Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?
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?
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
Which of the following applies to the act of swallowing?
Requires coordination of cranial nerves five, nine, ten and twelve
Which of the following applies to cleft palate?
The hard and soft palates do not fuse during the first trimester of pregnancy
What does the pathophysiology of chronic gastritis include?
Atrophy of the gastric mucosa with decreased secretions
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
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:
Increased stimulation of mucous-producing glands
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.
What can be concluded if the hepatitis B antigen level remains high in the serum?
Chronic infection has developed
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
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
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
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.
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
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
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 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.
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
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
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