ATI LPN
Chapter 15 The Gastrointestinal System Review Questions Questions
Question 1 of 5
What is the MOST common cause of pulmonary fibrosis?
Correct Answer: D
Rationale: The correct answer is D: Idiopathic. Idiopathic pulmonary fibrosis is the most common cause of pulmonary fibrosis, accounting for about 20-30% of cases. It is a chronic and progressive lung disease of unknown cause. Other choices are less common causes: A) Iatrogenic refers to fibrosis caused by medical interventions, B) Occupational chemical exposure can lead to fibrosis but is not the most common cause, and C) Sarcoidosis causes granulomatous inflammation, not fibrosis.
Question 2 of 5
A 45-year-old woman with occasional indigestion has had episodes of chest pain and dysphagia to both solids and liquids. An upper GI series and EGD fail to disclose any structural abnormalities. What is the most appropriate initial therapy?
Correct Answer: B
Rationale: The correct answer is B: Proton-pump inhibitor. The patient's symptoms of chest pain and dysphagia suggest possible gastroesophageal reflux disease (GERD). Proton-pump inhibitors reduce gastric acid production, providing relief for symptoms of GERD. This is the most appropriate initial therapy given the symptoms. Choice A: Sucralfate is a cytoprotective agent that forms a protective barrier over ulcers but does not address the underlying issue of acid reflux. Choice C: Prokinetic agents help with motility disorders but are not the first-line treatment for GERD. Choice D: Benzodiazepines are not indicated for the treatment of GERD and would not address the underlying cause of the patient's symptoms.
Question 3 of 5
A 56-year-old Brazilian woman with a history of idiopathic cardiomyopathy presents complaining of weight loss, dysphagia, and regurgitation. A chest x-ray is done that reveals an air-fluid level at the level of the esophagus. No gastric bubble is appreciated. A barium swallow reveals a dilated esophagus that tapers at the lower esophageal sphincter. Which of the following is appropriate in this patient's evaluation/treatment?
Correct Answer: D
Rationale: The correct answer is D: Obtain serologic studies for antibodies to Trypanosoma cruzi. This patient's presentation is consistent with Chagas disease, caused by Trypanosoma cruzi. The patient is from Brazil, where Chagas disease is endemic. The dilated esophagus and lower esophageal sphincter tapering are classic findings of megaesophagus, a complication of Chagas disease. Serologic studies for antibodies to Trypanosoma cruzi are necessary for definitive diagnosis. Choice A: Refer for partial esophagectomy - Not appropriate as surgery is not indicated without confirming the diagnosis. Choice B: Thick and thin smears of peripheral blood looking for parasites - Not appropriate as Chagas disease is diagnosed through serologic testing, not blood smears. Choice C: Therapeutic trial of a proton pump inhibitor - Not appropriate as the patient's symptoms are likely due to Chagas disease, not gastroesophageal reflux disease.
Question 4 of 5
A 46-year-old woman with a history of alcohol abuse is admitted for acute pancreatitis due to alcohol. She is treated with supportive care but continues to deteriorate over 72 hours. A CT scan is obtained that reveals extensive pancreatic inflammation with the suggestion of necrosis. All of the following statements are correct regarding this patient's management except
Correct Answer: A
Rationale: The correct answer is A: Endoscopic retrograde cholangiopancreatography (ERCP) should be performed urgently. ERCP is not indicated in the acute setting of pancreatitis unless there is evidence of biliary obstruction or cholangitis. The priority in this case would be to manage the acute pancreatitis and potential pancreatic necrosis. Antibiotic therapy (Choice B) may be considered in cases of infected necrosis. A CT-guided needle aspirate (Choice C) may be helpful for diagnosing infected necrosis but is not typically done urgently. Surgical debridement (Choice D) is indicated if there is evidence of infected pancreatic necrosis on culture results, but this should be done after appropriate medical management.
Question 5 of 5
All of the following are extraintestinal manifestations that are associated with ulcerative colitis except
Correct Answer: D
Rationale: The correct answer is D: Perianal fistula formation. Ulcerative colitis primarily affects the colon and rectum, leading to inflammation and ulceration of the intestinal lining. Perianal fistula formation is more commonly associated with Crohn's disease, not ulcerative colitis. Rationale: A: Arthritis - Extraintestinal manifestation commonly seen in ulcerative colitis due to immune system involvement. B: Sclerosing cholangitis - Liver complication associated with ulcerative colitis. C: Autoimmune hemolytic anemia - Blood disorder linked to ulcerative colitis due to immune system dysregulation. D: Perianal fistula formation - More characteristic of Crohn's disease, not ulcerative colitis.