Question 1

A 55-year-old male died in a motor vehicle accident.Autopsy revealed an enlarged liver caused by fatty infiltration,testicular atrophy,and mild jaundice secondary to cirrhosis.The most likely cause of his condition is:
A) Bacterial infection
B) Viral infection
C) Alcoholism
D) Drug overdose

Accepted Answer

The most common cause of cirrhosis is alcoholism.
The most common cause of cirrhosis is alcoholism,not a bacterial infection.
The most common cause of cirrhosis is alcoholism,not a viral infection.
The most common cause of cirrhosis is alcoholism,not drug overdose.

Question 2

The most common cause of chronic vascular insufficiency among the elderly is:
A) Anemia
B) Aneurysm
C) Lack of nutrition in gut lumen
D) Atherosclerosis

Accepted Answer

The most common cause of chronic vascular insufficiency is atherosclerosis,especially in the elderly.
Anemia does not lead to vascular insufficiency.
An aneurysm would lead to acute vascular insufficiency.
Lack of nutrition does not lead to vascular insufficiency; it is due to atherosclerosis.

Question 3

Complete obstruction of bile flow to the liver would be manifested by:
A) Elevated hemoglobin and hematocrit
B) Lower-leg edema
C) Clay-colored stools
D) Hypotension

Accepted Answer

Complete obstruction of bile flow leads to clay-colored stools.
Complete obstruction of bile flow leads to clay-colored stools,not elevated hemoglobin and hematocrit.
Complete obstruction of bile flow leads to clay-colored stools,not lower-leg edema.
Complete obstruction of bile flow leads to clay-colored stools,not hypotension.

Question 4

A 3-month-old female develops colicky pain,abdominal distention,and diarrhea after drinking cow's milk.The best explanation for her symptoms is:
A) Deficiency of bile that stimulates digestive secretions and bowel motility
B) Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea
C) Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and decreased bowel motility
D) Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Accepted Answer

Undigested lactose increases the osmotic gradient in the intestine,causing irritation and osmotic diarrhea.
The child is experiencing lactose intolerance,not bile deficiency.
This child is experiencing lactose intolerance,not an excess of amylase.
The child is experiencing lactose intolerance,not in infectious process.

Question 5

Clinical manifestations of bile salt deficiencies are related to poor absorption of:
A) Fats and fat-soluble vitamins
B) Water-soluble vitamins
C) Proteins
D) Minerals

Accepted Answer

Clinical manifestations of bile salt deficiency are related to poor intestinal absorption of fat and fat-soluble vitamins (A,D,E,K).
Water-soluble vitamins do not require bile salts for absorption; thus,they are not affected.
Protein breakdown is facilitated by bile,but its absorption is not dependent upon it; thus,the correct answer is the fat soluble vitamins.
Absorption of minerals do not require bile salts for absorption; thus,they are not affected.

Question 6

A 16-year-old female presents with abdominal pain in the right lower quadrant.Physical examination reveals rebound tenderness and a low-grade fever.A possible diagnosis would be:
A) Colon cancer
B) Pancreatitis
C) Appendicitis
D) Hepatitis

Accepted Answer

Appendicitis is manifested by right lower quadrant pain with rebound tenderness.
Colon cancer may be asymptomatic,followed by bleeding.
Pancreatitis is manifested by vomiting.
Hepatitis would be manifested by upper abdominal pain,not lower.

Question 7

A 54-year-old male complains that he has been vomiting blood.Tests reveal portal hypertension.Which of the following is the most likely cause of his condition?
A) Thrombosis in the spleen
B) Cirrhosis of the liver
C) Left ventricular failure
D) Renal stenosis

Accepted Answer

Portal hypertension occurs secondarily to cirrhosis of the liver.
Portal hypertension occurs secondarily to cirrhosis of the liver,not thrombosis of the spleen.
Portal hypertension occurs secondarily to cirrhosis of the liver,not left ventricular failure.
Portal hypertension occurs secondarily to cirrhosis of the liver,not renal stenosis.

Question 8

A 13-year-old female confides to her mother that she binge eats and induces vomiting to prevent weight gain.This disease is referred to as:
A) Anorexia nervosa
B) Bulimia nervosa
C) Long-term starvation
D) Laxative abuse

Accepted Answer

Binge eating and vomiting is characteristic of bulimia nervosa.
Anorexia nervosa is starvation eating.
Binge eating and vomiting is characteristic of bulimia nervosa,not long-term starvation.
Binge eating and vomiting is characteristic of bulimia nervosa,not laxative abuse.

Question 9

The most common clinical manifestation of portal hypertension is _____ bleeding.
A) Rectal
B) Duodenal
C) Esophageal
D) Intestinal

Accepted Answer

Vomiting of blood from bleeding esophageal varices is the most common clinical manifestation of portal hypertension.
Esophageal bleeding,not rectal bleeding,is the most common clinical manifestation of portal hypertension.
Esophageal bleeding,not duodenal bleeding,is the most common clinical manifestation of portal hypertension.
Esophageal bleeding,not intestinal bleeding,is the most common clinical manifestation of portal hypertension.

Question 10

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:
A) Hyperbilirubinemia and jaundice
B) Fluid and electrolyte imbalances
C) Impaired ammonia metabolism
D) Decreased cerebral blood flow

Accepted Answer

Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy.
Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy.Symptoms are primarily neurologic,not jaundice oriented.
Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy.Fluid and electrolyte changes that occur would not lead to the manifestations seen in hepatic encephalopathy.
Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy.Cerebral blood flow is not affected.

Question 11

The icteric phase of hepatitis is characterized by which of the following clinical manifestations?
A) Fatigue, malaise, vomiting
B) Jaundice, dark urine, enlarged liver
C) Resolution of jaundice, liver function returns to normal
D) Fulminant liver failure, hepatorenal syndrome

Accepted Answer

The icteric phase is manifested by jaundice,dark urine,and clay-colored stools.The liver is enlarged,smooth,and tender,and percussion causes pain; this is the actual phase of illness.
Fatigue and vomiting occur during the prodromal stage.
Resolution occurs in the recovery phase.
Fulminant liver failure does not involve icterus.

Question 12

In alcoholic cirrhosis,hepatocellular damage is caused by:
A) Acetaldehyde accumulation
B) Bile toxicity
C) Acidosis
D) Fatty infiltrations

Accepted Answer

Alcoholic cirrhosis is caused by the toxic effects of alcohol metabolism on the liver.Alcohol is transformed to acetaldehyde,and excessive amounts significantly alter hepatocyte function and activate hepatic stellate cells,a primary cell involved in liver fibrosis.
Bile toxicity does not cause alcoholic cirrhosis.
Acidosis does not cause alcoholic cirrhosis.
Fatty infiltrations do not cause alcoholic cirrhosis.

Question 13

An increase in the rate of red blood cell breakdown causes which form of jaundice?
A) Obstructive
B) Hemolytic
C) Hepatocellular
D) Metabolic

Accepted Answer

Excessive hemolysis (breakdown)of red blood cells can cause hemolytic jaundice (prehepatic jaundice).
Excessive hemolysis (breakdown)of red blood cells can cause hemolytic jaundice (prehepatic jaundice).It is not due to obstruction.
Excessive hemolysis (breakdown)of red blood cells can cause hemolytic jaundice (prehepatic jaundice).It is not hepatocellular.
Excessive hemolysis (breakdown)of red blood cells can cause hemolytic jaundice (prehepatic jaundice).It is not metabolic.

Question 14

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?
A) Abdominal pain
B) Pattern of remission/exacerbations
C) Diarrhea
D) Malabsorption

Accepted Answer

Malabsorption is common in Crohn disease and is rare in ulcerative colitis.
Both disorders can lead to abdominal pain.
Both disorders have a clinical course of remissions and exacerbations.
Both disorders lead to diarrhea.

Question 15

The risk of hypovolemic shock is high with acute mesenteric arterial insufficiency because:
A) The resulting liver failure causes a deficit of plasma proteins and a loss of oncotic pressure.
B) Ischemia alters mucosal membrane permeability, and fluid is shifted to the bowel wall and peritoneum.
C) Massive bleeding occurs in the GI tract.
D) Overstimulation of the parasympathetic nervous system results in ischemic injury to the intestinal wall.

Accepted Answer

Fluid shifts lead to hypovolemia.
Arterial insufficiency is not related to liver failure.
Bleeding may occur,but hypovolemia is related to fluid shifts.
Fluid shifts lead to hypovolemia; it is not due to overstimulation of the parasympathetic nerves.

Question 16

Which of the following conditions is thought to contribute to the development of obesity?
A) Insulin excess
B) Leptin resistance
C) Adipocyte failure
D) Malabsorption

Accepted Answer

Leptin resistance disrupts hypothalamic satiety signaling and promotes overeating and excessive weight gain and is a factor in the development of obesity.
Insulin becomes resistant,not present in excess.
Leptin resistance,not adipocyte failure,leads to obesity.
Malabsorption does not lead to obesity,but primarily to weight loss.

Question 17

A 50-year-old male complains of frequently recurring abdominal pain,diarrhea,and bloody stools.A possible diagnosis would be:
A) Ulcerative colitis
B) Hiatal hernia
C) Pyloric obstruction
D) Achalasia

Accepted Answer

Ulcerative colitis is manifested by fever,elevated pulse rate,frequent diarrhea (10 to 20 stools/day),urgency,obviously bloody stools,and continuous lesions present in the colon.
Hiatal hernia is most often asymptomatic and would not be manifested by abdominal pain.
Pyloric obstruction would be manifested by forceful or projectile vomiting.
Achalasia would be manifested by difficulty or uncomfortable swallowing.

Question 18

A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain.Physical examination reveals severe ascites.This condition is caused by decreased:
A) Albumin and lack of cellular integrity
B) Capillary filtration pressure
C) Capillary permeability
D) Antidiuretic hormone secretion

Accepted Answer

Ascites is due to decreased albumin and lack of cellular integrity.
Ascites is due to decreased albumin and lack of cellular integrity,not capillary filtration pressure.
Ascites is due to decreased albumin and lack of cellular integrity,not decreased capillary permeability.
Ascites is due to decreased albumin and lack of cellular integrity,not antidiuretic hormone secretion.

Question 19

Which of the following characteristics is associated with an acute occlusion of mesenteric blood flow to the small intestine?
A) Often precipitated by an embolism
B) Commonly associated with disease such as pancreatitis and gallstones
C) Caused by chronic malnutrition and mucosal atrophy
D) Often a complication of hypovolemic shock

Accepted Answer

Occlusion of blood flow is often precipitated by embolism.
Occlusion of blood flow is often precipitated by embolism; it is not associated with pancreatitis.
Occlusion of blood flow is often precipitated by embolism,even if chronic malnutrition is present.
Occlusion of blood flow is often precipitated by embolism; it is not a complication of hypovolemic shock.

Question 20

A 30-year-old obese female underwent gastric resection in an attempt to lose weight.Which of the following complications could the surgery cause?
A) Constipation
B) Acid reflux gastritis
C) Anemia
D) Hiccups

Accepted Answer

One of the complications is anemia due to iron malabsorption,which may result from decreased acid secretion.
Diarrhea,not constipation,occurs.
The reflux would be alkaline,not acidic.
Hiccups are not associated with gastrectomy.

Quiz 34: Alterations of Digestive Function

A 55-year-old male died in a motor vehicle accident.Autopsy revealed an enlarged liver caused by fatty infiltration,testicular atrophy,and mild jaundice secondary to cirrhosis.The most likely cause of his condition is:

The most common cause of chronic vascular insufficiency among the elderly is:

Complete obstruction of bile flow to the liver would be manifested by:

A 3-month-old female develops colicky pain,abdominal distention,and diarrhea after drinking cow's milk.The best explanation for her symptoms is:

Clinical manifestations of bile salt deficiencies are related to poor absorption of:

A 16-year-old female presents with abdominal pain in the right lower quadrant.Physical examination reveals rebound tenderness and a low-grade fever.A possible diagnosis would be:

A 54-year-old male complains that he has been vomiting blood.Tests reveal portal hypertension.Which of the following is the most likely cause of his condition?

A 13-year-old female confides to her mother that she binge eats and induces vomiting to prevent weight gain.This disease is referred to as:

The most common clinical manifestation of portal hypertension is _____ bleeding.

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

The icteric phase of hepatitis is characterized by which of the following clinical manifestations?

In alcoholic cirrhosis,hepatocellular damage is caused by:

An increase in the rate of red blood cell breakdown causes which form of jaundice?

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

The risk of hypovolemic shock is high with acute mesenteric arterial insufficiency because:

Which of the following conditions is thought to contribute to the development of obesity?

A 50-year-old male complains of frequently recurring abdominal pain,diarrhea,and bloody stools.A possible diagnosis would be:

A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain.Physical examination reveals severe ascites.This condition is caused by decreased:

Which of the following characteristics is associated with an acute occlusion of mesenteric blood flow to the small intestine?

A 30-year-old obese female underwent gastric resection in an attempt to lose weight.Which of the following complications could the surgery cause?