GI/GU Final Practice

T/F. If there is suspicion of pancreatitis, a blood test could be performed for a decrease in ALT/AST.

a. True

b. False

b. False

Which test would you recommend for a patient that you suspect has colorectal cancer?

a. Fecal occult blood test

b. Urinalysis

c. Blood test for urea

d. Upper GI endoscopy

a. Fecal occult blood test

T/F. A fecal elastase test would demonstrate a deficiency of elastase in stool for a patient with pancreatitis.

a. True

b. False

a. True

Which of the following can cause hydronephrosis?

a. Sepsis

b. Appendicitis

c. Kidney stone

d. Hyperglycemia

c. Kidney stone

Which of the following would be a symptom of phimosis?

a. Flank pain

b. Herniation of the side that is affected

c. Irritation on prepuce of penis

d. Inability to reduce an erection

c. Irritation on prepuce of penis

Which one of the following exam findings would be present with a patient diagnosed with irritable bowel syndrome.

a. Positive Murphy's sign

b. Rebound tenderness

c. Palpable sigmoid

d. Guarding and rigidity in all four quadrants

c. Palpable sigmoid

Select all that are seen with IBS.

a. Diarrhea

b. Constipation

c. Blood is stool

d. Unintentional weight loss

e. Abdominal cramping

f. Mucus in stool

a. Diarrhea

b. Constipation

e. Abdominal cramping

f. Mucus in stool

Which one of the following statements correctly describes Meckel's?

a. It is an acquired out-pouching of the colon seen in elderly patients

b. It is a congenital remnant of the vitellin duct

c. It arises from the sigmoid colon and is always symptomatic

d. It results from inflammation of the appendix.

b. It is a congenital remnant of the vitellin duct

Which of the following would be a complication of Meckel's diverticulum?

a. Pale stool due to obstruction

b. Bleeding in intestinal tract

c. Radiation pain of right scapular region

d. Episodic diarrhea

b. Bleeding in intestinal tract

Which one of the following would be a finding for someone suspected of having prostate cancer?

a. Decreased serum creatinine

b. Elevated prostate-specific antigen (PSA) blood test

c. Normal digital rectal exam (DRE)

d. Low testosterone levels

b. Elevated prostate-specific antigen (PSA) blood test

All of the following are signs and symptoms of prostate cancer, except:

a. Difficulty urinating

b. Blood in the urine

c. Erectile dysfunction

d. Blood in the stool

d. Blood in the stool

A 24 year old male complains of a painful erection and a history of a previous urinary tract infection. Which of the following would a probable diagnosis?

a. Nonischemic priapism

b. Ischemic priapism

c. Erectile dysfunction

d. Peyronie's disease

b. Ischemic priapism

T/F: Skin rash along with joint pain may indicate Crohn's.

T

Which one of the following diagnostic tests would be helpful in identifying Crohn's?

a. Barium swallow

b. Lower GI endoscopy

c. Upper GI endoscopy

d. Ultrasound

b. Lower GI endoscopy

T/F: Mallory-Weiss is associated with people that consume an excessive amount of processed foods that are high in refined carbohydrates.

F

Which one of the following would be the cause of nonischemic priapism?

a. Sickle cell anemia

b. Spinal cord injury

c. Ruptured artery

d. Antidepressant medication

c. Ruptured artery

T/F: Ischemic priapism was defined as an erect but not fully rigid penile shaft lasting more than 4 hours, and not usually painful.

F - nonischemic does

A person may develop cholecystitis that is not a result of a gallstone. Which risk factor below can be involved in acalculus cholecystitis?

a. High-fiber diet

b. Major surgery

c. Lactose intolerance

d. Regular physical activity

b. Major surgery

A 39 year old presents with abdominal pain that radiates to the right shoulder has been present for the last 10 hours. It gets worse after eating and the last bowel movement was described as pale in color. Which of the following would be the best diagnosis?

a. Acute pancreatitis

b. Peptic ulcer disease

c. Appendicitis

d. Cholecystitis

e. Gastroenteritis

d. Cholecystitis

Which one of the following is a symptom for gastric cancer in the late advanced stage of the disease?

a. Mild indigestion after eating

b. Presence of blood in stool

c. Increased appetite

d. Weight gain and abdominal bloating

b. Presence of blood in stool

As described in class which one of the following is an exam finding for stomach cancer?

a. Positive Murphy's sign

b. Palpable mass of the abdomen

c. McBurney's point tenderness

d. Costovertebral angle tenderness

b. Palpable mass of the abdomen

Which one of the options is correct with respect to cholelithiasis?

a. It always causes severe abdominal pain

b. It is commonly diagnosed in children under 5 years old

c. Most people with cholelithiasis have no symptoms

d. It can be cured with antibiotics alone.

c. Most people with cholelithiasis have no symptoms

T/F: Gallbladder attack due to cholelithiasis presents with pain of the upper right quadrant of the abdomen lasting several hours but usually not more than 6 hours

T

Which one of the following is correct with respect to liver cancer?

a. A symptom would be upper abdominal pain

b. Liver cancer usually causes symptoms early in its development

c. Liver cancer is typically unrelated to hepatitis infections

d. Jaundice is never seen in liver cancer

a. A symptom would be upper abdominal pain

Which of the following tests or findings will be positive for pyelonephritis?

a. Colonoscopy showing inflamed mucosa

b. Chest X-ray revealing pulmonary infiltrates

c. CT scan showing blunted calyces

d. MRI revealing brain lesions

c. CT scan showing blunted calyces

Which one of the following is NOT a sign or symptom of pyelonephritis?

a. Costovertebral angle tenderness

b. Fever and chills

c. Dysuria

d. Upper right quadrant pain

e. Flank pain

d. Upper right quadrant pain

A 35 year old women complains of pelvic pan and urgency to void her bladder says she needs to use bathroom 40 times everyday to urinate. She has a fever and other signs of infection what would be a likely condition?

a. Nephrolithiasis

b. Interstitial cystitis

c. Pyelonephritis

d. Hydronephritis

b. Interstitial cystitis

Which one of the following would be a symptom of interstitial cystitis?

a. Cloudy urine with a foul odor

b. High fever and chills

c. Increased urinary frequency

d. Absence of urinary urgency

c. Increased urinary frequency

T/F: Internal hemorrhoids occur above the pectinate line, whereas external are below.

T

T/F: Internal hemorrhoids are more prone to thrombosis and cause the most pain.

F - external are

What is the diagnostic test used to observe internal hemorrhoids.

a. Colonoscopy

b. Sigmoidoscopy

c. Anoscopy

d. Digital rectal exam

c. Anoscopy

Which of the following test would have a positive finding if there was a suspicion of UC?

a. Sigmoidoscopy

b. Anti tTg blood test

c. Barium swallow

d. Ultrasound

a. Sigmoidoscopy

If there is suspicion of celiac disease, which blood test would help diagnosis?

a. Serum glucose

b. Anti tissue transglutaminase test

c. Serum PSA test

d. Antiglomerular basement membrane antibody test

b. Anti tissue transglutaminase test

Which one of the following is correct with respect to prostatitis?

a. Acute bacterial prostatitis may be negative pre-massage for bacteria

b. Chronic prostatitis always shows a positive urine culture before prostatic massage

c. Nonbacterial prostatitis is confirmed by presence of bacteria in the post-massage urine sample

d. Prostatitis only occurs in elderly men and is always asymptomatic

Acute bacterial prostatitis may be negative pre-massage for bacteria

If you suspected someone had acute bacterial prostatitis which one of the following symptoms would you expect the patient to report?

a. Increased thirst and dry mouth

b. Fever and chills

c. Chest pain and shortness of breath

d. Rash on the lower extremities

b. Fever and chills

T/F: Nephrotic syndrome is a group of kidney pathological conditions that produce urine containing blood and protein.

F

What is one of the primary causes of nephrotic syndrome?

a. IgA nephropathy

b. Membranous nephropathy

c. Goodpasture syndrome

d. NSAIDs

b. Membranous nephropathy

T/F: Barrett's esophagus is a disease that presents with metaplasia of stratified squamous epithelium that is typically seen in the esophagus with epithelium that resembles the gastric lining.

T

All of the following are correct for Barrett's esophagus EXCEPT?

a. It is a complication of chronic gastroesophageal reflux disease (GERD)

b. It increases the risk for esophageal adenocarcinoma

c. It involves metaplasia of the esophageal squamous epithelium to columnar epithelium

d. Most individuals with GERD will develop this condition after a few years

e. It requires regular surveillance via endoscopy.

d. Most individuals with GERD will develop this condition after a few years

Which one of the statements is NOT correct with respect to diverticulitis?

a. Left lower quadrant abdominal pain is a common symptom

b. Fever and elevated white blood cell count may be present

c. Fatty stools would be a finding for diverticulitis

d. Diverticulitis can lead to complications such as abscesses or perforation.

c. Fatty stools would be a finding for diverticulitis

Which one of the following tests would be practical for diagnosing benign prostate hypertrophy?

a. Colonoscopy

b. Digital rectal exam

c. PTCA

d. Biopsy

b. Digital rectal exam

All of the following are signs and symptoms of benign prostate hypertrophy EXCEPT?

a. Urinary hesitancy

b. Weak urine stream

c. Nocturia

d. Rectal bleeding

d. Rectal bleeding

Your 65 year old patient presents with edema of the lower extremities, weight loss, and appears jaundiced, what would be your clinical impression?

a. Cirrhosis

b. Pancreatitis

c. Cholecystitis

d. Colorectal cancer

a. Cirrhosis

When we discussed cirrhosis, which one of the following was a risk factor?

a. Iron-deficiency anemia

b. Non-alcoholic steatohepatitis

c. Lack of physical activity

d. H. pylori

b. Non-alcoholic steatohepatitis

Which one of the following tests would be beneficial for detecting GERD?

a. Colonoscopy

b. Abdominal ultrasound

c. 24-hour esophageal pH monitoring

d. Chest X-ray

c. 24-hour esophageal pH monitoring

A 48-year-old male patient with a 20-year history of smoking and describes his diet as poor (eating fast-food) presents with pyrosis and odynophagia for the past 3 months. Which of the following would be the best clinical impression?

a. GERD

b. Peptic ulcer disease

c. Acute viral pharyngitis

d. Esophageal varices

e. Esophageal cancer

GERD

Which one of the following is a risk factor for esophageal cancer?

a. Crohn's disease

b. Barrett's esophagus

c. IBD

d. NASH

b. Barrett's esophagus

Which one of the following is a symptom of esophageal cancer?

a. Increased appetite

b. Painful swallowing

c. Frequent urination

d. Joint stiffness

b. Painful swallowing

Appendicitis could result from which one of the following?

a. Viral hepatitis

b. Lymphoid hyperplasia

c. Nephrolithiasis

d. Peptic ulcer disease

b. Lymphoid hyperplasia

Which one of the following is NOT correct with respect to colon cancer?

a. Symptoms occur from onset

b. It can develop from precancerous polyps

c. Screening is effective in early detection

d. Risk increases with age.

a. Symptoms occur from onset

There are four classification for gastric cancer, which one describes a lesion that is ulcerated?

a. Penetrating

b. Linitus plastics

c. Superficial spreading

d. Protruding

a. Penetrating

Biliary cholangitis may have which one of the possible findings?

a. Elevated levels of gamma glutamyl transaminase

b. Elevated levels of fecal elastase

c. A positive fecal blood test

d. Elevated levels of BUN

a. Elevated levels of gamma glutamyl transaminase

Which one of the following is a risk factor for colorectal cancer?

a. Fibromyalgia

b. High-fiber diet

c. Polyposis

d. Family with IBS

c. Polyposis

Which one of the following is incorrect with respect to autosomal dominant polycystic kidney disease?

a. It typically affects children

b. It can lead to hypertension and kidney failure

c. It is caused by mutations in the PKD1 or PKD2 genes

d. It may present with flank pain and hematuria.

a. It typically affects children

T/F: One of the theories for BPH is that the proportion of estrogen is increased compared to testosterone it will promote increased prostatic growth factor.

T

Which one of the tests listed would help you to detect autosomal dominant polycystic kidney disease?

a. Serum creatinine test

b. Urinalysis

c. Ultrasound

d. Biopsy

c. Ultrasound

Which one of the following statements is not correct regarding gastroenteritis?

a. Viral gastroenteritis is rarely seen in developed countries

b. Gastroenteritis can be caused by bacteria, viruses, or parasites

c. Symptoms commonly include diarrhea, vomiting, and abdominal cramps

d. Proper hand hygiene is an effective method to prevent gastroenteritis.

a. Viral gastroenteritis is rarely seen in developed countries

A 25 year old appears with sudden onset of watery diarrhea and nausea that has been present for the last 8 hours. Headache and muscle pain are also complaints. Which one of the following would be a viable diagnosis?

a. Gastroenteritis

b. Irritable Bowel Syndrome

c. Appendicitis

d. Peptic Ulcer Disease

a. Gastroenteritis

All of the following are signs and symptoms associated with ulcerative colitis EXCEPT?

a. Abdominal pain and cramping

b. Bloody diarrhea

c. Urgency to defecate

d. Yellowing of the skin

d. Yellowing of the skin

Which one of the following is correct with respect to ulcerative colitis?

a. It is a chronic inflammatory disease that affects the entire gastrointestinal tract, including the small intestine

b. It is an inflammatory bowel disease that affects only the colon and commonly appears between the ages of 15-30 and over 60

c. It is a non-inflammatory condition that causes ulcers in the esophagus and stomach

d. It is a bacterial infection that primarily affects children under 10 years of age.

b. It is an inflammatory bowel disease that affects only the colon and commonly appears between the ages of 15-30 and over 60

T/F: One in seven people with gallstones develop choledocholithiasis.

T

Which one of the following tests could show a positive finding if celiac disease is suspected?

a. Colonoscopy

b. Upper GI endoscopy

c. Abdominal ultrasound

d. Barium enema

b. Upper GI endoscopy

Which one of the following signs/symptoms are NOT seen with Celiac's disease?

a. Chronic diarrhea

b. Abdominal bloating

c. Iron-deficiency anemia

d. Blood in stool

e. Weight loss

d. Blood in stool

All of the following are tests that would be beneficial for the diagnosis of hydronephrosis EXCEPT?

a. Ultrasound of the kidney

b. Intravenous pyelography

c. Lower endoscopy

d. CT scan of the abdomen and pelvis

c. Lower endoscopy

Please select all that are symptoms of peptic ulcers. Select all that apply.

a. Epigastric pain

b. Dark tarry stool

c. Jaundice

d. Nausea

e. Increased appetite

f. Chest pain that worsens with breathing

a. Epigastric pain

b. Dark tarry stool

d. Nausea

T/F: If a patient mentions that shortly after a meal their upper abdominal pain decreases but then rises again after about an hour, the peptic ulcer may be located in the duodenum.

T

A 35-year-old Life grad comes into your office complaining of upper abdominal pain. History reveals that she drinks 1-2 glasses of wine per day for dinner, consumes NSAIDS (3-4g/day) for a week every month when she has her periods. What would be the most logical diagnosis?

a. Cholelithiasis

b. Gastritis

c. Appendicitis

d. Irritable Bowel Syndrome

e. Pancreatitis

b. Gastritis

T/F: In lecture we discussed that there are two forms of gastritis. The non-erosive gastritis produces inflammation but is not accompanied by ulcerations.

T

A 22-year-old male patient reports that he has difficulty eating his meals. There is pressure that builds up in his chest. He has noticed that it is getting worse and also finds that he wakes up from sleep because of a cough that develops in his chest. Which one is your best clinical impression?

a. Gastroesophageal reflux disease b. Esophageal carcinoma

c. Achalasia

d. Peptic ulcer disease

e. Hiatal hernia

c. Achalasia

T/F: One of the findings for achalasia is smooth pipe sign after performing contrast x-ray.

F - Rat tail sign or Bird beak sign

Please select the most correct response regarding achalasia.

a. Because of excessive stomach acid damaging the esophagus

b. Due to the esophagus narrowing from chronic inflammation

c. Because the lower esophageal sphincter fails to relax properly

d. Due to the overproduction of saliva leading to choking

c. Because the lower esophageal sphincter fails to relax properly

T/F: Epispadias is a malformation of the ureter that opens to the underside of the penis.

F - this would be hypospadias

Which of the hepatitis viruses is referred to as a type of flavivirus?

a. Hepatitis A

b. Hepatitis B

c. Hepatitis C

d. Hepatitis E

c. Hepatitis C

All of the following are symptoms that a person may exhibit if they have viral hepatitis EXCEPT?

a. Jaundice

b. Fatigue

c. Abdominal pain

d. Dark stools

d. Dark stools

All of the following are symptoms of nephritic syndrome except

a. Facial swelling

b. Hypertension

c. Increased urinary frequency

d. Oliguria

c. Increased urinary frequency

Which one of the following is the most common type of kidney stones?

a. Uric acid

b. Struvite

c. Cystine

d. Calcium oxalate

e. Calcium phosphate

d. Calcium oxalate

Which blood test can be used to confirm a diagnosis of pancreatic cancer?

a. Alkaline phosphatase

b. Amylase and lipase

c. High triglyceride

d. Hemoglobin A1c

a. Alkaline phosphatase

Which one of the following is correct for pancreatic cancer?

a. It is usually diagnosed in individuals younger than 30

b. It is most commonly found in the pediatric population

c. It is usually diagnosed in people older than 55

d. It is most often detected early due to clear symptoms.

c. It is usually diagnosed in people older than 55

T/F: Post-streptococcal glomerulonephritis is a form of nephritic syndrome that is seen affecting children?

T

All of the following would be diagnostic criteria for nephritic syndrome EXCEPT?

a. Hematuria

b. Hypertension

c. Oliguria

d. Polyuria

e. Proteinuria

d. Polyuria

A 44-year-old male presents with fatigue, right upper abdominal pain, and inflamed skin due to scratching. He mentions that he also suffers with ulcerative colitis. What is the most likely co-morbidity this patient has?

a. Primary biliary cholangitis

b. Primary sclerosing cholangitis

c. Acute cholecystitis

d. Hepatitis A infection

b. Primary sclerosing cholangitis

T/F: Biliary cholangitis/Primary sclerosing cholangitis is more common in women between 40-60 years of age.

F - MC in men in 40s

Which one of the following would be a diagnostic finding for a male baby suspected of having cryptorchidism?

a. Palpable mass in the scrotum

b. Bilateral hydroceles present

c. Exam would reveal an empty scrotum

d. Presence of varicocele on the left side

c. Exam would reveal an empty scrotum

If a male infant was born with cryptorchidism which one of the possible diagnostic options would help the diagnosis?

a. An abdominal ultrasound to locate the undescended testicle

b. A chest X-ray to check for respiratory complications

c. A scrotal biopsy to examine tissue pathology

d. An ECG to rule out congenital heart defects

a. An abdominal ultrasound to locate the undescended testicle

Which of the following is a risk factor for pancreatic cancer?

a. Chronic GERD

b. Long term diabetes

c. Excessive use of NSAIDs

d. Chaga's disease

b. Long term diabetes

All of the following are risk factors for fatty liver discussed in class EXCEPT?

a. Obesity

b. Type 2 diabetes

c. Excessive alcohol consumption

d. Excessive use of NSAIDs

d. Excessive use of NSAIDs

What exam finding would be associated with fatty liver disease/NASH?

a. Visualization of skin for rash

b. Poor sensation of abdomen

c. Excessive weight

d. Fever

c. Excessive weight

Which one of the following statements is not correct with respect to fatty liver/NASH?

a. Palpation will reveal an enlarged liver

b. It is commonly associated with metabolic syndrome

c. Liver enzymes are always elevated in NASH

d. Fat accumulation in the liver can be seen on imaging

c. Liver enzymes are always elevated in NASH

If a male infant was born with cryptorchidism which one of the possible diagnostic options would help the diagnosis?

a. Two of the options are correct

b. diagnosis usually is not made until the child reaches 6 years of age

c. an inguinal hernia is noted on the infant

d. the infant is unable to urinate

c. an inguinal hernia is noted on the infant

T/F - Epispadias is a malformation of the ureter that opens to the underside of the penis?

False

Which one of the following statements correctly describes Meckel's?

a. it is an acquired condition

b. this diverticulum is a remanent of the vitellin duct

c. two percent of the people that have this condition are asymptomatic

d. the diverticulum usually affects the lower half of the esophagus

b. this diverticulum is a remenant of the vitellin duct

Match the type of hemorrhoid with the description. This question is worth 2 points

Occur above the pectinate line

Prone to thrombosis

internal hemorrhoid

external hemorrhoid

Occur above the pectinate line - internal hemorrhoid

Prone to thrombosis -external hemorrhoid

Pancreatitis may have which of the following signs during examination

a. string sign

b. murphys sign

c. obturator sign

d. cullen sign

d. cullen sign

Which one of the following statements is correct with respect to Chohn's

a. it is mostly in the rectum and can of affects the colon

b. it is only seen in patients in their 6th decade of life

c. it is usually seen affecting the ileum

d. fecal blood test is the only method of testing for this condition

c. it is usually seen affecting the ileum

Which one of the following is a risk factor for esophageal cancer?

a. gastritis

b. excessive NSAIDs

c. mallory-weiss

d. Barrett's

d. Barrett's

Which statement is correct with respect to gastritis?

a. patient may appear pale with gastritis

b. palpation would be positive for an enlarged stomach

c. a blood test would reveal hypertriglyceridemia

d. there would be a positive murphy's sign

a. patient may appear pale with gastritis

A 62-year-old patient complains of lower abdominal pain more on the left and with constipation. He is also complaining of nausea and vomiting. What would be the most appropriate clinical impression?

a. Pancreatic cancer

b. Gastric cancer

c. Barrett's esophagus

d. Diverticulitis

d. Diverticulitis

Select the statement that correctly relates to Mallory-Weiss syndrome as discussed in class.

a. The peak age for this condition is 15-30 years of age.

b. A symptom which is seen frequently is hematuria.

c. Can be caused by hiccups.

d. It is a condition that causes dysplasia of the esophago-gastric junction.

c. Can be caused by hiccups

All of the following would be diagnostic criteria for nephritic syndrome EXCEPT?

a. Hematuria

b. Proteinuria

c. Elevated BUN

d. Polyuria

d. Polyuria

Which one of the following can cause hydronephrosis?

a. Enlarged prostate

b. Hyperglycemia

c. Sepsis

d. Appendicitis

a. Enlarged prostate