Module 15: Alterations of Digestive Function

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Which of the following structures prevents reflux of stomach contents into the esophagus?

A) Pyloric sphincter
B) Fundus
C) Upper esophageal sphincter
D) Lower esophageal sphincter

D) Lower esophageal sphincter

Saliva contains all of the following substances except:

A) water.
B) IgA.
C) lipase.
D) amylase.

C) lipase.

The chief cells of the gastric glands secrete:

A) secretin.
B) pepsinogen.
C) mucus.
D) hydrochloric acid.

B) pepsinogen.

Mucus production in the stomach is blocked by medications that block the release of:

A) histamine.
B) gastrin.
C) pepsin.
D) prostaglandins.

D) prostaglandins.

Pepsin is necessary for the digestion of which of the following nutrients?

A) Carbohydrates
B) Proteins
C) Lipids
D) All of the above

B) Proteins

Which of the following structures is not part of the small intestine?

A) Cecum
B) Ileum
C) Duodenum
D) Jejunum

A) Cecum

Which of the following structures are tiny projections of the intestinal mucosal lining that form the brush border and increase the surface area for absorption?

A) Cilia
B) Lacteals
C) Mesenteries
D) Microvilli

D) Microvilli

In which abdominal quadrant is the appendix located?

A) Right upper
B) Right lower
C) Left upper
D) Left lower

B) Right lower

The majority of the small intestine receives splanchnic blood flow from which artery?

A) Celiac
B) Superior mesenteric
C) Inferior mesenteric
D) Omental

B) Superior mesenteric

Which sphincter controls the release of pancreatic enzymes and bile into the duodenum?

A) Ileocecal
B) Oddi
C) Pyloric
D) O'Beirne

B) Oddi

Parasympathetic stimulation of the digestive system results in:

A) inhibition of smooth activity in the wall of the small intestine.
B) increased gastric and pancreatic secretions.
C) decreased blood flow to the digestive tract.
D) contraction of the pyloric sphincter.

B) increased gastric and pancreatic secretions.

The cells of the liver lobules that synthesize and release bile are called:

A) hepatic sinusoids.
B) Kupffer cells.
C) alpha cells.
D) hepatocytes.

D) hepatocytes.

Bilirubin in bile comes from:

A) bile salt metabolism.
B) the degradation of fatty acids.
C) the accumulation of albumin.
D) phagocytosis of aged red blood cells.

D) phagocytosis of aged red blood cells.

Functions of the liver include all of the following except:

A) storage of vitamins.
B) synthesis of plasma proteins.
C) metabolic detoxification
D) secretion of digestive enzymes.

D) secretion of digestive enzymes.

In the liver, ammonia is converted to:

A) amino acids.
B) ketoacids.
C) urea.
D) bile salts.

C) urea.

Common causes of constipation include all of the following except:

A) inadequate fluid intake.
B) laxative use.
C) a low-fiber diet.
D) medications.

B) laxative use.

Which of the following types of diarrhea can be caused by an inability to digest lactose in dairy products?

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

C) Osmotic

Which of the following disorders can result in lower gastrointestinal bleeding?

A) Mallory-Weiss tear
B) Peptic ulcers
C) Cancer
D) Hernia

C) Cancer

Which of the following conditions is a complication of gastrointestinal bleeding?

A) Iron deficiency anemia
B) Polyps
C) Hypertension
D) Ascites

A) Iron deficiency anemia

The presence of digested dark blood in the stool is called:

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

A) melena.

Which of the following conditions can cause dysphagia?

A) Hiatal hernia
B) Achalasia
C) Gastroesophageal reflux
D) All of the above

D) All of the above

Reflux esophagitis is defined as:

A) the autoimmune destruction of the esophageal lining.
B) dysplasia of the epithelial lining of the esophagus.
C) a congenital anomaly of the esophagus.
D) an inflammatory response to gastroesophageal reflux.

D) an inflammatory response to gastroesophageal reflux.

Common manifestations of gastroesophageal reflux disease (GERD) include:

A) nausea, vomiting, and weight loss.
B) diarrhea, abdominal cramping, and fever.
C) heartburn, dysphagia, and pain within one hour of eating.
D) back pain, ascites, and anorexia.

C) heartburn, dysphagia, and pain within one hour of eating.

Complications associated with gastroesophageal reflux disease (GERD) include which of the following?

A) Esophageal ulcerations
B) Esophageal cancer
C) Esophageal strictures
D) All of the above

D) All of the above

A hiatal hernia is a protrusion of the _____ through the ______.

A) stomach; diaphragm
B) duodenum; pyloric sphincter
C) small intestine; inguinal canal
D) rectum; anus

A) stomach; diaphragm

Paralytic ileus often occurs after:

A) gastroesophageal reflux resolves.
B) abdominal surgery.
C) pregnancy.
D) vomiting.

B) abdominal surgery.

Intestinal obstruction can lead to all of the following complications except:

A) hepatic failure.
B) dehydration.
C) peritonitis.
D) perforation.

A) hepatic failure.

The classic symptoms of a small bowel obstruction are:

A) nausea, dyspnea, and mid-back pain.
B) vomiting, severe abdominal pain, and abdominal distension.
C) constipation, pelvic pain, and dysuria.
D) fever, heartburn, and diaphoresis.

B) vomiting, severe abdominal pain, and abdominal distension.

The most common cause of chronic gastritis is:

A) viral infection.
B) bacterial infection.
C) parasitic infection.
D) fungal infection.

B) bacterial infection.

Individuals with chronic gastritis are at risk for developing which of the following problems?

A) Gastric cancer
B) Achlorhydria
C) Gastrointestinal bleeding
D) All of the above

D) All of the above

How does a chronic infection with Helicobacter pylori (H. pylori) lead to duodenal ulcers?

A) Chronic inflammation inhibits the proton pumps in the gastric lining.
B) Presence of bacteria in the stomach causes the pyloric sphincter to open prematurely, releasing acid into the duodenum.
C) H. pylori inhibits prostaglandins, leading to decreased mucus production.
D) H. pylori produces substances that are toxic to the duodenal mucosa.

D) H. pylori produces substances that are toxic to the duodenal mucosa.

Non-steroidal anti-inflammatory agents (NSAIDS) cause peptic ulcer by:

A) decreasing gastric bicarbonate production.
B) accelerating the proton pump in parietal cells.
C) inhibiting mucosal prostaglandin synthesis.
D) reducing mucosal blood flow.

C) inhibiting mucosal prostaglandin synthesis.

In addition to NSAID use, possible risk factors for peptic ulcer disease include all of the following except:

A) smoking.
B) alcoholism.
C) psychological stress.
D) female gender.

D) female gender.

Which type of ulcer is a stress ulcer that is associated with burn injuries?

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

C) Curling

Gastric ulcers are characterized by:

A) increased acid secretion.
B) regurgitation of bile.
C) pain with eating.
D) bloody diarrhea.

C) pain with eating.

Severe trauma can result in stress ulcers that often first manifest with:

A) abdominal pain.
B) peritonitis.
C) severe bleeding.
D) dumping syndrome.

C) severe bleeding.

Gastrectomy surgery commonly leads to a vitamin B12 deficiency anemia because:

A) vitamin B12 is absorbed in the stomach.
B) decreased HCl production affects vitamin B12 absorption.
C) pepsin is required for the conversion of vitamin B12 into its active form.
D) decreased intrinsic factor production results in decreased vitamin B12 absorption in the ileum.

D) decreased intrinsic factor production results in decreased vitamin B12 absorption in the ileum.

Which of the following disorders is characterized by night blindness, osteopathy, and clotting disorders?

A) Post-gastrectomy syndrome
B) Gluten-sensitive enteropathy
C) Bile salt deficiency
D) Lactase deficiency

C) Bile salt deficiency

Which of the following disorders is characterized by the inability to digest all nutrients?

A) Pancreatic insufficiency
B) Gluten-sensitive enteropathy
C) Bile salt deficiency
D) Lactase deficiency

A) Pancreatic insufficiency

All of the following are characteristics of ulcerative colitis except:

A) iron deficiency anemia.
B) the presence of "skip" lesions.
C) diarrhea.
D) an increased risk of colon cancer.

B) the presence of "skip" lesions.

Which of the following factors are known causes of ulcerative colitis?

A) Genetic predisposition
B) Autoimmune injury
C) Inflammation
D) All of the above

D) All of the above

Common characteristics of Chron disease include which of the following?

A) Significant blood loss in diarrhea
B) Gastroesophageal reflux
C) Vitamin B12 deficiency
D) Mucosal erosions of the rectum

C) Vitamin B12 deficiency

Diverticula are:

A) ulcers that form in the colon.
B) outpouchings of the colon's mucosa.
C) perforations of the colon wall.
D) areas where the colon wall is hypertrophied.

B) outpouchings of the colon's mucosa.

Diverticulosis can be related to which of the following dietary problems?

A) Lactose deficiency
B) Diet high in refined foods
C) Iron deficiency
D) High fiber intake

B) Diet high in refined foods

Appendicitis usually presents with pain that manifests in which abdominal quadrant?

A) Right upper
B) Right lower
C) Left upper
D) Left lower

B) Right lower

Which of the following nutritional disorders is characterized by consumption of large amounts of food (binging) followed by self-induced vomiting and/or the use of laxatives (purging)?

A) Obesity
B) Anorexia nervosa
C) Bulimia nervosa
D) Kwashiorkor

C) Bulimia nervosa

What is the most common cause of acute mesenteric (vascular) insufficiency?

A) Emboli
B) Heart failure
C) Ileus
D) Anemia

A) Emboli

Although the term hepatitis describes any inflammatory process affecting the liver, it is usually used to describe liver inflammation due to:

A) bacterial infection.
B) viral infection.
C) prescription drug toxicity.
D) street drug toxicity.

B) viral infection.

Which of the following types of hepatitis is acquired from ingesting contaminated food and manifests acutely with fever, abdominal pain, and jaundice, but does not usually result in fulminant liver failure?

A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) All of the above

A) Hepatitis A

The most common cause of liver cirrhosis are hepatitis C and:

A) alcoholism.
B) cocaine abuse.
C) overdose of antibiotic medications.
D) liver cancer.

A) alcoholism.

Cholelithiasis is:

A) an infection of the gallbladder.
B) gallbladder atrophy.
C) hypersecretion of bile by the liver.
D) the accumulation of gallstones in the gallbladder.

D) the accumulation of gallstones in the gallbladder.

The most common cause of portal hypertension is:

A) renal failure.
B) liver cirrhosis.
C) congestive heart failure.
D) esophageal varices.

B) liver cirrhosis.

Which of the following statements explains why portal hypertension leads to ascites?

A) Hepatosplenomegaly develops
B) Back-up of blood in the intra-abdominal veins occurs
C) Esophageal varices form in the lower esophagus
D) Hemorrhoids can bleed

B) Back-up of blood in the intra-abdominal veins occurs

Symptoms of hepatic encephalopathy are caused by increased serum levels of:

A) ammonia.
B) potassium.
C) urea.
D) creatinine.

A) ammonia.

Which of the following symptoms is associated with hepatic encephalopathy?

A) Ascites, bleeding disorders, and immunosuppression
B) Peripheral edema, dyspnea, and weight gain
C) Decreased urinary output, increased serum creatinine, and elevated liver enzymes
D) Memory loss and confusion, progressing to coma

D) Memory loss and confusion, progressing to coma

Jaundice related to biliary duct obstruction is manifested by which of the following laboratory alterations?

A) Decreased unconjugated bilirubin
B) Increased unconjugated bilirubin
C) Decreased conjugated bilirubin
D) Increased conjugated bilirubin

D) Increased conjugated bilirubin

Tissue damage in acute pancreatitis is caused by:

A) leakage of pancreatic enzymes into pancreatic tissue.
B) hydrochloric acid reflux into the pancreatic duct.
C) autoimmune destruction of the pancreas.
D) insulin toxicity.

A) leakage of pancreatic enzymes into pancreatic tissue.

The most common cause of chronic pancreatitis is:

A) narcotic addiction.
B) gall stones.
C) alcohol abuse.
D) diabetes mellitus.

C) alcohol abuse.

Which of the following risk factors increases a person's chance of developing esophageal cancer?

A) Smoking
B) Alcohol
C) Gastroesophageal reflux
D) All of the above

D) All of the above

Risk of developing cancer is increased with which of the following gastrointestinal disorders?

A) Duodenal ulcers
B) Diverticulosis
C) Ulcerative colitis
D) Dumping syndrome

C) Ulcerative colitis

Which of the following symptoms is most specific to colon cancer?

A) Nausea and jaundice
B) Abdominal pain and hematochezia
C) Epigastric pain and vomiting
D) Heartburn and dysphagia

B) Abdominal pain and hematochezia

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