P20(A)

1. What is a common cause of gastroenteritis due to Salmonella?

A. unrefrigerated custards or salad dressings

B. poorly canned foods

C. raw or undercooked poultry or eggs

D. contaminated water

2. Which of the following applies to cleft palate?

A. The mandibular processes do not fuse.

B. The hard and soft palates do not fuse during the first trimester of pregnancy.

C. Exposure to environmental factors in the last trimester causes the defect.

D. Speech and eating are not affected.

3. Why does mild hyperbilirubinemia occur in newborns?

A. blood incompatibility between mother and child

B. there is damage to many erythrocytes during the birth process

C. poor circulation and albumin transport for bilirubin

D. the immature liver cannot process bilirubin quickly enough

4. Which of the following applies to hepatitis A infection?

A. It is also called serum hepatitis.

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

C. It contains a double strand of DNA.

D. It frequently leads to chronic hepatitis.

5. Which of the following applies to the act of swallowing?

A. requires coordination of cranial nerves V, IX, X, and XII

B. is entirely voluntary

C. is controlled by a center in the hypothalamus

D. does not affect respiration

6. What is/are common location(s) for oral cancer?

A. floor of the mouth or tongue borders

B. mucosa lining the cheeks

C. hard and soft palate

D. gingivae near the teeth

7. Why does herpes simplex infection tend to recur?

A. Active infection is usually asymptomatic.

B. The virus builds up a resistance.

C. The virus persists in latent form in sensory nerve ganglia.

D. The virus mutates; therefore, no effective immunity develops.

8. In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?

A. pancreas

B. liver

C. small intestine

D. spleen

9. What is a common cause of hiatal hernia?

A. an abnormally long esophagus

B. increased intra-abdominal pressure

C. stenosis of the hiatus in the diaphragm

D. a small fundus in the stomach

10. Which of the following statements applies to bile salts?

A. They give feces the characteristic brown color.

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

C. They emulsify lipids and lipid-soluble vitamins.

D. They are excreted in the feces.

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

A. anemia and leucopenia

B. jaundice and pruritus

C. recurrent infections

D. deficit of vitamin K and prothrombin

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

A. parietal cells

B. chief cells

C. mucous cells

D. gastrin cells

13. 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

14. Which of the following is the primary site for absorption of nutrients?

A. stomach

B. duodenum

C. ileum

D. ascending colon

15. Dehydration causes acidosis because of increased:

A. ketones produced

B. CO2 retained in the lungs and kidneys

C. hypovolemia and lactic acid production

D. metabolic rate

16. 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

17. Which of the following stimulates increased peristalsis and secretions in the digestive tract?

A. sympathetic nervous system

B. vagus nerve

C. increased saliva

D. absence of food in the system

18. What does the term gluconeogenesis refer to?

A. breakdown of glycogen to produce glucose

B. conversion of excess glucose into glycogen for storage

C. formation of glucose from protein and fat

D. breakdown of glucose into carbon dioxide and water

19. An alkaline environment is required in the duodenum to:

A. activate pepsinogen

B. activate intestinal and pancreatic enzymes

C. activate bile salts

D. produce mucus

20. A patient with acquired pyloric stenosis would likely:

A. have an increase in appetite

B. have chronic diarrhea

C. develop severe colicky pains

D. vomit undigested food from previous meals

21. What would be the result of chronic bleeding from gastric carcinoma?

A. occult blood in the stool and anemia

B. hematemesis and shock

C. abdominal pain and distention

D. red blood on the surface of the stool

22. Which of the following describes the supply of bile following a cholecystectomy?

A. Bile is no longer available for digestion.

B. Bile is stored in the liver sinusoids until a fatty meal is consumed.

C. Bile is not diluted and is less effective as an emulsifier.

D. Small amounts of bile are continuously secreted and flow into the duodenum.

23. The early stage of vomiting causes:

A. metabolic alkalosis

B. metabolic acidosis

C. increased respirations

D. increased excretion of hydrogen ions

24. Oral candidiasis is considered to:

A. be a common bacterial infection in infants and young children

B. cause painful ulcerations in the mucosa and tongue

C. cause white patches in the mucosa that cannot be scraped off

D. be an opportunistic fungal infection of the mouth

25. What does the term periodontitis refer to?

A. erosion of the enamel tooth surface

B. bacterial damage to the ligaments and bone surrounding teeth

C. inflammation and infection of the gingivae

D. formation of calcified plaque on the tooth

26. Predisposing factors to cholelithiasis include excessive:

A. bilirubin or cholesterol concentration in the bile

B. water content in the bile

C. bile salts in the bile

D. bicarbonate ions in the bile

27. Which of the following breaks protein down into peptides?

A. amylase

B. peptidase

C. lactase

D. trypsin

28. What is the first change in arterial blood gases with diarrhea?

A. increased bicarbonate ion

B. decreased bicarbonate ion

C. increased carbonic acid

D. increased serum pH

29. The visceral peritoneum:

A. lines the abdominal wall

B. hangs from the stomach over the loops of small intestine

C. contains many pain receptors

D. forms the outer covering of the stomach and intestines

E. covers the kidneys and bladder

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

A. Acute infection is present.

B. Chronic infection has developed.

C. Liver failure is in progress.

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

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

A. serum urea

B. conjugated bilirubin

C. serum ammonia

D. serum pH

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

A. glycogenesis

B. anabolic processes

C. catabolic processes

D. autodigestion

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

A. gastrin

B. secretin

C. cholecystokinin

D. histamine

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

A. increased unconjugated bilirubin in the blood

B. increased bleeding tendencies

C. pale stool and dark urine

D. elevated liver enzymes in the blood

35. Normally, proteins or amino acids are required to produce all of the following EXCEPT:

A. peptide hormones

B. clotting factors and antibodies

C. cellular energy

D. hemoglobin

36. What is the most common type of hepatitis transmitted by blood transfusion?

A. HAV

B. HBV

C. HCV

D. HEV

37. Which of the following processes is likely to occur in the body immediately after a meal?

A. lipolysis

B. ketogenesis

C. gluconeogenesis

D. glycogenesis

38. What does congenital pyloric stenosis involve?

A. absence of peristalsis in the lower section of the stomach

B. failure of an opening to develop between the stomach and duodenum

C. hypertrophy and hyperplasia of smooth muscle in the pylorus

D. thickening of the gastric wall due to chronic inflammation

39. The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:

A. decreased resistance of the mucosal barrier

B. increased stimulation of pepsin and acid secretions

C. infection by H. pylori

D. increased stimulation of mucus-producing glands

40. What is the major effect when a gallstone obstructs the cystic duct?

A. intrahepatic jaundice

B. acute pancreatitis

C. severe colicky pain in upper right quadrant

D. inflammation and infection in the gall bladder

41. Which of the following is contained in pancreatic exocrine secretions?

A. bicarbonate ion

B. hydrochloric acid

C. activated digestive enzymes

D. insulin

42. What is the definition of achalasia?

A. a herniation of the gastric mucosa through a segment of weakened muscle

B. recurrent reflux of chime into the esophagus

C. absence of a connection of the esophagus to the stomach

D. lack of a nerve plexus to relax the lower esophageal sphincter

43. What does esophageal atresia cause?

A. direct passage of saliva and food from the mouth into the trachea

B. repeated reflux of gastric secretions into the esophagus

C. no fluid or food entering the stomach

D. gastric distention and cramps

44. What does the pathophysiology of chronic gastritis include?

A. atrophy of the gastric mucosa with decreased secretions

B. hyperchlorhydria and chronic peptic ulcers

C. frequent vomiting and diarrhea

D. episodes of acute inflammation and edema of the mucosa

45. Prolonged or severe stress predisposes to peptic ulcer disease because:

A. of reduced blood flow to the gastric wall and mucous glands

B. of reduced bicarbonate content in bile and pancreatic secretions

C. stress increases the number of acid/pepsinogen secreting cells

D. increased epinephrine increases motility

46. 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

47. What does the defecation reflex require?

A. stimulation by the sympathetic nervous system

B. contraction of the internal anal sphincter

C. coordination through the sacral spinal cord

D. voluntary contraction of abdominal muscles

48. Which of the following individuals is likely to develop acute gastritis?

A. a long-term, heavy cigarette smoker

B. patient with arthritis taking enteric-coated aspirin on a daily basis

C. a person with an autoimmune reaction in the gastric mucosa

D. an individual with an allergy to shellfish

49. 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

B. severe hypoglycemia has developed

C. the pylorus is restricting the flow of chyme

D. bile and pancreatic secretions are irritating the small intestine

50. What is a common sign of acute gastritis?

A. colicky right upper quadrant pain

B. vomiting with epigastric tenderness

C. projectile vomiting after eating

D. diarrhea with abdominal distention

51. Which of the following would a perforated gastric ulcer likely cause?

A. severe anemia

B. chemical peritonitis

C. severe gastric hemorrhage

D. pyloric obstruction

52. 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

53. What is frequently the first manifestation of stress ulcers?

A. abdominal discomfort between meals and at night

B. nausea and diarrhea

C. hematemesis and hypotension

D. sharp colicky pain with food intake

54. Prolonged vomiting cause a state of acidosis due to:

A. catabolism of proteins and lipids

B. continued loss of gastric secretions

C. loss of pancreatic enzymes

D. retention of sodium ions and water

55. In patients with cirrhosis, serum ammonia may increase when:

A. ingesting excessive lipids

B. bleeding occurs in the digestive tract

C. an increase in unconjugated bilirubin occurs in the serum

D. less bile is produced