Digestive Diseases

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Select the True statement from below:

a) Spicy food and stress cause ulcers.
b) Irritable bowel syndrome generally leads to more serious digestive diseases later, such as cancer.
c) Most people with diverticulosis have no symptoms or complications.
d) Inflammatory bowel disease is caused by tension, anxiety, or other psychological problems.

2. What is peristalsis?

a) juncture of the esophagus and stomach
b) typical movement of the esophagus, stomach, and intestine
c) underactive pancreas
d) lethargy produced through constipation

3. Which organ produces bile?

a) liver
b) gallbladder
c) pancreas
d) stomach
e) small intestine

4. Which hormone is responsible for stimulating appetite?

a) ghrelin
b) peptide YY

5. Food irradiation has the advantage of killing bacteria but the disadvantage of making the food "radioactive."

a) True
b) False

6. There's no vaccine available for viral gastroenteritis.

a) True
b) False

7. A normal, healthy person should have a bowel movement at least once every day.

a) True
b) False

8. What is the generally accepted definition of constipation?

a) inability to defecate when desired
b) incomplete evacuation
c) bowel movements of fewer than three per week
d) abdominal discomfort associated with defecation
e) straining with bowel movements

9. Chronic constipation is a risk factor for colon cancer.

a) True
b) False

10. People with lactose intolerance are usually born without the ability to produce lactose.

a) True
b) False

11. Which group is most widely affected by lactose intolerance?

a) persons of northern European descent
b) African Americans
c) Asian Americans

12. Treatment for lactose intolerance is relatively __________.

a) easy
b) difficult

13. It is normal for people to pass gas a couple dozen times a day.

a) True
b) False

14. Which foods cause gas?

a) carbohydrates
b) fats
c) proteins

15. If the stool shows bright red color, it means bleeding comes from the

a) upper part of the colon or at the far end of the small intestine.
b) rectum or the lower colon.

16. What is the primary diagnostic and therapeutic procedure for most causes of GI bleeding?

a) barium x-rays
b) angiography
c) radionuclide scan
d) endoscopy

17. Select the True statement about fecal incontinence from below:

a) Fecal incontinence is a normal part of aging.
b) Fecal incontinence is more common in men than in women.
c) People with fecal incontinence should avoid eating high fiber foods.
d) Constipation is one of the most common causes of fecal incontinence.

18. Select the incorrect statement about appendicitis:

a) Once it starts, there is no effective medical therapy for appendicitis; it is considered a medical emergency.
b) When treated promptly, most patients recover without difficulty.
c) As many as 20 percent of cases operated on for appendicitis do not actually have that disease.
d) There are no specific laboratory tests to identify appendicitis.
e) An increased fiber intake combined with reduction in fatty foods has been found to prevent appendicitis.

19. Which of the following statements is not True about appendix and appendecitis?

a) Appendix is located in the lower right portion of the abdomen, attached to the large intestine.
b) Appendix has no known function.
c) Genetics have a lot to do with appendicitis.
d) If diagnosed early, appendicitis can be treated with antibiotics.

20. Which ethnic group has the greatest genetic predisposition to develop gallstones?

a) Caucasians
b) Native Americans
c) Hispanic Americans
d) African Americans

21. Of the two types of gallstones, which ones are more common?

a) cholesterol stones
b) pigment stones

22. Cholesterol-lowering drugs, such as statins, also reduce the risk of developing gallstones.

a) True
b) False

23. Identify factors that contribute to the development of gallstones:

a) obesity
b) birth control pills
c) rapid weight loss
d) fasting
e) all of the above

24. Many people with gallstones have no symptoms ("silent stones.") These require no treatment.

a) True
b) False

25. What is the most sensitive and specific test for gallstones?

a) computed tomography (CT)
b) endoscopic retrograde cholangiopancreatography (ERCP)
c) ultrasound
d) blood tests

26. Which form of diverticular disease is much more common in the general population?

a) diverticulosis
b) diverticulitis

27. For most people with diverticulosis, eating a high-fiber diet is the only treatment needed.

a) True
b) False

28. People with diverticulosis are generally advised to avoid one of the following foods:

a) tomatoes
b) strawberries
c) sesame seeds
d) poppy seeds

29. Wilson's disease occurs when the body retains excess amounts of _________.

a) zinc
b) iron
c) mercury
d) copper

30. Wilson's disease requires lifelong treatment.

a) True
b) False

31. Select the correct response from below:

a) One of the causes of gastroparesis is poor blood glucose control.
b) Gastroparesis contributes to poor blood glucose.
c) both of the above
d) none of the above

32. People with gastroparesis are advised to eat high-fiber food.

a) True
b) False

33. The condition in which there is an inflammation of the stomach lining is called

a) gastroparesis.
b) gastritis.
c) proctitis.
d) rapid gastric emptying.

34. What is the major cause of chronic pancreatitis?

a) gallstones
b) alcohol use
c) heredity
d) unknown cause (idiopathic)

35. Select the correct statement about cyclic vomiting syndrome (CVS):

a) Each episode of cyclic vomiting syndrome (CVS) is different.
b) Each episode is similar to the previous ones; the episodes tend to start at about the same time of day, last the same length of time, and present the same symptoms at the same level of intensity.

36. Is there a connection between CVS and migraine headaches?

a) Yes
b) No

37. What do the ganglion cells do?

a) ganglion cells make the muscles push the stool
b) they secrete digestive enzymes into the small intestine
c) they control absorption of fluids and nutrients as the food moves through the intestine
d) they control bowel movement

38. Hirschsprung's disease is a disease of the _______ intestine.

a) large
b) small

39. If the mother drinks excessive alcohol during pregnancy, the newborn baby is more likely to develop Hirschsprung's disease.

a) True
b) False

40. Which type of hepatitis has no vaccine?

a) hepatitis A
b) hepatitis B
c) hepatitis C
d) hepatitis D

41. Which type of hepatitis is generally not transmitted through contact with infected blood?

a) hepatitis A
b) hepatitis B
c) hepatitis C
d) hepatitis D

42. Autoimmune hepatitis affects women much more than men.

a) True
b) False

43. At present, one of the following modes of transmission of hepatitis C is least likely to occur:

a) injection drug use
b) blood transfusion
c) infants born to HCV-infected mothers
d) healthcare workers who suffer needle-stick accidents

44. It usually takes more than a decade of heavy drinking to develop liver disease.

a) True
b) False

45. Liver damage from cirrhosis caused by alcohol abuse is reversible by abstaining from alcohol.

a) True
b) False

46. Which physical characteristics make patients susceptible to nonalcoholic steatohepatitis (NASH)?

a) obese, have elevated blood lipids, such as cholesterol and triglycerides, have diabetes or prediabetes
b) are not obese, do not have diabetes, and have normal blood cholesterol and lipids
c) either of the above

47. At present there's no specific treatment for NASH.

a) True
b) False

48. Which test procedure is used to diagnose problems in the liver?

a) ECRP (Endoscopic Retrograde Cholangiopancreatography)
b) liver biopsy
c) colonoscopy
d) flexible sigmoidoscopy
e) a and b

49. Which of the following procedures is insufficient for examining the entire colon?

a) colonoscopy
b) virtual colonoscopy
c) flexible sigmoidoscopy
d) lower GI series

50. Virtual colonoscopy has the advantage over conventional colonoscopy in that the doctor can take tissue samples or remove polyps during the procedure.

a) True
b) False

51. Some people have gastroesophageal reflux disease (GERD) without the heartburn.

a) True
b) False

52. Which of the following medicines is used as the first line of defense against heartburn and other mild GERD symptoms?

a) Tagamet HB
b) Zantac 75
c) Rolaids
d) Prilosec

53. Which class of drugs is effective in relieving symptoms in almost everyone who has GERD?

a) antacids
b) foaming agents
c) H2 blockers
d) proton pump inhibitors

54. GERD is common in infants, but most infants grow out of it by the time they are 1-year old.

a) True
b) False

55. Barrett's esophagus is about twice as common in men as in women.

a) True
b) False

56. Barrett's esophagus can easily be diagnosed on the basis of symptoms, physical exam, or blood tests.

a) True
b) False

57. People who must have their esophagus removed, for example because of cancer, can live a relatively healthy life without it.

a) True
b) False

58. Select the correct statement about ulcerative colitis from below:

a) Ulcerative colitis is primarily a disease of the small intestine.
b) Ulcerative colitis affects older adults more often than younger adults.
c) Ulcerative colitis is caused by emotional distress or sensitivity to certain foods.
d) Surgery is the only cure for ulcerative colitis.

59. Which of the following statements is incorrect concerning collagenous colitis and lymphocytic colitis?

a) Collagenous colitis and lymphocytic colitis are more severe forms of inflammatory bowel disease.
b) They affect the large intestine.
c) They are not related to Crohn's disease or ulcerative colitis.
d) Collagenous colitis and lymphocytic colitis significantly increase the risk of colon cancer.

60. Select the incorrect statement about Crohn's disease from below:

a) Crohn's disease usually occurs in the lower part of the small intestine.
b) For about 20 percent of people with Crohn's disease there usually is a blood relative with some form of IBD.
c) Crohn's disease is most often caused by emotional distress.
d) There's no cure for Crohn's disease.

61. Surgery to remove part of the intestine is the only way to cure Crohn's disease.

a) True
b) False

62. Strict diet is the key to good management of Crohn's disease.

a) True
b) False

63. Select the incorrect statement about celiac disease from below:

a) Celiac disease is an autoimmune disease.
b) Celiac disease affects the large intestine.
c) Celiac disease is a genetic disease.
d) People with celiac disease are often malnourishedregardless of the quantity of food eaten.

64. For people with celiac disease, gluten-free diet is a lifetime requirement.

a) True
b) False

65. Which foods should people with celiac disease avoid?

a) meat, fish
b) rice
c) fruits and vegetables
d) breads and baked products

66. Celiac disease is rather common in the United States.

a) True
b) False

67. Ostomy patients can bathe with or without the pouching system in place.

a) True
b) False

68. Which of the following describes stoma?

a) surgically created opening in the body for the discharge of body wastes
b) actual end of the ureter or bowel protruding through the abdominal wall

69. Which is a more common type of ostomy surgery?

a) ascending colostomy
b) descending colostomy

70. For most male ostomates, failure to achieve and/or sustain an erection is permanent.

a) True
b) False

71. Which of the following is not a True statement about hemochromatosis?

a) Hemochromatosis is an inherited disorder.
b) Hemochromatosis causes the blood to develop low levels of hemoglobin.
c) It most often affects Caucasians than African Americans or Hispanic Americans.
d) Men are about five times more likely to be diagnosed with the effects of hereditary hemochromatosis than women.

72. What is the treatment for hemochromatosis?

a) phlebotomy
b) daily iron supplements
c) there's no effective treatment except relieving the symptoms

73. Which is the most efficient method to remove iron from the body?

a) phlebotomy
b) chelation
c) aspirin
d) certain health foods

74. Which of the following is not a good diet tip for someone undergoing phlebotomy for iron overload?

a) eat more fiber
b) take vitamin C with meals
c) refrain from cooking in an iron skillet
d) drink tea

75. What is the level of serum ferritin desired in the treatment of iron overload?

a) 35
b) 15
c) 10

76. Patients with hemochromatosis require periodic phlebotomies for the rest of their lives even after they have been de-ironed.

a) True
b) False

77. Select the True statement about peptic ulcers from below:

a) Peptic ulcers are common.
b) Peptic ulcers are not caused by stress or eating spicy foods.
c) H.pylori is responsible for the majority of peptic ulcers; however, most infected people do not develop ulcers.
d) Abdominal discomfort caused by peptic ulcer occurs when the stomach is empty and is relieved by eating.
e) all of the above

78. H. pylori infection can be transmitted from person-to-person through mouth-to-mouth contact such as kissing.

a) True
b) False

79. Which complication of ulcers is more common?

a) perforation
b) hemorrhage
c) penetration of the ulcer into adjacent organs
d) gastric outlet obstruction

80. Which of the following is the most proven effective treatment for H.pylori?

a) single-drug treatment
b) two-week triple therapy
c) two-week dual therapy
d) two-week quadruple therapy

81. Which type of ulcer is responsible for much higher disability and mortality?

a) gastric ulcer
b) duodenal ulcer

82. Who is more likely to be affected by peptic ulcer?

a) sedentary workers
b) workers involved in manual labor

83. Which type of cancer usually occurs in the upper and middle part of the esophagus?

a) squamous cell carcinoma
b) adenocarcinoma

84. Identify the stage of the cancer that's found only in the top layers of cells lining the esophagus:

a) Stage I
b) Stage II
c) Stage III
d) Stage IV

85. If stomach cancer spreads to the liver, the cancer cells in the liver are ________ cancer cells.

a) stomach
b) liver

86. Cancer of the stomach is difficult to cure unless it is found in an early stage.

a) True
b) False

87. In which part of the world the stomach cancer rate is the lowest?

a) Japan
b) Korea
c) Eastern Europe
d) Latin America
e) Unites States

88. Which phrase below describes adjuvant therapy?

a) outpatient treatment
b) combination of chemotherapy and radiation therapy
c) treatment given after the primary treatment to increase the chances of a cure
d) treatment that helps the body's immune system attack and destroy cancer cells

89. Incidence rates of colorectal cancer are on the decline in recent years.

a) True
b) False

90. Beginning at age 50, men and women who are at average risk for developing colorectal cancer should have fecal occult blood test (FOBT) every 5 years.

a) True
b) False

91. Of various tests available for detecting colorectal cancer, which is the most sensitive?

a) fecal occult blood test
b) sigmoidoscopy
c) colonoscopy
d) double contrast barium enema
e) digital rectal exam

92. Which test for colorectal cancer allows the doctor to view the rectum and the entire colon?

a) sigmoidoscopy
b) colonoscopy

93. Stage O in colorectal cancer means the patient has no cancer.

a) True
b) False

94. How would you classify colorectal cancer that has spread to nearby lymph nodes, but not to other parts of the body?

a) Stage I
b) Stage II
c) Stage III
d) Stage III

95. For rectal cancers surgery is usually not performed; radiation therapy or chemotherapy is the most common treatment.

a) True
b) False

96. When diagnosed and treated, Whipple's disease can usually be cured.

a) True
b) False

97. The ulcers caused by Zollinger-Ellison Syndrome are __________ responsive to treatment than ordinary peptic ulcers.

a) more
b) less

98. Which of the following terms is associated with Ménétrier's disease?

a) heme
b) gastrin
c) albumin
d) Tropheryma whippelii

99. Portal hypertension is connected with which organ?

a) pancreas
b) colon
c) liver
d) kidney

100. The role of dietary fiber in preventing colon cancer is uncertain as of yet.

a) True
b) False