Gastrointestinal

Question 1

Constipation that involves difficulty expelling stool because of failure of the pelvic floor muscles or anal sphincter to relax with defecation

Answer 1

Pelvic floor dysfunction or outlet dysfunction

Question 2

Diarrhea where a nonabsorbale substance in the intestine draws water into the lumen by osmosis and increases stool weight and volume producing large volume diarrhea

Answer 2

osmotic diarrhea

Question 3

The rapid emptying of hypertonic chyme from the surgically created, residual stomach into the small intestine 10 to 20 minutes after eating

Answer 3

Dumping syndrome

Question 4

Which type of diarrhea is usually caused by an inflammatory disorder of the intestine such as ulcerative colitis, Crohn disease or microscopic colitis

Answer 4

Small-volume diarrhea

Question 5

Diarrhea caused by resection of the small intestine (short bowel syndrome), surgical bypass of an area of the intestine, fistula formation between loops of intestine, irritable bowel syndrome

Answer 5

motility diarrhea

Question 6

this pain arises from the parietal peritoneum, is more localized and intense

Answer 6

Parietal pain

Question 7

This pain arises from a stimulus acting on mechanical and chemical nociceptors of abdominal organs

Answer 7

Visceral pain

Question 8

this pain is felt at some distance form a diseased or affected organ and is well localized

Answer 8

Referred pain

Question 9

Bleeding in the esophagus, stomach, or duodenum and is characterized by frank, bright red bleeding in emesis or dark grainy digestedd blood “coffee grounds” in stool

Answer 9

Upper gastrointestinal bleeding

Question 10

Bleeding from the jejunum or ileum of the small intestine, colon or rectum and can be caused by polyps, inflammatory bowel disease, diverticular disease, cancer, mucosal vascular ectasias, or hemorrhoids

Answer 10

Lower gastrointestinal bleeding

Question 11

Bleeding caused by slow chronic blood loss. Is not obvious and results in iron deficiency anemia

Answer 11

Occult bleeding

Question 12

What are the best indicators of massive blood loss in the gastrointestinal tract

Answer 12

Changes in blood pressure and heart rate

Question 13

Why are hematocrit and hemoglobin values not the best indicator of acute GI bleeding?

Answer 13

Because plasma and red cell volume are lost proportionately

Question 14

Symptoms of severe GI blood loss may include?

Answer 14

Light headedness, loss of vision, tachycardia, hypovolemic shock, decreased urine output

Question 15

Bloody vomitus; either fresh, bright red blood or dark, grainy, digested blood with “coffee grounds” appearance

Answer 15

Hematemesis

Question 16

Black, sticky, tarry, foul-smelling stools caused by digestion of blood in the GI tract

Answer 16

Melena

Question 17

Fresh, bright red blood passed from the rectum

Answer 17

Hematochezia

Question 18

Trace amounts of blood in normal appearing stools or gastric secretions; detectable with a guaiac test

Answer 18

Occult bleeding

Question 19

Difficulty swallowing or preception of obstruction during swallowing

Answer 19

Dysphagia

Question 20

This type of dysphagia originates outside the esophogeal lumen and narrow the esophagus by pressing inward on the esophageal wall

Answer 20

Extrinsic mechanical obstruction dysphagia

Question 21

A rare disorder related to the loss of inhibitory neurons in the myenteric plexus with smooth muscle atrophy in the middle and lower portions of the esophagus causing functional obstruction of the lower esophagus. Food accumulates above the obstruction, distends the esophagus, and causes dysphagia. Ad hydrostatic pressure increases food is slowly forced past the obstruction into the stomach

Answer 21

Achalasia

Question 22

Heartburn, chronic cough, asthma attacks, laryngitis, sinusitis, upper abdominal pain within 1 hour of eating. Symptoms worsen if the individual lies down or if intra-abodminal pressure increases

Answer 22

GERD

Question 23

A rare idiopathic inflammatory disease of the esophagus characterized by esophageal infiltration of eosinophils associated with atopic disease including asthma and fool allergies.

Answer 23

Eosinophilic esophagitis

Question 24

A type of diaphragmatic hernia with protrusion of the upper part of the stomach through the diaphragm and into the thorax

Answer 24

hiatal hernia

Question 25

Delayed gastric emptying in the absence of mechanical gastric outlet obstruction and is associated with DM, surgical vagotomy, or fundoplication

Answer 25

Gastroparesis

Question 26

The narrowing or blocking of the opening between the stomach and the duodenum

Answer 26

Pyloric obstruction (gastric outlet obstruction)

Question 27

Rolling or jarring of the abdomen produces a sloshing sound called

Answer 27

succusion splash

Question 28

Why is the small intestine more commonly obstructed

Answer 28

Because of its narrower lumen

Question 29

The mechanical blockage of the lumen by a lesion, but blood flow is preserved

Answer 29

simple obstruction

Question 30

Blood flow is compromised, leading to intestinal iscehmia and if left untreated necrosis and perforation

Answer 30

strangulated obstruction

Question 31

A failure of GI motility after intestinal or abdominal surgery, acute pancreatitis or hypokalemia

Answer 31

paralytic ileus

Question 32

If the GI obstruction is at the pylorus or high in the small intestine the patient will develop

Answer 32

metabolic alkalosis

Question 33

If the GI obstruction is prolonged or lower in the intestine the patient will develop

Answer 33

metabolic acidosis

Question 34

Which electrolyte imbalance is likely to occur during obstruction?

Answer 34

Hypokalemia

Question 35

This type of obstruction is less common and often related to carcinoma

Answer 35

Large Bowel obstruction

Question 36

A rare functional, massive dilation of the large bowel that is related to excessive sympathetic motor input or decreased parasympathetic motor input with absence of mechanical obstruction and occurs in people who are critically ill and immobilized older adults

Answer 36

Acute colonic pseudo-obstruction (Ogilvie Syndrome)

Question 37

Protrusion of the intestine through the abdominal muscles or through the inguinal ring

Answer 37

Herniation

Question 38

Telescoping of one part of the intestine into another, causing strangulation of blood supply, more common in ileocecal area in infants 10-15 months of age

Answer 38

Intussusception

Question 39

Twisting of the intestine on its mesenteric pedicle, with occlusion of the blood supply, often associated with fibrous adhesions in the small intestine; occurs most often in the large intestine in older adults

Answer 39

torsion

Question 40

Inflammed saccular herniations of the mucosa and submucosa through the tunica muscularis of the colon; diverticular are interspersed between thick circular fibrous bands; most common in obese individuals older than 60

Answer 40

Diverticulitis

Question 41

Peritoneal irritation from surgery or trauma leads to formation of fibrin and adhesions that attach to intestine, omentum, or peritoneum and cause traction and obstruction usually in the small intestine

Answer 41

Fibrous adhesions

Question 42

inflammatory disorder of the gastric mucosa

Answer 42

Gastritis

Question 43

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach or duodenum

Answer 43

Peptic ulcer

Question 44

A superficial ulceration that erode the mucosa but do not penetrate the muscularis mucosae

Answer 44

Erosions

Question 45

A rare syndrome also associated with peptic ulcers caused by a gastrin-secreting neuroendocrine tumor or multiple tumors of the pancreas or duodenum

Answer 45

Zollinger-Ellison syndrome

Question 46

An acute form of erosive inflammatory peptic ulcers that tends to accompany the physiologic stress of severe illness, multisystem organ failure; or major trauma, including severe burns or head injury

Answer 46

stress-related mucosal disease (stress ulcer)

Question 47

This type of stress ulcer develops within hours of an event such as hemorrhage, multisystem trauma, severe burns, heart failure, or sepsis

Answer 47

Ischemic ulcers

Question 48

Stress ulcers that result due to burn injury are often called

Answer 48

Curling ulcers

Question 49

A stress ulcer associated with severe head trauma or brain surgery

Answer 49

cushing ulcer

Question 50

This gastritis is caused by reflux of bile and alkaline pancreatic secretions containing proteolytic enzymes that disrupt the mucosal barrier in the remnant stomach

Answer 50

Alkaline reflux gastritis

Question 51

This disease is characterized by intermittent periods of remission and exacerbation, loss of absorptive mucosal surface, large volume watery diarrhea, bleeding, cramping pain, and an urge to defecate might have

Answer 51

Ulcerative colitis

Question 52

An idiopathic inflammatory disorder that affects ANY part of the GI tract from the mouth to the anus and involves "skip lesions" with inflamed areas mixed with uninflamed areas, noncaseating granulomas, fistulas, and deep penetrating ulcers.

Answer 52

Crohn disease

Question 53

Which gene mutation has the strongest association with Chron's disease?

Answer 53

CARD15/NOD2

Question 54

A complication of Chron's disease treatment involving a surgical resection of the small intestine that results in malabsorption, diarrhea, and nutritional deficiencies.

Answer 54

short bowel syndrome

Question 55

A disorder of the brain gut interaction characterized by abdominal pain with altered bowel habits, more common in women, with higher prevalence in youth and middle age

Answer 55

Irritable bowel syndrome

Question 56

A relatively common cause of chronic watery diarrhea. Risk factors include age 50 years or older, female sex, weight loss, absence of abdominal pain, use of PPI's or NSAIDS.

Answer 56

Microscopic colitis

Question 57

Herniations or saclike outpouchings of mucosa through the muscle layers of the colon wall

Answer 57

Diverticula

Question 58

Asymptomatic diverticular disease

Answer 58

Diverticulosis

Question 59

Inflammation of the diverticula

Answer 59

diverticulitis

Question 60

Portal hypertension is the elevation of hepatic venous pressure above

Answer 60

5 mmHg

Question 61

The accumulation of fluid in the peritoneal cavity and is a complication of portal hypertension.

Answer 61

ascites

Question 62

This ascites theory is the most accepted theory and proposes that circulating nitric oxide and carbon monoxide cause splanchnic vasodilation.

Answer 62

Peripheral arterial vasodilation theory or forward theory

Question 63

This disorder occurs due to liver dysfunction and collateral vessels that shunt blood around the liver to the systemic circulation permitting neurotoxins and other substances absorbed from the GI tract to accumulate and circulate freely to the brain

Answer 63

Hepatic encephalopathy

Question 64

A rare chronic, progressive autoimmune inflammatory liver disease that affects genetically susceptible individuals usually women and children?

Answer 64

Autoimmune hepatitis

Question 65

This type of hepatitis can be recovered from feces, bile, and sera of infected individuals. The usual mode of transmission is fecal-oral route, but can be spread by infected blood and by men having sex with men

Answer 65

Hepatitis A (HAV)

Question 66

This type of hepatitis is a parenterally and sexually transmitted virus with 8 genotypes. Those who are at highest risk are immunosuppressed, receive hemodialysis, multiple blood transfusions, use immunosuppressive drugs, have multiple sex partners, share needles/syringes, and infants born to infected mothers.

Answer 66

Hepatitis B (HBV)

Question 67

This type of hepatitis is a parenterally transmitted flavivirus with 10 genotypes and a significant number of cases involve IV drug users with 80% developing chronic liver disease

Answer 67

HCV

Question 68

This type of hepatitis is a defective, single strand RNA virus and occurs as a co-infection with hepatitis B

Answer 68

HDV

Question 69

This type of hepatitis is most common in Asian and African countries, is transmitted via fecal-oral route from contaminated water or uncooked meat, domestic pigs, wild boars, deer, mongoose, and rabbits are all reservoirs for it.

Answer 69

HEV

Question 70

Fibrosis in cirrhosis is a consequence of

Answer 70

Kupffer cell activation

Question 71

This disease differs from alcoholic cirrhosis in that damage and inflammation leading to cirrhosis begin in bile canaliculi and bile ducts, rather than in hepatocytes

Answer 71

Biliary cirrhosis

Question 72

What is the hall mark of primary biliary cirrhosis?

Answer 72

Antimitochondrial antibody

Question 73

This disease can be chronic or acute but both forms are almost always caused by the lodging of a gallstone in the cystic duct causing the gallbladder to become distended and inflamed

Answer 73

cholecystitis

Question 74

The mutation of which gene is an early event in esophageal cancer?

Answer 74

TP53

Question 75

A patient presenting with loss of appetite (especially meat), malaise, indigestion, unexplained weight loss, upper abdominal pain, vomiting, change in bowel habits and anemia caused by occult bleeding probably has

Answer 75

Stomach cancer

Question 76

why is a stomach cancer prognosis generally poor?

Answer 76

Because it is asymptomatic until it has distant metastases

Question 77

This cancer is rare but occurs more frequently in familial adenomatous polyposis and Crohn disease.

Answer 77

Small intestine carcinoma

Question 78

The third most common cause of cancer and cancer death in the United States.

Answer 78

Colorectal cancer (CRC)

Question 79

Familial adenomatous polyposis, HNPCC or Lynch Syndrome are both high risk factors for

Answer 79

CRC

Question 80

A mass or finger like projection arising from the intestinal mucosal epithelium

Answer 80

polyp

Question 81

What two medication have been shown to prevent and treat colorectal cancer?

Answer 81

aspirin and NSAIDS

Question 82

Tumors that occur up to 15 cm from the anal opening.

Answer 82

rectal carcinoma

Question 83

Why is screening so important for CRC?

Answer 83

Because polyps and early stage tumors are asymptomatic

Question 84

The leading cause of cancer death worldwide and is highest in Eastern and Southeastern Asia

Answer 84

Liver Cancer

Question 85

This develops in the hepatocytes and can be nodular, massive, or diffuse.

Answer 85

Hepatocellular carcinoma

Question 86

This is a rare but lethal disease associated with gallstones, advancing age, female sex, anomalous pancreaticobiliary ductal junction and obesity

Answer 86

Gallbladder cancer

Question 87

Risk factors for this cancer include use of tobacco, heavy alcohol use, family history, DM type 2, chronic pancreatitis, and non O blood group

Answer 87

pancreatic cancer

Question 88

This is a rare autoimmune fibroinflammatory disorder of the pancreas that mimics radiologic and clinical symptoms of pancreatic cancer and must be differentiated

Answer 88

autoimmune pancreatitis

Question 89

What tumor marker is useful for diagnosis and response to treatment of pancreatic cancer?

Answer 89

CA19-9