Pathophysiology GI Chapter 37 Part 1

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2.

Swallowing is painful
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Odynophagia

Explanation

Odynophagia refers to the sensation of pain or discomfort while swallowing. It can be caused by various conditions such as infections, inflammation, or structural abnormalities in the throat or esophagus. The other options listed in the question do not specifically relate to pain during swallowing. Achalasia is a condition where the lower esophageal sphincter does not relax properly, causing difficulty in swallowing. Esophageal atresia is a birth defect where the esophagus does not develop properly. Gastroesophageal reflux refers to the backward flow of stomach acid into the esophagus. Dysphagia is difficulty in swallowing. Barrett esophagus is a condition where the cells lining the lower esophagus change due to chronic acid reflux. Tracheoesophageal fistulae are abnormal connections between the trachea and esophagus. Mallory Weiss syndrome refers to tears in the lining of the esophagus or stomach. Perforation refers to a hole or tear in the esophagus. Helicobacter pylori is a bacteria that can cause stomach ulcers.

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3.

Backward movement of gastric contents into the esophagus
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Gastroesophageal reflux

Explanation

Gastroesophageal reflux refers to the backward movement of gastric contents into the esophagus. This occurs when the lower esophageal sphincter (LES) fails to close properly, allowing stomach acid and partially digested food to flow back up into the esophagus. This can cause symptoms such as heartburn, regurgitation, and difficulty swallowing. Gastroesophageal reflux is a common condition and can be managed with lifestyle changes, medication, and in some cases, surgical intervention.

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4.

Difficulty in swallowing
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Dysphagia

Explanation

Dysphagia refers to difficulty in swallowing, which can be caused by various factors such as muscle weakness, nerve damage, or obstruction in the esophagus. It can be a symptom of various conditions including achalasia, esophageal atresia, gastroesophageal reflux, Barrett esophagus, tracheoesophageal fistulae, Mallory Weiss syndrome, perforation, or Helicobacter pylori infection. Therefore, dysphagia is the correct answer as it encompasses the general difficulty in swallowing experienced in these conditions.

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5.

Squamous mucosa that lines the esophagus gradually is replaced by columnar epithelium
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Barrett esophagus

Explanation

The given statement describes the process of metaplasia, where the squamous mucosa of the esophagus is gradually replaced by columnar epithelium. This is a characteristic feature of Barrett esophagus, a condition where the normal tissue lining the lower esophagus is replaced by a type of tissue similar to that normally found in the intestines. This change in the lining of the esophagus is often associated with chronic gastroesophageal reflux disease (GERD) and can increase the risk of developing esophageal cancer.

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6.

Esophagus is connected to the trachea
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Tracheoesophageal fistulae

Explanation

Tracheoesophageal fistulae is a condition where there is an abnormal connection between the esophagus and the trachea. This means that there is a direct passage between the two structures, allowing food or liquid to enter the respiratory system. This condition can lead to symptoms such as difficulty swallowing, coughing or choking while eating, and respiratory issues. Therefore, the correct answer is tracheoesophageal fistulae because it is the only option that is directly related to the connection between the esophagus and the trachea.

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7.

Tears in the esophagus at the esophagogastric junction
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Mallory Weiss syndrome

Explanation

Mallory Weiss syndrome is a condition characterized by tears in the esophagus at the esophagogastric junction. These tears are typically caused by severe vomiting or retching, which puts excessive pressure on the esophagus. This can lead to bleeding and can be associated with symptoms such as hematemesis (vomiting blood) and melena (black, tarry stools). Mallory Weiss syndrome is often seen in individuals with alcoholism or those who have undergone prolonged and forceful vomiting. Treatment may involve supportive care, such as fluid resuscitation and blood transfusions, as well as addressing the underlying cause of the vomiting.

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8.

Ulcer erodes through all layers of the stomach
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Perforation

Explanation

Perforation refers to a hole or tear in the stomach that allows the contents to leak into the abdominal cavity. This condition can be life-threatening and requires immediate medical attention. It is characterized by severe abdominal pain, tenderness, and rigidity. Perforation can occur due to various causes such as trauma, ulcers, or surgical complications. In the given list of options, only "Perforation" directly relates to the erosion of the stomach wall through all its layers, making it the correct answer.

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9.

Most common cause of chronic gastritis in the United States
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Helicobacter pylori

Explanation

Helicobacter pylori is the most common cause of chronic gastritis in the United States. This bacterium infects the lining of the stomach and can lead to inflammation and damage to the stomach lining, causing chronic gastritis. Helicobacter pylori is a common bacterial infection that can be transmitted through contaminated food, water, or close contact with an infected person. It is estimated that around half of the world's population is infected with Helicobacter pylori, and it is a major cause of peptic ulcers and stomach cancer. Treatment usually involves a combination of antibiotics and acid-reducing medications to eradicate the infection and heal the stomach lining.

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10.

Tubelike passages that form connections between different sites in the gastrointestinal tract.
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Fistulas

Explanation

Fistulas are tubelike passages that form connections between different sites in the gastrointestinal tract. They can occur due to various reasons such as infection, inflammation, or trauma. Fistulas can develop between different parts of the gastrointestinal tract, such as the intestines or the anus, or between the gastrointestinal tract and other organs, such as the bladder or the skin. These abnormal connections can cause symptoms such as pain, infection, and the passage of abnormal substances through the fistula. Treatment for fistulas may involve medication, surgery, or other interventions depending on the underlying cause and severity of the condition.

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11.

Gastrin-secreting tumor
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Zollinger-Ellison syndrome

Explanation

Zollinger-Ellison syndrome is the correct answer because it is a condition characterized by the presence of gastrin-secreting tumors, which leads to hypergastrinemia. This results in excessive production of gastric acid, causing peptic ulcers in the stomach and small intestine. The other options listed are not associated with the specific features of Zollinger-Ellison syndrome.

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12.

Infection by Entamoeba histolytica
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Amebiasis

Explanation

Amebiasis is the correct answer because it is an infection caused by the protozoan parasite Entamoeba histolytica. This infection can lead to symptoms such as diarrhea, abdominal pain, and fever. Amebiasis can cause the formation of fistulas, which are abnormal connections between different organs or tissues. The other options listed do not directly relate to the infection by Entamoeba histolytica.

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13.

Water is pulled into the bowel by the hyperosmotic nature of its contents
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Osmotic diarrhea

Explanation

Osmotic diarrhea occurs when there is an excess of unabsorbed solutes in the bowel, creating an osmotic gradient that pulls water into the bowel. This can be caused by various factors such as malabsorption, certain medications, or ingestion of certain substances. In this case, the hyperosmotic nature of the contents in the bowel is causing water to be pulled into the bowel, leading to osmotic diarrhea.

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14.

Presence of an excess of gastrin in the blood
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Hypergastrinemia

Explanation

Hypergastrinemia refers to the presence of an excess of gastrin in the blood. Gastrin is a hormone that stimulates the production of gastric acid in the stomach. When there is an excess of gastrin, it can lead to increased acid production, which can cause various gastrointestinal symptoms such as acid reflux, stomach ulcers, and diarrhea. Hypergastrinemia can be caused by conditions such as Zollinger-Ellison syndrome, a rare disorder characterized by gastrin-secreting tumors in the pancreas or duodenum. Therefore, hypergastrinemia is the correct answer because it directly relates to the presence of excess gastrin in the blood.

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15.

Stools contain excess fat
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Steatorrheic

Explanation

Steatorrhea is a condition characterized by the presence of excess fat in the stool. It occurs when the body is unable to properly digest and absorb fats from the diet, leading to their excretion in the feces. This can be caused by various factors such as pancreatic insufficiency, celiac disease, or certain medications. Steatorrheic stools are often greasy, bulky, and foul-smelling. Therefore, the given answer, Steatorrheic, is the most appropriate explanation for the presence of excess fat in the stools.

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16.

Hallmark symptom of Chrohn disease
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Cobblestone appearance

Explanation

The hallmark symptom of Crohn's disease is a "cobblestone appearance" in the gastrointestinal tract. This refers to the appearance of multiple small ulcers or sores that are surrounded by normal tissue, giving the appearance of a cobblestone road. This characteristic finding is seen on imaging studies such as endoscopy or radiographic imaging, and is a key diagnostic feature of Crohn's disease. Other symptoms and findings may also be present in Crohn's disease, but the cobblestone appearance is specific to this condition.

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17.

Ulcer crater erodes into adjacent organs
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Penetration

Explanation

Penetration refers to the ulcer crater eroding into adjacent organs. This can occur in certain conditions such as Zollinger-Ellison syndrome, amebiasis, and adenomatous polyps. It is a serious complication that can lead to the formation of fistulas, which are abnormal connections between different parts of the body. Penetration can cause symptoms such as pain, infection, and bleeding. Proper diagnosis and treatment are important to prevent further complications and manage the underlying condition causing the penetration.

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18.

Benign neoplasms that arise from the mucosal epithelium of the intestine
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Adenomatous polyps

Explanation

Adenomatous polyps are benign neoplasms that arise from the mucosal epithelium of the intestine. They are growths that occur on the lining of the colon or rectum and can potentially develop into colorectal cancer if not removed. Adenomatous polyps are considered a precursor to colon cancer and are commonly detected during routine colonoscopies. Therefore, the given correct answer is Adenomatous polyps.

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19.

Causes diarrhea in children
- Fistulas
- Zollinger-Ellison syndrome
- Amebiasis
- Osmotic diarrhea
- Hypergastrinemia
- Steatorrheic
- Cobblestone appearance
- Penetration
- Adenomatous polyps
- Rotavirus
Correct Answer

A. Rotavirus

Explanation

Rotavirus is a common cause of diarrhea in children. It is a highly contagious virus that infects the intestines, leading to inflammation and fluid accumulation, resulting in diarrhea. Rotavirus can be transmitted through contaminated food, water, or direct contact with an infected person. Symptoms of rotavirus infection include watery diarrhea, vomiting, fever, and abdominal pain. It is important to ensure proper hygiene and vaccination to prevent the spread of rotavirus and protect children from this common cause of diarrhea.

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20.

Esophageal atresia (EA) is the most common congenital anomaly of the esophagus and is incompatible with life. The majority of children born with EA also have tracheoesophageal fistulae. What are the signs and symptoms of EA in a newborn?
- Cyanosis and respiratory distress
- Poor feeding and tire easily
- Episodes of choking and coughing
- Poor feeding and low blood sugar
Correct Answer

A. Cyanosis and respiratory distress

Explanation

Esophageal atresia (EA) is a condition where the esophagus does not properly connect to the stomach. This results in an inability to swallow and can lead to serious respiratory problems. Cyanosis, which is a bluish discoloration of the skin due to lack of oxygen, and respiratory distress are common signs of EA in a newborn. The inability to properly feed and easily tiring can also be observed in infants with EA. Episodes of choking and coughing can occur due to the abnormal connection between the esophagus and the trachea. Poor feeding and low blood sugar may be present as a result of the baby's inability to consume enough nutrients.

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21.

Hiatal hernias can cause severe pain if the hernia is large. Gastroesophageal reflux is a common comorbidity of hiatal hernia, and when this occurs, what might the hernia do?
- Increase esophageal acid clearance
- Retard esophageal acid clearance
- Decrease esophageal acid clearance
- Accelerate esophageal acid clearance
Correct Answer

A. Retard esophageal acid clearance

Explanation

A hiatal hernia can cause gastroesophageal reflux, which is the backward flow of stomach acid into the esophagus. This can lead to symptoms such as heartburn and discomfort. The correct answer states that the hernia would retard or slow down the clearance of acid from the esophagus. This means that the acid would stay in the esophagus for a longer period of time, exacerbating the symptoms of reflux and potentially causing more severe pain.

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22.

Infants and children commonly have gastroesophageal reflux. Often it is asymptomatic and resolves on its own. What are the signs and symptoms of gastroesophageal reflux in infants with severe disease?
- Consolable crying and early satiety
- Delayed satiety and sleeping after feeding
- Tilting of the head to one side and arching of the back
- Inconsolable crying and delayed satiety
Correct Answer

A. Tilting of the head to one side and arching of the back

Explanation

Infants with severe gastroesophageal reflux may exhibit the signs and symptoms of tilting their head to one side and arching their back. This is often seen during or after feeding and is indicative of discomfort or pain caused by the reflux. The tilting of the head and arching of the back can be a reflexive response to the acid reflux irritating the esophagus. It is important to note that this answer choice is specific to infants with severe disease, as milder cases may present with different symptoms or be asymptomatic.

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23.

The stomach secretes acid to begin the digestive process on the food that we eat. The gastric mucosal barrier works to prevent acids secreted by the stomach from actually damaging the wall of the stomach. What are the factors that make up the gastric mucosal barrier? Mark all that apply.
- Impermeable epithelial cell surface covering
- Mechanisms for selective transport of bicarbonate and potassium ions
- Characteristics of gastric mucus
- Cell coverings that act as antacids
- Mechanisms for selective transport of hydrogen and bicarbonate ions
Correct Answer(s)

A. Impermeable epithelial cell surface covering
A. Characteristics of gastric mucus
A. Mechanisms for selective transport of hydrogen and bicarbonate ions

Explanation

The gastric mucosal barrier is made up of several factors. The first factor is an impermeable epithelial cell surface covering, which prevents the acids from seeping through the stomach wall. Another factor is the characteristics of gastric mucus, which provides a protective layer over the stomach lining. Additionally, the barrier includes mechanisms for selective transport of hydrogen and bicarbonate ions, which help regulate the acidity levels in the stomach. These factors work together to prevent damage to the stomach wall caused by the acids secreted during the digestive process.

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24.

Helicobacter pylori gastritis has a prevalence in more than 50% of American adults older than 50 years and is believed to be caused by a previous infection when the patient was younger. What can chronic gastritis caused by H. pylori cause?
- Decreased risk of gastric adenocarcinoma
- Decreased risk of low-grade B-cell gastric lymphoma
- Duodenal ulcer
- Gastric atrophy
Correct Answer

A. Gastric atrophy

Explanation

Chronic gastritis caused by H. pylori can lead to gastric atrophy. Gastric atrophy is a condition characterized by the thinning of the stomach lining and a decrease in the number of gastric glands. This can result in a reduction in the production of stomach acid and digestive enzymes, leading to impaired digestion. Gastric atrophy is also associated with an increased risk of developing gastric cancer. Therefore, chronic gastritis caused by H. pylori can have significant implications for the health of the stomach.

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25.

A 39-year-old Caucasian woman presents at the clinic with complaints of epigastric pain that is cramplike, rhythmic, and just below the xiphoid. She states that it wakes her up around 1 AM and that she is not sleeping well because of it. She further states that this is her third painful episode in the past year. THe nurse suspects the patient has a peptic ulcer and expects to receive what orders from the physician?
- Schedule patient for a complete metabolic panel and a complete blood count
- Schedule patient for a laprascopic examination
- Schedule patient for a swallow study
- Schedule patient for a lower gastrointestinal study
Correct Answer

A. Schedule patient for a complete metabolic panel and a complete blood count

Explanation

The nurse suspects that the patient has a peptic ulcer based on her symptoms of epigastric pain that is cramplike, rhythmic, and wakes her up at night. To confirm the diagnosis and assess the severity of the condition, the physician would order a complete metabolic panel and a complete blood count. These tests can help evaluate the patient's electrolyte levels, liver function, and blood cell counts, which can be affected by a peptic ulcer. This information will guide the physician in determining the appropriate treatment plan for the patient.

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26.

A patient in a nursing home complains to her nurse that she is not feeling well. When asked to describe how she feels, the patient states that she really is not hungry anymore and seems to have indigestion a lot. The nurse checks the patient's chart and finds that her vital signs are normal, but that she has lost weight over the past 2 months. She also notes that there is a history of gastric cancer in the patient's family. The nurse notifies the physician and expects to receive what orders? Mark all that apply.
- Schedule a barium x-ray and an endoscopy
- Perform a Papanicolaou smear on the patient's gastric secretions
- Order cytologic studies to be done during the endoscopy
- Schedule a lower gastrointestinal study
- Have the tech do an endoscopic ultrasound
Correct Answer(s)

A. Schedule a barium x-ray and an endoscopy
A. Order cytologic studies to be done during the endoscopy

Explanation

Based on the patient's symptoms of loss of appetite and frequent indigestion, along with the family history of gastric cancer and weight loss, the nurse suspects the possibility of gastric cancer. To confirm the diagnosis and assess the extent of the disease, the nurse expects to receive orders for a barium x-ray and an endoscopy. These procedures can help visualize the stomach and identify any abnormalities or tumors. Additionally, ordering cytologic studies during the endoscopy can further evaluate the cells and tissues for signs of cancer. The other options, such as performing a Papanicolaou smear on gastric secretions, scheduling a lower gastrointestinal study, or having an endoscopic ultrasound, are not specifically indicated for the given symptoms and family history.

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27.

Irritable bowel syndrome is believed to be present in 10% to 15% of the population in the United States. What is the hallmark symptom?
- Nausea and abdominal pain unrelieved by defecation
- Abdominal pain relieved by defecation with a change in consistency or frequency of stools
- Diarrhea and abdominal pain unrelieved by defecation
- Abdominal pain relieved by defecation and bowel impaction
Correct Answer

A. Abdominal pain relieved by defecation with a change in consistency or frequency of stools

Explanation

The hallmark symptom of irritable bowel syndrome is abdominal pain that is relieved by defecation, along with a change in consistency or frequency of stools. This means that individuals with irritable bowel syndrome experience pain in their abdomen, which is alleviated when they have a bowel movement. Additionally, they may notice a change in the consistency or frequency of their stools, such as diarrhea or constipation. This combination of symptoms is characteristic of irritable bowel syndrome.

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28.

Crohn disease is a recurrent inflammatory disease that can affect any area of the bowel. The characteristic of this disease is granulomatous lesions that are sharply demarcated from the surrounding tissue. As the PA caring for a patient with newly diagnosed Crohn disease, you would know to include what in your teaching?
- Definition of Crohn disease that indicates that it is a recurrent disease that affects only the large intestine
- Information on which nonsteroidal anti-inflammatory drugs to take and how often to take them
- Information on sulfasalazine, including dosage, route, frequency, and side effects of the drug
- Information on the chemotherapy that will be ordered to cure the disease
Correct Answer

A. Information on sulfasalazine, including dosage, route, frequency, and side effects of the drug

Explanation

The correct answer is information on sulfasalazine, including dosage, route, frequency, and side effects of the drug. This is because sulfasalazine is commonly used as a treatment for Crohn's disease. Providing information on the medication will help the patient understand how to take it properly and be aware of any potential side effects. It is important for the PA to educate the patient about the medication as part of their overall treatment plan.

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29.

Rotavirus is a common infection in children younger than 5 years. Like other diseases, rotavirus is most severe in children younger than 24 months. What is a symptom of rotavirus infection?
- Mild to moderate fever that gets higher after the second day
- Vomiting that lasts for the course of the disease
- Fever that disappears after 7 days
- Vomiting that disappears around the second day
Correct Answer

A. Vomiting that disappears around the second day

Explanation

Rotavirus infection is characterized by vomiting, and the symptom of vomiting that disappears around the second day aligns with this. The other options do not accurately reflect the typical course of rotavirus infection.

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30.

Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people older than 85 years old. Diverticulitis is often asymptomatic, but when symptoms do occur, what is the patient's most common complaint?
- Lower left quadrant pain with nausea and vomiting
- Right lower quadrant pain with nausea and vomiting
- Midepigastric pain with nausea and vomiting
- Right lower quadrant pain with rebound tenderness on the left
Correct Answer

A. Lower left quadrant pain with nausea and vomiting

Explanation

The correct answer is lower left quadrant pain with nausea and vomiting. Diverticulitis typically presents with pain in the lower left quadrant of the abdomen due to inflammation and infection in the diverticula, which are small pouches that form in the colon. This pain may be accompanied by nausea and vomiting. The other options are not consistent with the typical presentation of diverticulitis.

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31.

Diarrhea is described as a change in frequency of stool passage to where it is excessively frequent. Diarrhea can be acute or chronic, inflammatory or noninflammatory. What are the symptoms of noninflammatory diarrhea? Mark all that apply.
- Small-volume watery stools
- Nonbloody stools
- Periumbilical cramps
- Nausea and/or vomiting
- Large-volume bloody stools
Correct Answer(s)

A. Nonbloody stools
A. Periumbilical cramps
A. Nausea and/or vomiting

Explanation

Noninflammatory diarrhea is characterized by nonbloody stools, periumbilical cramps, and nausea and/or vomiting. This type of diarrhea typically does not present with large-volume bloody stools or small-volume watery stools.

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32.

Peritonitis is an inflammatory condition of the lining of the abdominal cavity. WHat is one of the most important signs of peritonitis?
- Vomiting of coffee ground-appearing emesis
- Translocation of extracellular fluid into the peritoneal cavity
- Translocation of intracellular fluid into the peritoneal cavity
- Vomiting of bloody emesis
Correct Answer

A. Translocation of extracellular fluid into the peritoneal cavity

Explanation

One of the most important signs of peritonitis is the translocation of extracellular fluid into the peritoneal cavity. This occurs due to inflammation and infection in the abdominal cavity, causing fluid to leak from blood vessels into the peritoneal space. This fluid accumulation can lead to abdominal distension, pain, and tenderness. It is a significant sign that indicates the presence of peritonitis and the need for medical intervention. Vomiting of coffee ground-appearing emesis and bloody emesis may also occur in peritonitis, but the translocation of extracellular fluid is a more specific and important sign.

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33.

Celiac disease commonly presents in infancy as failure to thrive. It is an inappropriate T-cell-mediated immune response, and there is no cure for it. What is the treatment of choice for celiac disease?
- Removal of protein from the diet
- Removal of fat from the diet
- Removal of gluten from the diet
- Removal of sugar from the diet
Correct Answer

A. Removal of gluten from the diet

Explanation

The treatment of choice for celiac disease is the removal of gluten from the diet. Celiac disease is an inappropriate T-cell-mediated immune response to gluten, a protein found in wheat, barley, and rye. Removing gluten from the diet is essential to manage the disease and prevent symptoms and complications. This involves avoiding foods and products that contain gluten, such as bread, pasta, and certain processed foods. The removal of protein, fat, or sugar from the diet is not specific to celiac disease and would not address the underlying immune response triggered by gluten.

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34.

One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, you would instruct the patient to do what?
- Eat a lot of red meat for 3 or 4 days before the test is done
- Take 1000 mg of vitamin C in supplement form for 1 week prior to testing
- Eat citrus fruits at least five times a day for 2 days prior to testing
- Avoid nonsteroidal anti-inflammatory drugs for 1 week prior to testing.
Correct Answer

A. Avoid nonsteroidal anti-inflammatory drugs for 1 week prior to testing.

Explanation

Nonsteroidal anti-inflammatory drugs (NSAIDs) can interfere with the accuracy of occult blood tests by causing gastrointestinal bleeding. Therefore, it is important for the patient to avoid taking NSAIDs for at least one week prior to the test in order to minimize the risk of false-positive results. Eating red meat, taking vitamin C supplements, or consuming citrus fruits would not have any impact on the accuracy of the test.

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35.

Upper esophagus ends in a blind pouch
- Achalasia
- Esophageal atresia
- Odynophagia
- Gastroesophageal reflux
- Dysphagia
- Barrett esophagus
- Tracheoesophageal fistulae
- Mallory Weiss syndrome
- Perforation
- Helicobacter pylori
Correct Answer

A. Esophageal atresia

Explanation

Esophageal atresia is a congenital condition where the upper part of the esophagus does not connect to the lower part of the esophagus and stomach. This results in a blind pouch at the upper esophagus, which means that it ends in a dead-end without connecting to the rest of the digestive system. This condition requires surgical intervention to correct the abnormality and allow for proper food and liquid passage from the mouth to the stomach.

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Quiz Edited by
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Jan 08, 2012

Quiz Created by
Bikisoucy

Pathophysiology GI Chapter 37 Part 1

Difficulty passing food into the stomach

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Swallowing is painful

Backward movement of gastric contents into the esophagus

Difficulty in swallowing

Squamous mucosa that lines the esophagus gradually is replaced by columnar epithelium

Esophagus is connected to the trachea

Tears in the esophagus at the esophagogastric junction

Ulcer erodes through all layers of the stomach

Most common cause of chronic gastritis in the United States

Tubelike passages that form connections between different sites in the gastrointestinal tract.

Gastrin-secreting tumor

Infection by Entamoeba histolytica

Water is pulled into the bowel by the hyperosmotic nature of its contents

Presence of an excess of gastrin in the blood

Stools contain excess fat

Hallmark symptom of Chrohn disease

Ulcer crater erodes into adjacent organs

Benign neoplasms that arise from the mucosal epithelium of the intestine

Causes diarrhea in children

Esophageal atresia (EA) is the most common congenital anomaly of the esophagus and is incompatible with life. The majority of children born with EA also have tracheoesophageal fistulae. What are the signs and symptoms of EA in a newborn?

Hiatal hernias can cause severe pain if the hernia is large. Gastroesophageal reflux is a common comorbidity of hiatal hernia, and when this occurs, what might the hernia do?

Infants and children commonly have gastroesophageal reflux. Often it is asymptomatic and resolves on its own. What are the signs and symptoms of gastroesophageal reflux in infants with severe disease?

The stomach secretes acid to begin the digestive process on the food that we eat. The gastric mucosal barrier works to prevent acids secreted by the stomach from actually damaging the wall of the stomach. What are the factors that make up the gastric mucosal barrier? Mark all that apply.

Helicobacter pylori gastritis has a prevalence in more than 50% of American adults older than 50 years and is believed to be caused by a previous infection when the patient was younger. What can chronic gastritis caused by H. pylori cause?

Irritable bowel syndrome is believed to be present in 10% to 15% of the population in the United States. What is the hallmark symptom?

Rotavirus is a common infection in children younger than 5 years. Like other diseases, rotavirus is most severe in children younger than 24 months. What is a symptom of rotavirus infection?

Diarrhea is described as a change in frequency of stool passage to where it is excessively frequent. Diarrhea can be acute or chronic, inflammatory or noninflammatory. What are the symptoms of noninflammatory diarrhea? Mark all that apply.

Peritonitis is an inflammatory condition of the lining of the abdominal cavity. WHat is one of the most important signs of peritonitis?

Celiac disease commonly presents in infancy as failure to thrive. It is an inappropriate T-cell-mediated immune response, and there is no cure for it. What is the treatment of choice for celiac disease?

One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, you would instruct the patient to do what?

Upper esophagus ends in a blind pouch