Deck 34: Alterations of Digestive Function

Question 1

A 29-year-old male presents complaining of colicky pain followed by vomiting, sweating, nausea, and hypotension. Testing reveals a condition in which one part of the intestine telescopes into another. From which type of intestinal obstruction is he suffering?

A) Hernia
B) Ileus
C) Torsion
D) Intussusception

Answer 1

Intussusception

Question 2

A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as:

A) osmotic diarrhea.
B) secretory diarrhea.
C) hypotonic diarrhea.
D) motility diarrhea.

Answer 2

osmotic diarrhea.

Question 3

Chronic gastritis is classified according to the:

A) severity.
B) location of lesions.
C) patient's age.
D) signs and symptoms.

Answer 3

location of lesions.

Question 4

A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastroesophageal reflux. This condition is caused by:

A) fibrosis of the lower third of the esophagus.
B) sympathetic nerve stimulation.
C) loss of muscle tone at the lower esophageal sphincter.
D) reverse peristalsis of the stomach.

Question 5

A 45-year-old female presents to her physician with chronic constipation, fatigue, and cold intolerance. Which of the following could be the cause?

A) Neurogenic disorder of the large intestine
B) Sedentary lifestyle
C) Hypothyroidism
D) Aging

Question 6

A serious complication of paraesophageal hiatal hernia is:

A) hemorrhage.
B) strangulation.
C) peritonitis.
D) ascites.

Question 7

The adult intestine processes approximately _____ liters of luminal content per day, of which 99% of the fluid is normally reabsorbed.

A) 2
B) 6
C) 9
D) 12

Question 8

A 38-year-old female complains of epigastric fullness following a meal, nausea, and epigastric pain. Tests reveal narrowing of the opening between the stomach and the duodenum. This condition is referred to as:

A) ileocecal obstruction.
B) hiatal hernia.
C) pyloric obstruction.
D) hiatal obstruction.

Question 9

A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as:

A) visceral.
B) somatic.
C) parietal.
D) retroperitoneal.

Question 10

A 34-year-old male was diagnosed with a bacterial gastrointestinal infection. Which of the following types of diarrhea would most likely occur with his condition?

A) Osmotic
B) Secretory
C) Hypotonic
D) Motility

Question 11

A 40-year-old female develops an intestinal obstruction that causes injury to the gut lumen proximal to the obstruction. This condition is related to:

A) autodigestion by intestinal enzymes.
B) toxic effects of bile accumulation.
C) decreased blood flow from increasing intraluminal pressure.
D) bacterial infection of the gut wall.

Question 12

A 42-year-old female presents with abdominal discomfort, epigastric tenderness, and bleeding. Gastroscopy reveals degeneration of the gastric mucosa in the body and fundus of the stomach. Which of the following would most likely follow?

A) Pernicious anemia
B) Osmotic diarrhea
C) Increased acid secretion
D) Decreased gastrin secretion

Question 13

A 22-year-old male presents with difficulty swallowing. Tests reveal a loss of esophageal peristalsis and failure of the lower esophageal sphincter to relax. Which of the following is the most likely cause?

A) Neurologic dysfunction
B) Intrinsic mechanical obstruction
C) Extrinsic mechanical obstruction
D) Smooth muscle hyperplasia

Question 14

A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

A) pyloric stenosis.
B) gastric cancer.
C) achalasia.
D) hiatal hernia.

Question 15

Hypotension and shock are serious consequences of bowel obstruction caused by:

A) a shift of fluids to the peritoneal cavity.
B) a loss of protein to the gut lumen.
C) a neurogenic reflex to the sympathetic nervous system.
D) malabsorption.

Question 16

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

A) constipation.
B) diarrhea.
C) vomiting.
D) heartburn.

Question 17

The vomiting reflex can be stimulated by:

A) severe pain.
B) hypertension.
C) fluid aspiration.
D) diarrhea.

Question 18

A 52-year-old presents with bleeding from the rectum. This condition is referred to as:

A) melena.
B) occult bleeding.
C) hematochezia.
D) hematemesis.

Question 19

Reflux esophagitis is defined as:

A) an immune response to gastroesophageal reflux.
B) an inflammatory response to gastroesophageal reflux.
C) a congenital anomaly.
D) a secretory response to hiatal hernia.

Question 20

The most common disorder associated with upper gastrointestinal bleeding is:

A) diverticulosis.
B) hemorrhoids.
C) esophageal varices.
D) cancer.

Question 21

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) all macronutrients.

Question 22

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) Heart disorder

Question 23

A 54-year-old male is diagnosed with peptic ulcer disease. This condition is most likely caused by:

A) hereditary hormonal imbalances with high gastrin levels.
B) breaks in the mucosa and presence of corrosive secretions.
C) decreased vagal activity and vascular engorgement.
D) gastric erosions related to high ammonia levels and bile reflux.

Question 24

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

A) Often precipitated by a thromboembolism
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

Question 25

Problems associated with chronic vascular insufficiency include:

A) hypotension and shock.
B) bowel obstruction and peritonitis.
C) malabsorption and alterations in bowel function.
D) hepatic and splenic dysfunction.

Question 26

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) ascites.

Question 27

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) a deficiency of bile that stimulates digestive secretions and bowel motility.
B) an excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea.
C) an overgrowth of bacteria from undigested fat molecules, which leads to gas formation and decreased bowel motility.
D) an excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility.

Question 28

The primary cause of duodenal ulcers is:

A) hypersecretion of pepsin by the stomach.
B) chronic gastritis.
C) hypersecretion of acid by the duodenum.
D) bacterial infection.

Question 29

A 39-year-old female presents with chronic intermittent pain in the epigastric area 2 to 3 hours after eating. She is diagnosed with a duodenal ulcer associated with:

A) increased acid secretion.
B) occurrence of chronic ulcers.
C) pain with eating.
D) bloody diarrhea.

Question 30

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

A) ulcerative colitis.
B) hiatal hernia.
C) pyloric obstruction.
D) achalasia.

Question 31

The most common cause of chronic mesenteric (vascular) insufficiency is:

A) anemia.
B) aneurysm.
C) lack of nutrition in gut lumen.
D) atherosclerosis.

Question 32

A 46-year-old female is diagnosed with gastric ulcers. This disease is associated with:

A) pain relief with eating.
B) an increased risk of gastric cancer.
C) regurgitation of bile.
D) decreased gastrin production.

Question 33

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 gastrointestinal tract.
D) overstimulation of the parasympathetic nervous system results in ischemic injury to the intestinal wall.

Question 34

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) emetic syndrome.

Question 35

Common symptoms of acute vascular insufficiency include:

A) normal bowel sounds and mild abdominal pain.
B) hematemesis and melena.
C) cramping abdominal pain and abdominal distention.
D) hypertension and anemia.

Question 36

A 24-year-old male sustained a head injury and fractured femur. He develops an ulcer caused by:

A) an increase in the penetration of Helicobacter pylori.
B) the presence of ulcers in both the stomach and duodenum.
C) the absence of spontaneous bleeding.
D) overstimulation of the vagus nerve.

Question 37

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 and exacerbation
C) Diarrhea
D) Malabsorption and steatorrhea

Question 38

A 60-year-old male presents with gastrointestinal bleeding and abdominal pain. He reports that he takes nonsteroidal anti-inflammatory agents (NSAIDs) daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:

A) decreasing subepithelial bicarbonate production.
B) accelerating the H⁺ (proton) pump in parietal cells.
C) inhibiting mucosal prostaglandin synthesis.
D) stimulating a shunt of mucosal blood flow.

Question 39

A 16-year-old female is diagnosed with anorexia nervosa. Excessive weight loss can cause:

A) improved eating habits.
B) chronic hypertension.
C) bulimia nervosa.
D) cardiac failure.

Question 40

A 22-year-old male underwent brain surgery to remove a tumor. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _____ ulcer.

A) Addison
B) Cushing
C) ischemic
D) Curling

Question 41

Acute pancreatitis often manifests with pain to which of the following regions?

A) Right lower quadrant
B) Right upper quadrant
C) Epigastric
D) Suprapubic

Question 42

Problems 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.

Question 43

Cholecystitis is inflammation of the gallbladder wall usually caused by:

A) accumulation of bile in the hepatic duct.
B) obstruction of the cystic duct by a gallstone.
C) accumulation of fat in the wall of the gallbladder.
D) viral infection of the gallbladder.

Question 44

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.

Question 45

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

Question 46

In alcoholic cirrhosis, hepatocellular damage is caused by:

A) acetaldehyde accumulation.
B) bile toxicity.
C) acidosis.
D) fatty infiltrations.

Question 47

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

Question 48

A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:

A) intrahepatic bile canaliculi.
B) gallbladder.
C) cystic duct.
D) common bile duct.

Question 49

A common clinical manifestation of portal hypertension is:

A) rectal bleeding.
B) duodenal bleeding.
C) esophageal bleeding.
D) intestinal bleeding.

Question 50

A 39-year-old female presents with abdominal pain and jaundice. She is diagnosed with gallstones and undergoes cholecystectomy. An analysis of her gallstones would most likely reveal a high concentration of:

A) phosphate.
B) bilirubin.
C) urate.
D) cholesterol.

Question 51

Shock can develop with acute pancreatitis for which of the following reasons?

A) The pancreas is always infected in pancreatitis.
B) Vasoactive inflammatory mediators are released into the bloodstream.
C) Pancreatitis usually results in severe bleeding.
D) Insulin deficiency and hyperglycemia lead to a high output state.

Question 52

Intrahepatic obstructive jaundice is characterized by elevated levels of serum:

A) unconjugated bilirubin only.
B) conjugated bilirubin only.
C) unconjugated and conjugated bilirubin.
D) urobilinemic.

Question 53

A 40-year-old male presents with epigastric pain. Tests reveal acute pancreatitis. The most likely cause of his condition is:

A) pancreatic duct obstruction by a malignant tumor.
B) surgical trauma to the pancreas.
C) obstruction of the biliary tract by a gallstone.
D) toxic injury to the pancreas from nonprescription medications.

Question 54

A 40-year-old female presents with right flank pain. Testing reveals severe hepatic necrosis, encephalopathy, and organ failure. From which of the following types of hepatitis is she most likely suffering?

A) A
B) B
C) D
D) E

Question 55

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

A) Obstructive
B) Hemolytic
C) Hepatocellular
D) Metabolic

Question 56

A 55-year-old male IV drug user with a history of advanced liver disease presents with oliguria, jaundice, ascites, and gastrointestinal bleeding. He is diagnosed with hepatorenal syndrome. Which of the following would aid in this diagnosis?

A) Cirrhosis and renal artery stenosis
B) Hepatitis and glomerulonephritis
C) Ascites and nephrotic syndrome
D) Portal hypertension and renal failure caused by circulatory problems

Question 57

Tissue damage in pancreatitis is caused by:

A) insulin toxicity.
B) autoimmune destruction of the pancreas.
C) premature activation of pancreatic proenzymes.
D) hydrochloric acid reflux into the pancreatic duct.

Question 58

A 31-year-old female presents with midabdominal pain. She is expected to have acute pancreatitis. Which of the following lab results is (are) most specific to this diagnosis?

A) Low hematocrit and hemoglobin
B) Elevated white blood cell count
C) Elevated serum lipase
D) Hyperglycemia

Question 59

Hepatitis A is characterized by:

A) an incubation period of 180 days.
B) an acute onset with fever.
C) a positive carrier state.
D) a sexual mode of transmission.

Question 60

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:

A) decreased albumin and capillary oncotic pressure.
B) decreased capillary filtration pressure.
C) decreased capillary permeability.
D) aldosterone and antidiuretic hormone suppression.

Question 61

Which of the gastrointestinal cancers has the highest rate of incidence and is responsible for the highest number of deaths?

A) Esophageal
B) Stomach
C) Pancreatic
D) Colorectal

Question 62

A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease?

A) Reflux esophagitis
B) Intestinal parasites and polyps
C) Nitrates and salty foods
D) Aflatoxin from moldy peanuts

Question 63

Pancreatic insufficiency seen in chronic pancreatitis results from:

A) chronic inflammation leading to injury and scarring of the pancreas.
B) autoimmune destruction of the pancreas.
C) decreased bile secretion because of chronic obstruction to the common bile duct.
D) oversecretion of insulin by the chronically inflamed pancreas.

Question 64

A 40-year-old male who consumes a diet high in fat and low in fiber is at risk for:

A) cancer of the stomach.
B) cancer of the liver and biliary ducts.
C) cancer of the small intestine.
D) cancer of the colon and rectum.

Question 65

Which modifiable risk factor is associated with esophageal, stomach, and colorectal cancer?

A) Helicobacter pylori infection
B) Cigarette and alcohol use
C) Ionizing radiation exposure
D) Obesity and sedentary lifestyle

Question 66

A 52-year-old female presents with continuous abdominal pain that intensifies after eating. She is diagnosed with chronic pancreatitis. Which of the following is the most likely cause of her disease?

A) Chronic alcohol abuse
B) Narcotic addiction
C) Gallbladder disease
D) Malabsorption syndrome