Patho 4 Practice Quiz GI
GI with a little bit of neuro
- 1.
What controls the peristaltic movements of the esophagus?
- A.
Brain stem
- B.
Vagus nerve
- C.
Auerbach's plexus
- D.
Greater splanchnic nerve
- E.
Esophageal plexus
Correct Answer
C. Auerbach's plexusExplanation
Auerbach's plexus, also known as the myenteric plexus, is a network of nerves located between the circular and longitudinal muscle layers of the esophagus. It plays a crucial role in controlling the peristaltic movements of the esophagus. Peristalsis is the coordinated contraction and relaxation of the muscles that propel food and liquids through the digestive system. Auerbach's plexus coordinates these contractions, ensuring that food moves smoothly from the esophagus to the stomach.Rate this question:
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- 2.
Which is true?
- A.
Peristalsis is the same thing as tonic motor movements of the stomach.
- B.
The esophagus, like the stomach, is an acidic environment.
- C.
The beginning of the esophageal phase of swallowing is when the upper esophageal sphincter contracts.
- D.
Waterbrash often occurs right before vomiting.
- E.
Achalasia occurs when the upper esophageal sphincter fails to relax.
Correct Answer
D. Waterbrash often occurs right before vomiting. -
- 3.
Which is a possible cause of secondary achalasia?
- A.
Degeneration of Auerbach's plexus
- B.
Toxins
- C.
Degeneration of vagal fibers
- D.
Mallory-Weiss syndrome
- E.
Scleroderma
Correct Answer
B. ToxinsExplanation
Scleroderma can cause incompetence of the LES, failure to constrict.Rate this question:
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- 4.
Which is associated with esophageal varices?
- A.
Mallory-Weiss syndrome
- B.
Cirrhosis
- C.
Hepatitis
- D.
GERD
- E.
Scleroderma
Correct Answer
B. CirrhosisExplanation
Esophageal varices are enlarged and swollen veins in the lower part of the esophagus. They are commonly associated with cirrhosis, a condition characterized by scarring of the liver. Cirrhosis causes increased pressure in the portal vein, which carries blood from the digestive organs to the liver. This increased pressure leads to the development of varices in the esophagus. Mallory-Weiss syndrome is a condition characterized by tears in the lining of the esophagus and is not directly associated with esophageal varices. Hepatitis is inflammation of the liver, GERD is a chronic condition where stomach acid flows back into the esophagus, and scleroderma is a connective tissue disorder, none of which are directly associated with esophageal varices.Rate this question:
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- 5.
Which is false concerning esophageal tumors?
- A.
Leiomyomas are benign
- B.
Dysphagia is an early sign of esophageal cancer
- C.
Genetic tendency in 50% of cases
- D.
Adenocarcinoma from Barrett's is usually distal
- E.
Squamous cell carcinoma accounts for half of esophageal cancers
Correct Answer
B. Dysphagia is an early sign of esophageal cancerExplanation
Dysphagia is not an early sign of esophageal cancer. In fact, dysphagia, which is difficulty swallowing, is usually a late symptom of esophageal cancer. Other early signs of esophageal cancer may include weight loss, chest pain, and heartburn.Rate this question:
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- 6.
Which is released in response to the presence of food in the stomach? (two answers)
- A.
Pepsinogen
- B.
Mucus
- C.
Gastrin
- D.
HCL
- E.
Pepsin
Correct Answer(s)
C. Gastrin
D. HCLExplanation
Gastrin is released in response to the presence of food in the stomach. It is a hormone that stimulates the release of gastric acid, which aids in the digestion of food. HCL (hydrochloric acid) is also released in response to the presence of food in the stomach. It helps to break down proteins and kill bacteria that may be present in the food.Rate this question:
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- 7.
Which secrete pepsinogen?
- A.
Chief cells
- B.
Parietal cells
- C.
Intrinsic factors
- D.
Cardiac glands
- E.
G cells
Correct Answer
A. Chief cellsExplanation
Chief cells secrete pepsinogen. Pepsinogen is an inactive form of the enzyme pepsin, which plays a crucial role in the digestion of proteins. Chief cells are found in the gastric glands of the stomach and are responsible for producing and releasing pepsinogen into the stomach. Once pepsinogen reaches the stomach's acidic environment, it is converted into pepsin, which can then break down proteins into smaller peptides. Parietal cells, on the other hand, secrete hydrochloric acid, while intrinsic factors are involved in the absorption of vitamin B12. Cardiac glands and G cells are not directly involved in the secretion of pepsinogen.Rate this question:
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- 8.
Which does not stimulate the secretion of stomach acid?
- A.
The vagus nerve
- B.
Histamine 2
- C.
Prostaglandins
- D.
Proton pump
- E.
Gastrin
Correct Answer
C. ProstaglandinsExplanation
Prostaglandins do not stimulate the secretion of stomach acid. While the vagus nerve, histamine 2, proton pump, and gastrin are all known to stimulate the secretion of stomach acid, prostaglandins have the opposite effect. Prostaglandins are lipid compounds that have various physiological functions, including the inhibition of gastric acid secretion. They help protect the stomach lining by promoting mucus production and maintaining the integrity of the gastric mucosa. Therefore, prostaglandins can be used as medications to reduce stomach acid production and treat conditions like ulcers.Rate this question:
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- 9.
Which is not an effect of prostoglandins?
- A.
Inhibition of acid secretion
- B.
Increase blood flow
- C.
Increase mucus production
- D.
Increase HCO3 secretion
- E.
Create a lipid layer to protect from self digestion
Correct Answer
E. Create a lipid layer to protect from self digestionExplanation
Prostaglandins have various effects on the body, including inhibition of acid secretion, increase in blood flow, increase in mucus production, and increase in HCO3 secretion. However, creating a lipid layer to protect from self digestion is not one of the effects of prostaglandins.Rate this question:
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- 10.
Which is a cause of Type A chronic gastritis?
- A.
Helicobacter pylori infection
- B.
Low gastrin levels
- C.
Pernicious anemia
- D.
Crohn's disease
- E.
Tobacco, alcohol or excessive NSAID use
Correct Answer
C. Pernicious anemiaExplanation
Pernicious anemia is a cause of Type A chronic gastritis. Pernicious anemia is an autoimmune condition in which the body is unable to absorb vitamin B12 from the gastrointestinal tract. This leads to a deficiency of vitamin B12, which is necessary for the production of healthy red blood cells. The lack of vitamin B12 can cause damage to the lining of the stomach, leading to chronic gastritis.Rate this question:
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- 11.
Which is a cause of type B chronic gastritis?
- A.
Autoimmune disorder
- B.
Atrophy of glandular epithelium
- C.
Decreased pepsin
- D.
Crohns disease
- E.
High gastrin levels
Correct Answer
D. Crohns diseaseExplanation
Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract, including the stomach. It is characterized by chronic inflammation and can lead to the development of chronic gastritis. This inflammation can damage the lining of the stomach and cause symptoms such as abdominal pain, nausea, and vomiting. Therefore, Crohn's disease is a cause of type B chronic gastritis.Rate this question:
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- 12.
Which is not a possible cause of peptic ulcer disease
- A.
NSAIDS
- B.
Increased acid from increased histamine
- C.
Decreased pepsinogen from cholinergic stimulation
- D.
Helicobacter pylori
- E.
Caffeine
Correct Answer
C. Decreased pepsinogen from cholinergic stimulationExplanation
Decreased pepsinogen from cholinergic stimulation is not a possible cause of peptic ulcer disease. Peptic ulcers are commonly caused by factors such as NSAIDs, increased acid from increased histamine, Helicobacter pylori infection, and caffeine consumption. Cholinergic stimulation typically increases the production of pepsinogen, which is an enzyme involved in the digestion of proteins. Therefore, a decrease in pepsinogen from cholinergic stimulation would not contribute to the development of peptic ulcers.Rate this question:
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- 13.
Which is false concerning helicobacter pylori?
- A.
It causes an increase in HCL and a decrease in HCO3
- B.
95% of duodenal ulcers result from h. pylori infection
- C.
Infection decreases gastrin and pepsin secretion
- D.
Secretion of urease leads to ammonia and diminished mucus
- E.
15% of people with h. pylori infection will get peptic ulcer disease
Correct Answer
C. Infection decreases gastrin and pepsin secretionExplanation
Helicobacter pylori infection actually increases gastrin and pepsin secretion, so the statement that infection decreases gastrin and pepsin secretion is false.Rate this question:
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- 14.
Which is false concerning the pathogenesis of peptic ulcer disease?
- A.
NSAIDS: cyclooxygenase inhibition decreases prostaglandin synthesis
- B.
H. pylori: inflammatory mediators increase HCL, gastrin and pepsin secretion
- C.
Zollinger-Ellison: HCL increases secondary to increased pepsin from a mucosal pepsinoma
- D.
Gastric ulcers can result from bile reflux
- E.
Duodenal ulcers can be freom gastric hypomotility
Correct Answer
C. Zollinger-Ellison: HCL increases secondary to increased pepsin from a mucosal pepsinomaExplanation
The statement that is false concerning the pathogenesis of peptic ulcer disease is "Zollinger-Ellison: HCL increases secondary to increased pepsin from a mucosal pepsinoma." In Zollinger-Ellison syndrome, there is excessive production of gastric acid due to gastrin-secreting tumors called gastrinomas, which are usually found in the pancreas or duodenum. This leads to increased gastric acid secretion, but it is not caused by increased pepsin from a mucosal pepsinoma.Rate this question:
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- 15.
Which is true of duodenal ulcers?
- A.
They occur more often in men than in women
- B.
Hypothyroidism is a risk factor
- C.
They are not a concern in the Western world
- D.
They are more common in people with type O blood
- E.
They are often malignant
Correct Answer
D. They are more common in people with type O bloodExplanation
Duodenal ulcers are more common in people with type O blood. This means that individuals with type O blood have a higher likelihood of developing duodenal ulcers compared to those with other blood types. The statement suggests that blood type O may be a risk factor for the development of duodenal ulcers.Rate this question:
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- 16.
Which is correct?
- A.
Curling's ulcer is from increased acid from vagal stimulation
- B.
Cushing's ulcer is from decreased blood flow from catecholamines and hypotension
- C.
Curling's ulcers often occur following head injury
- D.
Cushing's ulcers occur following severe trauma or sepsis
- E.
Curling's ulcers are a concern in severe burn patients.
Correct Answer
E. Curling's ulcers are a concern in severe burn patients.Explanation
Curling's ulcers are a concern in severe burn patients because they are stress ulcers that occur as a result of severe physiological stress, such as burns. The stress and trauma from the burn injury can lead to a decrease in blood flow to the stomach, causing ischemia and the development of ulcers. These ulcers are typically found in the proximal duodenum and can lead to significant bleeding if left untreated. Therefore, it is important to monitor and manage the risk of Curling's ulcers in severe burn patients.Rate this question:
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- 17.
Which is the most common cause of gastroparesis?
- A.
Thyroid disease
- B.
Diabetes mellitus
- C.
scleroderma
- D.
Amyloidosis
- E.
Medications
Correct Answer
B. Diabetes mellitusExplanation
Diabetes mellitus is the most common cause of gastroparesis. Gastroparesis is a condition where the stomach takes too long to empty its contents into the small intestine. In diabetes mellitus, high blood sugar levels can damage the nerves that control the muscles in the stomach, leading to gastroparesis. This can result in symptoms such as nausea, vomiting, bloating, and feeling full quickly. Other conditions like thyroid disease, scleroderma, amyloidosis, and certain medications can also cause gastroparesis, but diabetes mellitus is the most common cause.Rate this question:
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- 18.
Which is true of gastric cancer?
- A.
It occurs more often in females than males
- B.
Type O blood is a risk factor
- C.
50% are in the fundus of the stomach
- D.
They are more common in Thailand than the US
- E.
Gastric ulcers are not a risk factor
Correct Answer
D. They are more common in Thailand than the USExplanation
Gastric cancer is more common in Thailand than in the US. This suggests that there may be certain factors unique to Thailand that contribute to a higher incidence of gastric cancer in that country. It is important to note that this answer does not provide any information about the occurrence of gastric cancer in females compared to males, the association between type O blood and gastric cancer, the location of gastric cancer in the fundus of the stomach, or the relationship between gastric ulcers and gastric cancer.Rate this question:
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- 19.
Which is true?
- A.
Fats are absorbed in the colon
- B.
Magnesium is absorbed in the stomach
- C.
Bile salts are aborbed in the jejunum
- D.
Electrolytes are absorbed in the colon
- E.
Proteins are absorbed in the ileum
Correct Answer
D. Electrolytes are absorbed in the colonExplanation
Electrolytes are absorbed in the colon. The colon is responsible for reabsorbing water and electrolytes from the remaining undigested food material. Electrolytes such as sodium, potassium, and chloride are essential for maintaining proper fluid balance and cellular function. The colon plays a crucial role in regulating electrolyte levels in the body by selectively absorbing these ions and preventing their loss through feces.Rate this question:
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- 20.
Which is not a sign or symptom of malabsorption?
- A.
Steatorrhea
- B.
Anemia
- C.
Constipation
- D.
Nocturia
- E.
Peripheral neuropathy
Correct Answer
C. ConstipationExplanation
Constipation is not typically a sign or symptom of malabsorption. Malabsorption refers to the inability of the body to properly absorb nutrients from the digestive system. Common signs and symptoms of malabsorption include steatorrhea (fatty, greasy stools), anemia (due to nutrient deficiencies), nocturia (excessive urination at night), and peripheral neuropathy (nerve damage). However, constipation is more commonly associated with other gastrointestinal issues such as a lack of fiber, dehydration, or a sedentary lifestyle.Rate this question:
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- 21.
Which of these would indicate Crohn's disease?
- A.
Absence of strictures
- B.
Continuous involvement as opposed to cobblestoning and skip lesions
- C.
Primary in the ileum and secondarily in the colon
- D.
Presence of rectal bleeding
- E.
Exudative and ulcerative inflammation
Correct Answer
C. Primary in the ileum and secondarily in the colonExplanation
Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. It is characterized by patchy inflammation with skip lesions, meaning that there are areas of inflammation separated by normal tissue. The primary involvement of Crohn's disease is often seen in the ileum, which is the last part of the small intestine, and it can extend secondarily to involve the colon. The presence of rectal bleeding and exudative and ulcerative inflammation are more indicative of other inflammatory bowel diseases such as ulcerative colitis. Therefore, the primary involvement in the ileum and secondary involvement in the colon is a characteristic finding in Crohn's disease.Rate this question:
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- 22.
What is the most common site of involvement in diverticular disease?
- A.
Small intestine
- B.
Cecum
- C.
Ascending colon
- D.
Descending colon
- E.
Sigmoid colon
Correct Answer
E. Sigmoid colonExplanation
Diverticular disease is characterized by the presence of small pouches or diverticula that form in the wall of the colon. These pouches are most commonly found in the sigmoid colon, which is the S-shaped portion of the large intestine located just before the rectum. This is because the sigmoid colon has higher pressure and weaker areas in its wall, making it more prone to the development of diverticula. The other options, such as the small intestine, cecum, ascending colon, and descending colon, are less commonly involved in diverticular disease.Rate this question:
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- 23.
Which involves initial lesions in the crypts of Lieberkuhn?
- A.
Crohn's disease
- B.
Diverticulosis
- C.
Ulcerative colitis
- D.
Carcinoma of the colon
- E.
Mechanical obstruction
Correct Answer
C. Ulcerative colitisExplanation
Ulcerative colitis involves initial lesions in the crypts of Lieberkuhn. This condition is characterized by inflammation and ulcers in the lining of the colon and rectum. The inflammation typically starts in the rectum and spreads to other parts of the colon. The crypts of Lieberkuhn are small glands in the lining of the colon that produce mucus and are affected by the inflammation in ulcerative colitis. This leads to the formation of ulcers and other symptoms associated with the disease.Rate this question:
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- 24.
Which is frequently caused by a bacterial offender?
- A.
Appendicitis
- B.
Peritonitis
- C.
Diverticulosis
- D.
Crohn's disease
- E.
Ulcerative colitis
Correct Answer
B. PeritonitisExplanation
Peritonitis is frequently caused by a bacterial offender. This condition refers to inflammation of the peritoneum, which is the lining of the abdominal cavity. Bacteria can enter the peritoneum through various means, such as a ruptured appendix, a perforated gastrointestinal tract, or an infection in another part of the body that spreads to the peritoneum. The bacterial infection leads to inflammation and can cause symptoms like severe abdominal pain, fever, and nausea. Prompt medical intervention is necessary to treat peritonitis and prevent complications.Rate this question:
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- 25.
Which is not a function of the liver?
- A.
Produces bile salts
- B.
Metabolizes protein, fats and sugars
- C.
Stores vitamins and minerals
- D.
Converts urea to uric acid
- E.
Synthesizes clotting factors
Correct Answer
D. Converts urea to uric acidExplanation
The liver performs various important functions in the body, such as producing bile salts, which aid in digestion and the absorption of fats. It also metabolizes proteins, fats, and sugars, playing a crucial role in energy production and maintaining blood sugar levels. The liver stores vitamins and minerals, which are essential for various bodily functions. Additionally, it synthesizes clotting factors, necessary for blood coagulation. However, the liver does not convert urea to uric acid. Urea is produced in the liver as a waste product of protein metabolism and is excreted by the kidneys in the form of urine. Uric acid, on the other hand, is a byproduct of purine metabolism and is primarily excreted by the kidneys as well.Rate this question:
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- 26.
Which is false of cholestasis?
- A.
It is often secondary to intrinsic liver disease or obstruction of the ducts
- B.
Symptoms include xanthomas, pruritis, and fat soluble vitamin deficiency
- C.
Leads to fibrosis, then fatty changes, then cirrhosis
- D.
There is decreased secretion of water and bile through the canaliculi
Correct Answer
C. Leads to fibrosis, then fatty changes, then cirrhosisExplanation
Cholestasis is a condition characterized by a decrease or interruption in the flow of bile from the liver. It can be caused by intrinsic liver disease or obstruction of the ducts. Symptoms of cholestasis include the formation of xanthomas (yellowish deposits of fat under the skin), pruritis (itching), and deficiency of fat-soluble vitamins. However, the statement that cholestasis leads to fibrosis, then fatty changes, then cirrhosis is false. Cholestasis can lead to fibrosis, but it does not progress to fatty changes and cirrhosis.Rate this question:
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- 27.
Which is incorrect?
- A.
Heme is converted to biliverdin
- B.
Biliverdin is converted to bilirubin
- C.
Uncongigated bilirubin is water soluble
- D.
Unconjugated bilirubin is conjugated by glucoronyl transferase in the endoplasmic reticulum of the hepatocytes
- E.
Conjugated bilirubin is water soluble
Correct Answer
C. Uncongigated bilirubin is water soluble -
- 28.
Which is false?
- A.
The brain uses 15% of cardiac output and 20% of O2
- B.
Increasing potassium temporarily decreases cerebral blood flow
- C.
Polycythemia vera will decrease cerebral blood flow.
- D.
Increasing intracranial pressure will decrease cerebral blood flow.
- E.
Decreasing O2 increases cerebral blood flow
Correct Answer
B. Increasing potassium temporarily decreases cerebral blood flowExplanation
Increasing potassium temporarily decreases cerebral blood flow. This statement is false because increasing potassium levels in the blood can actually cause cerebral vasoconstriction, leading to a decrease in cerebral blood flow.Rate this question:
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- 29.
The following is not a mechanism of hyperbilirubinemia:
- A.
Excess production of bilirubin
- B.
Impaired conjugation of bilirubin
- C.
Impaired hepatic uptake of beliverdin
- D.
Decreased excretion of conjugated bilirubin into bile
Correct Answer
C. Impaired hepatic uptake of beliverdinExplanation
Hyperbilirubinemia is a condition characterized by an excess of bilirubin in the blood. Bilirubin is produced when red blood cells break down, and excess production of bilirubin is one of the mechanisms of hyperbilirubinemia. Impaired conjugation of bilirubin refers to the inability of the liver to convert unconjugated bilirubin into a water-soluble form for excretion. Decreased excretion of conjugated bilirubin into bile is another mechanism of hyperbilirubinemia. However, impaired hepatic uptake of biliverdin, which is a precursor of bilirubin, is not a mechanism of hyperbilirubinemia.Rate this question:
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- 30.
Which of the following is from hemolysis and increased turnover or decreased bilirubin clearance?
- A.
Physiologic jaundice of newborn
- B.
Gilbert's syndrome
- C.
Crigler-Najjar
- D.
Bilirubinuria
- E.
Hereditary spherocytes
Correct Answer
B. Gilbert's syndromeExplanation
Gilbert's syndrome is a hereditary condition characterized by impaired bilirubin metabolism and decreased bilirubin clearance. It is caused by a deficiency of the enzyme UDP-glucuronosyltransferase, which is responsible for conjugating bilirubin and making it water-soluble for excretion. As a result, there is an increased level of unconjugated bilirubin in the blood, leading to jaundice. This condition is not associated with hemolysis or increased turnover of red blood cells, unlike other options such as physiologic jaundice of newborn, Crigler-Najjar, and hereditary spherocytes. Bilirubinuria, on the other hand, refers to the presence of bilirubin in the urine and is not directly related to Gilbert's syndrome.Rate this question:
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- 31.
Which of the following is most common in the US?
- A.
Hepatitis A
- B.
Hepatitis B
- C.
Hepatitis C
- D.
Hepatitis D
- E.
Hepatitis E
Correct Answer
A. Hepatitis AExplanation
Hepatitis A is the most common type of hepatitis in the US. It is primarily transmitted through contaminated food or water, and is most commonly found in areas with poor sanitation. Hepatitis A is usually a short-term illness, and most people recover completely with no lasting liver damage. The best way to prevent hepatitis A is through vaccination and practicing good hygiene, such as washing hands thoroughly.Rate this question:
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- 32.
Which of the following is the only one that causes spiking fevers?
- A.
Hepatitis A
- B.
Hepatitis B
- C.
Hepatitis C
- D.
Hepatitis D
- E.
Hepatitis E
Correct Answer
A. Hepatitis AExplanation
Hepatitis A is the only one among the listed options that causes spiking fevers. This viral infection primarily affects the liver and is transmitted through contaminated food or water. It typically leads to symptoms such as fever, fatigue, loss of appetite, nausea, and abdominal pain. Unlike other forms of hepatitis, Hepatitis A is known to cause intermittent high fevers that come and go, hence making it the correct answer in this case.Rate this question:
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- 33.
Around 50% of patients with chronic active hepatitis were originally infected with
- A.
Hepatitis A
- B.
Hepatitis B
- C.
Hepatitis C
- D.
Hepatitis D
- E.
Hepatitis E
Correct Answer
C. Hepatitis CExplanation
The correct answer is Hepatitis C because it is stated that around 50% of patients with chronic active hepatitis were originally infected with it. This suggests that Hepatitis C is a common cause of chronic active hepatitis.Rate this question:
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- 34.
The following presents with impotence, loss of libido, gynecomastia, weight loss, cramps and ascites
- A.
Hepatitis
- B.
Hyperbilirubinemia
- C.
Esophageal varices
- D.
Cirrhosis
- E.
Choledocholithiasis
Correct Answer
D. CirrhosisExplanation
This set of symptoms is commonly associated with cirrhosis, which is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and alcoholism. Impotence, loss of libido, gynecomastia (enlarged breasts in males), weight loss, cramps, and ascites (accumulation of fluid in the abdominal cavity) are all manifestations of advanced liver damage and dysfunction, which are typical in cirrhosis.Rate this question:
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- 35.
Other than a viral hepatitis infection, what might cause postnecrotic cirrhosis?
- A.
Alcoholism
- B.
Industrial chemicals
- C.
Elevated alkaline phosphatase
- D.
Sjogren's syndrome
- E.
Scleroderma
Correct Answer
B. Industrial chemicalsExplanation
Postnecrotic cirrhosis refers to liver scarring that occurs after extensive liver cell death. While viral hepatitis is a common cause, industrial chemicals can also lead to this condition. Exposure to certain toxins and chemicals in the workplace or environment can cause liver damage, leading to cirrhosis over time. This can occur in individuals who have been exposed to substances such as vinyl chloride, carbon tetrachloride, or arsenic. Therefore, industrial chemicals can be a potential cause of postnecrotic cirrhosis.Rate this question:
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