Disorders of the Gastrointestinal System, 2nd Edition
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ANSWER KEY AND RATIONALES
QUESTION 1: B . Rationale: Chronic gastroesophageal reflux disease can lead to Barrett’s esophagus, a condition in which normal squamous cells of the esophagus are replaced with glandular cells. Barrett’s esophagus is highly associated with adenocarcinoma of the esophagus. QUESTION 2: C . Rationale: Hiatal hernia, also referred to as hiatus hernia, is a deficiency or defect in the diaphragm that allows part of the stomach to pass through the opening in the diaphragm into the chest. QUESTION 3: C . Rationale: Treatment is now available to cure HCV using interferon and ribavirin, although it is not guaranteed to be successful in all cases. Unfortunately, no other form of viral hepatitis can be cured at this time, but antivirals may be useful in stopping the progression of HBV. QUESTION 4: D . Rationale: Ulcerative colitis is a chronic inflammatory disease that affects the mucosal layer of the colon. QUESTION 5: A . Rationale: Celiac disease— also referred to as nontropical sprue, gluten enteropathy, and celiac sprue—is a disease that damages the small intestine. It is characterized by an inability to properly absorb nutrients and intolerance to gluten, a protein found in wheat, wheat products, rye and barley. QUESTION 6: C . Rationale: Diverticulosis is the term used to identify diverticula that do not cause bleeding or become inflamed.
QUESTION 7: B . Rationale: Intussusception is a serious, potentially fatal, condition in which a portion of either the small intestine or the colon moves into another part of the intestine. This movement is referred to as telescoping, and it can cause a blockage of the intestine and prevent the passage of food and liquids as well as cut off the blood supply to the affected portion of the intestine. QUESTION 8: A . Rationale: Intestinal obstruction can be classified in three categories: Simple: Intestinal contents cannot move through the bowel and cause edema and irritation, but there are no complications or blood flow alterations. Strangulated: Blood supply is cut off to the affected section of bowel. This may be partial or complete and occurs in about 40% of patients with a bowel obstruction. This condition can be fatal and lead to gangrene, perforation, and sepsis. Closed-looped: Both ends of a portion of the bowel are blocked isolating it from the rest of the intestine and trapping fluid and gas and placing it at risk for ischemia and volvulus. QUESTION 9: A . Rationale: Adequate hydration as well as a diet high in fiber causes water to be pulled into stools by osmosis, thus keeping stools soft and facilitating their movement through the intestine. QUESTION 10: C . Rationale: When the gallbladder becomes inflamed, it is called cholecystitis. Inflammation of the gallbladder is caused by a blockage of the cystic duct; in 90% of cases, the blockage is related to gallstones.
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