurs during swallowing is known as:

A) Aphasia
B) Odynophagia
C) Coprophagia
D) Apraxia

Question 8

A person who aspirates foods is prone to:

A) Overweight or obesity
B) Pancreatitis
C) Gastric ulcers
D) Pneumonia

Question 9

Of the listed choices below, the most common cause of ulceration of the stomach and duodenum is:

A) Helicobacter pylori
B) Salmonella infection
C) Infection with parasites
D) Zollinger-Ellison syndrome

Question 10

Gastric stapling for weight loss:

A) Limits the size of the stomach
B) Typically causes iron deficiency
C) Produces malabsorption of nutrients
D) All of the above
E) None of the above

Question 11

The disease formerly known as "non-A, non-B hepatitis," is now identified as:

A) Peptic ulcer disease
B) Gastroesophageal reflux
C) Hepatitis C
D) Gluten-sensitive enteropathy (Celiac disease)

Question 12

A tumor mass that obstructs the esophagus may cause:

A) Vomiting
B) Weight loss
C) Both
D) Neither

Question 13

A large tumor that obstructs the large intestine may contribute to:

A) Iron deficiency anemia
B) Constipation
C) Both
D) Neither

Question 14

Which of the following, if any, are tests that can be used to screen for colon cancer?

A) Stool cards used to detect occult bleeding
B) Sigmoidoscopy
C) Colonoscopy
D) Virtual colonoscopy
E) All of the above
F) None of the above

Question 15

The vermiform appendix is located:

A) Within the peritoneum
B) In the right lower quadrant of the abdomen
C) Near the cecum
D) All of the above
E) None of the above

Question 16

The splenic flexure of the colon is found in:

A) The left upper quadrant of the abdomen
B) The right upper quadrant of the abdomen
C) The left lower quadrant of the abdomen
D) The right lower quadrant of the abdomen

Question 17

The gallbladder is located:

A) Between the spleen and the diaphragm
B) Between the liver and the diaphragm
C) Inferior to the spleen
D) Inferior to the liver

Question 18

The liver is an organ that:

A) Has three lobes
B) Is located in the pleural cavity
C) Accepts blood flow from the portal vein
D) All of the above
E) None of the above

Question 19

A patient with an elevated amylase and lipase in her serum is most likely to have:

A) Pancreatitis
B) Colon cancer
C) An ectopic pregnancy
D) Celiac disease (gluten-sensitive enteropathy)

Question 20

Which of the following organs secretes amylase?

A) The salivary glands
B) The gallbladder
C) The vermiform appendix
D) The spleen

Question 21

Epigastric pain is located in:

A) The right upper quadrant
B) The left upper quadrant
C) The left lower quadrant
D) All of the above
E) None of the above

Question 22

An obstructing gallstone can cause:

A) Pain in the right upper quadrant of the abdomen
B) Pain with deep breathing
C) Nausea and vomiting after meals
D) Jaundice
E) All of the above

Question 23

Which of the following organs is located in the retroperitoneum?

A) The pancreas
B) The large intestine
C) The small intestine
D) The esophagus

Question 24

Which of the following organs propels food with smooth muscle?

A) The duodenum
B) The jejunum
C) The large intestine
D) All of the above
E) None of the above

Question 25

Esophageal varices are typically found in patients with:

A) Peptic ulcers
B) Cirrhosis of the liver
C) Colon cancer
D) Malabsorption

Question 26

Which of the following diseases or conditions IS NOT an important cause of malabsorption of essential nutrients?

A) Surgical removal or bypass of the proximal small intestine
B) Celiac disease
C) Chronic pancreatitis
D) Ulcerative colitis

Question 27

Digestion of starches begins in the:

A) Oral cavity
B) Esophagus
C) Stomach
D) Duodenum

Question 28

Which of the following agents is LEAST LIKELY to cause irritation of the lining of the gastrointestinal tract?

A) Alcohol
B) Anti-inflammatory drugs, like ibuprofen
C) Cigarettes
D) Tricyclic antidepressants

Question 29

Bleeding from the UPPER gastrointestinal tract is least likely to be caused by:

A) Duodenal ulcers
B) Esophagitis
C) Gastric ulcers
D) Ulcerative colitis

Question 30

Which of the following bacteria is a cause of ulcers of the stomach and small intestine?

A) Haemophilus influenzae
B) Helicobacter pylori
C) Campylobacter jejuni
D) Escherichia coli

Question 31

The bacteria that live in the large intestine include:

A) Aerobes only
B) Anaerobes only
C) Aerobes and anaerobes
D) Important pathogens like Streptococcus pyogenes

Question 32

The cells that line a healthy oral cavity and proximal esophagus are:

A) Squamous cells
B) Smooth muscle cells
C) Striated muscle cells
D) Endothelial cells

Question 33

Primary functions of the pancreas include all of the following EXCEPT:

A) The production of enzymes used to metabolize proteins
B) The production of antibodies against disease-causing substances ingested orally
C) The production of enzymes used to metabolize fats
D) The production and secretion of insulin

Question 34

Parietal cells in the stomach produce:

A) Hydrochloric acid
B) Bile
C) Glucagon
D) Trypsin

Question 35

Intrinsic factor, a glycoprotein secreted in the stomach, assists in the absorption of:

A) Vitamin A
B) Vitamin B₆
C) Vitamin B₁₂
D) Vitamin C

Question 36

Bile is funneled through the cystic duct, which merges with the hepatic duct to form the common bile duct. It is discharged into the ______________, through the _______.

A) Pancreas; duct of Wirsung
B) Small intestine; ampulla of Vater
C) Large intestine; appendix
D) Stomach; diaphragmatic hiatus

Question 37

Which of the following veins drains blood primarily from the large bowel?

A) The gastroepiploic
B) The inferior mesenteric
C) The superior mesenteric
D) The inferior vena cava

Question 38

A hemorrhoid consists of which of the following anatomical structures:

A) A clotted artery
B) A clotted vein
C) An obstructed diverticulum
D) An obstructed duct

Question 39

Most of the water ingested in the gastrointestinal tract is absorbed in the:

A) Oral cavity
B) Esophagus
C) Small intestine
D) Large intestine

Question 40

End products of digestion include all of the following, EXCEPT

A) Amino acids
B) Amino acids.
C) Monosaccharides
D) Peptidases

Question 41

The end products of digestion are primarily absorbed by the:

A) Endothelium of the gallbladder
B) Sinusoids of the liver
C) Microvilli in the small intestine
D) Islets of Langerhans in the pancreas

Question 42

The ileocecal valve separates:

A) The oropharynx and the esophagus
B) The esophagus and the stomach
C) The stomach and the small intestine
D) The small intestine and the large intestine

Question 43

A common location for inflammatory lesions in Crohn's disease is:

A) The pyloric valve
B) The ileocecal valve
C) The infundibulum of the gallbladder
D) The anal verge

Question 44

The transverse colon begins at the _________________, and ends at the ____________.

A) Cecum; hepatic flexure
B) Hepatic flexure; splenic flexure
C) Splenic flexure; sigmoid colon
D) Sigmoid colon; anus

Question 45

Peyer's patches are:

A) Collections of mucus-secreting cells in the stomach
B) Collections of endocrine-secreting cells in the pancreas
C) Collections of antibody-producing lymph nodes in the wall of the small intestine
D) Localized areas of small bowel atrophy in gluten-sensitive enteropathy

Question 46

An esophageal varix is a diseased:

A) Artery
B) Vein
C) Diverticulum
D) Duct

Question 47

Blood that drains from the lower gastrointestinal tract passes through which of the following organs for detoxification?

A) The spleen
B) The liver
C) The pancreas
D) The kidneys

Question 48

Constipation is best defined as:

A) A decrease in a person's normal frequency of bowel movements, usually with stools that are dry, hard, or incompletely evacuated
B) The passage of less than one bowel movement daily
C) The passage of less than one bowel movement a week
D) The passage of stools containing digested blood

Question 49

Bleeding from which of the following sites in the gastrointestinal tract is least accessible to endoscopic therapy?

A) The oral cavity
B) A duodenal ulcer
C) An arteriovenous malformation in the small bowel
D) A ruptured diverticulum in the sigmoid colon

Question 50

Which of the following is used to remediate constipation or diarrhea in patients with irritable bowel syndrome?

A) Psyllium
B) St. John's wort
C) Cranberry
D) Mercuric chloride

Question 51

An elderly male tells you for the first time in his life he has trouble passing his stools. He has previously had problems with urination. (He gets up often at night to urinate, takes a long time to urinate, and then has to return to the bathroom shortly after he voids to urinate again.) You advise him:

A) That constipation is a natural part of aging
B) To let you know if the constipation is associated with rectal bleeding, weight loss, his urinary symptoms, or jaundice
C) That he likely has colon cancer
D) That he needs to see a health care professional for evaluation

Question 52

A vaccine against rotavirus that was initially released to the public was withdrawn after:

A) It was found to cause diarrhea
B) It was found to cause intussusception of the bowel
C) It was found to contribute to poor performance of children in schools
D) It was discovered that it was contaminated with lead

Question 53

Of the following, which is the deadliest disease (the disease that kills the GREATEST NUMBER of human beings every year worldwide)?

A) Diarrhea
B) HIV/AIDS
C) Malaria
D) Mycobacterium tuberculosis

Question 54

All of the following are causes of pharyngitis except:

A) Mycoplasma pneumonia
B) Corynebacterium diphtheria
C) Streptococcus pyogenes
D) Adenoviruses
E) Entamoeba histolytica

Question 55

The most likely place to find anaerobic bacteria in the human body is:

A) On the skin and inside the sinuses
B) In the lungs and in the kidneys
C) On hair and nails
D) In the lower gastrointestinal tract and between the teeth

Question 56

The following are all aerobic microorganisms that cause otitis media, acute sinusitis, and pneumonia, except:

A) Streptococcus pneumonia
B) Legionella pneumophila
C) Chlamydia TWAR
D) C.difficile

Question 57

In most Western nations, infectious diarrheal illnesses are relatively rare, compared to the incidence of these illnesses in tropical nations. Which of the following organisms is NOT a cause of diarrhea?

A) Cyclospora cayetanensis
B) Enteroaggregative Escherichia coli (EAEC)
C) Enterococci
D) Campylobacter jejuni

Question 58

Which of the following forms of diarrhea are commonly encountered in the United States?

A) Cyclospora cayetanensis
B) Enteroaggregative Escherichia coli (EAEC)
C) Enterococci
D) Campylobacter jejuni

Question 59

Hepatitis A virus is often transmitted:

A) By food handlers who do not use adequate hand hygiene
B) By injection drug users
C) By sexual intercourse
D) By organ transplantation

Question 60

Injection drug users who share contaminated needles are likely to transmit all of the following viruses to each other by injection, except:

A) Hepatitis B virus
B) Hepatitis C virus
C) Norovirus
D) West Nile Virus

Question 61

The influenza virus is:

A) A common cause of diarrhea
B) A common cause of recurrent genital and oral skin infections
C) A common cause of respiratory illness, characterized by fever, sore throat, and headache
D) A common cause of chronic connective tissue disease

Question 62

Foods that are likely to worsen symptoms of irritable bowel syndrome include all of the following EXCEPT:

A) Beans
B) Cruciferous vegetables
C) Dairy products
D) Oatmeal

Question 63

Diseases that result in the malabsorption of nutrients often cause patients to have fatty or greasy diarrheal bowel movements. The evacuation of fatty or oily bowel movements is known as:

A) Hematemesis
B) Hematochezia
C) Lipodystrophy
D) Steatorrhea

Question 64

Weight loss resulting from the malabsorption of nutrients is the goal of some forms of bariatric surgery. Which of the following procedures relies partly on nutrient malabsorption to produce weight loss?

A) Gastric banding
B) Gastric stapling
C) Roux-En-Y bypass

Question 65

A peptide hormone produced by adipose tissue that suppresses appetite is known as:

A) An anorexiant
B) Leptin
C) Lutein
D) Nicotine

Question 66

Anorexia nervosa differs from bulimia in that:

A) In anorexia, the patient limits the intake of healthy nutrients
B) In anorexia, the patient suffers from a disorder of body image
C) In bulimia, the patient is unlikely to have electrolyte disturbances
D) In bulimia, patients often overeat before vomiting, using diuretics or cathartics

Question 67

During critical illnesses, patients often lose large amounts of muscle mass and body weight. Wasting that results from illness is best described as:

A) Cachexia
B) Overnutrition
C) Parenteral nutrition
D) Ketoacidosis

Question 68

People who have trouble swallowing food may develop aspiration pneumonia or become undernourished. A food consistency that many people with dysphagia can tolerate is one consisting of:

A) Meats and other solids
B) Thickened liquids
C) Clear liquids
D) Bioactive foods

Question 69

An obstruction is:

A) Decreased awareness and arousal in response to stimulation
B) A persisting or recurrent idea or feeling that causes emotional distress
C) The affirmation of a belief
D) A blockage within a structure that prevents it from functioning normally

Question 70

Blood flows into the liver from organs in the gastrointestinal tract via the:

A) Hepatic artery
B) Celiac artery
C) Vena cava
D) Portal vein

Question 71

Bile is produced by the liver and ultimately excreted into the ____. It ____, by ____.

A) Blood; enters the lungs; osmosis
B) Small intestine; aids digestion; emulsifying fats
C) Blood; boosts immunity; helping white blood cells mature
D) Urine; maintains a healthy level of sodium and potassium in the body; its cleansing of the renal tubules

Question 72

Which of the following is NOT a metabolic function of the liver?

A) It helps to convert the thyroid hormone levothyroxine to its more metabolically active form, triiodothyronine.
B) It synthesizes cholesterol.
C) It synthesizes proteins, like albumin, complement, and clotting factors, which circulate in the blood.
D) It secretes tryptase and other enzymes, which enter the small intestine through the ampulla of Vater, aiding the digestion of proteins in the small intestine.

Question 73

Hepatitis (inflammation of the liver) can be caused by a wide variety of insults to the liver. Which of the following causes of viral hepatitis is not transmitted from person to person by injection drug use?

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D

Question 74

Activated charcoal is a substance often given to patients after oral overdose to absorb poisonous substances from the gastrointestinal (GI) tract. Which of the following ingestions can be safely and effectively treated with orally administered activated charcoal?

A) Ferrous sulfate (iron tablets)
B) Lithium carbonate
C) Lye
D) Tricyclic antidepressants, like amitriptyline