Quiz 36 37 38 39 40 41 PDF

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Chapter 36 1. Which of the following symptoms suggests the presence of a hiatal hernia? a. Nausea b. Heartburn c. Diarrhea d. Abdominal cramps 2. Histamine antagonists may be used in the management of peptic ulcer disease to a. increase gastric motility. b. inhibit secretion of pepsinogen. c. neutralize gastric acid. d. decrease hydrochloric acid (HCl) secretion. 3. Epigastric pain that is relieved by food is suggestive of a. pancreatitis. b. cardiac angina. c. gastric ulcer. d. dysphagia. 4. The most common cause of mechanical bowel obstruction is a. volvulus. b. intussusception. c. adhesions. d. fecal impaction. 5. Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of a. appendicitis. b. peritonitis. c. cholecystitis. d. gastritis. 6. A silent abdomen 3 hours after bowel surgery most likely indicates a. peritonitis. b. mechanical bowel obstruction. c. perforated bowel. d. functional bowel obstruction. 7. Ulcerative colitis is commonly associated with a. bloody diarrhea. b. malabsorption of nutrients. c. fistula formation between loops of bowel. d. inflammation and scarring of the submucosal layer of the bowel. 8. An early indicator of colon cancer is a. rectal pain. b. bloody diarrhea.

c. a change in bowel habits. d. jaundice. 9. A patient who should be routinely evaluated for peptic ulcer disease is one who is a. taking 6 to 8 tablets of acetaminophen per day. b. being treated with high-dose oral glucocorticoids. c. experiencing work-related stress. d. routinely drinking alcoholic beverages. 10. Celiac sprue is a malabsorptive disorder associated with a. inflammatory reaction to gluten-containing foods. b. megacolon at regions of autonomic denervation. c. ulceration of the distal colon and rectum. d. deficient production of pancreatic enzymes. 11. Which of the following clinical findings would suggest an esophageal rather than an oropharyngeal cause of dysphagia? a. Nasal regurgitation b. Airway obstruction with swallowing c. Chest pain during meals d. Coughing when swallowing 12. Combined dysphagia with both solids and liquids is typical of a. esophageal stricture. b. achalasia. (Because it is the second type of dysphagia) c. esophageal tumors. d. Mallory-Weiss syndrome. 13. In which of the following cases would it be inappropriate to manage dyspepsia with an empiric trial of an H2 blocker? a. Concomitant dysphagia b. sic use of nonsteroidal antiinflammatory drugs c. Dyspepsia occurring after meals d. Dyspepsia relieved by meals 14. A Barrett esophagus is a. best managed with H2 antagonists. b. a preneoplastic lesion. c. a benign condition. d. a gastrin-secreting tumor. 15. Which of the following findings should prompt further diagnostic testing in a child presenting with diarrhea? a. Periumbilical discomfort b. Greenish, watery diarrhea c. Frequent, large-volume diarrhea d. Blood and mucus in the stools

16. Fecal leukocyte screening would be indicated in a patient with suspected a. lactose intolerance. b. inflammatory bowel disease. c. laxative abuse. d. giardiasis. 17. Which of the following findings would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? a. Negative stool leukocytes b. Intermittent constipation c. Abdominal pain and distention d. Bloody stools 18. An urgent surgical consult is indicated for the patient with acute abdominal pain and a. vomiting. b. CVA tenderness. c. absent bowel tones. d. borborygmi. 19. Painful swallowing: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis 20. Difficulty swallowing: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis 21. Herniations in the bowel wall: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis 22. Absence of peristalsis in a portion of the esophagus: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

23. Stasis and involuntary leakage of stool: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis Chapter 37 1. A deficiency of lipid digestion or absorption commonly results in a. steatorrhea. b. constipation. c. hyperlipidemia. d. cholelithiasis. 2. Patients with acute pancreatitis are generally not allowed to eat and may require continuous gastric suctioning to a. prevent abdominal distention. b. remove the usual stimuli for pancreatic secretion. c. prevent hyperglycemia associated with loss of insulin secretion. d. prevent mechanical obstruction of the intestine. 3. Most gallstones are composed of a. bile. b. cholesterol. c. calcium. d. uric acid salts. 4. Elevated serum lipase and amylase levels are indicative of a. gallbladder disease. b. appendicitis. c. pancreatitis. d. peritonitis. 5. The definitive treatment for cholecystitis is a. lithotripsy of stones. b. chemical dissolution of stones. c. antibiotics and antiinflammatories. d. cholecystectomy. 6. A biliary cause of acute pancreatitis is suggested by which of the following laboratory results? a. Elevated serum lipase b. Elevated serum amylase c. Elevated serum glucose d. Elevated serum alkaline phosphatase

7. A patient with pancreatitis may experience muscle cramps and laryngospasm secondary to a. alkalosis. b. hyperglycemia. c. hypocalcemia. d. hypermagnesemia. 8. Chronic pancreatitis may lead to a. diabetes mellitus. b. Crohn disease. c. gallstones. d. celiac sprue. 9. The usual treatment for chronic pancreatitis includes a. pancreatectomy. b. strict dietary avoidance of fats. c. abstinence from alcohol. d. long-term narcotic administration for pain. 10. The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis a. is an expected finding and requires no specific intervention. b. indicates peritonitis with substantial risk for sepsis and shock. c. requires immediate surgical intervention. d. is an unusual finding in pancreatitis and indicates misdiagnosis. Chapter 38 1. Jaundice is a common manifestation of a. malabsorption syndromes. b. anemia. c. liver disease. d. cholecystitis. 2. Esophageal varices may develop as a complication of liver disease. Pathophysiologically, this condition can be attributed to a. elevated bilirubin. b. diminished protein metabolism. c. fluid accumulation. d. portal hypertension. 3. Hepatitis B is usually transmitted by exposure to a. hepatitis vaccine. b. feces. c. blood or semen. d. contaminated food.

4. Hepatic encephalopathy is associated with a. hyperbilirubinemia. b. hyperuricemia. c. toxic effects of alcohol on brain cells. d. increased blood ammonia levels. 5. An increased urine bilirubin is associated with a. an increased indirect serum bilirubin. b. hemolytic reactions. c. Gilbert syndrome. d. hepatitis. 6. Liver transaminase elevations in which aspartate aminotransferase (AST) is greater than alanine aminotransferase (ALT) by a 2:1 ratio is characteristic of a. viral hepatitis. b. alcohol-induced injury. c. cirrhosis. d. acetaminophen toxicity. 7. A viral hepatitis screen with positive hepatitis B surface antigen, positive anti-HB core IgM, and negative anti-HB surface IgG should be interpreted as _____ hepatitis B. a. recovered from . b. immunity to c. chronic active d. acute 8. Hemochromatosis is a common genetic disorder that may lead to chronic liver failure. Which of the following laboratory data would support a diagnosis of hemochromatosis? a. Deficient protease inhibitor b. Elevated ferritin c. Elevated urine copper d. Positive antinuclear antibody 9. Which of the following forms of viral hepatitis is likely to be transmitted sexually? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis E 10. Brain injury secondary to high serum bilirubin is called a. hepatic encephalopathy. b. hepatic meningitis. c. kernicterus. d. encephalitis. 11. Which of the following forms of viral hepatitis is likely to be transmitted oral-fecal? a. Hepatitis A b. Hepatitis B

c. Hepatitis C d. Hepatitis E

Chapter 40 1. Slow mentation a. Addison disease b. Acromegaly c. Aldosteronism d. Myxedema 2. Hypertension a. Addison disease b. Acromegaly c. Aldosteronism d. Myxedema 3. Hyperglycemia a. Addison disease b. Acromegaly c. Aldosteronism d. Myxedema 4. Hypotension a. Addison disease b. Acromegaly c. Aldosteronism d. Myxedema 5. Growth hormone excess in adults a. results in the condition of acromegaly. b. leads to abnormally tall stature. c. is associated with hypoglycemia. d. is usually asymptomatic. 6. An increase in ADH secretion occurs in response to a. a decrease in serum osmolality. b. dehydration. c. hypervolemia. d. hyponatremia. 7. Antidiuretic hormone (ADH) increases a. sodium reabsorption in the distal tubule of the kidney. b. potassium secretion in the distal tubule of the kidney. c. water reabsorption in the collecting tubule of the kidney. d. urinary output.

8. A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is a. hypovolemia. b. hyponatremia. c. increased osmolality. d. dehydration. 9. Diabetes insipidus is a condition a. resulting from inadequate ADH secretion. b. characterized by oliguria. c. associated with anterior pituitary dysfunction. d. characterized by glycosuria. 10. Synthesis of thyroid hormones a. is increased by thyrotropin-inhibiting factor. b. occurs in perifollicular C cells. c. is stimulated by ACTH. d. is inhibited by iodine deficiency. 11. In comparison to triiodothyronine (T3), thyroxine (T4) a. has greater biological activity. b. is more abundant in the circulation. c. has a shorter half-life. d. binds to nuclear receptors with greater affinity. 12. Clinical manifestations of Graves disease may include a. tremor. b. cold intolerance. c. lethargy. d. weight gain. 13. Graves disease is a. a secondary endocrine disorder. b. associated with autoantibodies to TSH receptors. c. characterized by high serum TSH levels. d. untreatable. 14. Propylthiouracil may be used to treat hyperthyroidism because it a. destroys thyroid gland cells. b. inhibits the release of TSH. c. suppresses production of autoantibodies. d. inhibits thyroid hormone synthesis. 15. Myxedema coma is a severe condition associated with a. hypothyroidism. b. hyperthermia. c. acute cortisol insufficiency. d. pheochromocytoma.

16. Clinical manifestations of hypoparathyroidism a. are similar to those occurring with hypermagnesemia. b. result from decreased neuromuscular excitability. c. are similar to those occurring with hypokalemia. d. result from decreased serum ionized calcium. 17. The formation of active vitamin D a. occurs in the skin. b. depends on hydroxylation in the kidney. c. is dependent on oral intake of vitamin D. d. is necessary for normal potassium metabolism. 18. Adrenocortical hormones are all derived from the common precursor molecule a. progesterone. b. corticoglobulin. c. ACTH. d. cholesterol. 19. A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is a. hypokalemia. b. hypoglycemia. c. hypertension. d. moon face. 20. What effect would adrenocortical insufficiency have on an individual's response to surgical stress? a. More prone to hyperglycemia b. Decreased sensitivity to anesthesia c. More susceptible to hypertensive crisis d. More prone to hypotension 21. Which response to an injection of ACTH indicates a primary adrenal insufficiency? a. No change in serum glucocorticoid level b. An increase in serum glucocorticoid level c. A decrease in serum glucose level d. An increase in serum ACTH level 22. A laboratory finding that would help confirm the diagnosis of aldosterone deficiency is a. hypernatremia. b. hyperkalemia. c. hypokalemia. d. hypoglycemia. 23. The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder. A symptom associated with primary Cushing syndrome is a. hyperpigmentation. b. hypotension.

c. hyperglycemia. d. hyperkalemia. 24. Congenital adrenal hyperplasia (adrenogenital syndrome) results from a. cortisol excess. b. testosterone-secreting tumor. c. exogenous androgens. d. blocked cortisol production.

Chapter 41 1. The underlying pathogenic mechanism for both type 1 and type 2 diabetes is a. pancreatic β-cell destruction. b. lack of insulin receptors. c. lack of exercise and chronic overeating. d. impaired glucose transport into cells. 2. nsulin binding to its receptor on target cells results in a. increased active transport of glucose into the cell. b. glycogen breakdown within target cells. c. increased facilitated diffusion of glucose into cells. d. gluconeogenesis. 3. A clinical finding consistent with a hypoglycemic reaction is a. acetone breath. b. warm, dry skin. c. trembling. d. hyperventilation. 4. Which of the following clinical findings usually is not associated with type 1 diabetes mellitus? a. Polyuria b. Polydipsia c. Polyphagia d. Obesity 5. Type 2 diabetes mellitus is often associated with a. nonketotic hyperosmolality. b. childhood. c. autoimmune destruction of the pancreas. d. ketoacidosis. 6. Which of the following indicators is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus? a. Blood glucose levels b. Urine glucose levels

c. Glycosylated hemoglobin levels (HbA1c) d. Clinical manifestations of hyperglycemia 7. Diabetic neuropathy is thought to result from a. elevated neuronal osmolality. b. elevated HbA1c. c. deficient neuronal insulin receptors. d. neuronal demyelination. 8. Which of the following therapies would not be appropriate for a patient with type 1 diabetes mellitus? a. High-carbohydrate, low-fat diet b. Daily exercise c. Insulin d. Oral hypoglycemic agents 9. A type of insulin that would be most appropriate for acute management of hyperglycemia is a. NPH. b. semilente. c. regular. d. ultralente. 10. Which of the following hormones will not increase serum glucose level? a. Vasopressin b. Glucagon c. Growth hormone d. Catecholamine...