Gastrointestinal Practice Exam! Trivia Questions Quiz

60 Questions | Total Attempts: 112

SettingsSettingsSettings
Please wait...
Gastrointestinal Practice Exam! Trivia Questions Quiz

What do you know about the gastrointestinal system? Do you think you know enough to pass this exam? The gastrointestinal tract is a string of hollow organs connected by a long, weaving tube from the mouth to the rectal area, typically referred to as the anus. The organs that make up the gastrointestinal tract include the mouth, esophagus, stomach, small intestine, large intestine, and anus. Take a pass at this quiz and test your knowledge of the gastrointestinal tract.


Questions and Answers
  • 1. 
    Which of the following statements is most accurate regarding the biological functions of hepatocytes?
    • A. 

      Gluconeogenesis occurs primarily in Zone 3

    • B. 

      Cholesterol synthesis occurs primarily in Zone 2

    • C. 

      Glycolysis occurs primarily in Zone 3

    • D. 

      Drug detoxification occurs primarily in Zone 1

    • E. 

      Lipogenesis occurs primarily in Zone 1

  • 2. 
    In the setting of cirrhosis, which of the following is most likely to happen to liver sinusoids?
    • A. 

      Narrowing of the Space of Disse

    • B. 

      Smaller and fewer fenestrations

    • C. 

      Increased fenestrations

    • D. 

      Increased molecular transport across the Space of Disse

    • E. 

      Lose resemblance to systemic capillaries

  • 3. 
    In the setting of hepatocyte injury, which of the following is most likely to happen?
    • A. 

      Stellate cells are activated and transform into collagen-producing myofibroblasts

    • B. 

      Stellate cells are deactivated transform to prevent collagen production and cirrhosis

    • C. 

      Kupffer cells will turn into fibrotic bodies

    • D. 

      Dr. Servoss will write straightforward wrap-up questions to facilitate understanding of key concepts

  • 4. 
    Which organelle is correctly matched up with its function within the liver?
    • A. 

      Rough ER: Drug metabolism

    • B. 

      Smooth ER: Copper digestion

    • C. 

      Mitochondria: Alcohol metabolism

    • D. 

      Smooth ER: P450 oxidation rxns

    • E. 

      Lysosomes: Bile acid synthesis

  • 5. 
    Which of the following is most correct regarding apolipoproteins?
    • A. 

      Absence of Apo-C2 causes hypotriglyceridemia

    • B. 

      Apo E, found on all lipoproteins, is Important for removal of lipoprotein remnants from serum

    • C. 

      Apo-A1 is the major component of LDL

    • D. 

      Apo-B100 is found only in HDL

    • E. 

      Decreasing Apo-E levels is clinically helpful in patients with hyperlipidemia

  • 6. 
    A 46-year-old obese woman presents with a 6-hour history of moderate pain in the RUQ that began after eating dinner. The severity of the pain gradually increased before reaching a constant over the last few hours. She has had previous episodes of similar pain for which she has not sought medical advice. When asked about stool patterns, she noted that her stools have been a pale gray lately.  Her vital signs are normal. Her physical exam is noted for tenderness to palpation in the right upper quadrant with no guarding or rebound tenderness.How is her condition related to bilirubin metabolism?
    • A. 

      She has an obstruction in her biliary tract causing a lack of conjugated bilirubin in the intestine.

    • B. 

      She has an excess of urobilinogen due to bile duct obstruction

    • C. 

      She has a lack of albumin, causing decreased transport of conjugated bilirubin

    • D. 

      She has hyperactive bile ducts due to her obesity

    • E. 

      She has gallstones blocking her bile ducts, leading to excess unconjugated bilirubin entering the intestine

  • 7. 
    Which of the following patients would you expect to have an elevated level of indirect bilirubin?
    • A. 

      46 year old man with pancreatic cancer

    • B. 

      26 year old pregnant woman with cholestasis

    • C. 

      66 year old woman with pancreatic cancer

    • D. 

      23 year old male with mononucleosis acquired during a late night rendezvous in Ft. Lauderdale

  • 8. 
    A 3 week old male is seen by a neonatologist because of severe jaundice that appeared at birth and has been worsening since.  He is the first born child of a healthy Jewish couple.  His mother's pregnancy and delivery were uneventful.  On PE he is average height and weight for his age, and in no acute distress.  He has marked jaundice and slight hepatomegaly.  Lab tests show markedly elevated bilirubin of 15 mg/dL and a very low fecal urobilinogen.  Phenobarbital treatment is initiated, but is ultimately unsuccessful.  The child dies at 6 months of age after showing signs of delayed development.What is the most likely diagnosis?
    • A. 

      Dubin-Johnson syndrome

    • B. 

      Gilbert syndrome

    • C. 

      Criglar-Najjar Type 1

    • D. 

      Criglar-Najjar Type 2

    • E. 

      Rotor syndrome

  • 9. 
    A 56 year old male with a history of mild, controlled Ulcerative Colitis presents with complaints of fatigue and upper abdominal pain. When asked he recalls an itching sensation on the palms and soles, and loose, pale stools, but denies fever. Physical examination is unremarkable.  Which of the following sets of lab values would you expect to see in this patient?
    • A. 

      AST 40, ALT 40, Alk Phos 50

    • B. 

      AST 100, ALT 100, Alk Phos 500

    • C. 

      AST 1000, ALT 1000, Alk Phos 150

    • D. 

      AST 1000, ALT 1000, Alk Phos 500

    • E. 

      AST 10000, ALT 10000, Alk Phos 50000

  • 10. 
    A 43 year old asymptomatic woman has an ultrasound of her RUQ for the heck of it.  The result is shown here: What is the next most appropriate step in treatment?
    • A. 

      Open Cholecystectomy

    • B. 

      Laproscopic Cholecystectomy

    • C. 

      Reassure the patient, no further treatment required

    • D. 

      Bring the patient to the local medical school for a new 3 hour patient panel on mildly inconvenient diseases

  • 11. 
    A 20-year-old obese woman with a 2-year history of gallstones presents to the emergency room with severe, constant RUQ pain, nausea, and vomiting after eating fried chicken for dinner. She denies any chest pain or diarrhea. Three months ago she developed intermittent, sharp RUQ pains. On physical exam, she has a temperature of 100.4°F (38ºC), moderate RUQ tenderness on palpation, but no evidence of jaundice.Which of these is part of the standard treatment for her disease?
    • A. 

      Antibiotics

    • B. 

      NPO

    • C. 

      Surgery (laproscopic cholecystectomy)

    • D. 

      IV fluids

    • E. 

      All of the above are standard

  • 12. 
    Which of the following is most correct regarding pigment stones?
    • A. 

      Black pigmented stones are composed of Calcium bilirubinate

    • B. 

      Brown pigmented stones are the result of bacteria conjugating the bilirubin in the GB

    • C. 

      Chronic hemolysis is protective against pigmented stones

    • D. 

      Alcohol has no effect on the pathogenesis of pigmented stones

  • 13. 
    A 47-year-old overweight female patient is admitted with generalized abdominal pain. She has been unable to eat or drink due to nausea and vomiting. She states the pain started in the right upper quadrant, similar to previous episodes that she had been to the emergency room with over the past few months. An ultrasound obtained on her last visit to the emergency room revealed gallstones with no inflammation of the gallbladder and was told that she should see a surgeon. She looks jaundiced and in distress. She has point tenderness under her ribs on the right, which is worsened with deep palpation. No mass is palpable. Blood work reveals leukocytosis, hyperglycemia, elevated alkaline phosphatases, conjugated bilirubin, and gamma-GT. Lipase and amylase are 3 times their normal value.What is the diagnosis?
    • A. 

      Renal colic

    • B. 

      Acute pancreatitis

    • C. 

      Acute cholecystitis

    • D. 

      Intestinal obstruction

    • E. 

      Dubin-Johnson syndrome

  • 14. 
    Identify the three images below:A:B:C:
    • A. 

      A: Normal, B: Abscess, C: Pseudocyst

    • B. 

      A: Abscess, B: Normal, C: Abscess

    • C. 

      A: Abscess, B: Pseudocyst, C: Pseudocyst

    • D. 

      A: Pseudocyst, B: Abscess, C: Normal

  • 15. 
    Which of the following are attributed as causes of Chronic Pancreatitis?
    • A. 

      Alcohol abuse

    • B. 

      CFTR mutations

    • C. 

      Sjogren's Syndrome

    • D. 

      Diabetes Type 2

    • E. 

      A, B, and C

    • F. 

      All of the above

  • 16. 
    Which type of gallstones is the condition depicted below associated with?
    • A. 

      Black pigmented stones

    • B. 

      Brown pigmented stones

    • C. 

      Cholesterol stones

    • D. 

      Flint stones

    • E. 

      All of the above

  • 17. 
    Which of the following represents a mucinous cystadenoma of the pancreas?A:B: C:D:
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

  • 18. 
    A 55 year old Taiwanese male presents with painless jaundice.  He has no other symptoms and no history of gallstones or liver disease.  Upon physical exam the gallbladder is palpable.  Within 2 years, he dies from a cholangiocarcinoma.Which of the following statements is true regarding his condition?
    • A. 

      Risk factors include liver fluke infection, IBD, PSC, and Thorotrast use

    • B. 

      Strong association with gallstones

    • C. 

      Most tumors of this type are intrahepatic

    • D. 

      Intrahepatic tumors of this type are decreasing in incidence in the US due to rigorous testing

    • E. 

      The majority of the extrahepatic variety of these tumors are fast growing and metastasize often

  • 19. 
    A 63-year-old woman is admitted to the hospital with new-onset ascites. She has a history of longstanding diabetes and hypertension, but has never abused alcohol. She has never formally been given a diagnosis of liver disease. Despite increasing abdominal distension, she has lost 13.5 kg in the last year. Physical exam reveals a lethargic-appearing woman with temporal wasting, massive ascites, and 2+ pitting edema. She has numerous spider nevi over her chest wall and marked palmar erythema.Which of the following is most likely be found in a liver biopsy of this patient?
    • A. 

      Mild inflammation only

    • B. 

      Diffuse macrovesicular steatosis without fibrosis

    • C. 

      Cirrhosis

    • D. 

      Hyaline bodies

    • E. 

      C and D

  • 20. 
    A 50-year-old man presents to his primary-care clinic physician with complaints of fatigue for 2 months. The patient also notes distention of his abdomen and shortness of breath beginning 2 weeks ago. His wife reports that the patient has been having episodes of confusion lately. The patient has a significant medical history of chronic heavy alcohol consumption of about a half pint of vodka daily for around 20 years. On physical exam the patient is noted to have scleral icterus, tremors of both hands, and spider angiomata on the chest. There is abdominal distention with presence of shifting dullness, fluid waves, and splenomegaly. Laboratory examination shows low hemoglobin, low platelets, low sodium, AST elevation > ALT elevation, high PT and INR. Ultrasound of the abdomen shows liver hyperechogenicity, portal hypertension, splenomegaly, and ascites.Assuming an MDF value of 35, which of the following options is most appropriate?
    • A. 

      Reassure the patient, no further treatment necessary

    • B. 

      Liver biopsy

    • C. 

      Pentoxifylline

    • D. 

      Prednisolone

    • E. 

      B, C, and D are all possible

  • 21. 
    Which set of lab values would be expected in a patient with alcoholic liver disease?
    • A. 

      AST 150, ALT 75

    • B. 

      AST 75, ALT 75

    • C. 

      AST 500, ALT 250

    • D. 

      AST 250, ALT 500

  • 22. 
    An 18-year-old woman presents with bilateral tremor of the hands. She is a senior in high school and during the year her grades have plummeted to the point that she is failing. She says her memory is now poor, and she has trouble focusing on tasks. Her behavior has changed in the past 6 months in that she has frequent episodes of depression, separated by episodes of bizarre behavior, including shoplifting and excessive drinking. Her parents and other authorities have begun to suspect her of using street drugs, which she denies. Her handwriting has become very sloppy. Her parents have noted slight slurring of her speech. Physical exam reveals upper extremity tremor, mild dystonia of the upper extremities, and mild incoordination involving her hands.  She is found to have elevated serum aminotransferase enzymes (AST 150 units/L, ALT 175 units/L) an elevated serum bilirubin (77.0 micromol/L(4.5 mg/dL) and Coombs negative hemolytic anemia.Which of the following would be most likely to be seen on physical exam?
    • A. 

      Splenomegaly

    • B. 

      Kaiser-Fleicher rings

    • C. 

      Jaundice

    • D. 

      Ascites

    • E. 

      Peripheral edema

  • 23. 
    A 50 year old Caucasian male presents to his PCP with symptoms of chronic fatigue, weakness, lethargy, and apathy.  Upon physical exam he has hepatomegaly and dark appearing skin.  Lab results reveal a hemoglobin A1C of 9.5% and elevated ALT and AST.  X ray shows narrowing of joint spaces.  Which of the following is most accurate about the pathogenesis of his condition?
    • A. 

      He has elevated Hepcidin levels

    • B. 

      He has decreased Ferroportin function

    • C. 

      He probably has an elevated Transferrin saturation level

    • D. 

      His serum Ferritin level is likely decreased

    • E. 

      Liver biopsy will show iron deposition in Kupffer cells

  • 24. 
    The patient with the above liver biopsy presents to their PCP with jaundice, scleral icterus, abnormal LFTs, fatigue, and asterixis.  They were treated in the past with AAT augmentation for pulmonary symptoms.Which of the following accurately describes the expected findings in this liver biopsy?
    • A. 

      Normal liver tissue

    • B. 

      Acute hepatitis

    • C. 

      PAS - globules

    • D. 

      PAS + globules

    • E. 

      Pretty polka-dots

  • 25. 
    A 55 year old woman presents with fatigue, chronic itching, and jaundice.  She also has rheumatoid arthritis and chronic thyroiditis.  She does not drink alcohol.  PE shows xanthelasmas and scleral icterus.  Labs show Alk Phos of 350, ALT 80, AST 110, Total BR 2.5, Albumin 3.2, PTT 16 seconds.  AMA is positive.Which of the following is most correct about her condition?
    • A. 

      Ursodeoxycholic acid, while not curative, is the best available treatment

    • B. 

      Liver biopsy shows lack of bile ducts

    • C. 

      AMA has a low sensitivity

    • D. 

      Negative AMA is diagnostic

    • E. 

      Autoreactive CD8 cells cause symptoms

Back to Top Back to top