GI/GU Midterm Practice

What is correct regarding peptic ulcers?

a. most patients are asymptomatic

b. peptic ulcers can be due to Zollinger-Ellison syndrome

c. a risk factor is rich fatty meals that delat stomach emptying

d. two of the options are correct

b. peptic ulcers can be due to Zollinger-Ellison syndrome

Select the symptoms of peptic ulcers. (select all that apply)

a. constipation

b. dark tarry stools

c. epigastric pain

d. sputum that contains blood

b. dark tarry stools

c. epigastric pain

d. sputum that contains blood

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 in the duodenum.

a. True

b. False

a. True

Which exam finding would you find with peptic ulcers?

a. yellowing of the skin

b. positive Rovsing's sign

c. Pallor

d. Low pulse rate

c. Pallor

Which test(s) will help diagnose peptic ulcers? (select all that apply)

a. urea breath test

b. barium swallow x-ray

c. upper GI endoscopy

d. lower GI endoscopy

e. ERCP

f. Blood test for nitrogenous wastes

a. urea breath test

b. barium swallow x-ray

c. upper GI endoscopy

Which is the most correct regarding gastric cancer?

a. an acid blocker will produce decreased pain

b. an exam finding would be tachycardia

c. a test that may help with diagnosis is an endoscopic exam

d. gastric cancer is due to a dysplasia of squamous cells

e. two of the options are correct

c. a test that may help with diagnosis is an endoscopic exam

All are risk factors for developing gastric cancer EXCEPT:

a. smoking

b. history of H. Pylori infection

c. family history of stomach cancer

d. excessive consumption of fruits

d. excessive consumption of fruits

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

a. pale stool

b. blood in urine

c. nocturnal cough

d. blood in stool

d. blood in stool

Which of the following is an exam finding for stomach cancer?

a. palpable mass of the abdomen

b. Dunphy's sign

c. absent bowel sounds

d. a positive rebound tenderness test

a. palpable mass of the abdomen

Which test(s) would have a positive finding for gastric cancer (select all that apply)

a. a complete blood test

b. upper GI endoscopy

c. ultrasound

d. x-ray with contrast medium

a. a complete blood test

b. upper GI endoscopy

d. x-ray with contrast medium

Which is related to Mallory Weiss syndrome?

a. a symptom which is frequently seen is melena

b. it is a condition that is due to an erosion of the esophagus-gastric junction

c. can be caused by hiccups

d. the peak age for this condition is 15-30 years of age

c. can be caused by hiccups

Mallory Weiss is associated with excessive process food consumption or eating disorders.

a. True

b. False

b. False

Which applies to Mallory Weiss syndrome? (select all that apply)

a. it is a condition that affects the esophagus and trachea

b. it produces unbearable pain

c. upper endoscopy would be a good test to diagnose

d. it can be caused by a viral infection

e. it is a condition that effects only the esophagus

f. coffee-ground emesis may be a history finding

c. upper endoscopy would be a good test to diagnose

f. coffee-ground emesis may be a history finding

IBS results from a pathology/damage of the colon causing intermittent bouts of diarrhea or constipation.

a. True

b. False

b. False

Select the region(s) directly affected by IBS. (select all that apply)

a. stomach

b. ileum

c. descending colon

d. sigmoid colon

c. descending colon

d. sigmoid colon

Which is correct regarding IBS?

a. there may be fissuring of the bowel

b. a symptom may be mucus in the stool

c. a stool test would be positive for pathological bacteria

d. it is usually asymptomatic

b. a symptom may be mucus in the stool

Which symptoms are seen with IBS? (select all that apply)

a. diarrhea

b. blood in feces

c. constipation

d. vomiting

e. pale stool

f. abdominal pain

g. dark urine

a. diarrhea

c. constipation

f. abdominal pain

A palpable sigmoid or swollen and bloated abdomen could be findings for someone suffering with IBS.

a. True

b. False

a. True

Which exam finding would be present with a patient diagnosed with IBS?

a. inspecting the abdomen for Cullen's sign

b. taking the temperature to find out if there is fever

c. a positive psoas sign

d. palpable sigmoid

d. palpable sigmoid

A 33 yo female presents with abdominal pain, constipation, and no fever. Blumberg sign is absent. All blood tests were within normal limits. What is your clinical diagnosis.

a. appendicitis

b. pancreatitis

c. inflammatory bowel disease

d. irritable bowel syndrome

d. irritable bowel syndrome

A 44 yo 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. pancreatitis

b. gastric cancer

c. biliary cholangitis

d. colorectal cancer

c. biliary cholangitis

Biliary cholangitis is a disease known for destruction of the biliary tree with poor etiology, but it could be due to:

a. hepatitis due to viral infections

b. a complication of cirrhosis

c. chronic celiac disease

d. autoimmune dysfunction

d. autoimmune dysfunction

Biliary cholangiopancreatography is more common in women between 40-60 years of age.

a. True

b. False

b. False

The cause of biliary cholangiopancreatography is not fully determined, but all the following may be related EXCEPT:

a. autoimmune

b. exposure to chemicals

c. infection

d. trauma

d. trauma

Biliary cholangitis has nonspecific symptoms; which would be a possibility once it has fully developed?

a. pain on the right upper abdominal quadrant

b. vomiting especially with meals that have a large carb load

c. regurgitation of a meal while it is being consumed

d. pain of the right scapular region

a. pain on the right upper abdominal quadrant

Which are symptoms of biliary cholangitis? (select all that apply)

a. pink urine

b. constant hunger

c. hyperbilirubinemia

d. not enough energy to perform daily activities

c. hyperbilirubinemia

d. not enough energy to perform daily activities

Which special test(s) for biliary cholangitis can be abnormal? (select all that apply)

a. blood test showing hypercholesterolemia

b. abnormal AST and ALT

c. fecal elastase test

d. anti-mitochondrial antibody test

a. blood test showing hypercholesterolemia

b. abnormal AST and ALT

d. anti-mitochondrial antibody test

Which special test would NOT be beneficial for detection or confirmation of biliary cholangitis?

a. biopsy

b. serum liver function

c. stool culture

d. all the above test will provide positive findings

c. stool culture

Which is correct regarding diverticulitis?

a. it usually affects people between the age 15-30

b. an upper GI series is recommended for diagnosis of diverticulitis

c. a risk factor for developing diverticulosis is a diet high in fiber

d. fever and constipation are related to diverticulitis

d. fever and constipation are related to diverticulitis

Which is NOT correct regarding diverticulitis?

a. possible cause may be diets low in fiber

b. obesity is a risk factor

c. fatty stools would be a sign

d. this is more common in older

c. fatty stools would be a sign

Which test(s) can help diagnose diverticulitis? (select all that apply)

a. a barium enema with lower GI series can help visualize anatomy

b. a urinalysis to identify bacterial infection

c. a lower GI endoscopy looking for structural changes

d. a stool test to identify blood

a. a barium enema with lower GI series can help visualize anatomy

d. a stool test to identify blood

Which is correct regarding pancreatic cancer? (select all that apply)

a. it is one of the most common cancers in the US

b. a risk factor for this cancer is hep B and C

c. it is usually diagnosed in people older than 65

d. the average age of diagnosis is 70

c. it is usually diagnosed in people older than 65

d. the average age of diagnosis is 70

Select the risk factor(s) for pancreatic cancer.

a. chronic GERD

b. history of smoking

c. excessive use of NSAIDs

d. long term diabetes

b. history of smoking

d. long term diabetes

Pancreatic cancer may exhibit which symptoms later in the disease process?

a. bloody diarrhea

b. pain may radiate to the back

c. tenesmus

d. pain starts at the lower left quadrant

b. pain may radiate to the back

Which blood test can help with detection to confirm pancreatic cancer?

a. trypansoma cruzi antigen

b. serum elastase

c. serum bilirubin

d. serum glucose

e. alkaline phosphatase

f. BUN test

g. Anti-tTg test

h. creatinine test

c. serum bilirubin

e. alkaline phosphatase

Which test can help with detection of tumors in the pancreas?

a. colonoscopy

b. MRCP

c. blood test showing elevated estrogen

d. stool culture

b. MRCP

A 65 yo presents with edema of the lower extremities, weight loss, and looks jaundiced. Whats your clinical diafnosis

a. colorectal cancer

b. cirrhosis

c. diverticulitis

d. none of the above

b. cirrhosis

Which is a risk factor for cirrhosis?

a. gastroenteritis

b. non-alcoholic steatohepatitis

c. excessive NSAID use

d. excessive cholesterol

b. non-alcoholic steatohepatitis

Symptoms of cirrhosis include all except:

a. pruritus

b. pyrosis

c. weight loss

d. weakness

b. pyrosis

Which are complications of cirrhosis? (select all that apply)

a. episodic diarrhea

b. risk of developing liver cancer

c. medications may be a problem due to increased sensitivity

d. may develop splenomegaly

b. risk of developing liver cancer

c. medications may be a problem due to increased sensitivity

d. may develop splenomegaly

Which is an exam finding for someone with cirrhosis?

a. palpable mass on the right lower quadrant

b. a positive rebound tenderness test

c. edema in the abdomen

d. skin rash

c. edema in the abdomen

All are positive exam findings for cirrhosis EXCEPT:

a. erythema of the thenar region of the palm

b. melena

c. discoloration of the skin

d. Muecke's nails which is a white banding across the nail bed

b. melena

Which is correct regarding special tests for cirrhosis? (select all that apply)

a. A serum test would reveal low levels of bilirubin

b. A blood test will reveal a high amount of albumin

c. A blood test will reveal high amounts of ALT

c. A blood test will reveal high amounts of ALT