1.26: Gastrointestinal Function and Digestive Disease
- Page ID
- 38606
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \) \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)\(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\) \(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\)\(\newcommand{\AA}{\unicode[.8,0]{x212B}}\)
- Which of the following statements concerning gastric function is INCORRECT
- Acid is produced by the chief cells of the stomach
- Gastrin is produced by G-cells, primarily in the antrum
- Intrinsic factor is produced by parietal cells, found throughout the stomach
- Mucous cells are important in protection of the stomach from acid digestion
- Pepsinogen, produced by chief cells, begins the process of protein digestion
- Fat soluble vitamins include all of the following EXCEPT:
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin E
- Vitamin K
For questions 3 and 4, use the following Answer Key:
- 1,2, and 3 are correct
- 1 and 3 are correct
- 2 and 4 are correct
- only 4 is correct
- all are correct
- Helicobacter pylori has been implicated in the pathogenesis of
- Chronic gastritis
- Gastric cancer
- Peptic ulcer
- Gastric lymphoma
- Which of the following statements concerning tests for H. pylori is correct?
- Antibody tests for H. pylori are both sensitive and specific
- The CLO test measures urease activity in gastric biopsies and detects H. pylori indirectly by detecting a color change in a pH indicator
- Urease tests are more sensitive in patients taking proton pump inhibitors than in untreated patients
- Stool antigen tests detect current infection, and become negative with successful eradication of infection
- All of the following statements concerning Zollinger-Ellison syndrome are true EXCEPT:
- Associated with recurrent gastric ulcers, often involving the duodenum
- Basal acid output (BAO) is usually over half of the maximal acid output (MAO)
- Diarrhea is often present and may be accompanied by steatorrhea
- Gastrin production by G-cell hyperplasia is the most common cause
- Tumors are often small, but metastatic tumor occurs in over half of cases
- Which of the following statements concerning Multiple Endocrine Neoplasia (MEN), type 1, is correct?
- Associated with tumors of the ovary and pheochromocytoma
- Chromosome mutations are found on chromosome 11
- Due to a mutation in the Ret oncogene
- Occurs in women much more frequently than in men ((10:1)
- Occurs sporadically with no inheritance pattern
- Which of the following statements concerning laboratory diagnosis of Zollinger-Ellison (Z-E) syndrome is INCORRECT?
- Gastrin level over 4 times the upper reference limit is strongly suggestive of the disease
- It is important to document lack of achlorhydria before making the diagnosis of Z-E syndrome
- Provocative tests of gastrin production are more reliable than basal gastrin in establishing the diagnosis.
- Secretin is the most sensitive and specific secretory agent for the diagnosis of Z-E syndrome
- When secretin is given, gastrin should be checked at 1 and 2 hours after administration
- Steps involved in the absorption of Vitamin B12 include all of the following EXCEPT
- Release of B12 from food by the action of gastric acid
- Binding of B12 to non-specific (R-binders) in the stomach
- Release of B12 from R-binders by the action of pancreatic bicarbonate
- Binding of B12 to intrinsic factor, produced by gastric parietal cells
- Absorption of B12 in the ileum when bound to intrinsic factor
- All of the following might be abnormal in both malabsorption and maldigestion EXCEPT:
- Beta carotene level in plasma
- D-xylose absorption
- Fecal fat excretion
- Serum albumin
- Vitamin B12 absorption
- The most sensitive test for malabsorption or maldigestion is:
- Beta carotene level in plasma
- D-xylose absorption
- Fecal fat excretion
- Serum albumin
- Vitamin B12 absorption
- All of the following statements concerning celiac disease are correct EXCEPT:
- Antibodies to tissue transglutaminase are the most sensitive and specific marker of diseae
- Antibodies to gliadin are present in most affected individuals
- Gluten, found in wheat and some other grain products, is the trigger for celiac disease
- Individuals with celiac disease are at high risk for developing carcinomas of the small bowel
- Use of a gluten free diet may lead to disappearance of circulating antibodies
- Which of the following statements concerning lactose intolerance is correct?
- Associated with symptoms when beef or pork is ingested
- Causes malabsorption syndrome in 50% of affected individuals
- Diarrhea after ingestion of lactose-containing foods is a common mode of presentation
- Most commonly seen in persons of European ancestry
- Usually requires lactose tolerance testing to establish the diagnosis
- All of the following statements regarding carcinoid syndrome are true EXCEPT:
- Associated with flushing and diarrhea
- Caused by carcinoid tumors, usually found in the distal ileum or appendix
- Markedly increased urine excretion of 5-hydroxyindole acetic acid is seen in most cases of carcinoid syndrome
- Metastasis to the liver is usually required before symptoms of carcinoid syndrome occur
- Primary carcinoid tumors of the appendix are the single most common cause of carcinoid syndrome
- Which of the following statements concerning inflammatory bowel disease is correct?
- Antibodies to neutrophil cytoplasmic antigens are often associated with Crohn’s disease
- Antibodies to Saccharomyces cerevisiae are commonly found in ulcerative colitis
- Autoimmune markers are found in about half of cases
- Both Crohn’s disease and ulcerative colitis typically affect the colon and rectum exclusively
- Specificity of these autoimmune markers is only about 50-60%
- All of the following statements concerning tests for occult blood in stool is correct EXCEPT:
- Assays usually rely on the peroxidase activity of hemoglobin
- Drying of stool samples results in reduced sensitivity, so rehydration of cards before testing is usually recommended to reduce both false positive and false negative results
- Immunochemical methods for hemoglobin reduce the likelihood of false positive results due to plant peroxidases
- Immunochemical tests may be falsely negative is stool samples are contaminated by toilet bowl sanitizers.
- Restriction of meat in the diet is recommended to prevent false positive results
- Correct statements concerning CEA and colorectal cancer include all of the following EXCEPT:
- CEA is a family of glycoprotein molecules rather than a single antigen
- CEA levels are usually highly reproducible between assays from different manufacturers
- Early colon cancer is associated with increased CEA in only about 25% of cases
- Increased CEA may also be due to smoking, liver disease, or inflammatory bowel diseae
- The most important use of CEA is not in screening for colon cancer, but in follow-up of patients after surgery or other form of treatment
- Answer
-
- a (p. 552)
- b (p. 554)
- e (p. 556)
- c (p. 556)
- d (p. 556-557)
- b (p. 557)
- e (p. 556-557)
- c (p. 557)
- b (p. 560-561)
- c (p. 561)
- d (p. 558)
- c (p. 558)
- e (p. 558-559)
- c (p. 559)
- b (p. 563)
- b (p. 563)