Patho 1st Lecture, 2nd Half

58 Questions | Total Attempts: 154

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Patho 1st Lecture, 2nd Half - Quiz

PA school pathophysiology quiz. Relating to GI system patho


Questions and Answers
  • 1. 
    Inflammatory Bowel Disease refers to what two closely related but distinct diseases?
    • A. 

      Gastric Adenocarcinoma and Iflammatory Bowel Syndrome

    • B. 

      Crohn's Disease and Cholecystitis

    • C. 

      Peptic Ulcer Disease and Crohn's Disease

    • D. 

      Crohn's Disease and Chronic Ulcerative Colitis

    • E. 

      Inflammatory Bowel Syndrom and Peptic Ulcer Disease

  • 2. 
    Which of the following is true about CUC as compared to Crohn's Disease in Western Countries?
    • A. 

      CUC has a prevalence of 20-40/100,000 while Crohn's has a prevalence of 70-150/100,000.

    • B. 

      CUC is 2-3 times more prevalent than Crohn's Disease.

    • C. 

      Crohn's disease is 2-4 times more prevalent than CUC.

    • D. 

      CUC has a prevalence of 10/100,000 while Crohn's has a prevalence of 1/100,000.

  • 3. 
    A 32 year old white patient of Eastern European descent presents with chronic GI inflammation.  The patient has a family history of Crohn's Disease.  What is your initial diagnosis?
    • A. 

      Crohn's Disease

    • B. 

      Inflammatory Bowel Syndrome

    • C. 

      Inflammatory Bowel Disease

    • D. 

      Chronic Ulcerative Colitis (CUC)

    • E. 

      Diverticulosis

  • 4. 
    What is the correct order for the most common place of occurance for Crohn's Disease?
    • A. 

      In 50% of cases, the disease affects both the terminal ileum and colon. In 30%, only the ileum, and in 20% of cases, limited to the colon.

    • B. 

      In 50% of cases, the disease affects the colon only. In 30% of cases, both the colon and the terminal ileum, and in 20% of cases, limited to the terminal ileum.

    • C. 

      In 75% of cases, the disease affects both the terminal ileum and the colon. In the remainding 25%, the disease afflicts only the colon.

    • D. 

      In 95% of cases, the disease affects only the terminal ileum. The remainding 5% occurs in the Duodenum.

    • E. 

      In 50% of cases, the disease affects both the duodenum and the terminal ileum. In 30%, it affects the colon and the rectum. And in 20% of cases, only the colon.

  • 5. 
    True or False:  The appendix is involved in most cases of Crohn's Disease.
    • A. 

      True

    • B. 

      False

  • 6. 
    True or False: 10% of patients with Crohn's Disease have involvement of the esophagus, stomach, or fallopian tubes.
    • A. 

      True

    • B. 

      False

  • 7. 
    Which answer best describes Peyer's Patches?
    • A. 

      Inflammation extending through the entire wall of the intestine forming patch-like designs seen in Crohn's disease.

    • B. 

      Non-caseating granulomas within the mucosa and submucosa associated with fibrosis of the muscularis and the serosa seen in Crohn's disease.

    • C. 

      Creeping fat on the surface of the mucosa seen in CUC.

    • D. 

      Creeping fat on the surface of the mucosa arranged in a patch-like formation seen in Crohn's disease.

    • E. 

      Shallow mucosal defects overlying lymphoid aggregets which suggest immune cell involvement seen in Crohn's disease.

  • 8. 
    Sharply demarcated non-caseating granulomas within the mucosa and submucosa, associated with fibrosis of the muscularis and the serosa causing the wall to be thickened and rigid describes which characteristic sign of Crohn's Disease?
    • A. 

      Peyer's Patches

    • B. 

      Skip Lesions

    • C. 

      Transmural inflammation

    • D. 

      Rubber-hose fibrosis

    • E. 

      Cobblestoning

  • 9. 
    In Crohn's Disease, what leads to the formation of a fistula?
    • A. 

      The narrowing of the fibrotic intestines causing stricture.

    • B. 

      Anal involvement.

    • C. 

      Inflammation of the serosa leading to adhesions with adjacent intestinal loops.

    • D. 

      Shallow mucosal defects overlying lymphoid aggregates.

    • E. 

      Cobblestone appearance interspersed between more normal appearing mucosa.

  • 10. 
    True or False: Anal involvement in Crohn's disease is often associated with formation of fistulas as well as abscesses.
    • A. 

      True

    • B. 

      False

  • 11. 
    What are the most common symptoms associated with Crohn's Disease?
    • A. 

      Bleeding, rectal involvement, and fever.

    • B. 

      Fever and constipation, associated with chronic exacerbations.

    • C. 

      Nasea, heartburn, indigestion, upset stomach, diarrhea.

    • D. 

      Diarrhea, abdominal pain, and weight loss characterized by exacerbations and remissions.

    • E. 

      Nausea, vomitting, and fever.

  • 12. 
    Diagnostic tools used to identify Crohn's Disease include:
    • A. 

      Endoscopy and liver biopsy

    • B. 

      Colonoscopy, X-ray, and mucosal biopsy

    • C. 

      Ultra Sound, Colonoscopy, X-ray

    • D. 

      CT scan, Endoscopy, biopsy

    • E. 

      X-ray, mucosal biopsy, HIDA scan.

  • 13. 
    This picture depicts:
    • A. 

      CUC with transmural inflammation

    • B. 

      Crohn's disease-cobblestone mucosa and creeping fat

    • C. 

      Crohn's disease with rubber hose fibrosis

    • D. 

      CUC with raw, ulcerated hemorrhagic mucosa.

  • 14. 
    Which of the following is NOT true of Ulcerative Colitis?
    • A. 

      A diffuse disease that does not usually extend into the ileum aside from mild inflammation of the terminal ileum ("backwash ileitis")

    • B. 

      Initially starts as rectal lesions and spreads proximally, eventually involving the entire colon.

    • C. 

      A disease leading to the involvement of the colon which is typically segmental.

    • D. 

      An Intestinal Inflammation of unknown etitology that most often involves the colon.

    • E. 

      A disease typically limited to thecolonic mucosa and submucosa.

  • 15. 
    The earliest lesions in CUC (visualized by rectoscope and colonoscope) appear as flattened edematous patches involving the entire circumfrence of the colonic mucosa.  What does the mucosa appear like?
    • A. 

      Thick, purulent, and prone to bleeding

    • B. 

      Shows cobblestone pattern with creeping fat.

    • C. 

      Prone to deep fissures penetrating into the muscle wall.

    • D. 

      Sandpaper, friable, and prone to bleeding.

  • 16. 
    Which disease histologically presents initially with fragile mucosa that is edematous and inflammed and then begins to show atrophy of the crypts with aggregates of lymphocytes in the base of the crypts ("crypt abscesses").
    • A. 

      CUC

    • B. 

      PUD

    • C. 

      IBS

    • D. 

      Crohn's disease

    • E. 

      Barretts esophagus.

  • 17. 
    In this histological picture of CUC, what do the circular capsules represent?
    • A. 

      Rubber Hose Fibrosis

    • B. 

      Ulcerating Hemorrhagic mucosa

    • C. 

      Crypt Abscesses

    • D. 

      Creeping Fat

  • 18. 
    What causes the Inflammatory Pseudopolyps (false tumors) usually seen in CUC?
    • A. 

      They are due to neoplastic epithelium that show no evidence of normal differentiation.

    • B. 

      Small remnants of inlfammed mucosa that appear to be elevated over the base of the surrounding ulcerations

    • C. 

      Dilated glands due to the obstructed flow of mucus.

    • D. 

      Invading aliens pushing through the lumen trying to make their way into the vasculature.

  • 19. 
    What does the following picture show?
    • A. 

      Small remnants of inflammed mucosa that appear to be elevated over the base of the surrounding ulcerations known as inflammatory pseudopolyps.

    • B. 

      Atrophy of the crypts with aggregates of lymphocytes in the base of the crypts known as crypt abscesses.

    • C. 

      Mild inflammation of the terminal ileum that can occur in CUC known as backwash ileitis.

    • D. 

      Colonic ulcerations that spread through the entire colon and become confluent during ulcerative colitis known as serpiginous ulcerations.

  • 20. 
    True or false: This picture represents foci of mucosal regeneration that will never undergo malignant transformation.
    • A. 

      True

    • B. 

      False

  • 21. 
    A chronic course of CUC is characterized by alternating periods of recrudenscence and asymptomatic intervals in what precentage of patients?
    • A. 

      7%

    • B. 

      25%

    • C. 

      55%

    • D. 

      95%

    • E. 

      70%

  • 22. 
    True of False: In 10% of patients, ulcerative colitis has only a single episode and then heals spontaneously.
    • A. 

      True

    • B. 

      False

  • 23. 
    Your patient presents with GI inflammation primarily affecting the left side of the colon.  The lesions are diffuse and limited to the mucosa and submucosa.  What is your initial diagnosis?
    • A. 

      IBS

    • B. 

      CUC

    • C. 

      GERD

    • D. 

      Crohn's Disease

    • E. 

      Apendicitis

  • 24. 
    Your patient presents with GI inflammation of the ileum accompanied by granulomas.  The ulcers involved are linear and resemble cobblestones.  What is your initial diagnosis.
    • A. 

      CUC

    • B. 

      Gastric Adenocarcinoma

    • C. 

      PUD

    • D. 

      Crohn's Disease

  • 25. 
    What diagnostic tools/tests would you use to confirm the diagnosis of a disease that causes a thin colonic wall which predisposes the patient to intestianal dilation and toxic megacolon with chance of perforation creating an increased risk for cancer?
    • A. 

      Colonoscopy and biopsy

    • B. 

      Clinical, radiographic, and pathologic evaluation.

    • C. 

      Endoscopy and HIDA scan

    • D. 

      Biopsy only

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