Quiz 8 - Digestive and Hepatic Disorders

Question 1

Coeliac disease is an auto-immune disorder due to hypersensitivity to

a. lactose.
b. sucrose.
c. gluten.
d. leptin.

Answer 1

c. gluten.

Question 2

A 20-year-old male was recently diagnosed with lactose intolerance. He eats ice-cream and develops diarrhoea. His diarrhoea can be classified as:

a. osmotic diarrhoea.
b. secretory diarrhoea.
c. hypotonic diarrhoea.
d. motility diarrhoea.

Answer 2

a. osmotic diarrhoea.

Question 3

A 54-year-old male is diagnosed with peptic ulcer disease. This condition is most likely caused by:

a. hereditary hormonal imbalances with low gastrin levels.
b. breaks in the mucosa and the presence of corrosive secretions.
c. decreased vagal activity and vascular engorgement.
d. gastric erosions related to high ammonia levels and bile reflux.

Answer 3

b. breaks in the mucosa and the presence of corrosive secretions.

Question 4

Inflammation of the gastric mucosa in gastritis can occur due to:

a. disruption of the mucosal blood flow.
b. the presence of bacterial toxins.
c. impaired prostaglandin synthesis by the mucosa.
d. all of the above.

Answer 4

d. all of the above.

Question 5

Symptoms of cholelithiasis include all the following EXCEPT:

a. food intolerances, particularly fats.
b. epigastric pain.
c. jaundice.
d. decreased serum bilirubin levels.

Answer 5

d. decreased serum bilirubin levels.

Question 6

Shock can develop with acute pancreatitis for which of the following reasons?

a. The pancreas needs a large blood supply.
b. Large amounts of exudates which result in hypovolaemia.
c. Pancreatitis usually results in severe bleeding.
d. Insulin deficiency and hyperglycaemia lead to a high output state.

Answer 6

b. Large amounts of exudates which result in hypovolaemia.

Question 7

A 62-year-old male with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition may be caused by:

a. increased serum albumin and decreased capillary colloid osmotic pressure.
b. increased capillary filtration pressure.
c. decreased capillary permeability.
d. aldosterone and antidiuretic hormone suppression.

Answer 7

b. increased capillary filtration pressure.

Question 8

The hepatocellular damage of alcoholic cirrhosis is caused by:

a. acetaldehyde accumulation.
b. bile toxicity.
c. acidosis.
d. fatty infiltrations.

Answer 8

it’s not b. bile toxicity.

Question 9

Gastric-oesophageal reflux is:

a. caused by rapid gastric emptying.
b. excessive contraction of the upper oesophageal sphincter.
c. associated with abdominal surgery.
d. caused by malfunctioning of the lower oesophageal sphincter.

Answer 9

d. caused by malfunctioning of the lower oesophageal sphincter.

Question 10

A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastro-oesophageal reflux. This condition is caused by:

a. fibrosis of the lower third of the oesophagus.
b. sympathetic nerve stimulation.
c. loss of muscle tone at the lower oesophageal sphincter.
d. reverse peristalsis of the stomach.

Answer 10

c.

loss of muscle tone at the lower oesophageal sphincter.

Question 11

A 54-year-old male complains that he has been vomiting blood (haematemesis). Tests reveal portal hypertension. Which of the following is the most likely cause of his condition?

a. thrombosis in the spleen
b. cirrhosis of the liver
c. left ventricular failure
d. renal stenosis

Answer 11

b. cirrhosis of the liver

Question 12

Problems associated with hepatic encephalopathy from chronic liver disease are the result of:

a. hyperbilirubinaemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia clearance.
d. decreased cerebral blood flow.

Answer 12

c. impaired ammonia clearance.

Question 13

A 60-year-old male is diagnosed with Barrett disease. Which of the following factors most likely contributed to his disease?

a. gastric oesophageal reflux
b. intestinal parasites and polyps
c. nitrates and salty foods
d. aflatoxin from mouldy peanuts

Answer 13

a. gastric oesophageal reflux

Question 14

Management of gastric-oesophageal reflux include all of the following EXCEPT:

a. avoiding fatty food, caffeine and alcohol.
b. stay upright following meals.
c. consumption of large meals.
d. administration of proton pump inhibitors.

Answer 14

c. consumption of large meals.

Question 15

Chronic gastritis is most commonly caused by:

a. aspirin consumption.
b. alcohol consumption.
c. Helicobacter pylori infection.
d. overeating.

Answer 15

c. Helicobacter pylori infection.

Question 16

Non-steroidal anti-inflammatory drugs (NSAIDs) affect the gastric mucosa by:

a. decreasing prostaglandin synthesis.
b. decreasing gastric acid secretion.
c. increasing mucus production.
d. increasing bicarbonate production.

Answer 16

a. decreasing prostaglandin synthesis.

Question 17

Suzy presents to her medical practitioner reporting a recent history of continuous abdominal pain which becomes more intense following meals. Signs of malabsorption syndrome are becoming apparent. Suzy has a history of long-term alcohol abuse. Which of the following conditions is most likely responsible for Suzy’s pain?

a. hepatic encephalopathy
b. acute pancreatitis
c. portal hypertension
d. chronic pancreatitis

Answer 17

d. chronic pancreatitis

Question 18

A 39-year-old female presents with abdominal pain and jaundice. She is diagnosed with gallstones and later undergoes cholecystectomy. An analysis of her gallstones would most likely reveal a high concentration of:

a. phosphate.
b. ammonia.
c. urea.
d. cholesterol.

Answer 18

d. cholesterol.

Question 19

A 40-year-old male presents with left upper quadrant pain. Tests reveal the reason for the pain is acute pancreatitis. The most likely cause of his condition is:

a. failure of the lower oesophageal sphincter to constrict.
b. toxic injury to the pancreas from non-prescription medications.
c. blockage of the common bile duct by gallstones.
d. blockage of the lower oesophageal sphincter.

Answer 19

c. blockage of the common bile duct by gallstones.

Question 20

Inflammation of the pancreas may result from which of the following?

a. blockage of the common bile duct by gallstones.
b. alcohol abuse.
c. blockage of the pancreatic duct by gallstones.
d. all of the above

Answer 20

d. all of the above

Question 21

Which of the following is likely to be recommended for the management of gastric-oesophageal reflux?

a. avoiding fatty foods and alcohol
b. recline following meals
c. consume few large meals per day
d. increase consumption of caffeine to promote digestion

Answer 21

a. avoiding fatty foods and alcohol

Question 22

A 60-year-old male is diagnosed with cancer of the oesophagus. Which of the following factors most likely contributed to his disease?

a. gastric-oesophageal reflux
b. intestinal parasites and polyps
c. nitrates and salty foods
d. aflatoxin from mouldy peanuts

Answer 22

a. gastric-oesophageal reflux

Question 23

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy and mild jaundice secondary to cirrhosis. The most likely cause of his pre-accident condition was:

a. bacterial infection.
b. viral infection.
c. alcoholism.
d. drug overdose.

Answer 23

c. alcoholism.

Question 24

A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition may be caused by:

a. decreased serum albumin and decreased capillary colloid osmotic pressure.
b. decreased capillary filtration pressure.
c. decreased capillary permeability.
d. aldosterone and antidiuretic hormone suppression.

Answer 24

a. decreased serum albumin and decreased capillary colloid osmotic pressure.
- however remember the easier pathway - cirrhosis leads to portal hypertension which leads to increased capillary filtration pressure resulting in ascites.

Question 25

Inflammation of the gastric mucosa in gastritis can occur due to: a. disruption of the mucosal blood flow. b. the presence of bacterial toxins. c. impaired prostaglandin synthesis by the mucosa. d. all of the above.

Answer 25

d. all of the above

Question 26

The most common disorder associated with upper gastrointestinal bleeding is: a. diverticulosis. b. haemorrhoids. c. peptic ulcer disease. d. cancer.

Answer 26

c. peptic ulcer disease.

Question 27

A 62-year-old male with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition may be caused by: a. increased serum albumin and decreased capillary colloid osmotic pressure. b. increased capillary filtration pressure. c. decreased capillary permeability. d. aldosterone and antidiuretic hormone suppression.

Answer 27

b. increased capillary filtration pressure.

Question 28

Which of the following statements about gallstones is true? a. The formation of cholesterol gallstones is associated with high bilirubin levels. b. Cholesterol gallstones are less common than pigmented gallstones. c. Cholesterol gallstones are more likely to develop in women who are taking oral contraceptives. d. Cholesterol gallstones are more likely to develop in conditions that decrease the conjugation of bilirubin.

Answer 28

c. Cholesterol gallstones are more likely to develop in women who are taking oral contraceptives.

Question 29

Hepatic steatosis is associated with accumulation of _________ in the liver. a. jaundice b. fat c. albumin d. protein

Answer 29

b. fat

Question 30

Acute gastritis is commonly caused by: a. consumption of lactose-containing foods. b. alcohol consumption. c. low food intake. d. overeating.

Answer 30

b. alcohol consumption.

Question 31

Coeliac disease is characterised by alterations to the small intestine a. glands. b. villi. c. smooth muscle wall. d. sphincters.

Answer 31

b. villi.

Question 32

A 3-month-old female develops colicky pain, abdominal distension and diarrhoea after drinking cow’s milk. The best explanation for her symptoms is: a. a deficiency of bile that stimulates digestive secretions and bowel motility. b. an excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhoea. c. an overgrowth of bacteria from undigested fat molecules, which leads to gas formation and decreased bowel motility. d. an excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility.

Answer 32

d. an excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility.

Question 33

A 22-year-old complains about epigastric pain when he feels hungry and in the middle of the night. This pain is relieved when he ingests food. It is likely that he is suffering from: a. a gastric ulcer. b. gastritis. c. a myocardial infarction. d. gastro-oesophageal reflux.

Answer 33

a. a gastric ulcer.

Question 34

Of the following, the most common clinical manifestation of portal hypertension is: a. rectal bleeding. b. duodenal bleeding. c. oesophageal bleeding. d. intestinal bleeding.

Answer 34

c. oesophageal bleeding.

Question 35

A 31-year-old female presents with mid-abdominal pain. She is suspected to have acute pancreatitis. Which of the following laboratory results is/are most specific to this diagnosis? a. low haematocrit and haemoglobin b. elevated white blood cell count c. elevated serum amylase d. hyperglycaemia

Answer 35

c. elevated serum amylase

Question 36

A 52-year-old complains about epigastric pain immediately within 1 hour after she starts to eat. This condition is referred to as: a. gastric ulcer. b. gastritis. c. duodenum ulcer. d. gastro-oesophageal reflux.

Answer 36

d. gastro-oesophageal reflux. A gastric ulcer can feel better upon eating.