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 (IPF) is the most common type of pulmonary fibrosis with unknown cause. It is a chronic, progressive, and irreversible lung disease. Iatrogenic causes refer to those induced by medical treatment, which are not as common as IPF. Occupational chemical exposure and sarcoidosis are known causes of pulmonary fibrosis, but they are not as prevalent as idiopathic cases. In summary, the most common cause of pulmonary fibrosis is idiopathic, followed by occupational exposures, sarcoidosis, and iatrogenic factors.
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 are suggestive of gastroesophageal reflux disease (GERD). Proton-pump inhibitors (PPIs) are the first-line therapy for GERD as they reduce gastric acid secretion, alleviating symptoms and promoting healing of esophageal mucosa. Sucralfate is not effective for GERD symptoms. Prokinetic agents are used for motility disorders, not GERD. Benzodiazepines are not indicated for GERD and may even exacerbate symptoms. Therefore, the most appropriate initial therapy for this patient is a proton-pump inhibitor.
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. The patient's presentation of dysphagia, regurgitation, and dilated esophagus suggests Chagas disease, caused by Trypanosoma cruzi. Serologic studies are necessary for definitive diagnosis. Choice A is incorrect because esophagectomy is not warranted without confirming the diagnosis. Choice B is incorrect as there are no indications of parasitic infection. Choice C is incorrect as proton pump inhibitors are not appropriate for Chagas 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 because performing an urgent ERCP is not indicated in the management of acute pancreatitis with necrosis. ERCP is typically not recommended in the acute phase of severe pancreatitis due to the risk of exacerbating pancreatitis. - B: Antibiotic therapy with imipenem may be initiated to address potential infection in necrotizing pancreatitis. - C: A CT-guided needle aspirate of the pancreas may be performed to guide antimicrobial therapy. - D: Surgical debridement may be considered if there is evidence of infection based on gram stain and cultures from a pancreatic aspirate.
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, which can affect any part of the gastrointestinal tract. Choices A, B, and C are extraintestinal manifestations commonly seen in ulcerative colitis due to the systemic nature of the disease and immune system involvement. Arthritis can occur due to inflammation in joints, sclerosing cholangitis affects the bile ducts, and autoimmune hemolytic anemia involves the destruction of red blood cells.