What Do You Know About Digestive System? Pathophysiology Trivia Quiz

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What Do You Know About Digestive System? Pathophysiology Trivia Quiz - Quiz

What do you know about the digestive system? In this pathophysiology trivia quiz, you will get to see all there is a specific way that the system works, and there are different parts of the body that are involved in the whole process. Do give it a look and get to see just how


Questions and Answers
  • 1. 

    What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis?

    • A.

      Systemic effects of viral infection

    • B.

      Obstruction of bile ducts and malabsorption

    • C.

      Necrosis of liver cells

    • D.

      Ammonia toxicity

    Correct Answer
    C. Necrosis of liver cells
    Explanation
    During the preicteric stage of hepatitis, elevated serum levels of AST (aspartate aminotransferase) and ALT (alanine aminotransferase) indicate necrosis of liver cells. Hepatitis is characterized by inflammation of the liver, which can lead to the death of liver cells. As a result, AST and ALT, which are normally present within liver cells, are released into the bloodstream. Therefore, elevated levels of AST and ALT in the serum during the preicteric stage of hepatitis indicate the destruction of liver cells.

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  • 2. 

    What is the likely effect of long-term exposure to a hepatotoxin?

    • A.

      Full recovery to normal tissue after the toxic material is removed

    • B.

      Acute onset of vomiting, steatorrhea, and jaundice

    • C.

      Continued mild inflammation of the liver without permanent damage

    • D.

      Gradual irreversible damage to the liver and cirrhosis

    Correct Answer
    D. Gradual irreversible damage to the liver and cirrhosis
    Explanation
    Long-term exposure to a hepatotoxin is likely to cause gradual irreversible damage to the liver and eventually lead to cirrhosis. Hepatotoxins are substances that are toxic to the liver and can cause inflammation and injury to liver cells. Over time, this damage can accumulate and result in the scarring of liver tissue, known as cirrhosis. Cirrhosis is a chronic condition that impairs liver function and can lead to various complications, including liver failure. Therefore, the correct answer suggests that long-term exposure to a hepatotoxin is likely to have a detrimental effect on the liver, causing irreversible damage and cirrhosis.

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  • 3. 

    What indicates the presence of third-stage alcohol hepatitis?

    • A.

      Below normal blood levels of AST and ALT

    • B.

      ULQ tenderness and dull pain

    • C.

      A small, firm, nodular liver and portal hypertension

    • D.

      Accumulation of fat in the hepatocytes and hepatomegaly

    Correct Answer
    D. Accumulation of fat in the hepatocytes and hepatomegaly
    Explanation
    The presence of third-stage alcohol hepatitis is indicated by the accumulation of fat in the hepatocytes and hepatomegaly. This suggests that the liver cells have been damaged and are unable to properly metabolize and store fat, leading to its buildup in the cells. Hepatomegaly, or an enlarged liver, is also a common finding in alcohol hepatitis due to inflammation and scarring of the liver tissue. These signs are characteristic of advanced stages of alcohol-related liver disease.

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  • 4. 

    A primary factor causing encephalopathy with cirrhosis is the elevated:

    • A.

      Serum urea

    • B.

      Conjugated bilirubin

    • C.

      Serum ammonia

    • D.

      Serum pH

    Correct Answer
    C. Serum ammonia
    Explanation
    Encephalopathy with cirrhosis is primarily caused by elevated serum ammonia levels. In cirrhosis, the liver is unable to effectively remove ammonia from the blood, leading to its accumulation in the body. Elevated ammonia levels can lead to neurological symptoms such as confusion, disorientation, and impaired cognitive function. Therefore, monitoring and managing serum ammonia levels is crucial in the management of encephalopathy with cirrhosis.

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  • 5. 

    In patients with cirrhosis, serum ammonia may increase when:

    • A.

      Ingesting excessive lipids

    • B.

      Bleeding occurs in the digestive tract

    • C.

      An increase in unconguated bilirubin occurs in the serum

    • D.

      Less bile is produced

    Correct Answer
    B. Bleeding occurs in the digestive tract
    Explanation
    In patients with cirrhosis, serum ammonia may increase when bleeding occurs in the digestive tract. This is because when there is bleeding in the digestive tract, it can lead to the breakdown of blood and release of hemoglobin. The breakdown of hemoglobin produces ammonia as a byproduct, which can then be absorbed into the bloodstream. In patients with cirrhosis, the liver is already compromised and unable to effectively metabolize and detoxify ammonia, leading to an increase in serum ammonia levels.

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  • 6. 

    What is the primary cause of esophageal varices?

    • A.

      Portal hypertension

    • B.

      Alcohol irritating the mucosa

    • C.

      Failure to inactivate estrogen

    • D.

      Poor nutritional status

    Correct Answer
    A. Portal hypertension
    Explanation
    Esophageal varices are primarily caused by portal hypertension, which refers to increased pressure in the portal vein system. This increased pressure is often a result of liver cirrhosis, a condition that causes scarring and damage to the liver. As the liver becomes scarred, blood flow through the liver is obstructed, leading to increased pressure in the portal vein. This increased pressure then causes the development of varices, which are dilated blood vessels in the esophagus. These varices can be prone to rupture, leading to potentially life-threatening bleeding. Therefore, portal hypertension is the primary cause of esophageal varices.

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  • 7. 

    What is the primary cause of increased bleeding tendencies associated with cirrhosis?

    • A.

      Anemia and leukopenia

    • B.

      Jaundice and pruritus

    • C.

      Recurrent infections

    • D.

      Deficit of vitamin K and prothrombin

    Correct Answer
    D. Deficit of vitamin K and prothrombin
    Explanation
    The primary cause of increased bleeding tendencies associated with cirrhosis is a deficit of vitamin K and prothrombin. Cirrhosis is a condition where the liver is damaged and unable to perform its normal functions, including the production of clotting factors. Vitamin K is essential for the production of prothrombin, which is a clotting factor. Without sufficient levels of vitamin K and prothrombin, the blood is unable to clot properly, leading to increased bleeding tendencies in individuals with cirrhosis.

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  • 8. 

    Which factors contribute to ascites in patients with cirrhosis?

    • A.

      Increased aldosterone and deficit of albumin

    • B.

      Severe anemia and increase serum bilirubin

    • C.

      Hypoalemia and increased serum ammonia

    • D.

      Hyperproteinemia and persistent hypotension

    Correct Answer
    A. Increased aldosterone and deficit of albumin
    Explanation
    In patients with cirrhosis, ascites can occur due to increased aldosterone levels and a deficit of albumin. Aldosterone is a hormone that regulates sodium and water balance in the body. In cirrhosis, there is an increase in aldosterone production, leading to sodium and water retention in the kidneys, which contributes to the development of ascites. Additionally, cirrhosis can also cause a deficit of albumin, which is a protein responsible for maintaining fluid balance in the blood vessels. The decrease in albumin levels further exacerbates fluid accumulation in the abdominal cavity, leading to ascites.

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  • 9. 

    Which of the following is a major cause of primary hepatocellular cancer?

    • A.

      Metastic tumors

    • B.

      Acute hepatitis

    • C.

      Long term exposure to certain chemicals

    • D.

      Chronic cholelithiasis

    Correct Answer
    C. Long term exposure to certain chemicals
    Explanation
    Long term exposure to certain chemicals is a major cause of primary hepatocellular cancer. Prolonged exposure to certain chemicals, such as aflatoxins, vinyl chloride, and arsenic, can lead to the development of hepatocellular cancer. These chemicals are known to be carcinogenic and can damage the liver cells over time, increasing the risk of cancer. Other factors such as chronic viral hepatitis, alcohol abuse, and obesity can also contribute to the development of hepatocellular cancer, but long term exposure to certain chemicals is specifically mentioned as a major cause.

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  • 10. 

    What causes massive inflammation and necrosis in acute pancreatitis?

    • A.

      Formation of multiple thrombi and ischemia

    • B.

      Infection by intestinal

    • C.

      Immune complex reaction

    • D.

      Activation and spread of proteolytic enzymes

    Correct Answer
    D. Activation and spread of proteolytic enzymes
    Explanation
    In acute pancreatitis, the activation and spread of proteolytic enzymes is the main cause of massive inflammation and necrosis. These enzymes, such as trypsin, are normally produced by the pancreas to help with digestion. However, in acute pancreatitis, these enzymes become activated within the pancreas itself, leading to the destruction of pancreatic tissue. The spread of these enzymes can also cause inflammation and damage to surrounding tissues and organs. This process can result in severe pain, organ failure, and even death if not treated promptly.

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  • 11. 

    How does chemical peritonitis and shock frequently result from acute pancreatitis?

    • A.

      Inflammation and increased vascular permeability of the peritoneum affect fluid balance

    • B.

      Erosions in the intestinal wall causes release of bacteria

    • C.

      Fat necrosis and hypocalcemia develop

    • D.

      Secretions from the pancreas and intestine become more acidic

    Correct Answer
    A. Inflammation and increased vascular permeability of the peritoneum affect fluid balance
    Explanation
    The correct answer explains that inflammation and increased vascular permeability of the peritoneum affect fluid balance. This means that the inflammation and increased permeability of blood vessels in the peritoneum (the membrane lining the abdominal cavity) can cause fluid to leak into the abdominal cavity, leading to a condition called chemical peritonitis. This can result in shock, as the loss of fluid can cause a decrease in blood volume and inadequate perfusion of organs.

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  • 12. 

    Malnutrition may develop in children with celiac disease because of:

    • A.

      Damage to the intestinal villi

    • B.

      Obstruction in the pancreatic ducts

    • C.

      Acidosis preventing activation of digestive enzymes

    • D.

      Insufficient bile for absorption

    Correct Answer
    A. Damage to the intestinal villi
    Explanation
    Malnutrition may develop in children with celiac disease due to damage to the intestinal villi. The intestinal villi play a crucial role in absorbing nutrients from food. When they are damaged, the absorption of nutrients, including vitamins and minerals, is impaired, leading to malnutrition. This is because the damaged villi are unable to effectively absorb the necessary nutrients for proper growth and development.

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  • 13. 

    Which of the following best describes steatorrhea?

    • A.

      A light gray colored stool

    • B.

      A tarry black stool

    • C.

      Bulky, fatty, foul-smelling stools

    • D.

      Watery stools with mucus and blood

    Correct Answer
    C. Bulky, fatty, foul-smelling stools
    Explanation
    Steatorrhea is a condition characterized by bulky, fatty, and foul-smelling stools. This occurs when the body is unable to properly digest and absorb fats from the diet, resulting in the presence of undigested fat in the stool. This can be caused by various conditions such as pancreatic insufficiency, celiac disease, or Crohn's disease. The other options, including light gray colored stool, tarry black stool, and watery stools with mucus and blood, do not accurately describe steatorrhea.

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  • 14. 

    What is the dietary requirement for a child with celiac disease?

    • A.

      Low sodium, high fat

    • B.

      High carbohydrate, low protein

    • C.

      High calorie with vitamin supplements

    • D.

      Gluten-free

    Correct Answer
    D. Gluten-free
    Explanation
    The dietary requirement for a child with celiac disease is a gluten-free diet. Celiac disease is an autoimmune disorder in which the consumption of gluten, a protein found in wheat, barley, and rye, triggers an immune response that damages the small intestine. Therefore, individuals with celiac disease must strictly avoid gluten-containing foods to prevent symptoms and long-term complications. A gluten-free diet involves consuming foods that are naturally gluten-free, such as fruits, vegetables, lean meats, fish, dairy products, and gluten-free grains like rice and quinoa, while avoiding foods that contain gluten or are cross-contaminated with gluten.

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  • 15. 

    What are the typical changes occurring with Crohn's disease?

    • A.

      Degeneration and flattening of the villi in the small intestine

    • B.

      Multiple herniations of the mucosa through weak areas of the muscularis

    • C.

      A continuous area of mucosal inflammation and ulceration in the rectum and colon

    • D.

      Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas

    Correct Answer
    D. Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
    Explanation
    Crohn's disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. The typical changes occurring with Crohn's disease involve inflamed areas of the wall of the ileum, which is the last part of the small intestine, alternating with thick fibrotic or normal areas. This inflammation can lead to symptoms such as abdominal pain, diarrhea, and weight loss. The alternating pattern of inflammation and fibrosis can cause complications like strictures or narrowing of the intestine, leading to bowel obstruction. Understanding these typical changes is crucial for diagnosing and managing Crohn's disease.

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  • 16. 

    Stools that are more liquid and contain mucus, frank blood, and pus are typical of:

    • A.

      Diverticulitis

    • B.

      Ulcerative colitis

    • C.

      Chron's disease

    • D.

      Celiac disease

    Correct Answer
    B. Ulcerative colitis
    Explanation
    Stools that are more liquid and contain mucus, frank blood, and pus are typical of ulcerative colitis. This is because ulcerative colitis is an inflammatory bowel disease that primarily affects the colon and rectum. The inflammation in the colon leads to the production of excess mucus, which can cause stools to become more liquid. The presence of frank blood and pus in the stools is also characteristic of ulcerative colitis, as the inflamed colon can lead to bleeding and the formation of ulcers.

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  • 17. 

    How may a fistula form with Crohn's disease?

    • A.

      Lack of peristalsis leading to dilated areas of intestine

    • B.

      Fibrosis and thickening of the wall causing obstruction

    • C.

      Erosion of the mucosa causing bleeding

    • D.

      Recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops

    Correct Answer
    D. Recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops
    Explanation
    In Crohn's disease, the recurrent inflammation, necrosis, and fibrosis can cause damage to the intestinal wall. Over time, this can lead to the formation of abnormal connections, known as fistulas, between different loops of the intestine. These fistulas can allow the contents of the intestines to leak into surrounding tissues or organs, leading to complications and symptoms such as pain, infection, and abscess formation.

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  • 18. 

    How does iron-deficiency anemia frequently develop with ulcerative colitis?

    • A.

      Loss of surface area for absorption in the ileum

    • B.

      Bone marrow depression by toxic wastes

    • C.

      Chronic blood loss in stools

    • D.

      Insufficient hydrochloric acid for iron absorption

    Correct Answer
    C. Chronic blood loss in stools
    Explanation
    Iron-deficiency anemia frequently develops with ulcerative colitis due to chronic blood loss in stools. Ulcerative colitis is a condition characterized by inflammation and ulcers in the colon and rectum, which can lead to bleeding. The chronic blood loss results in a decrease in the body's iron levels, leading to iron-deficiency anemia.

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  • 19. 

    What is the cause of inflammatory bowel disease?

    • A.

      Physical and emotional stress

    • B.

      An autoimmune reaction

    • C.

      A combination of recessive genes

    • D.

      Idiopathic

    Correct Answer
    D. Idiopathic
    Explanation
    Inflammatory bowel disease is a term used to describe a group of disorders characterized by chronic inflammation in the digestive tract. The term "idiopathic" means that the exact cause of the disease is unknown. In other words, it is not clear what specifically triggers the inflammatory response in the digestive tract. While factors such as physical and emotional stress, autoimmune reactions, and genetic predisposition may play a role in the development of inflammatory bowel disease, none of them can be definitively identified as the sole cause of the condition. Therefore, the term "idiopathic" is used to acknowledge the lack of a known cause.

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  • 20. 

    What pain is typical of diverticulitis?

    • A.

      Lower left quadrant

    • B.

      Lower right quadrant

    • C.

      Sharp, colicky, periumbilical

    • D.

      Lower abdominal pain, radiating into the groin

    Correct Answer
    A. Lower left quadrant
    Explanation
    Diverticulitis is a condition characterized by inflammation or infection of small pouches (diverticula) that develop in the lining of the colon. The pain associated with diverticulitis is typically felt in the lower left quadrant of the abdomen. This pain is often described as a constant or intermittent ache that may be accompanied by other symptoms such as fever, nausea, and changes in bowel habits. The location of the pain in the lower left quadrant is due to the presence of diverticula in that area of the colon.

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  • 21. 

    What usually initiates acute appendicitis?

    • A.

      Infection in the appendix

    • B.

      An episode of severe diarrhea

    • C.

      Obstruction of the lumen in the appendix

    • D.

      Eating a low-fiber diet

    Correct Answer
    C. Obstruction of the lumen in the appendix
    Explanation
    Acute appendicitis is typically initiated by the obstruction of the lumen in the appendix. This obstruction can occur due to various factors such as fecal matter, enlarged lymphoid tissue, or tumors. When the lumen is blocked, it leads to the buildup of mucus, bacteria, and other substances, which can result in inflammation and infection. If left untreated, the appendix can rupture, leading to a potentially life-threatening condition. Infection in the appendix, severe diarrhea, and a low-fiber diet are not typically the primary causes of acute appendicitis.

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  • 22. 

    With acute appendicitis, localized pain and tenderness in the lower right quadrant results from:

    • A.

      Increased peristalsis in the adjacent colon

    • B.

      Inflammation and stretching of the appendiceal wall

    • C.

      Increased gas and fluid inside the appendix

    • D.

      Local inflammation of the parietal peritoneum

    Correct Answer
    D. Local inflammation of the parietal peritoneum
    Explanation
    The correct answer is "local inflammation of the parietal peritoneum." Acute appendicitis is characterized by inflammation of the appendix, which can lead to the rupture of the appendix if not treated promptly. This inflammation can cause irritation and inflammation of the surrounding tissues, including the parietal peritoneum. The parietal peritoneum is the outer layer of the peritoneum that lines the abdominal cavity, and its inflammation can result in localized pain and tenderness in the lower right quadrant, which is a common symptom of acute appendicitis.

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  • 23. 

    How does localized peritonitis develop from acute appendicitis before rupture?

    • A.

      The (m)omentum walls off the inflamed area.

    • B.

      Intestinal bacteria escape through the necrotic appendiceal wall

    • C.

      The obstructing object inside the appendix perforates the wall

    • D.

      Bacteria escape into the circulating blood

    Correct Answer
    B. Intestinal bacteria escape through the necrotic appendiceal wall
    Explanation
    When acute appendicitis occurs, the inflammation of the appendix causes necrosis (tissue death) in the wall of the appendix. This necrotic wall becomes a weak point, allowing intestinal bacteria to escape from the appendix into the surrounding peritoneal cavity. This leads to localized peritonitis, as the body's immune response causes inflammation in the area to try to contain the infection. If the appendix ruptures, the bacteria can spread further and potentially cause a more severe form of peritonitis.

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  • 24. 

    What is a typical early sign of cancer in the ascending colon?

    • A.

      Change in shape of the stool

    • B.

      Bleeding with defecation

    • C.

      Mild but persisitant pain in the lower left quadrant

    • D.

      Occult blood in the stool

    Correct Answer
    D. Occult blood in the stool
    Explanation
    Occult blood in the stool is a typical early sign of cancer in the ascending colon. Occult blood refers to the presence of blood that is not visible to the naked eye but can be detected through laboratory tests. The presence of occult blood suggests that there may be bleeding occurring in the gastrointestinal tract, which can be a sign of colorectal cancer. It is important to note that occult blood can also be caused by other conditions, such as hemorrhoids or ulcers, so further diagnostic tests would be needed to confirm the presence of cancer.

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  • 25. 

    To which site does colon cancer usually first metastasize?

    • A.

      Lungs

    • B.

      Stomach

    • C.

      Liver

    • D.

      Spleen

    Correct Answer
    C. Liver
    Explanation
    Colon cancer usually first metastasizes to the liver. This is because the liver receives a large blood supply from the colon, allowing cancer cells to easily spread through the bloodstream. Additionally, the liver provides a favorable environment for the growth and survival of cancer cells. Therefore, it is common for colon cancer to spread to the liver before metastasizing to other organs.

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  • 26. 

    How does a volvulus cause localized gangrene in the intestine?

    • A.

      Hypotension and shock causes ischemia

    • B.

      The mesenteric arteries are compressed in the twisted section of intestine

    • C.

      A section of intestine herniates between the muscles of the abdominal wall

    • D.

      The distention of the intestinal wall causes increased permeability of the tissue

    Correct Answer
    B. The mesenteric arteries are compressed in the twisted section of intestine
    Explanation
    When a volvulus occurs, the intestine twists on itself, causing compression of the mesenteric arteries. These arteries supply blood to the intestine, and when they are compressed, blood flow is restricted. This leads to ischemia, a condition where the tissue does not receive enough oxygen and nutrients. Without adequate blood supply, the affected section of the intestine becomes necrotic, leading to localized gangrene.

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  • 27. 

    Which of the following is a typical indicator of an intestinal obstruction caused by paralytic ileus?

    • A.

      Excessive audbile bowel sounds

    • B.

      Intermittent colicky pain

    • C.

      Severe steady abdominal pain

    • D.

      Visible peristalsis

    Correct Answer
    C. Severe steady abdominal pain
    Explanation
    Severe steady abdominal pain is a typical indicator of an intestinal obstruction caused by paralytic ileus. Paralytic ileus is a condition in which there is a disruption in the normal movement of the intestines, leading to a blockage. This blockage can cause severe and steady abdominal pain as the intestines are unable to properly move and function. The other options, such as excessive audible bowel sounds, intermittent colicky pain, and visible peristalsis, may be seen in other conditions but are not specific to paralytic ileus.

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  • 28. 

    Partial obstruction of the sigmoid colon resulting from diverticular disease would likely:

    • A.

      Cause severe colicky pain

    • B.

      Cause frequent diarrhea

    • C.

      Develops very rapidly

    • D.

      Result in a small, hard stool

    Correct Answer
    D. Result in a small, hard stool
    Explanation
    Partial obstruction of the sigmoid colon resulting from diverticular disease can lead to a small, hard stool. Diverticular disease is characterized by the formation of small pouches or diverticula in the colon wall. When these pouches become inflamed or infected, they can cause narrowing of the colon, leading to a partial blockage. This can result in difficulty passing stool, leading to the formation of small, hard stools. Other symptoms of diverticular disease may include abdominal pain, constipation, and changes in bowel habits. However, severe colicky pain, frequent diarrhea, and rapid development are not typically associated with partial obstruction in diverticular disease.

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  • 29. 

    What causes hypovolemic shock to develop with intestinal obstruction?

    • A.

      Continued vomiting and fluid shift into the intestine

    • B.

      Hemorrhage into the intestine

    • C.

      Rupture of the intestinal wall

    • D.

      Repeated bouts of severe diarrhea

    Correct Answer
    A. Continued vomiting and fluid shift into the intestine
    Explanation
    Continued vomiting and fluid shift into the intestine can cause hypovolemic shock to develop with intestinal obstruction. When a person has an intestinal obstruction, the normal flow of fluids and contents through the intestine is blocked. This can lead to continued vomiting, which causes the loss of fluids from the body. Additionally, the fluid that would normally be absorbed by the intestine is instead shifted into the blocked area, further contributing to fluid loss. This loss of fluids can result in hypovolemic shock, which is a life-threatening condition characterized by low blood volume and inadequate tissue perfusion.

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  • 30. 

    What causes the characteristic rigid abdomen found in the patient with peritonitis?

    • A.

      Increased fluid and gas causing abdominal distention

    • B.

      Inflammation of the peritoneum and organs causing a firm mass in the abdomen

    • C.

      Inflamed peritoneum resulting in reflex abdominal muscle spasm

    • D.

      The patient voluntarily contracts the abdominal muscles as a protective mechanism

    Correct Answer
    C. Inflamed peritoneum resulting in reflex abdominal muscle spasm
    Explanation
    The characteristic rigid abdomen found in a patient with peritonitis is caused by inflamed peritoneum resulting in reflex abdominal muscle spasm. In peritonitis, the peritoneum, which is the thin tissue lining the inner wall of the abdomen, becomes inflamed due to infection or inflammation in the abdominal cavity. This inflammation triggers a reflex response in the abdominal muscles, causing them to contract and become rigid. This reflex abdominal muscle spasm helps protect the inflamed peritoneum and underlying organs from further injury or irritation.

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  • 31. 

    What would be the likely outcome from chemical peritonitis related to a perforated gall bladder?

    • A.

      Leakage of intestinal bacteria into blood and the peritoneal cavity

    • B.

      Massive hemorrhage and shock

    • C.

      Breakdown of the gallstones

    • D.

      Increasing peristalsis with intermittent painful spasms

    Correct Answer
    A. Leakage of intestinal bacteria into blood and the peritoneal cavity
    Explanation
    Chemical peritonitis occurs when there is a perforation in the gall bladder, causing leakage of intestinal bacteria into the bloodstream and the peritoneal cavity. This can lead to infection and inflammation in the peritoneum, the lining of the abdominal cavity. The presence of bacteria in the blood can also lead to systemic infection and sepsis if left untreated. Therefore, the likely outcome of chemical peritonitis related to a perforated gall bladder is the leakage of intestinal bacteria into the blood and the peritoneal cavity.

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  • 32. 

    How does pelvic inflammatory disease frequently lead to bacterial peritonitis?

    • A.

      Chemical irritation by excessive ovarian and uterine secretions causes inflammation

    • B.

      Ulceration and perforation of the uterus allows the bacteria to spread

    • C.

      Infection spreads through the fallopian tubes directly into the peritoneal cavity

    • D.

      Gangrene in the uterine wall spreads through into the pelvic cavity

    Correct Answer
    C. Infection spreads through the fallopian tubes directly into the peritoneal cavity
    Explanation
    The correct answer explains that the infection in pelvic inflammatory disease spreads through the fallopian tubes directly into the peritoneal cavity. This means that the bacteria from the infection move from the reproductive organs into the abdominal cavity, leading to bacterial peritonitis. This explanation highlights the direct pathway through which the infection spreads and causes the complication.

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  • 33. 

    Choose the significant change in arterial blood gases expected with prolonged severe vomiting:

    • A.

      Increased bicarbonate ion, increased PCO2, serum pH 7.4

    • B.

      Decreased bicarbonate ion, decreased PCO2, serum pH 7.35

    • C.

      Increased bicarbonate ion, decreased PCO2, serum pH 7.35

    • D.

      Decreased bicarbonate ion, increased PCO2, serum pH 7.45

    Correct Answer
    B. Decreased bicarbonate ion, decreased PCO2, serum pH 7.35
    Explanation
    Prolonged severe vomiting can lead to a loss of stomach acid, which in turn can cause a decrease in bicarbonate ion levels. Additionally, vomiting can cause a loss of carbon dioxide, leading to a decrease in PCO2 levels. These changes would result in a decrease in serum pH, as indicated by a pH of 7.35. Therefore, the expected significant change in arterial blood gases with prolonged severe vomiting is a decrease in bicarbonate ion, a decrease in PCO2, and a serum pH of 7.35.

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  • 34. 

    When dehydration reduces the compensation possible for acidosis resulting from prolonged diarrhea, what significant change in arterial blood gases indicates this?

    • A.

      Serum pH would rise above 7.45

    • B.

      Serum bicarbonate levels would increase, serum pH would remain in normal range

    • C.

      Serum bicarbonate levels would decrease, serum pH would drop below 7.35

    • D.

      Serum PCO2 would rise, serum pH would be around 7.4

    Correct Answer
    C. Serum bicarbonate levels would decrease, serum pH would drop below 7.35
    Explanation
    When dehydration reduces the compensation possible for acidosis resulting from prolonged diarrhea, the significant change in arterial blood gases that indicates this is a decrease in serum bicarbonate levels and a drop in serum pH below 7.35.

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  • 35. 

    How do body defenses respond immediately after the gall bladder ruptures?

    • A.

      A. A local inflammatory response occurs

    • B.

      B. The (m)omentum and peritoneum seal off the area.

    • C.

      C. Blood clots seal the perforation.

    • D.

      A and b

    • E.

      A and c

    Correct Answer
    C. C. Blood clots seal the perforation.
    Explanation
    When the gall bladder ruptures, blood clots are formed to seal the perforation. This is a mechanism by which the body tries to prevent further leakage of bile and other fluids into the abdominal cavity. This response helps to minimize the spread of infection and inflammation in the area.

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  • 36. 

    Dehydration limits compensation available for an acid-base imbalance resulting from prolonged vomiting and diarrhea because:

    • A.

      Hypovolemia limits renal function

    • B.

      Increased respirations cannot remove more H+

    • C.

      Increased ADH blocks secretion of H+

    • D.

      More sodium and potassium ions are retained

    Correct Answer
    A. Hypovolemia limits renal function
    Explanation
    Dehydration limits compensation available for an acid-base imbalance resulting from prolonged vomiting and diarrhea because hypovolemia limits renal function. When the body is dehydrated, there is a decrease in blood volume, which leads to reduced blood flow to the kidneys. This can impair the kidneys' ability to effectively filter and excrete waste products, including hydrogen ions (H+), which are involved in acid-base balance. Without proper renal function, the body is unable to regulate the levels of acid and base, leading to an imbalance.

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  • 37. 

    Which of the following is the most frequent location of peptic ulcers?

    • A.

      Lower esophagus

    • B.

      Antrum of the stomach

    • C.

      Proximal duodenum

    • D.

      Distal duodenum

    Correct Answer
    C. Proximal duodenum
    Explanation
    Peptic ulcers are most commonly found in the proximal duodenum, which is the upper part of the small intestine that connects to the stomach. The acidic digestive juices produced in the stomach can damage the lining of the duodenum, leading to the formation of ulcers. The location of the proximal duodenum makes it more susceptible to the effects of stomach acid, explaining why it is the most frequent location for peptic ulcers.

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  • 38. 

    In peptic ulcer disease, which of the following does NOT decrease the resistance of the mucosal barrier?

    • A.

      Prolonged vasoconstriction

    • B.

      Excessive glucocortiocoid intake

    • C.

      Proteases and cyotoxins from H. pylori

    • D.

      Decreased vagal stimulation

    Correct Answer
    D. Decreased vagal stimulation
    Explanation
    Vagal stimulation increases the resistance of the mucosal barrier in peptic ulcer disease. Decreased vagal stimulation would not decrease the resistance of the mucosal barrier.

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  • 39. 

    An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate?

    • A.

      Perforation

    • B.

      Obstruction

    • C.

      Erosion of a large blood vessel

    • D.

      Development of malignancy

    Correct Answer
    C. Erosion of a large blood vessel
    Explanation
    Hematemesis refers to the vomiting of blood, which is a symptom commonly associated with the erosion of a large blood vessel in individuals with peptic ulcer disease. This occurs when the ulcer erodes through a major blood vessel, leading to bleeding and subsequent vomiting of blood. Perforation, obstruction, and the development of malignancy are not typically associated with hematemesis in peptic ulcer disease.

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  • 40. 

    What does the term melena mean?

    • A.

      Blood in a dark colored stool

    • B.

      Occult blood in the stool

    • C.

      Blood in the sputum

    • D.

      Blood in vomitus

    Correct Answer
    A. Blood in a dark colored stool
    Explanation
    Melena refers to the presence of blood in a dark colored stool. This occurs when there is bleeding in the upper gastrointestinal tract, such as the stomach or small intestine. The blood undergoes digestion as it passes through the digestive system, resulting in a dark, tarry appearance in the stool. Melena is often a sign of a serious medical condition, such as a bleeding ulcer or gastrointestinal bleeding, and requires prompt medical attention.

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  • 41. 

    Which of the following is NOT a common predisposing factor to gastric carcinoma?

    • A.

      Ingestion of smoked foods

    • B.

      Genetic factors

    • C.

      Ingestion of foods preserved with nitrates

    • D.

      Anti-inflammatory medications such as ASA

    Correct Answer
    D. Anti-inflammatory medications such as ASA
    Explanation
    Anti-inflammatory medications such as ASA are not a common predisposing factor to gastric carcinoma. Gastric carcinoma is primarily caused by factors such as chronic infection with Helicobacter pylori, ingestion of smoked foods, ingestion of foods preserved with nitrates, and genetic factors. While anti-inflammatory medications can have other adverse effects on the gastrointestinal system, they are not typically associated with an increased risk of gastric carcinoma.

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  • 42. 

    Which of the following frequently occurs 2-3 hours after meals in post-gastrectomy patients?

    • A.

      Hypoglycemia

    • B.

      Hypovolemia

    • C.

      Abdominal cramps and distention

    • D.

      Increased peristalisis and diarrhea

    Correct Answer
    A. Hypoglycemia
    Explanation
    Hypoglycemia frequently occurs 2-3 hours after meals in post-gastrectomy patients because the stomach plays a role in releasing glucose into the bloodstream. In post-gastrectomy patients, the stomach is either partially or completely removed, leading to a decrease in the production of digestive enzymes and hormones, including insulin. As a result, there is a higher risk of low blood sugar levels after meals, causing symptoms such as dizziness, weakness, and confusion. Monitoring blood sugar levels and managing diet and medication are essential in preventing and managing hypoglycemia in these patients.

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  • 43. 

    Which term refers to obstruction of the biliary tract by gallstones?

    • A.

      Cholelithiasis

    • B.

      Cholecystitis

    • C.

      Cholangitis

    • D.

      Choledocholithiasis

    Correct Answer
    D. Choledocholithiasis
    Explanation
    Choledocholithiasis refers to the obstruction of the biliary tract by gallstones. This condition occurs when the gallstones, which are formed in the gallbladder, migrate into the common bile duct, causing a blockage. This obstruction can lead to symptoms such as abdominal pain, jaundice, and inflammation of the bile ducts. Treatment for choledocholithiasis often involves the removal of the gallstones through procedures like endoscopic retrograde cholangiopancreatography (ERCP) or surgery.

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  • 44. 

    Which of the following is NOT usually present during the icteric stage of viral hepatitis?

    • A.

      Hepatomegaly

    • B.

      Elevated serum liver enzymes

    • C.

      Esophageal varices

    • D.

      Lighter colored stools

    Correct Answer
    C. Esophageal varices
    Explanation
    Esophageal varices are not usually present during the icteric stage of viral hepatitis. The icteric stage is characterized by the yellowing of the skin and eyes due to elevated levels of bilirubin in the blood. Hepatomegaly, elevated serum liver enzymes, and lighter colored stools are commonly seen during this stage. Esophageal varices, on the other hand, are enlarged and swollen veins in the lower part of the esophagus that occur as a result of liver cirrhosis, not viral hepatitis.

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  • 45. 

    Which of the following statements about jaundice is/are true? 1. It is often the first manifestation of hepatitis 2. Jaundice indiciates permanent liver damage 3. Individuals with hepatitis are always jaundiced 4. Jaundice usually develops with hepatocellular carcinoma

    • A.

      1 only

    • B.

      4 only

    • C.

      1 and 3

    • D.

      2 and 4

    Correct Answer
    B. 4 only
    Explanation
    Jaundice is a condition characterized by the yellowing of the skin and eyes due to a buildup of bilirubin in the body. The correct answer, "4 only," is the statement that jaundice usually develops with hepatocellular carcinoma. This means that jaundice is commonly associated with liver cancer. The other statements are incorrect. Jaundice is not always the first manifestation of hepatitis (statement 1), it does not indicate permanent liver damage (statement 2), and individuals with hepatitis are not always jaundiced (statement 3).

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  • 46. 

    Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?

    • A.

      HBV

    • B.

      HCV

    • C.

      HBV and HCV

    • D.

      Neither HBV nor HCV

    Correct Answer
    C. HBV and HCV
    Explanation
    Both HBV (Hepatitis B virus) and HCV (Hepatitis C virus) increase the risk of hepatocellular carcinoma. Hepatocellular carcinoma is a type of liver cancer, and chronic infection with HBV or HCV can lead to the development of this cancer over time. Both viruses can cause inflammation and damage to the liver, which can eventually lead to the formation of cancerous cells. Therefore, individuals with chronic HBV or HCV infection have a higher risk of developing hepatocellular carcinoma compared to those without these infections.

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  • 47. 

    Which of the following are related to post-hepatic jaundice?

    • A.

      Pruritic skin and light-colored stools

    • B.

      Dark-colored stools and urine

    • C.

      Increased serum levels of unconjugated bilirubin

    • D.

      Loss of all metabolic functions

    Correct Answer
    A. Pruritic skin and light-colored stools
    Explanation
    Post-hepatic jaundice is a condition that occurs when there is a blockage in the bile ducts, preventing the flow of bile from the liver to the intestines. This blockage can lead to the accumulation of bilirubin in the bloodstream, causing symptoms such as pruritic skin (itchy skin) and light-colored stools. Dark-colored stools and urine are more commonly associated with pre-hepatic jaundice, where the excess bilirubin is due to increased breakdown of red blood cells. Increased serum levels of unconjugated bilirubin can be seen in both pre-hepatic and post-hepatic jaundice. Loss of all metabolic functions is not specific to post-hepatic jaundice and is not related to the condition.

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  • 48. 

    Which of the following occurs with hepatitis B?

    • A.

      The liver is inflammed and enlarged

    • B.

      Blood clotting delays are apparent at onset

    • C.

      Hepatocytes can not regenerate when virus is present

    • D.

      Infection is self limiting

    Correct Answer
    A. The liver is inflammed and enlarged
    Explanation
    Hepatitis B is a viral infection that affects the liver. It causes inflammation and enlargement of the liver, which is known as hepatomegaly. This occurs because the virus attacks and damages the liver cells, leading to an immune response and inflammation. The inflammation causes the liver to become enlarged. The other options mentioned in the question, such as blood clotting delays, inability of hepatocytes to regenerate, and self-limiting infection, are not specifically associated with hepatitis B.

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  • 49. 

    Identify a major reason making it difficult to prevent the spread of hepatitis B.

    • A.

      A vaccine is not available

    • B.

      The incubation period is too short to track contacts

    • C.

      Infection is often asymptomatic

    • D.

      Antibodies are not produced

    Correct Answer
    C. Infection is often asymptomatic
    Explanation
    One major reason that makes it difficult to prevent the spread of hepatitis B is that the infection is often asymptomatic. This means that infected individuals may not show any symptoms of the disease, making it challenging to identify and isolate them. As a result, they can unknowingly spread the virus to others through various means such as sexual contact or sharing needles. This lack of visible symptoms makes it harder to control the spread of hepatitis B and highlights the importance of regular screenings and vaccination efforts.

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  • 50. 

    What is the initial pathological change in alcoholic liver disease?

    • A.

      Formation of nodules with shrinkage of the liver

    • B.

      Inflammation with necrosis

    • C.

      Development of fibrous bands of tissue

    • D.

      Accumulation of fat in hepatocytes with hepatomegaly

    Correct Answer
    D. Accumulation of fat in hepatocytes with hepatomegaly
    Explanation
    The initial pathological change in alcoholic liver disease is the accumulation of fat in hepatocytes with hepatomegaly. This occurs due to the excessive consumption of alcohol, which leads to the buildup of fat in the liver cells. This can eventually progress to inflammation, necrosis, and the development of fibrous bands of tissue. However, the initial change is the accumulation of fat, which is a characteristic feature of alcoholic liver disease.

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