Deck 37: Alterations of Digestive Function

Question 1

Ammonia formation may increase hepatic encephalopathy.

Answer 1

True

Question 2

Parietal pain is diffuse because nerve endings in abdominal organs are sparse and multisegmented.

Answer 2

False

Question 3

Hepatitis A is transmitted through infected blood and other body fluids.

Answer 3

False

Question 4

Hepatitis D occurs in individuals with hepatitisB.

Question 5

Normal bowel habits range from two or three evacuations per day to one per:

A) day.
B) 2 days.
C) week.
D) month.

Question 6

Individuals with chronic hepatitis C are at increased risk for hepatic cancer.

Question 7

Obesity is defined as a body mass index greater than 40.

Question 8

What is the action of antiemetics,such as ondansetron and granisetron?

A) They block the effects of 5-HT serotonin.
B) They block the effects of histamine 2 (H₂).
C) They stimulate the effects of acetylcholine.
D) They stimulate the effects of dopamine (D₂).

Question 9

Primary biliary cirrhosis can be a result of gallstones.

Question 10

Anorexia is the lack of desire to eat despite physiologic stimuli that would normally produce hunger.

Question 11

Hepatitis B is a sexually transmitted disease.

Question 12

Chronic gastritis of the fundus occurs more frequently than chronic gastritis of the antrum.

Question 13

Because patterns of bowel evacuation differ greatly among individuals,constipation must be individually defined.

Question 14

_____ vomiting is caused by direct stimulation of the vomiting center by neurologic lesions involving the brainstem.

A) Retch
B) Periodic
C) Duodenal
D) Projectile

Question 15

After a gastrectomy,individuals develop anemias from deficiencies in iron,folate,and vitamin B₁₂.

Question 16

Diarrhea of more than _____ stools per day is considered abnormal.

A) two
B) three or more
C) five or more
D) seven or more

Question 17

With losses of more than 1000 ml or more,the heart rate is greater than 100 beats/min and systolic blood pressure is less than 100 mm Hg.

Question 18

Where is the chemoreceptor trigger zone (CTZ)for vomiting?

A) Hypothalamus
B) Medulla oblongata
C) Pons
D) Midbrain

Question 19

Endoscopy and biopsy may show long-standing inflammatory process and gastric atrophy indicating chronic gastritis in an individual with no history of abdominal distress.

Question 20

Chronic gastritis tends to occur in older adults and causes thinning and degeneration of the stomach wall.

Question 21

How does intussusception cause intestinal obstruction?

A) By telescoping of part of the intestine into another usually causing strangulation of the blood supply
B) By twisting the intestine on its mesenteric pedicle causing occlusion of the blood supply
C) By loss of peristaltic motor activity in the intestine,causing an adynamic ileus
D) By forming fibrin and scar tissue that attach to intestinal omentum and cause obstruction

Question 22

Which intestinal obstruction occurs most commonly in the small intestine?

A) Diverticulosis
B) Tumor
C) Volvulus
D) Adhesions

Question 23

Reflux esophagitis may be defined as a(n):

A) immune response to gastroesophageal reflux.
B) inflammatory response to gastroesophageal reflux.
C) congenital anomaly.
D) secretory response to gastroesophageal reflux.

Question 24

Functional dysphagia is caused by:

A) intrinsic mechanical obstruction.
B) extrinsic mechanical obstruction.
C) a tumor.
D) a neural or muscular disorder.

Question 25

Older adults experience which clinical manifestations of chronic gastritis?

A) Hemorrhage or perforation
B) Epigastric pain relieved by ingestion of food
C) Chronic intermittent pain in the epigastric area
D) Epigastric pain that interrupts sleep

Question 26

If a person lacks the enzyme lactase and ingests lactose,the lactose will not be hydrolyzed and absorbed into the intestinal wall;the type of diarrhea that results is _____ diarrhea.

A) motility
B) osmotic
C) secretory
D) small-volume

Question 27

_____ is the primary cause of duodenal ulcers.

A) Hypersecretion of acid by the stomach
B) Hypersecretion of pepsin by the stomach
C) Hypersecretion of acid by the duodenum
D) Hypersecretion of pepsin by the duodenum
E) Helicobacter pylori

Question 28

What are the cardinal symptoms of small intestinal obstruction?

A) Constant,dull pain in the lower abdomen relieved by defecation
B) Acute,intermittent pain 30 minutes to 2 hours after eating
C) Colicky pain caused by distention followed by vomiting
D) Excruciating pain in the hypogastric area caused by ischemia

Question 29

Which is a description of abdominal visceral pain?

A) Visceral pain is diffuse,vague,poorly localized and dull.
B) Nerve fibers for visceral pain travel from a specific organ to the spinal cord.
C) Visceral pain lateralizes because the viscera is innervated from only one side of the nervous system.
D) Visceral pain is intermittent in concert with the peristalsis of the gastrointestinal tract.

Question 30

Which statement is false about the contributing factors to duodenal ulcers?

A) There are a greater than usual number of parietal cells in the gastric mucosA.
B) Gastric emptying is slowed causing greater exposure of the mucosa to acid.
C) High serum gastrin levels remain high longer than normal after eating.
D) Failure of the feedback mechanism occurs,whereas acid in the gastric antrum inhibits gastrin release.

Question 31

Frank bleeding of the rectum is called:

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

Question 32

Which statement is false about how abdominal pain is produced?

A) Chemical mediators,such as histamine,bradykinin,and serotonin produce abdominal pain.
B) Edema and vascular congestion produce abdominal pain by stretching.
C) Ischemia caused by distention of bowel obstruction or mesenteric vessel thrombosis produce abdominal pain.
D) Low concentrations of anaerobes,such as streptococci,lactobacilli,staphylococci,enterobacteria,and Bacteroides,produce abdominal pain.

Question 33

Which inflammatory cytokines are released in chronic gastritis?

A) Tumor necrosis alpha (TNF-),interleukins (IL-6,IL-8,IL-10),and leukotrienes
B) Colony-stimulating factor (CSF),interleukins (IL-1,IL-5,IL-7),and prostaglandins
C) Interferon alpha (IFN-),interleukins (IL-2,IL-12,IL-18),and serotonin
D) Gastric-stimulating factor (GSF),interleukins (IL-4,IL-9,IL-11),and bradykinin

Question 34

A peptic ulcer may occur in all of the following areas except the:

A) stomach.
B) duodenum.
C) jejunum.
D) esophagus.

Question 35

Which type of ulcer is characterized by an increase in concentration of bile salts that damages the mucosal barrier by permitting hydrogen ions to diffuse into the mucosa,where they disrupt permeability and cellular structure?

A) Ischemic ulcer
B) Curling ulcer
C) Gastric ulcers
D) Duodenal ulcers

Question 36

A person who has cholera would be expected to have which type of diarrhea?

A) Osmotic diarrhea
B) Secretory diarrhea
C) Small volume diarrhea
D) Motility diarrhea

Question 37

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

A) 3
B) 6
C) 9
D) 12

Question 38

After a partial gastrectomy or pyloroplasty,what causes clinical manifestations of increased pulse,hypotension,weakness,pallor,sweating,and dizziness?

A) An anaphylactic reaction in which chemical mediators,such as histamine,prostaglandins,and leukotrienes,relax vascular smooth muscles causing shock.
B) These clinical manifestations are caused by hemorrhage postoperatively in which a large volume of blood is lost causing hypotension with compensatory tachycardia.
C) A concentrated bolus moves from stomach into the small intestine,which causes hyperglycemia,resulting in polyuria and eventually hypovolemic shock.
D) A rapid gastric emptying and creation of a high osmotic gradient in the small intestine that causes a sudden shift of fluid from the blood vessels to the intestinal lumen.

Question 39

What causes gastroesophageal reflux disease (GERD)?

A) Excessive production of hydrochloric acid
B) A zone of low pressure of the lower esophageal sphincter (LES)
C) Presence of H.pylori in the esophagus
D) Reverse muscular peristalsis of the esophagus

Question 40

How does an intestinal obstruction at the pylorus or high in the small intestine cause metabolic alkalosis?

A) By the gain of bicarbonate from pancreatic secretions that cannot be absorbed
B) By an excessive loss of hydrogen ions normally absorbed from gastric juice
C) By an excessive loss of potassium promoting atony of the intestinal wall
D) By the loss of bile acid secretions that cannot be absorbed

Question 41

Which symptoms characterize bulimia nervosa?

A) Recurrent episodes of binge eating with fears of not being able to stop eating
B) A fear of becoming obese despite progressive weight loss
C) A perception that the body is fat when it is actually underweight
D) Absence of three consecutive menstrual periods

Question 42

MATCHING
Match the descriptions with the corresponding terms.
Inflammation develops in crypts of Lieberkühn in the large intestine.

A)Ulcerative colitis
B)Crohn disease

Question 43

Which statement is false about the accumulation of fluid in the peritoneal cavity?

A) Impaired excretion of sodium by the kidneys promotes water retention.
B) Decreased oncotic pressure and increased hepatic sinusoidal hydrostatic pressure causes movement fluid into the peritoneal cavity.
C) Decreased blood flow to the kidneys activates aldosterone,which retains sodium.
D) Circulating nitric oxide causes vasoconstriction,which forces fluid from the capillaries into the peritoneal cavity.

Question 44

What is the most common manifestation of splenomegaly caused by portal hypertension?

A) Leukopenia
B) Thrombocytopenia
C) Erythrocytopenia
D) Pancytopenia

Question 45

MATCHING
Match the descriptions with the corresponding terms.
Susceptibility determined by discovery of NOD2/CARD15 gene on chromosome 16.

A)Ulcerative colitis
B)Crohn disease

Question 46

MATCHING
Match the descriptions with the corresponding terms.
Alterations in immunoglobulin A production have been found in individuals with this disorder.

A)Ulcerative colitis
B)Crohn disease

Question 47

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

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

Question 48

Which statement is false about the pathophysiology of acute pancreatitis?

A) Pancreatic acinar cells metabolize ethanol,which generates toxic metabolites.
B) Injury to the pancreatic acinar cells permit leakage of pancreatic enzymes,which digest pancreatic tissue.
C) Acute pancreatitis is an autoimmune disease in which immunoglobulins G (IgG)coats the pancreatic acinar cells so they are destroyed by the pancreatic enzymes.
D) When gallstones are present,bile flows into the pancreas contributing to attacks.

Question 49

Hepatic fat accumulation is seen in _____ cirrhosis.

A) biliary
B) metabolic
C) postnecrotic
D) alcohol

Question 50

The mutation of which gene occurs in cancers of the stomach,colon,liver,gallbladder,and pancreas?

A) K-ras mutation
B) p53 tumor suppressor gene
C) myc
D) HER2

Question 51

MATCHING
Match the descriptions with the corresponding terms.
Colonic epithelial immunoglobulin G (IgG)antibodies have been identified in sera of individuals with this disorder.

A)Ulcerative colitis
B)Crohn disease

Question 52

Which statement is false about the sources of increased ammonia that contribute to hepatic encephalopathy?

A) End products of intestinal protein digestion
B) Digested blood leaking from ruptured varices
C) Accumulation of short chain fatty acids attaches to ammonia
D) Ammonia-forming bacteria in the colon

Question 53

What regulates eating behavior,energy metabolism,and body fat mass?

A) Anterior pituitary
B) Hypothalamus
C) Posterior pituitary
D) Parietal lobe

Question 54

MATCHING
Match the descriptions with the corresponding terms.
Inflammation creates a pattern of skip lesions that have cobblestone projections of inflamed tissue surrounded by area of ulceration.

A)Ulcerative colitis
B)Crohn disease

Question 55

MATCHING
Match the descriptions with the corresponding terms.
Affects the entire gastrointestinal tract from the mouth to the anus.

A)Ulcerative colitis
B)Crohn disease

Question 56

Which are early (prodromal)clinical manifestations of hepatitis?

A) Fatigue,fever,hyperalgia,and vomiting
B) Light-colored stools,dark-colored urine
C) Large,tender liver;itching;jaundice
D) Pain in the left upper quadrant,splenomegaly

Question 57

Which characteristic is consistent with dumping syndrome?

A) Usually responds well to dietary management
B) Occurs 1 to 2 hours after eating,most commonly
C) Is seen following intestinal surgery
D) Can result in alkaline reflux gastritis

Question 58

Which hormone and/or peptide stimulates eating?

A) Agouti-related protein (AGRP)
B) Alpha-melanocyte stimulating hormone (-MSH)
C) Cocaine-and amphetamine-regulated transcript (CART)
D) Peptide YY (PYY)

Question 59

Which statement is false about the pathophysiology of alcoholic cirrhosis?

A) Inflammation and damage leading to cirrhosis begin in the bile canaliculi.
B) Alcohol is transformed to acetaldehyde,which promotes liver fibrosis.
C) Mitochondrial function is impaired,decreasing oxidation of fatty acids.
D) Acetaldehyde inhibits export of proteins from the liver.

Question 60

Which clinical manifestation is not consistent with cancer of the cecum and ascending colon?

A) Mahogany-colored blood mixed with stool
B) Anemia
C) Pain
D) Constipation