Likely 1 P20a

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  • 1. 
    In the liver, amino acids are used to produce complex molecules by means of:
    • A. 

      A. glycogenesis

    • B. 

      B. anabolic processes

    • C. 

      C. catabolic processes

    • D. 

      D. autodigestion


  • 2. 
    Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
    • A. 

      A. parietal cells

    • B. 

      B. chief cells

    • C. 

      C. mucous cells

    • D. 

      D. gastrin cells


  • 3. 
    When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?
    • A. 

      A. gastrin

    • B. 

      B. secretin

    • C. 

      C. cholecystokinin

    • D. 

      D. histamine


  • 4. 
    Which of the following breaks protein down into peptides?
    • A. 

      A. amylase

    • B. 

      B. peptidase

    • C. 

      C. lactase

    • D. 

      D. trypsin


  • 5. 
    Which of the following is contained in pancreatic exocrine secretions?
    • A. 

      A. bicarbonate ion

    • B. 

      B. hydrochloric acid

    • C. 

      C. activated digestive enzymes

    • D. 

      D. insulin


  • 6. 
    An alkaline environment is required in the duodenum to:
    • A. 

      A. activate pepsinogen

    • B. 

      B. activate intestinal and pancreatic enzymes

    • C. 

      C. activate bile salts

    • D. 

      D. produce mucus


  • 7. 
    Which of the following statements applies to bile salts?
    • A. 

      A. They give feces the characteristic brown color.

    • B. 

      B. They are enzymes used to break down fats into free fatty acids.

    • C. 

      C. They emulsify lipids and lipid-soluble vitamins.

    • D. 

      D. They are excreted in the feces.


  • 8. 
    The early stage of vomiting causes:
    • A. 

      A. metabolic alkalosis

    • B. 

      B. metabolic acidosis

    • C. 

      C. increased respirations

    • D. 

      D. increased excretion of hydrogen ions


  • 9. 
    Prolonged vomiting cause a state of acidosis due to:
    • A. 

      A. catabolism of proteins and lipids

    • B. 

      B. continued loss of gastric secretions

    • C. 

      C. loss of pancreatic enzymes

    • D. 

      D. retention of sodium ions and water


  • 10. 
    What is the first change in arterial blood gases with diarrhea?
    • A. 

      A. increased bicarbonate ion

    • B. 

      B. decreased bicarbonate ion

    • C. 

      C. increased carbonic acid

    • D. 

      D. increased serum pH


  • 11. 
    Dehydration causes acidosis because of increased:
    • A. 

      A. ketones produced

    • B. 

      B. CO2 retained in the lungs and kidneys

    • C. 

      C. hypovolemia and lactic acid production

    • D. 

      D. metabolic rate


  • 12. 
     Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates:
    • A. 

      A. a large volume of chyme has entered the intestines, causing distention

    • B. 

      B. severe hypoglycemia has developed

    • C. 

      C. the pylorus is restricting the flow of chyme

    • D. 

      D. bile and pancreatic secretions are irritating the small intestine


  • 13. 
    Which of the following is/are (a) manifestation(s) of hemolytic jaundice?
    • A. 

      A. increased unconjugated bilirubin in the blood

    • B. 

      B. increased bleeding tendencies

    • C. 

      C. pale stool and dark urine

    • D. 

      D. elevated liver enzymes in the blood


  • 14. 
    Predisposing factors to cholelithiasis include excessive:
    • A. 

      A. bilirubin or cholesterol concentration in the bile

    • B. 

      B. water content in the bile

    • C. 

      C. bile salts in the bile

    • D. 

      D. bicarbonate ions in the bile


  • 15. 
    Which of the following applies to hepatitis A infection?
    • A. 

      A. It is also called serum hepatitis.

    • B. 

      B. It is transmitted by the fecal-oral route.

    • C. 

      C. It contains a double strand of DNA.

    • D. 

      D. It frequently leads to chronic hepatitis.


  • 16. 
    What can be concluded if the hepatitis B antigen level remains high in the serum?
    • A. 

      A. Acute infection is present.

    • B. 

      B. Chronic infection has developed.

    • C. 

      C. Liver failure is in progress.

    • D. 

      D. The usual prolonged recovery from any viral infection is occurring.


  • 17. 
    What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis?
    • A. 

      A. systemic effects of viral infection

    • B. 

      B. obstruction of bile ducts and malabsorption

    • C. 

      C. necrosis of liver cells

    • D. 

      D. ammonia toxicity


  • 18. 
    What is the likely effect of long-term exposure to a hepatotoxin?
    • A. 

      A. full recovery to normal tissue after the toxic material is removed

    • B. 

      B. acute onset of vomiting, steatorrhea, and jaundice

    • C. 

      C. continued mild inflammation of the liver without permanent damage

    • D. 

      D. gradual irreversible damage to the liver and cirrhosis


  • 19. 
    What indicates the presence of third-stage alcohol hepatitis?
    • A. 

      A. below normal blood levels of AST and ALT

    • B. 

      B. ULQ tenderness and dull pain

    • C. 

      C. a small, firm, nodular liver and portal hypertension

    • D. 

      D. accumulation of fat in the hepatocytes and hepatomegaly


  • 20. 
    A primary factor causing encephalopathy with cirrhosis is the elevated:
    • A. 

      A. serum urea

    • B. 

      B. conjugated bilirubin

    • C. 

      C. serum ammonia

    • D. 

      D. serum pH


  • 21. 
    In patients with cirrhosis, serum ammonia may increase when:
    • A. 

      A. ingesting excessive lipids

    • B. 

      B. bleeding occurs in the digestive tract

    • C. 

      C. an increase in unconjugated bilirubin occurs in the serum

    • D. 

      D. less bile is produced


  • 22. 
    What is the primary cause of esophageal varices?
    • A. 

      A. portal hypertension

    • B. 

      B. alcohol irritating the mucosa

    • C. 

      C. failure to inactivate estrogen

    • D. 

      D. poor nutritional status


  • 23. 
    What is the primary cause of increased bleeding tendencies associated with cirrhosis?
    • A. 

      A. anemia and leucopenia

    • B. 

      B. jaundice and pruritus

    • C. 

      C. recurrent infections

    • D. 

      D. deficit of vitamin K and prothrombin


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