Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
Which of the following is the primary site for absorption of nutrients?
When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?
Which of the following breaks protein down into peptides?
In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?
Which of the following stimulates increased peristalsis and secretions in the digestive tract?
Which of the following is contained in pancreatic exocrine secretions?
An alkaline environment is required in the duodenum to:
activate intestinal and pancreatic enzymes
What does the term gluconeogenesis refer to?
Formation of glucose through protein and fat
Normally, proteins or amino acids are required to produce all of the following EXCEPT:
Which of the following statements applies to bile salts?
They emulsify lipids and lipid-soluble vitamins
The visceral peritoneum:
forms the outer covering of the stomach and intestines
The early stage of vomiting causes:
Prolonged vomiting cause a state of acidosis due to:
catabolism of proteins and lipids
What is the first change in arterial blood gases with diarrhea?
Decreased bicarbonate ion
Which of the following applies to the act of swallowing?
Requires coordination of cranial nerves five, nine, ten and twelve
What does the defecation reflex require?
Coordination through the sacral spinal cord
What is the definition of achalasia?
Lack of a nerve plexus to relax the lower esophageal sphincter
What does esophageal atresia cause?
No fluid or food entering the stomach
Which of the following applies to cleft palate?
The hard and soft palates do not fuse during the first trimester of pregnancy
Oral candidiasis is considered to:
be an opportunistic fungal infection of the mouth
What is/are common location(s) for oral cancer?
Increased intra-abdominal pressure
What is a common cause of hiatal hernia?
Increased intra-abdominal pressure
What does the pathophysiology of chronic gastritis include?
Atrophy of the gastric mucosa with decreased secretions
What is a common cause of gastroenteritis due to Salmonella?
Raw or undercooked poultry or eggs
Which of the following individuals is likely to develop acute gastritis?
An individual with allergy to shellfish
What does congenital pyloric stenosis involve?
Hypertrophy and hyperplasia of smooth muscle in the pylorus
A patient with acquired pyloric stenosis would likely:
vomit undigested food from previous meals
Prolonged or severe stress predisposes to peptic ulcer disease because:
of reduced blood flow
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:
Increased stimulation of mucous-producing glands
What is frequently the first manifestation of stress ulcers?
Hematemesis and hypotension
What would be the result of chronic bleeding from gastric carcinoma?
Occult blood in the stool and anemia
Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates:
a large volume of chime has entered the intestines, causing distention
Which of the following is/are (a) manifestation(s) of hemolytic jaundice?
Increased unconjugated bilirubin in the blood
Why does mild hyperbilirubinemia occur in newborns?
The immature liver cannot process bilirubin quickly enough
Predisposing factors to cholelithiasis include excessive:
bilirubin or cholesterol concentration in the bile
What is the major effect when a gallstone obstructs the cystic duct?
Severe colicky pain in upper right quadrant
Which of the following describes the supply of bile following a cholecystectomy?
Small amounts of bile are continuously secreted and flow into the duodenum.
Which of the following applies to hepatitis A infection?
It is transmitted by the fecal-oral route
What can be concluded if the hepatitis B antigen level remains high in the serum?
Chronic infection has developed
What is the most common type of hepatitis transmitted by blood transfusion?
What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis?
Necrosis of liver cells
What is the likely effect of long-term exposure to a hepatotoxin?
Gradual irreversible damage to the liver and cirrhosis
What indicates the presence of third-stage alcohol hepatitis?
Accumulation of fat in the hepatocytes and hepatomegaly
A primary factor causing encephalopathy with cirrhosis is the elevated:
In patients with cirrhosis, serum ammonia may increase when:
bleeding occurs in the digestive tract
What is the primary cause of esophageal varices?
What is the primary cause of increased bleeding tendencies associated with cirrhosis?
Deficit in vitamin k and prothrombin
Which factors contribute to ascites in patients with cirrhosis?
Increased aldosterone and deficit of albumin
Which of the following is a major cause of primary hepatocellular cancer?
Long-term exposure to certain chemicals
What causes massive inflammation and necrosis in acute pancreatitis?
Activation and spread of proteolytic enzymes
How does chemical peritonitis and shock frequently result from acute pancreatitis?
Inflammation and increased vascular permeability of the peritoneum affect fluid balance
Malnutrition may develop in children with celiac disease because of:
damage to the intestinal villi
Which of the following best describes steatorrhea?
Bulky, fatty, foul-smelling stools
What is the dietary requirement for a child with celiac disease?
What are the typical changes occurring with Crohn's disease?
Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
Stools that are more liquid and contain mucus, frank blood, and pus are typical of:
How may a fistula form with Crohn's disease?
recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops
How does iron-deficiency anemia frequently develop with ulcerative colitis?
Chronic blood loss in stool
What is the cause of inflammatory bowel disease?
What pain is typical of diverticulitis?
Lower left quadrant. Llq.
With acute appendicitis, localized pain and tenderness in the lower right quadrant results from:
local inflammation of the parietal peritoneum
How does localized peritonitis develop from acute appendicitis before rupture?
Intestinal bacteria escape through the necrotic appendiceal wall.
What is a typical early sign of cancer in the ascending colon?
Occult blood in the stool
To which site does colon cancer usually first metastasize?
How does a volvulus cause localized gangrene in the intestine?
The mesenteric arteries are compressed in the twisted section of intestine
Which of the following is a typical indicator of an intestinal obstruction caused by paralytic ileus?
Severe steady abdominal pain
Partial obstruction of the sigmoid colon resulting from diverticular disease would likely:
result in a small, hard stool
What causes hypovolemic shock to develop with intestinal obstruction?
Continued vomiting and fluid shift into the intestine
What causes the characteristic rigid abdomen found in the patient with peritonitis?
Inflamed peritoneum resulting in reflex abdominal muscle spasm
What would be the likely outcome from chemical peritonitis related to a perforated gall bladder?
Leakage of intestinal bacteria into the blood and the peritoneal cavity.
How does pelvic inflammatory disease frequently lead to bacterial peritonitis?
Infection spreads through the fallopian tubes directly into the peritoneal cavity
Choose the significant change in arterial blood gases expected with prolonged severe vomiting:
decreased bicarbonate ion, decreased PCO2, serum pH 7.35
When dehydration reduces the compensation possible for acidosis resulting from prolonged diarrhea, what significant change in arterial blood gases indicates this?
Serum bicarbonate levels would decrease, serum pH would drop below 7.35
How do body defenses respond immediately after the gall bladder ruptures?
Blood clots seal the perforation
Which of the following is the most frequent location of peptic ulcers?
In peptic ulcer disease, which of the following does NOT decrease the resistance of the mucosal barrier?
Decreased vagal stimulation
An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate?
Erosion of a large blood vessel
What does the term melena mean?
Blood in a dark-colored stool
Which of the following is NOT a common predisposing factor to gastric carcinoma?
Anti-inflammatory medications such as ASA
Which of the following frequently occurs 2-3 hours after meals in post-gastrectomy patients?
Which term refers to obstruction of the biliary tract by gallstones?
Which of the following is NOT usually present during the icteric stage of viral hepatitis?
Which of the following statements about jaundice is/are true?
Four only. Jaundice usually develops with hepatocellular carcinoma.
Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
HBV and HCV
Which of the following are related to post-hepatic jaundice?
pruritic skin and light-colored stools
Which of the following occurs with hepatitis B?
the liver is inflamed and enlarged
Identify a major reason making it difficult to prevent the spread of hepatitis B.
infection is often asymptomatic
What is the initial pathological change in alcoholic liver disease?
Accumulation of fat in hepatocytes with hepatomegaly
How does serum bilirubin change with cirrhosis?
Increased conjugated and unconjugated bilirubin
Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate?
Deficiencies of vitamins A, D, and K occur in patients with cirrhosis primarily because of decreased?
Production of bile for absorption
Tetany may develop in patients with acute pancreatitis because:
calcium ions bind with fatty acids in necrotic tissue
In which condition is a deficit of protein and vitamins most likely to occur?
When a portion of the proximal stomach and the paraesophageal junction move above the diaphragm, this is called a:
Which of the following applies to gastric cancer?
Most cases involve an adenocarcinoma of the mucous glands
Pancreatic cancer may be diagnosed early if obstruction of bile or pancreatic secretions develops when the tumor is located:
at the head of the pancreas
"A gluten-free diet as required" for the client with celiac disease means avoiding:
The telescoping of one section of bowel inside another section is called:
Hirschsprung's disease refers to:
congenital lack of PNS innervations in a segment of the colon