Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
a. Parietal cells
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?
b. Vagus nerve
Which of the following is contained in pancreatic exocrine secretions?
a. Bicarbonate ion
The presence of food in the intestine stimulates intestinal activity but inhibits gastric activity through the:
b. enterogastric reflex.
Which of the following processes is likely to occur in the body immediately after a meal?
What does the term gluconeogenesis refer to?
c. Formation of glucose from protein and fat
Normally, proteins or amino acids are required to produce all of the following EXCEPT:
c. cellular energy.
Which of the following statements applies to bile salts?
c. They emulsify lipids and lipid-soluble vitamins.
The visceral peritoneum:
d. forms the outer covering of the stomach.
The early stage of vomiting causes:
a. metabolic alkalosis.
Yellow or greenish stained vomitus usually indicates the presence of:
Small, hidden amounts of blood in stool are referred to as:
b. occult blood.
Severe vomiting can lead to metabolic acidosis because of increased:
c. hypovolemia and lactic acid production.
Which of the following applies to the act of swallowing?
a. It requires coordination of cranial nerves V, IX, X, and XII.
What does the defecation reflex require?
c. Coordination through the sacral spinal cord
What is the definition of dysphagia?
d. Difficulty in swallowing
What does congenital esophageal atresia cause?
c. No fluid or food entering the stomach
Which of the following applies to cleft palate?
b. The hard and soft palates do not fuse during the first trimester of pregnancy.
Oral candidiasis is considered to:
d. be an opportunistic fungal infection of the mouth.
Why does herpes simplex infection tend to recur?
c. The virus persists in latent form in sensory nerve ganglia.
25. What does the term periodontitis refer to?
b. Bacterial damage to the teeth and surrounding alveolar bone
What is/are common location(s) for oral cancer?
a. Floor of the mouth or tongue borders
What is a common cause of hiatal hernia?
b. Increased intra-abdominal pressure
What is a common sign of acute gastritis?
b. Vomiting and anorexia
What does the pathophysiology of chronic gastritis include?
a. Atrophy of the gastric mucosa with decreased secretions
What is a common cause of gastroenteritis due to Salmonella?
c. Raw or undercooked poultry or eggs
Which of the following individuals is likely to develop acute gastritis?
d. An individual with an allergy to shellfish
What does congenital pyloric stenosis involve?
c. Hypertrophy of smooth muscle in the pylorus
A patient with acquired pyloric stenosis would likely:
d. vomit undigested food from previous meals.
Prolonged or severe stress predisposes to peptic ulcer disease because:
a. of reduced blood flow to the gastric wall and mucous glands.
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:
d. increased stimulation of mucus-producing glands.
Which of the following would a perforated gastric ulcer likely cause?
b. Chemical peritonitis
What is frequently the first manifestation of stress ulcers?
What would be the result of chronic bleeding from gastric carcinoma?
a. Occult blood in the stool and anemia
Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates:
a. a large volume of chyme has entered the intestines, causing distention.
Bilirubin is a product of:
a. hemolysis of red blood cells (RBCs) and breakdown of hemoglobin.
Why does mild hyperbilirubinemia occur in newborns?
d. Immature liver cannot process bilirubin quickly enough
Predisposing factors to cholelithiasis include excessive:
a. bilirubin or cholesterol concentration in the bile.
What is the major effect when a gallstone obstructs the cystic duct?
c. Severe colicky pain in upper right quadrant
Obstruction of the biliary tract by gallstones is referred to as:
Which of the following applies to hepatitis A infection?
b. It is transmitted by the fecal-oral route.
What can be concluded if the hepatitis B antigen level remains high in the serum?
b. Chronic infection has developed.
What is the most common type of hepatitis transmitted by blood transfusion?
During the course of a hepatitis B infection, the onset of jaundice occurs in the:
c. icteric stage.
What is the likely effect of long-term exposure to a hepatotoxin?
d. Gradual irreversible damage to the liver and cirrhosis
What indicates the presence of third-stage alcohol hepatitis?
d. Decreased production of blood clotting factors
A factor that may precipitate encephalopathy with cirrhosis is the elevated:
c. serum ammonia.
In patients with cirrhosis, serum ammonia may increase when:
b. bleeding occurs in the digestive tract.
What is the primary cause of esophageal varices?
a. Increased hydrostatic pressure in the veins
What is the primary cause of increased bleeding tendencies associated with cirrhosis?
d. Deficit of vitamin K and prothrombin
Which factors contribute to ascites in patients with cirrhosis?
a. Increased aldosterone and deficit of albumin
Which of the following is a major cause of primary hepatocellular cancer?
c. Long-term exposure to certain chemicals
What causes massive inflammation and necrosis in acute pancreatitis?
d. Autodigestion of tissue by pancreatic enzymes
How does chemical peritonitis and shock frequently result from acute pancreatitis?
a. Inflammation and increased vascular permeability of the peritoneum affect fluid balance.
Malnutrition may develop in children with celiac disease because of:
a. damage to the intestinal villi.
Which of the following best describes steatorrhea?
c. 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?
d. Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
Stools that are more liquid and contain mucus and frank blood are typical of:
b. ulcerative colitis.
How may a fistula form with Crohn's disease?
d. Recurrent inflammation, necrosis, and fibrosis, forming a connection between intestinal loops
How does iron deficiency anemia frequently develop with ulcerative colitis?
c. Chronic blood loss in stools
What is the cause of inflammatory bowel disease?
What pain is typical of diverticulitis?
a. Lower left quadrant
What usually initiates acute appendicitis?
c. Obstruction of the lumen of the appendix
With acute appendicitis, localized pain and tenderness in the lower right quadrant results from:
d. local inflammation of the parietal peritoneum.
How does localized peritonitis develop from acute appendicitis before rupture?
b. Intestinal bacteria escape through the necrotic appendiceal wall.
What is a typical early sign of cancer in the ascending colon?
d. Occult blood in the stool
72. To which site does colon cancer usually first metastasize?
How does a volvulus cause localized gangrene in the intestine?
b. 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?
c. Severe steady abdominal pain
A congenital condition in which parasympathetic innervation is missing from a section of the colon, impairing motility is referred to as:
d. Hirschsprung's disease.
What causes hypovolemic shock to develop with intestinal obstruction?
a. Continued vomiting and fluid shift into the intestine
What causes the characteristic rigid abdomen found in the patient with peritonitis?
c. Inflamed peritoneum, resulting in reflex abdominal muscle spasm
What would be the likely outcome from chemical peritonitis related to a perforated gallbladder?
a. Leakage of intestinal bacteria into blood and the peritoneal cavity
How does pelvic inflammatory disease frequently lead to bacterial peritonitis?
c. Infection spreads through the fallopian tubes directly into the peritoneal cavity.
Choose the significant change in arterial blood gases expected with prolonged severe vomiting:
b. 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?
c. Serum bicarbonate levels would decrease, and serum pH would drop below 7.35.
Bile pigment gallstones are more common in individuals dealing with:
c. alcoholic cirrhosis.
Dehydration limits compensation available for an acid-base imbalance resulting from prolonged vomiting and diarrhea because:
a. hypovolemia limits renal function.
Which of the following is the most frequent location of peptic ulcers?
c. Proximal duodenum
In peptic ulcer disease, which of the following does NOT decrease the resistance of the mucosal barrier?
d. Decreased vagal stimulation
An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate?
c. Erosion of a large blood vessel
What does the term melena mean?
a. Blood in a dark-colored stool
Which of the following is NOT a common predisposing factor to gastric carcinoma?
d. Anti-inflammatory medications such as ASA
Which of the following frequently occurs 2 to 3 hours after meals in post-gastrectomy patients?
Which term refers to an inflammation usually related to infection of the bile ducts?
Which of the following is NOT usually present during the icteric stage of viral hepatitis?
c. Esophageal varices
Which of the following about jaundice is/are true? 1. It is often the first manifestation of hepatitis. 2. Jaundice indicates permanent liver damage. 3. Individuals with hepatitis are always jaundiced. 4. Jaundice usually develops with hepatocellular carcinoma.
b. 4 only
Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
c. HBV and HCV
Which of the following is/are related to post-hepatic jaundice?
a. Pruritic skin and light-colored stools
Which of the following occurs with hepatitis B?
a. The liver is inflamed and enlarged.
Identify a major reason making it difficult to prevent the spread of hepatitis B.
c. Infection is often asymptomatic.
What is the initial pathological change in alcoholic liver disease?
d. Accumulation of fat in hepatocytes with hepatomegaly
How does serum bilirubin change with cirrhosis?
c. Increased conjugated and unconjugated bilirubin
Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate?
At what stage of alcoholic liver disease can the damage be reversed?
b. Initial stage
Although many factors may precipitate pancreatitis, the two major causes are:
d. gallstones and alcohol abuse.
Which factor(s) appear(s) to have a role in the etiology of inflammatory bowel diseases?
c. Genetic and immunological factors
Gastroesophageal reflux disease involves:
a. periodic flow of gastric contents into the esophagus.
When a portion of the proximal stomach and the paraesophageal junction move above the diaphragm, this is called a:
c. sliding hernia.
Which of the following applies to gastric cancer?
b. 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:
a. at the head of the pancreas.
"A gluten-free diet as required" for the client with celiac disease means avoiding:
c. certain grains.
The telescoping of one section of bowel inside another section is called:
A viral infection of the parotid gland is commonly known as: