PACKRAT GI; Questions and Answers 100% Correct
Which of the following is a common physical examination finding in early intestinal obstruction?
A. high fever.
B. profuse flatulence.
C. rebound tenderness
D. hyperactive, high-pitched bowel sounds CORRECT ANSWER-(u) A. Fever and rebound
tender...
PACKRAT GI; Questions and Answers 100% Correct
Which of the following is a common physical examination finding in early intestinal obstruction?
A. high fever.
B. profuse flatulence.
C. rebound tenderness
D. hyperactive, high-pitched bowel sounds CORRECT ANSWER-(u) A. Fever and rebound
tenderness occur only if a perforation has occurred.
(u) B. Profuse flatulence is not noted in early intestinal obstruction.
(u) C. See A for explanation.
(c) D. Abdominal distention and high-pitched, hyperactive bowel sounds are common in early
intestinal obstruction.
Which of the following studies is most appropriate to diagnose celiac disease?
A. Urinary D-xylose test
B. Small bowel biopsy
C. Barium contrast x-ray
D. Schilling test CORRECT ANSWER-(u) A. Urinary D-xylose test assesses the proximal
small intestinal mucosa's absorption of carbohydrates but is not specific to celiac disease.
(c) B. Definitive diagnosis of celiac disease is made by small bowel biopsy.
(u) C. Barium contrast examination would reveal anatomic abnormalities or blind loop syndrome
that may lead to malabsorption but it would not help in the diagnosis of celiac disease.
(u) D. The Schilling test is used to determine the cause of cobalamine malabsorption from
pernicious anemia, chronic pancreatitis, achlorhydria and bacterial overgrowth syndrome but
has no role in the diagnosis of celiac disease.
, PACKRAT GI; Questions and Answers 100% Correct
Which of the following tumor markers is useful in monitoring a patient for recurrence of
colorectal cancer after surgical resection?
A. CA-125
B. Carcinoembryonic antigen
C. 5-hydroxindoleacetic acid
D. Alpha-1-fetoprotein CORRECT ANSWER-(u) A. CA-125 tumor marker is useful as a
tumor marker in ovarian cancer
(c) B. Carcinoembryonic antigen can be used to monitor a patient for the return of colorectal
cancer after treatment.
(u) C. 5-hydroxindoleacetic acid is used as a tumor marker in carcinoid syndrome.
(u) D. Hepatocellular and testicular cancer can be followed by the use of alpha-1-fetoprotein as
a tumor marker.
A 14 month-old male who attends day care presents with a two-day history of frequent watery
stools. His mother states that he had a fever and vomiting the day before but these have
resolved. His mother denies pain in the child. The child is mildly dehydrated but otherwise
appears well. Stool samples are free of blood and white blood cells. The lab reports no ova or
parasites noted in the stool samples. Which of the following is the most likely diagnosis?
A. Intussusception
B. Viral gastroenteritis
C. Shigella
, PACKRAT GI; Questions and Answers 100% Correct
D. Lactase insufficiency CORRECT ANSWER-(u) A. Intussusception may cause diarrhea,
however, after two days the stool would have blood present. The absence of pain or discomfort
would also argue against this diagnosis.
(c) B. Rotavirus is the most common cause of gastroenteritis in children and this is frequently
passed in the daycare setting.
(u) C. Patients with Shigella have dysentery with the passage of bloody stools in a toxic-
appearing child
(u) D. Lactase insufficiency would not have caused fever and vomiting.
A patient develops abdominal cramps and watery diarrhea 10 to 12 hours after eating a plate of
unrefrigerated meat and vegetables. The patient denies vomiting. The causative agent is most
likely
A. Staphylococcus aureus.
B. Clostridium perfringens.
C. Escherichia coli.
D. Salmonella. CORRECT ANSWER-(u) A. Staphylococcus aureus has an incubation period
of 1 to 6 hours and also characteristically has vomiting associated with it.
(c) B. Food poisoning caused by Clostridium perfringens
has an incubation period of 8 to 14 hours and results frompoorly refrigerated cooked meat.
(u) C. The incubation period for Escherichia coli and Salmonella is greater than 16 hours.
(u) D. See C for explanation.
The most common initial presenting symptom of primary biliary cirrhosis is
, PACKRAT GI; Questions and Answers 100% Correct
A. jaundice
B. palmar erythema
C. pruritus
D. xanthomas CORRECT ANSWER-(u) A. Jaundice, palmar erythema and xanthomas
appear late in the disease.
(u) B. See A for explanation.
(c) C. Pruritus is the most common initial symptom in primary biliary cirrhosis due to the
accumulation of bile salts.
(u) D. See A for explanation.
Which of the following medications used in the treatment of peptic ulcer disease is classified as
a proton pump inhibitor?
A. Cimetidine (Tagamet)
B. Sucralfate (Carafate)
C. Omeprazole (Prilosec)
D. Misoprostol (Cytotec) CORRECT ANSWER-(u) A. Cimetidine is an H2 receptor
antagonist.
(u) B. Sucralfate (Carafate) is a cytoprotective agent.
(c) C. Omeprazole is a proton pump inhibitor.
(u) D. Misoprostol is a prostaglandin analog.
Which of the following is the therapy of choice for long-term management of esophageal
varices in a patient who cannot tolerate beta blocker therapy?
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