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GI/LIVER - 308 Final Exam

Terms in this set (49)

vomiting reflex activities
promote forceful expulsion of stomach contents and reduce risk of aspiration of vomitus/emesis into airway
secretory diarrhea
excessive secretion of fluids into the intestine by glands of the mucosal lining
name some potential consequences of diarrhea
- malnutrition/ malabsorption syndromes
- weight loss
- dehydration, hypovolemia
- orthostatic hypotension
- electrolyte imbalance
- acidosis
visceral pain
colicky, poorly-localized pain associated with tissue injury and inflammation
name some common signs of dysphagia
- drooling
- a hoarse voice
- feeling that something is lodged in the throat
- regurgitation
- unexpected weight loss
- heartburn
- coughing or choking when swallowing
- pain when swallowing
esophageal atresia
absence of a normal bodily passage or cavity
esophageal achalasia
neurogenic motility disorder characterized by impaired esophageal peristalsis and a lack of LES during swallowing
paraesophageal (rolling) hernia
gastro-esophageal junction remains in normal place, but part of stomach protrudes into thorax
intussusception
telescoping or shortening of bowel, more common in infants/children
volvulus
twisting of bowel
most commonly caused by H. pylori infection
peptic ulcer disease (i.e., gastric ulcer)
esophageal varices
develop when normal blood flow through liver is blocked by clots, fibrotic changes, or scar buildup in liver; potentially fatal if ruptured
hematochezia
bright red bleeding from rectum
Crohn's disease
most commonly affects small intestine and proximal large intestine, causes skip lesions, affects all tissue layers
ulcerative colitis
begins in rectum and may extend proximally to entire colon, causes hematochezia, affects only innermost tissue layers
microscopic colitis
relatively chronic cause of daily watery diarrhea
irritable bowel syndrome
common, chronic colonic disease that causes cramping and abdominal pain but does not harm the intestines
diverticulosis vs. diverticulitis
diverticulosis: presence of diverticula
diverticulitis: inflammation of diverticula
gastritis
chronic inflammation of stomach mucosa
cholecystitis
chronic inflammation of gallbladder, usually due to obstruction of cystic duct by gallstones
pancreatitis
serious but rare condition involving duct obstruction and injury that causes leakage of digestive enzymes into pancreatic tissue
name some indications of liver dysfunction
- elevated serum bilirubin
- elevated AST and ALT
- elevated blood ammonia
- prolonged PT
- jaundice
name some complications of cirrhosis
ascites, varices, splenomegaly
Which statement is true regarding the act of retching?
a. it begins with a shallow respiration
b. hypersalivation and tachycardia are common
c. the esophagus becomes distended
d. reverse peristalsis seldom occurs
c. the esophagus becomes distended
A patient experiences increased mucosal discharge of chloride- or bicarbonate-rich fluid. Which of the following types of diarrhea is this?
a. osmotic
b. secretory
c. motility
d. parasitic
b. secretory
A patient experiences abdominal pain that is very localized and intense. Which type of pain does this describe?
a. parietal
b. visceral
c. referred
d. phantom
a. parietal
Which question assesses a possible cause of achalasia?
a. Are you chronically constipated?
b. What types of high fiber foods do you eat?
c. Do you become gassy after meals?
d. Have you ever been told you have problems with your esophagus?
d. Have you ever been told you have problems with your esophagus?
Which statement is true regarding hiatal hernia?
a. A mixed hernia is the most common type.
b. The least common type is a paraesophageal hernia.
c. Paraesophageal hernia is herniation of the greater curvature of the stomach.
d. A sliding hernia is triggered by standing and frequent meals.
c. paraesophageal hernia is herniation of the great curvature of the stomach
H. pylori is discovered in the GI tract of a client experiencing an inflammation of the gastric mucosa. Which findings support this diagnosis?
a. Chronic diarrhea
b. Paralytic ileus
c. Chronic antral gastritis
d. Pyloric obstruction
c. chronic astral gastritis
Which of the following regarding chronic gastritis is true?
a. There are four types.
b. Type A, or fundal gastritis, is the most severe.
c. Type B, or antral gastritis, is the most rare.
d. It tends to occur in young individuals.
a. type A, or fundal gastritis, is the most severe

(FYI: type A is also the most rare and occurs most frequently in the elderly)
A patient experiences chronic intermittent pain in the epigastric area when the stomach is empty and in the middle of the night. This history supports a diagnosis of:
a. acute gastritis.
b. chronic gastritis.
c. gastric ulcer.
d. duodenal ulcer.
d. duodenal ulcer
A client is diagnosed with a Cushing ulcer. Which assessment finding supports this diagnosis?
a. Third-degree burns over 20% of the body
b. Profound septicemia with high fever
c. Severe head trauma resulting from auto accident
d. Massive internal trauma as a result of a fall
c. severe head trauma resulting from auto accident
The poor absorption of vitamin A can result in:
a. osteoporosis.
b. neurologic deficiencies.
c. night blindness.
d. petechiae.
c. night blindness
Which of the following is a TRUE statement regarding ulcerative colitis?
a. It extends throughout the entire GI tract.
b. It generally appears in childhood.
c. Women are more affected than men
d. Bloody, purulent diarrhea is a common symptom.
d. bloody, purulent diarrhea is a common symptom
Which of the following is a TRUE statement regarding Crohn disease?
a. It involves the mucosa only.
b. Skip lesions are common.
c. It affects only the rectum.
d. The most common site is the rectum.
b. Skip lesions are common
A 20-year-old man presents with periumbilical pain, fever, and loss of appetite. Which of the following is the most likely cause of his abdominal discomfort?
a. Diverticulosis
b. Diverticulitis
c. Appendicitis
d. Mesenteric venous thrombosis
c. appendicitis
Which assessment observation supports a diagnosis of portal hypertension due to liver disease?
a. Hematemesis
b. Abdominal pain from splenomegaly
c. Ascites
d. Altered mental status
a. hematemesis

(due to bleeding esophageal varices)
Which occurs as the result of hemolysis of a hematoma from a traumatic injury?
a. There is a decrease in conjugated bilirubin.
b. Increased amounts of unconjugated bilirubin occur.
c. Bilirubin is excreted in the urine.
d. Hemolysis is identical to obstructive jaundice.
b. increased amounts of unconjugated bilirubin occur
A patient is diagnosed with hepatitis A. Transmission of this form of hepatitis occurs via:
a. fecal-oral route.
b. infected blood or body fluids.
c. sexual contact.
d. intravenous drug use.
a. fecal-oral route
Which stage of hepatitis is characterized by jaundice, fatigue, anorexia, nausea, and vomiting?
a. Prodromal phase
b. Icteric phase
c. Recovery phase
d. Chronic active hepatitis
a. prodromal phase

(FYI: the prodromal phase begins about 2 weeks after exposure and includes the symptoms described. The icteric phase begins 1-2 weeks after the prodromal phase and includes jaundice, dark urine, clay-colored stools, and hepatomegaly.)
A client presents with epigastric pain, which radiates to the back, and vomiting. Hyperglycemia and tachycardia are noted. Client reports being "a heavy drinker but never had problems like this before." Which disease process is supported by this client's symptoms?
a. Cholelithiasis
b. Cholecystitis
c. Acute pancreatitis
d. Appendicitis
c. acute pancreatitis
Which statement is TRUE regarding cancer of the colon?
a. It is the most frequent cause of cancer death.
b. It accounts for 25% of all cancer deaths.
c. It tends to occur in young individuals less than 30 years of age.
d. Treatment will include surgical resection of the colon.
d. treatment will include surgical resection of the colon
Chronic constipation may be a result of: (select all that apply)
a. low-residue diet.
b. sedentary lifestyle.
c. hyperthyroidism.
d. opiate use.
e. aging.
all answers excepting c

a. low-residue diet
b. sedendary lifestyle
d. opiate use
e. aging
Which assessment data confirms the presence of a peptic ulcer? (select all that apply)
a. Presence of H. pylori in the duodenum
b. Advanced age
c. Follows a strict vegetarian diet
d. History of alcohol abuse
e. Diagnosis of rheumatoid arthritis
all answers excepting c

a. presence of H. pylori in the duodenum
b. advanced age
d. history of alcohol abuse
e. diagnosis of rheumatoid arthritis
Which extraintestinal manifestations are found in ulcerative colitis? (select all that apply)
a. Gallstones
b. Uveitis
c. Polyarthritis
d. Cutaneous lesions
e. Liver disorders
all answers excepting a and b

c. polyarthritis
d. cutaneous lesions
e. liver disorders

(FYI: due to the fact that immune complexes may be related to this disease, it is not unexpected that problems are noted outside of the colon.)
Which statements regarding cirrhosis are true? (select all that apply)
a. Cirrhosis develops rapidly.
b. The causes are not clearly understood.
c. Portal hypertension is a complication.
d. Severity is determined by amount of the toxin.
e. Prognosis is poor even when contaminant is removed.
all answers excepting a and e

b. the causes are not clearly understood
c. portal hypertension is a complication
d. severity is determined by amount of the toxin
Risk factors for primary carcinoma of the gallbladder would include: (select all that apply)
a. advancing age.
b. female gender.
c. liver abscess.
d. obesity.
e. peritonitis.
all answers excepting c.

a. advancing age
b. female gender
d. obesity
e. peritonitis
Which statement is TRUE regarding the anomaly that results in a cleft lip?
a. The incomplete fusion of the nasomedial or intermaxillary process
b. Occurs in about 10 in 1000 births
c. Increased incidence in black populations
d. Increased incidence in females
a. the incomplete fusion of the nasomedial or inter maxillary process
Which term is used to identify the condition in which the esophagus ends in a blind pouch?
a. Esophageal atresia
b. Tracheoesophageal fistula
c. Esophageal achalasia
d. Malrotation
a. esophageal atresia
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