ATI LPN
Gastrointestinal System Quiz Questions Questions
Question 1 of 5
A 54-year-old Caucasian smoker with a history of type II diabetes mellitus controlled with diet has a blood pressure of 146/94 mmHg with optimal non-pharmacological management. Which of the following would be the most appropriate management?
Correct Answer: C
Rationale: Thiazide diuretics like chlorthalidone are first-line for hypertension with diabetes, with follow-up in 2-4 weeks to monitor electrolytes, making C the best choice.
Question 2 of 5
A 50-year-old patient is admitted with acute exacerbation of COPD. He is started on salbutamol, ipratropium nebulisers and oral steroids. The following day the nurses call the junior doctor as the patient is complaining of severe pain in the left eye. The doctor examines finds that his eye is red and a diagnosis of acute glaucoma is made. Which of the following statements is true?
Correct Answer: A
Rationale: Ipratropium, an anticholinergic, can cause pupillary dilatation via aerosol escape to the eye, precipitating angle-closure glaucoma, making A the correct answer.
Question 3 of 5
A 56-year-old woman presents to discuss the results of her recent upper endoscopy. She was having some mild abdominal pain, so she underwent the procedure, which revealed an ulcer in the antrum of the stomach. Biopsy of the lesion revealed the presence of H. pylori. All of the following statements regarding her condition are correct except
Correct Answer: B
Rationale: H. pylori is thought to be responsible for a majority of cases of peptic ulcer disease. It has been associated with MALT as well as adenocarcinoma. Triple drug therapy has been shown to be more effective than dual therapy. With adequate treatment, reinfection is rare. Although urea breath testing is probably a better tool for diagnosis of active infection and adequacy of treatment, quantitative serology can be used to monitor treatment efficacy. A $30 \%$ fall in IgG titer should be seen after therapy.
Question 4 of 5
A 65-year-old man reports that he frequently regurgitates food several hours after eating, and experiences chest pain and dysphagia to both liquids and solids. This has been associated with weight loss. He has no other medical problems. A CXR shows an air/fluid level in a dilated esophagus and an absent gastric air bubble. No mass in the distal esophagus or proximal stomach is identified at the time of endoscopy. The best therapy for this patient is
Correct Answer: B
Rationale: The patient has primary achalasia, with typical CXR findings. The upper endoscopy has ruled out secondary achalasia, in that no mass was detected at the GE junction or cardia. The best treatment for this patient is endoscopic balloon dilatation, to stretch the LES, and disrupt muscle fibers. This therapy remains the mainstay for most patients with achalasia, although surgical myotomy and injection of botulinum toxin are also used.
Question 5 of 5
Which of the following statements regarding pancreatic cancer is correct?
Correct Answer: C
Rationale: Although serum CA 19-9 is not a useful screening tool in asymptomatic patients, it is quite sensitive and specific in patients with symptoms of the disease. Tumors arising from the tail or body of the pancreas are usually associated with a poorer prognosis and these patients are rarely resectable. A palpable gallbladder (Courvoisier's sign) has been described as being suggestive of a tumor at the head of the pancreas but not the tail. This sign lacks specificity, however.