Gastrointestinal Pathophysiology Exam 2005

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Blood pressure

This photo shows a nurse taking a woman’s blood pressure with a blood pressure cuff. The nurse is pumping the cuff with her right hand and holding a stethoscope on the patient’s arm with her left hand.
A proficiency in anatomy and physiology is fundamental to any career in the health professions. (credit: Bryan Mason/flickr)

Chapter objectives

After studying this chapter, you will be able to:

  • Distinguish between anatomy and physiology, and identify several branches of each
  • Describe the structure of the body, from simplest to most complex, in terms of the six levels of organization
  • Identify the functional characteristics of human life
  • Identify the four requirements for human survival
  • Define homeostasis and explain its importance to normal human functioning
  • Use appropriate anatomical terminology to identify key body structures, body regions, and directions in the body
  • Compare and contrast at least four medical imagining techniques in terms of their function and use in medicine

Though you may approach a course in anatomy and physiology strictly as a requirement for your field of study, the knowledge you gain in this course will serve you well in many aspects of your life. An understanding of anatomy and physiology is not only fundamental to any career in the health professions, but it can also benefit your own health. Familiarity with the human body can help you make healthful choices and prompt you to take appropriate action when signs of illness arise. Your knowledge in this field will help you understand news about nutrition, medications, medical devices, and procedures and help you understand genetic or infectious diseases. At some point, everyone will have a problem with some aspect of his or her body and your knowledge can help you to be a better parent, spouse, partner, friend, colleague, or caregiver.

This chapter begins with an overview of anatomy and physiology and a preview of the body regions and functions. It then covers the characteristics of life and how the body works to maintain stable conditions. It introduces a set of standard terms for body structures and for planes and positions in the body that will serve as a foundation for more comprehensive information covered later in the text. It ends with examples of medical imaging used to see inside the living body.

Gastrointestinal Pathophysiology explores the pathophysiology of a variety of gastrointestinal disorders from gastroesophageal reflux disease to cirrhosis. The course emphasizes fundamental topics in gastrointestinal pathophysiology, with a focus on correlation to clinical issues including treatment options for various common gastrointestinal disorders, each of which are covered in detail. Topics are presented in the syllabus, in didactic lectures, and in small group sessions. The materials presented in this course are a foundation for further learning in Gastroenterology.

This course reviews the pathophysiology of common gastrointestinal conditions and assumes a general understanding of gastrointestinal physiology.

The course follows an organ based structure to include disorders of the esophagus, stomach and duodenum, small intestines, pancreas, biliary system, and liver.

The material is presented in the syllabus, lecture slides, and small group sessions.

Exam PDF eBook: 
Gastrointestinal Pathophysiology Exam 2005
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27 Pages
2014
English US
Educational Materials



Sample Questions from the Gastrointestinal Pathophysiology Exam 2005 Exam

Question: A 44 year old man complains of persistent heartburn which occurs daily. He denies any dysphagia or odynophagia. Which of the following pathophysiologic mechanisms most likely explains his symptoms?

Choices:

Transient lower esophageal sphincter contractions

Elevated lower esophageal sphincter pressures

Slow gastric motility

Transient lower esophageal sphincter relaxations

Reduced gastric acid production

Question: A 65 year old man comes to the emergency room with the acute onset of peri-umbilical abdominal pain, nausea, and vomiting. He drinks alcohol regularly. He takes no medications. On exam, he has a low grade temperature but other vital signs are stable. He has tenderness in the mid-abdomen without rebound or guarding. His lab tests are: ALT 58 U/l AST 95 U/l Total bilirubin 1.1 mg/dl Alkaline phosphatase 89 U/l Amylase 1105 U/l Lipase 1404 U/l Which of the following is the most likely pathophysiologic mechanism to explain the condition which is causing this patients pain?

Choices:

Prolonged hypotension causing ischemia

Cytotoxic damage to peri-portal hepatocytes

Reduced stimulation of intracellular calcium signaling pathways

Inappropriate activation of pancreatic enzymes

Reduced pancreatic enzyme synthesis and secretion

Question: A 65 year old woman has primary biliary cirrhosis and is awaiting liver transplantation. She has ascites and spider angiomata on physical examination and large esophageal varices on upper endoscopy. Which of the following would most likely be decreased?

Choices:

Resistance to blood flow through the liver

Rate of blood flow through the splanchnic circulation

Level of vasodilators in the blood

Hepatic vein pressure gradient

Peripheral vascular resistance

Question: A 21 year old man has weight loss and episodic bloody diarrhea. The bloody diarrhea has become more frequent recently. A colonoscopy shows erythema and diffuse small ulcers from the rectum to the mid-transverse colon. Biopsies show architectural distortion and cryptitis. The most likely diagnosis is which of the following?

Choices:

Ischemic colitis

AIDS-associated gastroenteritis

Clostridium difficile colitis

Crohn’s disease

Collagenous colitis (lymphocytic colitis)

Amebiasis

Ulcerative colitis

Cytomegalovirus colitis

Ulcerative jejunoileitis

Question: A 42 year old man abuses intravenous drugs. He complains of 2 weeks of anorexia and nausea. He noted that his urine turned dark and his stool turned light. Blood work is consistent with acute viral hepatitis. Serologic studies are done: Hepatitis A IgG: positive Hepatitis A IgM: negative Hepatitis C Antibody: negative Hepatitis B surface antigen: positive Hepatitis B surface antibody: negative Hepatitis B core IgM antibody: positive Which of the following best explains the mechanism of hepatic injury in this patient?

Choices:

Direct viral cytotoxic effect

Immune mediated hepatocyte damage

Direct inhibition of hepatocyte DNA replication

Direct inhibition of hepatocyte mRNA translation

Antibody destruction of virus

Question: A 65 year old woman has abnormal liver function tests. She has been experiencing nausea and abdominal pain over the last 7 days. She does not take anti-coagulants. A right upper quadrant ultrasound is normal. Her laboratory tests are as follows: White blood cell count: 12,500 Glucose: 80 mg/dl Amylase: 100 U/l LDH: 305 U/l Lipase: 25 U/l Iron: 250mcg/dl Total iron binding capacity (transferring): 350 mcg/l Ferritin: 100 ng/ml Total bilirubin 7.5 mg/dl (Direct bilirubin 7.1 mg/dl) Alkaline phosphatase 90 U/l ALT 145 U/l AST 295 U/l PT 25 (INR 3.1) Albumin 3.6 g/dl Which of the following is the most likely explanation for these findings?

Choices:

Chronic hepatitis B

Alcoholic hepatitis

Hepatitis A

Primary biliary cirrhosis

Primary sclerosing cholangitis

Question: A 66 year old woman has profuse watery diarrhea which has lasted more than 6 weeks. The diarrhea does not improve when oral intake is limited. She has had a 5 pound weight loss. She drinks two glasses of wine nightly. All stool cultures are negative. Fecal leukocytes are negative. A Sudan stain performed on a stool specimen is negative. The D-Xylose test shows 10 grams of xylose in the urine. Stool electrolytes are checked: stool sodium concentration is 85mmol/l and stool potassium concentration is 50mmol/l. Which of the following is the most likely diagnosis?

Choices:

Irritable bowel syndrome

Chronic pancreatitis

Carcinoid syndrome

Small intestinal bacterial overgrowth syndrome

Abuse of lactulose

Question: An 80 year old man has a history of constipation and intermittent left lower quadrant abdominal pain. A colonoscopy shows extensive diverticulosis in the sigmoid colon. He is at risk for which of the following conditions?

Choices:

Carcinoma of the colon

Angiodysplasia

Gastrointestinal hemorrhage

Ulcerative colitis

Malabsorption

Question: A 32 year old woman undergoes a gastric bypass operation for morbid obesity. The surgery goes well and she loses 70 kg in two months. She has two children; the youngest was delivered by caesarean section 2 years ago. She comes into the emergency room complaining of intermittent episodes of right upper quadrant abdominal pain. The physical exam is remarkable for right upper quadrant tenderness. Liver function studies are normal. A right upper quadrant ultrasound shows numerous mobile structures with acoustic shadowing in the gallbladder. The bile duct is not dilated. The most likely risk factor for this patient’s condition is which of the following?

Choices:

Recent pregnancy

Rapid weight loss

Age

High serum cholesterol

High cholesterol diet

Question: A barium study on a 55 year old man is shown below: Which of the following would you most likely expect this patient to have?

Choices:

Dysphagia to solids and liquids

Dysphagia to liquids

A hiatal hernia

A duodenal ulcer

Esophageal cancer

Question: A 62 year old man has abdominal pain, hematemesis, and melena. He is not taking NSAIDs (nonsteroidal anti-inflammatory drugs) or aspirin. An upper endoscopy reveals a large posterior wall duodenal ulcer. A biopsy is obtained from the gastric antrum and a rapid urease test is positive. Which of the following findings is most likely?

Choices:

Type A autoimmune gastritis

CagA positive H pylori

Low gastrin levels after a meal

Normal gastric acid production

Absence of gastric metaplasia in the duodenum

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Source:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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