P20(A)
- 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
Correct Answer
B. B. anabolic processes -
- 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
Correct Answer
A. A. parietal cells -
- 3.
Which of the following is the primary site for absorption of nutrients?
- A.
A. stomach
- B.
B. duodenum
- C.
C. ileum
- D.
D. ascending colon
Correct Answer
C. C. ileum -
- 4.
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
Correct Answer
B. B. secretin -
- 5.
Which of the following breaks protein down into peptides?
- A.
A. amylase
- B.
B. peptidase
- C.
C. lactase
- D.
D. trypsin
Correct Answer
D. D. trypsin -
- 6.
In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?
- A.
A. pancreas
- B.
B. liver
- C.
C. small intestine
- D.
D. spleen
Correct Answer
B. B. liver -
- 7.
Which of the following stimulates increased peristalsis and secretions in the digestive tract?
- A.
A. sympathetic nervous system
- B.
B. vagus nerve
- C.
C. increased saliva
- D.
D. absence of food in the system
Correct Answer
B. B. vagus nerve -
- 8.
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
Correct Answer
A. A. bicarbonate ion -
- 9.
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
Correct Answer
B. B. activate intestinal and pancreatic enzymes -
- 10.
Which of the following processes is likely to occur in the body immediately after a meal?
- A.
A. lipolysis
- B.
B. ketogenesis
- C.
C. gluconeogenesis
- D.
D. glycogenesis
Correct Answer
D. D. glycogenesis -
- 11.
What does the term gluconeogenesis refer to?
- A.
A. breakdown of glycogen to produce glucose
- B.
B. conversion of excess glucose into glycogen for storage
- C.
C. formation of glucose from protein and fat
- D.
D. breakdown of glucose into carbon dioxide and water
Correct Answer
C. C. formation of glucose from protein and fat -
- 12.
Normally, proteins or amino acids are required to produce all of the following EXCEPT:
- A.
A. peptide hormones
- B.
B. clotting factors and antibodies
- C.
C. cellular energy
- D.
D. hemoglobin
Correct Answer
C. C. cellular energy -
- 13.
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.
Correct Answer
C. C. They emulsify lipids and lipid-soluble vitamins. -
- 14.
The visceral peritoneum:
- A.
A. lines the abdominal wall
- B.
B. hangs from the stomach over the loops of small intestine
- C.
C. contains many pain receptors
- D.
D. forms the outer covering of the stomach and intestines
- E.
E. covers the kidneys and bladder
Correct Answer
D. D. forms the outer covering of the stomach and intestines -
- 15.
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
Correct Answer
A. A. metabolic alkalosis -
- 16.
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
Correct Answer
A. A. catabolism of proteins and lipids -
- 17.
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
Correct Answer
B. B. decreased bicarbonate ion -
- 18.
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
Correct Answer
C. C. hypovolemia and lactic acid production -
- 19.
Which of the following applies to the act of swallowing?
- A.
A. requires coordination of cranial nerves V, IX, X, and XII
- B.
B. is entirely voluntary
- C.
C. is controlled by a center in the hypothalamus
- D.
D. does not affect respiration
Correct Answer
A. A. requires coordination of cranial nerves V, IX, X, and XII -
- 20.
What does the defecation reflex require?
- A.
A. stimulation by the sympathetic nervous system
- B.
B. contraction of the internal anal sphincter
- C.
C. coordination through the sacral spinal cord
- D.
D. voluntary contraction of abdominal muscles
Correct Answer
C. C. coordination through the sacral spinal cord -
- 21.
What is the definition of achalasia?
- A.
A. a herniation of the gastric mucosa through a segment of weakened muscle
- B.
B. recurrent reflux of chime into the esophagus
- C.
C. absence of a connection of the esophagus to the stomach
- D.
D. lack of a nerve plexus to relax the lower esophageal sphincter
Correct Answer
D. D. lack of a nerve plexus to relax the lower esophageal sphincter -
- 22.
What does esophageal atresia cause?
- A.
A. direct passage of saliva and food from the mouth into the trachea
- B.
B. repeated reflux of gastric secretions into the esophagus
- C.
C. no fluid or food entering the stomach
- D.
D. gastric distention and cramps
Correct Answer
C. C. no fluid or food entering the stomach -
- 23.
Which of the following applies to cleft palate?
- A.
A. The mandibular processes do not fuse.
- B.
B. The hard and soft palates do not fuse during the first trimester of pregnancy.
- C.
C. Exposure to environmental factors in the last trimester causes the defect.
- D.
D. Speech and eating are not affected.
Correct Answer
B. B. The hard and soft palates do not fuse during the first trimester of pregnancy. -
- 24.
Oral candidiasis is considered to:
- A.
A. be a common bacterial infection in infants and young children
- B.
B. cause painful ulcerations in the mucosa and tongue
- C.
C. cause white patches in the mucosa that cannot be scraped off
- D.
D. be an opportunistic fungal infection of the mouth
Correct Answer
D. D. be an opportunistic fungal infection of the mouth -
- 25.
Why does herpes simplex infection tend to recur?
- A.
A. Active infection is usually asymptomatic.
- B.
B. The virus builds up a resistance.
- C.
C. The virus persists in latent form in sensory nerve ganglia.
- D.
D. The virus mutates; therefore, no effective immunity develops.
Correct Answer
C. C. The virus persists in latent form in sensory nerve ganglia. -
- 26.
What does the term periodontitis refer to?
- A.
A. erosion of the enamel tooth surface
- B.
B. bacterial damage to the ligaments and bone surrounding teeth
- C.
C. inflammation and infection of the gingivae
- D.
D. formation of calcified plaque on the tooth
Correct Answer
B. B. bacterial damage to the ligaments and bone surrounding teeth -
- 27.
What is/are common location(s) for oral cancer?
- A.
A. floor of the mouth or tongue borders
- B.
B. mucosa lining the cheeks
- C.
C. hard and soft palate
- D.
D. gingivae near the teeth
Correct Answer
A. A. floor of the mouth or tongue borders -
- 28.
What is a common cause of hiatal hernia?
- A.
A. an abnormally long esophagus
- B.
B. increased intra-abdominal pressure
- C.
C. stenosis of the hiatus in the diaphragm
- D.
D. a small fundus in the stomach
Correct Answer
B. B. increased intra-abdominal pressure -
- 29.
What is a common sign of acute gastritis?
- A.
A. colicky right upper quadrant pain
- B.
B. vomiting with epigastric tenderness
- C.
C. projectile vomiting after eating
- D.
D. diarrhea with abdominal distention
Correct Answer
B. B. vomiting with epigastric tenderness -
- 30.
What does the pathophysiology of chronic gastritis include?
- A.
A. atrophy of the gastric mucosa with decreased secretions
- B.
B. hyperchlorhydria and chronic peptic ulcers
- C.
C. frequent vomiting and diarrhea
- D.
D. episodes of acute inflammation and edema of the mucosa
Correct Answer
A. A. atrophy of the gastric mucosa with decreased secretions -
- 31.
What is a common cause of gastroenteritis due to Salmonella?
- A.
A. unrefrigerated custards or salad dressings
- B.
B. poorly canned foods
- C.
C. raw or undercooked poultry or eggs
- D.
D. contaminated water
Correct Answer
C. C. raw or undercooked poultry or eggs -
- 32.
Which of the following individuals is likely to develop acute gastritis?
- A.
A. a long-term, heavy cigarette smoker
- B.
B. patient with arthritis taking enteric-coated aspirin on a daily basis
- C.
C. a person with an autoimmune reaction in the gastric mucosa
- D.
D. an individual with an allergy to shellfish
Correct Answer
D. D. an individual with an allergy to shellfish -
- 33.
What does congenital pyloric stenosis involve?
- A.
A. absence of peristalsis in the lower section of the stomach
- B.
B. failure of an opening to develop between the stomach and duodenum
- C.
C. hypertrophy and hyperplasia of smooth muscle in the pylorus
- D.
D. thickening of the gastric wall due to chronic inflammation
Correct Answer
C. C. hypertrophy and hyperplasia of smooth muscle in the pylorus -
- 34.
A patient with acquired pyloric stenosis would likely:
- A.
A. have an increase in appetite
- B.
B. have chronic diarrhea
- C.
C. develop severe colicky pains
- D.
D. vomit undigested food from previous meals
Correct Answer
D. D. vomit undigested food from previous meals -
- 35.
Prolonged or severe stress predisposes to peptic ulcer disease because:
- A.
A. of reduced blood flow to the gastric wall and mucous glands
- B.
B. of reduced bicarbonate content in bile and pancreatic secretions
- C.
C. stress increases the number of acid/pepsinogen secreting cells
- D.
D. increased epinephrine increases motility
Correct Answer
A. A. of reduced blood flow to the gastric wall and mucous glands -
- 36.
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:
- A.
A. decreased resistance of the mucosal barrier
- B.
B. increased stimulation of pepsin and acid secretions
- C.
C. infection by H. pylori
- D.
D. increased stimulation of mucus-producing glands
Correct Answer
D. D. increased stimulation of mucus-producing glands -
- 37.
Which of the following would a perforated gastric ulcer likely cause?
- A.
A. severe anemia
- B.
B. chemical peritonitis
- C.
C. severe gastric hemorrhage
- D.
D. pyloric obstruction
Correct Answer
B. B. chemical peritonitis -
- 38.
What is frequently the first manifestation of stress ulcers?
- A.
A. abdominal discomfort between meals and at night
- B.
B. nausea and diarrhea
- C.
C. hematemesis and hypotension
- D.
D. sharp colicky pain with food intake
Correct Answer
C. C. hematemesis and hypotension -
- 39.
What would be the result of chronic bleeding from gastric carcinoma?
- A.
A. occult blood in the stool and anemia
- B.
B. hematemesis and shock
- C.
C. abdominal pain and distention
- D.
D. red blood on the surface of the stool
Correct Answer
A. A. occult blood in the stool and anemia -
- 40.
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
Correct Answer
A. A. a large volume of chyme has entered the intestines, causing distention -
- 41.
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
Correct Answer
A. A. increased unconjugated bilirubin in the blood -
- 42.
Why does mild hyperbilirubinemia occur in newborns?
- A.
A. blood incompatibility between mother and child
- B.
B. there is damage to many erythrocytes during the birth process
- C.
C. poor circulation and albumin transport for bilirubin
- D.
D. the immature liver cannot process bilirubin quickly enough
Correct Answer
D. D. the immature liver cannot process bilirubin quickly enough -
- 43.
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
Correct Answer
A. A. bilirubin or cholesterol concentration in the bile -
- 44.
What is the major effect when a gallstone obstructs the cystic duct?
- A.
A. intrahepatic jaundice
- B.
B. acute pancreatitis
- C.
C. severe colicky pain in upper right quadrant
- D.
D. inflammation and infection in the gall bladder
Correct Answer
C. C. severe colicky pain in upper right quadrant -
- 45.
Which of the following describes the supply of bile following a cholecystectomy?
- A.
A. Bile is no longer available for digestion.
- B.
B. Bile is stored in the liver sinusoids until a fatty meal is consumed.
- C.
C. Bile is not diluted and is less effective as an emulsifier.
- D.
D. Small amounts of bile are continuously secreted and flow into the duodenum.
Correct Answer
D. D. Small amounts of bile are continuously secreted and flow into the duodenum. -
- 46.
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.
Correct Answer
B. B. It is transmitted by the fecal-oral route. -
- 47.
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.
Correct Answer
B. B. Chronic infection has developed. -
- 48.
What is the most common type of hepatitis transmitted by blood transfusion?
- A.
A. HAV
- B.
B. HBV
- C.
C. HCV
- D.
D. HEV
Correct Answer
C. C. HCV -
- 49.
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
Correct Answer
C. C. necrosis of liver cells -
- 50.
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
Correct Answer
D. D. gradual irreversible damage to the liver and cirrhosis -
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