Comprehensive Radiographic Pathology 5th Edition by Eisenberg - Test Bank

Comprehensive Radiographic Pathology 5th Edition by Eisenberg – Test Bank

 

Instant Download – Complete Test Bank With Answers

 

 

Sample Questions Are Posted Below

 

Eisenberg: Comprehensive Radiographic Pathology, 5^th Edition

 

Chapter 5: Gastrointestinal System

 

Test Bank

 

MULTIPLE CHOICE

 

1. Where does the process of digestion begin?

a.	Stomach
b.	Small intestine
c.	Mouth
d.	Esophagus

 

 

ANS:   C

Digestion begins in the mouth with chewing breaking down food and mixing it with saliva.

 

REF:    p. 154

 

2. What is mastication?

a.	Chewing
b.	Swallowing
c.	Solid waste excretion
d.	Rhythmic contractions that move digestive contents through the GI tract

 

 

ANS:   A

Mastication is the medical term for chewing.

 

REF:    p. 154

 

3. Deglutition is defined as:

a.	Rhythmic contractions that move digestive contents through the GI tract
b.	Chewing
c.	Liquid waste excretion
d.	Swallowing

 

 

ANS:   D

Deglutition is the medical term for swallowing.

 

REF:    p. 154

 

4. Where does the greatest amount of digestion occur?

a.	Stomach
b.	Duodenum
c.	Jejunum
d.	Colon

 

 

ANS:   B

The greatest amount of digestion occurs in the duodenum, the first part of the small intestine.

 

REF:    p. 154

 

5. Smooth muscle contractions that move the contents of the digestive system along the GI tract are called:

a.	Peristalsis
b.	Deglutition
c.	Mastication
d.	Emulsification

 

 

ANS:   A

Peristalsis is the term that refers to the smooth muscle contractions that move the contents of the digestive system through the GI tract.

 

REF:    p. 154

 

6. Which of the following is an emulsifier that aids in the breakdown of fats during digestion?

a.	Bile
b.	Trypsin
c.	Pepsin
d.	Chyme

 

 

ANS:   A

Bile is an emulsifier that aids in the breakdown of fats during digestion.

 

REF:    p. 154

 

7. Which of the following are digestive enzymes secreted by the pancreas?

(1) Trypsin

(2) Chyme

(3) Chymotrypsin

a.	1 and 2 only
b.	1 and 3 only
c.	2 and 3 only
d.	1, 2, and 3

 

 

ANS:   B

Trypsin and chymotrypsin are digestive enzymes secreted by the pancreas. Chyme is the term applied to the milky white substance that is formed in the stomach when chewed food is mixed with hydrochloric acid and pepsin.

 

REF:    p. 154

 

8. The _____ is the largest gland in the body.

a.	Pancreas
b.	Thyroid
c.	Adrenals
d.	Liver

 

 

ANS:   D

The liver is the largest gland in the body; it provides many vital functions for the body, many of which are related to digestion.

 

REF:    p. 156

 

9. A pear-shaped organ that lies on the under surface of the liver is the:

a.	Pancreas
b.	Spleen
c.	Gallbladder
d.	Duodenum

 

 

ANS:   C

The gallbladder is a pear-shaped organ that lies on the under surface of the liver.

 

REF:    p. 157

 

10. What is the function of the gallbladder?

a.	Production of bile
b.	Store and concentrate bile
c.	Production of trypsin
d.	Breakdown of glycogen

 

 

ANS:   B

The gallbladder functions to store and concentrate bile. It releases bile into the duodenum when stimulated by the presence of dietary fat in the small bowel.

 

REF:    p. 157

 

11. An increase in glucose in the blood stimulates the beta cells in the _____ to secrete _____.

a.	Pancreas; insulin
b.	Pancreas; glucagon
c.	Liver; glycogen
d.	Liver; insulin

 

 

ANS:   A

Blood glucose levels in the blood are maintained by the secretion of insulin and glucagon by the pancreas. When there is an increase in glucose, the pancreas secretes insulin. When glucose is low, the pancreas secretes glucagon to accelerate glycogen breakdown by the liver.

 

REF:    p. 157

 

12. Acquired tracheoesophageal (TE) fistulas are commonly caused by:

a.	Gastroesophageal reflux disease (GERD)
b.	Barrett’s esophagus
c.	Malignancy in the mediastinum
d.	Portal hypertension

 

 

ANS:   C

Acquired TE fistulas are commonly caused by a malignancy in the mediastinum and are a serious, late complication of esophageal carcinoma. Another common cause of acquired TE fistulas is infections.

 

REF:    p. 158

 

13. What is esophageal atresia?

a.	An abnormal communication between the esophagus and the respiratory system
b.	Dilated, tortuous veins of the esophagus
c.	Functional obstruction causing proximal dilatation
d.	Congenital condition in which the esophagus ends in a blind pouch

 

 

ANS:   D

Esophageal atresia is a congenital condition in which the esophagus fails to form a sufficient lumen and ends in a blind pouch, so the newborn cannot ingest any food.

 

REF:    p. 157

 

14. Failure of a satisfactory esophageal lumen to develop separate from the trachea is termed:

a.	Tracheoesophageal fistula
b.	Achalasia
c.	Barrett’s esophagus
d.	Hiatal hernia

 

 

ANS:   A

Tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea caused by a failure of the two structures to develop separately.

 

REF:    p. 157

 

15. The most common type of congenital TE fistula is:

a.	Type I
b.	Type II
c.	Type III
d.	Type IV

 

 

ANS:   C

85% to 90% of congenital TE fistulas are Type III, which consists of the upper segment ending in a blind pouch and the lower segment attaching to the trachea.

 

REF:    p. 157

 

16. Which of the following is a serious complication of TE fistula?

a.	Hiatal hernia
b.	Gastroesophageal reflux disease (GERD)
c.	Esophagitis
d.	Aspiration pneumonia

 

 

ANS:   D

Aspiration pneumonia is an extremely serious complication of TE fistula.

 

REF:    p. 158

 

17. What is the most common cause of acute esophagitis?

a.	TE fistula
b.	Gastroesophageal reflux
c.	Infection
d.	Malignancy

 

 

ANS:   B

Reflux of the stomach contents into the distal esophagus is the most common cause of acute esophagitis.

 

REF:    p. 159

 

18. What increases the likelihood of reflux esophagitis?

a.	Hiatal hernia
b.	Achalasia
c.	Portal hypertension
d.	Diverticula

 

 

ANS:   A

Hiatal hernia greatly increases the likelihood of reflux esophagitis.

 

REF:    p. 159

 

19. What condition is associated with severe reflux esophagitis?

a.	Varices
b.	Barrett’s esophagus
c.	Traction diverticula
d.	TE fistula

 

 

ANS:   B

Barrett’s esophagus is a condition related to severe reflux esophagitis in which the normal squamous lining of the esophagus is destroyed and replaced by columnar epithelium similar to the stomach.

 

REF:    p. 160

 

20. Which organisms are most often responsible for infectious esophagitis?

a.	Streptococcal bacteria and herpesvirus
b.	Helicobacter pylori bacteria and Candida fungus
c.	Herpesvirus and H. pylori bacteria
d.	Candida fungus and herpesvirus

 

 

ANS:   D

Infectious esophagitis is most often caused by the Candida fungus and herpesvirus.

 

REF:    p. 160

 

21. Difficulty swallowing is termed:

a.	Deglutition
b.	Mastication
c.	Dysphagia
d.	Aphasia

 

 

ANS:   C

Dysphagia is the medical term for difficulty swallowing.

 

REF:    p. 163

 

22. Which of the following is strongly correlated with esophageal carcinoma?

(1) Excessive alcohol intake

(2) Smoking

(3) Portal hypertension

a.	1 and 2 only
b.	1 and 3 only
c.	2 and 3 only
d.	1, 2, and 3

 

 

ANS:   A

Esophageal carcinoma is strongly linked to excessive alcohol intake and smoking.

 

REF:    p. 163

 

23. Which imaging procedure is used to detect esophageal carcinoma?

a.	CT
b.	NM
c.	US
d.	Double-contrast barium swallow

 

 

ANS:   D

Double-contrast barium swallow will demonstrate the early plaquelike lesions or ulcers of esophageal cancer.

 

REF:    p. 163

 

24. Which imaging modality is used to stage esophageal carcinoma?

a.	Double-contrast barium swallow
b.	CT
c.	Ultrasound
d.	Nuclear medicine

 

 

ANS:   B

CT is used to stage esophageal carcinoma with 90% accuracy, including tumor size, extent, and resectability.

 

REF:    p. 164

 

25. Which type of esophageal diverticula contains all layers of the wall?

a.	Traction
b.	Pulsion
c.	Zenker’s
d.	Epiphrenic

 

 

ANS:   A

A traction or true diverticulum contains all layers of the esophageal wall.

 

REF:    p. 164

 

26. Which type of diverticula arises from the posterior wall of the cervical esophagus?

a.	Traction
b.	Pulsion
c.	Zenker’s
d.	Epiphrenic

 

 

ANS:   C

Zenker’s diverticula arise from the posterior wall of the cervical esophagus.

 

REF:    p. 165

 

27. Which type of diverticula arises in the distal 10 cm of the esophagus?

a.	Zenker’s
b.	Pulsion
c.	Traction
d.	Epiphrenic

 

 

ANS:   D

Epiphrenic diverticula occur in the distal 10 cm of the esophagus.

 

REF:    p. 165

 

28. Dilated veins in the walls of the esophagus are termed:

a.	Diverticula
b.	Varices
c.	Dysphagia
d.	Achalasia

 

 

ANS:   B

Dilated veins in the walls of the esophagus are termed varices. Outpouchings of the esophagus are called diverticula. Dysphagia is difficulty swallowing. Achalasia is a condition in which the esophagus is dilated from abnormal functioning of the sphincter.

 

REF:    p. 164

 

29. What is the most common cause of dilated veins in the walls of the esophagus?

a.	Abnormal function of the lower esophageal sphincter
b.	Reflux of abdominal contents into the esophagus
c.	Portal hypertension
d.	Weakness in the vessel wall

 

 

ANS:   C

Dilated veins of the esophagus, termed varices, are usually caused by portal hypertension.

 

REF:    pp. 164-165

 

30. Which imaging procedure is used to demonstrate dilated veins in the walls of the esophagus?

a.	Upper GI
b.	Barium enema
c.	MRI
d.	Double-contrast barium swallow

 

 

ANS:   D

A double-contrast barium swallow best demonstrates the wormlike filling defect that is evidence of esophageal varices.

 

REF:    p. 166

 

31. What is the most common abnormality found on upper GI exams?

a.	Hiatal hernia
b.	Esophageal varices
c.	Esophageal diverticula
d.	Gastric ulcer

 

 

ANS:   A

Hiatal hernia is the most common abnormality found on upper GI exams.

 

REF:    p. 166

 

32. Refer to the image. What esophageal pathologic condition is demonstrated?

From Eisenberg RL: Gastrointestinal radiology: a pattern approach, Philadelphia, 1990, Lippincott.

a.	Varices
b.	Hiatal hernia
c.	Barrett’s esophagus
d.	Esophageal diverticulum

 

 

ANS:   D

The image demonstrates an esophageal diverticulum, specifically a traction type.

 

REF:    p. 165

 

33. Refer to the image. This esophageal pathologic condition is described as resembling beads on a rosary. What pathologic condition is evident in this image?

a.	Varices
b.	Hiatal hernia
c.	Esophageal diverticula
d.	Gastric ulcer

 

 

ANS:   A

The wormlike filling defect demonstrated in the image is described as resembling beads on a rosary. Esophageal varices are demonstrated in this image.

 

REF:    p. 166

 

34. Perforation of the esophagus may be a complication of all of the following EXCEPT:

a.	Neoplasm
b.	Instrumentation
c.	Peptic ulcer
d.	Hiatal hernia

 

 

ANS:   D

Perforation of the esophagus may be a complication of esophagitis, peptic ulcer, neoplasm, external trauma, or instrumentation.

 

REF:    p. 168

 

35. Which of the following are complications of peptic ulcer disease?

(1) Hemorrhage

(2) Obstruction

(3) Perforation

a.	1 and 2 only
b.	1 and 3 only
c.	2 and 3 only
d.	1, 2, and 3

 

 

ANS:   D

Hemorrhage, obstruction, and perforation are all complications of peptic ulcer disease.

 

REF:    p. 172

 

36. What is the most common cause of acute gastrointestinal bleeding?

a.	Peptic ulcer disease
b.	Esophageal varices
c.	Esophageal diverticula
d.	Gastric cancer

 

 

ANS:   A

Peptic ulcer disease is the most common cause of acute GI bleeding.

 

REF:    p. 172

 

37. What is the most common manifestation of peptic ulcer disease?

a.	Gastric ulcer in fundus
b.	Duodenal ulcer
c.	Gastric ulcer on lesser curvature
d.	Esophageal ulcer

 

 

ANS:   B

Duodenal ulcer is the most common manifestation of peptic ulcer disease.

 

REF:    p. 172

 

38. Where is the most common location of gastric ulcers?

a.	Fundus
b.	Body
c.	Lesser curvature
d.	Greater curvature

 

 

ANS:   C

Gastric ulcers are usually located along the lesser curvature of the stomach.

 

REF:    p. 172

 

39. Where in the stomach do most gastric cancers occur?

a.	Fundus
b.	Cardiac antrum
c.	Body
d.	Distal stomach

 

 

ANS:   D

Gastric cancers usually occur in the distal stomach.

 

REF:    p. 175

 

40. Which imaging modality is used to stage gastric carcinoma?

a.	Ultrasound
b.	Upper GI series
c.	CT
d.	MRI

 

 

ANS:   C

CT is used to stage gastric carcinoma and also used for treatment planning and in evaluating response to therapy.

 

REF:    p. 176

 

41. A chronic inflammatory disorder of unknown cause that often affects the terminal ileum is called:

a.	Crohn’s disease
b.	Malabsorption syndrome
c.	Diverticulosis
d.	Gastritis

 

 

ANS:   A

Crohn’s disease, or regional enteritis, is a chronic inflammatory disorder of unknown cause and has a wide range of symptoms. The terminal ileum is usually the area most often affected.

 

REF:    p. 177

 

42. The most common cause of a mechanical small bowel obstruction is:

a.	Lack of peristalsis
b.	Intussusception
c.	Fibrous adhesions
d.	Volvulus

 

 

ANS:   C

About 75% of small bowel obstructions are caused by fibrous adhesions from previous surgery or peritonitis. The second most common cause of mechanical small bowel obstruction is external hernia.

 

REF:    p. 178

 

43. A common disorder of intestinal motor activity in which fluid and gas do not progress normally through an unobstructed bowel is called:

a.	Regional enteritis
b.	Adynamic ileus
c.	Intussusception
d.	Ischemic colitis

 

 

ANS:   B

Adynamic ileus is a common disorder in which the lack of peristalsis, or motor activity in the intestine, causes fluid and gas to not progress through the intestines.

 

REF:    p. 182

 

44. Which of the following is a major cause of bowel obstruction in children?

a.	Volvulus
b.	Intussusception
c.	Abdominal surgery
d.	Intraluminal neoplasm

 

 

ANS:   B

Intussusception is a major cause of bowel obstruction in children, but is rare in adults.

 

REF:    p. 183

 

45. What is intussusception?

a.	A twisting of the bowel on itself
b.	A type of inflammatory bowel disease of unknown cause, but with an associated psychogenic element
c.	Acquired herniation of the mucosa and submucosa of the intestinal wall
d.	The telescoping of one part of the intestinal tract into another

 

 

ANS:   D

Intussusception is the telescoping of one part of the intestinal tract into another and is a major cause of bowel obstruction in children.

 

REF:    p. 183

 

46. In which age group is appendicitis more common?

a.	Infants and toddlers
b.	Children and adolescents
c.	Young adults
d.	Elderly adults

 

 

ANS:   B

Appendicitis occurs in all age groups, but it is more common in children and adolescents.

 

REF:    p. 185

 

47. Which imaging modality is the gold standard for appendicitis?

a.	Radiography (KUB)
b.	Fluoroscopy (barium enema)
c.	CT
d.	MRI

 

 

ANS:   C

CT is the gold standard for detection of appendicitis and provides a more precise evaluation of the nature, extent, and location of the pathologic process.

 

REF:    p. 186

 

48. A condition of acquired herniations of mucosa and submucosa through muscular layers at points of weaknesses of the bowel wall is known as:

a.	Diverticulosis
b.	Ulcerative colitis
c.	Crohn’s colitis
d.	Volvulus

 

 

ANS:   A

Diverticulosis is a condition of acquired herniations of the mucosa and submucosa through muscular layers at points of weaknesses in the bowel wall. Almost 50% of patients over age 60 have diverticulosis.

 

REF:    p. 187

 

49. Refer to the image below. This typical saw-tooth configuration demonstrated on a barium enema exam is evidence of:

a.	Ulcerative colitis
b.	Diverticulosis
c.	Appendicitis
d.	Intussusception

 

 

ANS:   B

Diverticulosis demonstrates on barium enema with this saw-tooth configuration as demonstrated in this image.

 

REF:    p. 187

 

50. Progressive shortening and rigidity of the colon and absent haustral patterns are radiographic evidence of:

a.	Appendicitis
b.	Diverticulosis
c.	Diverticulitis
d.	Chronic ulcerative colitis

 

 

ANS:   D

Chronic ulcerative colitis demonstrates radiographically with progressive shortening and rigidity of the colon and absent haustral patterns caused by ulcer healing and subsequent reepithelization.

 

REF:    p. 190

 

51. Which of the following is an ominous complication of ulcerative colitis?

a.	Hemorrhage
b.	Toxic megacolon
c.	Obstruction
d.	Perforation

 

 

ANS:   B

Toxic megacolon, characterized by extreme dilatation of a segment of colon with systemic toxicity, is a severe and ominous complication of ulcerative colitis.

 

REF:    p. 189

 

52. Which of the following is associated with prior cardiovascular disease?

a.	Diverticulosis
b.	Ulcerative colitis
c.	Ischemic colitis
d.	Irritable bowel syndrome

 

 

ANS:   C

Ischemic colitis is characterized by an abrupt onset of abdominal pain and rectal pain. It is often seen in patients with prior cardiovascular disease.

 

REF:    p. 192

 

53. Which of the following is one of the most typical forms of primary colon cancer?

a.	Polypoid
b.	Fungating
c.	Ulcerative
d.	Annular

 

 

ANS:   D

Annular carcinoma of the colon is one of the most typical forms of primary colon cancer. Because of its characteristic appearance on a barium enema exam, it is also called “apple-core” or “napkin-ring” carcinoma.

 

REF:    pp. 193-194

 

54. What is one of the most common causes of obstruction in the large bowel?

a.	Intussusception
b.	Primary colon cancer
c.	Volvulus
d.	Appendicitis

 

 

ANS:   B

About 70% of large bowel obstructions are due to primary colonic cancers. Diverticulitis and volvulus account for most of the remaining cases of obstruction.

 

REF:    p. 195

 

55. Which of the following technical adjustments are required when imaging a patient with known obstruction of the large bowel?

a.	Increase in kVp
b.	Decrease in kVp
c.	Increase in kVp and double mAs
d.	Decrease in kVp and half mAs

 

 

ANS:   B

Obstruction causes the bowel to expand with accumulated gas, which requires less radiation to penetrate. A decrease in kVp is needed when imaging a patient with an obstruction.

 

REF:    p. 154

 

56. Where in the colon do most primary cancers arise?

a.	In preexisting polyps
b.	In diverticula
c.	In the perianal area
d.	In the ileocecal valve

 

 

ANS:   A

There is evidence that most primary cancers of the colon arise from preexisting polyps.

 

REF:    p. 193

 

57. A twisting of the bowel on itself that may lead to obstruction is termed:

a.	Intussusception
b.	Colitis
c.	Appendicitis
d.	Volvulus

 

 

ANS:   D

A volvulus is a twisting of the bowel on itself and can cause obstruction.

 

REF:    p. 196

 

58. Varicose veins of the lower end of the rectum that cause symptoms of pain, itching, and bleeding are:

a.	Volvulus
b.	Intussusception
c.	Hemorrhoids
d.	Crohn’s disease

 

 

ANS:   C

Hemorrhoids are varicose veins of the lower end of the rectum with symptoms of pain, itching, and bleeding.

 

REF:    p. 198

 

59. Which type of gallstone is more prevalent in the United States?

a.	Cholesterol
b.	Pigment
c.	Mixed cholesterol and calcium carbonate
d.	None of these. Gallstones are rare in the United States.

 

 

ANS:   A

Cholesterol stones are the predominant type of gallstones in the United States.

 

REF:    p. 199

 

60. What is the current imaging modality of choice for the gallbladder?

a.	Nuclear medicine
b.	Ultrasound
c.	Radiography
d.	CT

 

 

ANS:   B

Ultrasound is now the imaging modality of choice for the gallbladder. Oral cholecystogram was the gold imaging standard in the past.

 

REF:    p. 200

 

61. What is the primary cause of acute cholecystitis?

a.	Infection of the biliary system
b.	Cirrhosis of the liver
c.	Impacted gallstone in the cystic duct
d.	Peptic ulcer disease

 

 

ANS:   C

Acute cholecystitis usually occurs after obstruction of the cystic duct by impaction of a gallstone.

 

REF:    p. 201

 

62. What condition results from chronic cholecystitis in which the gallbladder becomes fibrotic and calcified?

a.	Cholecystectomy
b.	Pseudocyst
c.	Biliary carcinoma
d.	Porcelain gallbladder

 

 

ANS:   D

Porcelain gallbladder results from chronic cholecystitis and causes extensive calcification and fibrosis of the walls. The name is derived from the bluish discoloration and brittle consistency of the gallbladder.

 

REF:    p. 202

 

63. Hepatocellular carcinoma most commonly occurs in patients with:

a.	Diffuse hepatocellular disease
b.	Chronic hepatitis
c.	Porcelain gallbladder
d.	Portal hypertension

 

 

ANS:   A

Primary liver cancer is more common in persons with diffuse hepatocellular disease, such as alcoholic and postnecrotic cirrhosis.

 

REF:    p. 205

 

64. What is the modality of choice to image hepatocellular carcinoma?

a.	Radiography
b.	CT
c.	MRI
d.	Nuclear medicine

 

 

ANS:   B

CT is the imaging modality of choice for diagnosis of hepatocellular carcinoma.

 

REF:    p. 206

 

65. What is a common complication of cirrhosis?

a.	Acute pancreatitis
b.	Portal hypertension
c.	Ascites
d.	Biliary obstruction

 

 

ANS:   C

The accumulation of fluid in the peritoneal cavity, known as ascites, is a common complication of liver cirrhosis.

 

REF:    p. 204

 

66. Which of the following is appropriate when imaging a patient with known liver cirrhosis complicated by ascites?

a.	Increase in kVp
b.	Decrease in kVp
c.	Increase in kVp and decrease mAs by half
d.	Double mAs

 

 

ANS:   A

Fluid attenuates radiation, so an increase in kVp is necessary to penetrate the accumulated fluid in ascites.

 

REF:    p. 204

 

67. What is the most common cause of acute pancreatitis?

a.	Blockage of pancreatic duct by impacted stone
b.	Diabetes
c.	Excessive alcohol consumption
d.	Cirrhosis

 

 

ANS:   C

Excessive alcohol consumption is the most common cause of acute pancreatitis. Occasionally, acute pancreatitis is the result of gallstones.

 

REF:    p. 208

 

68. Which imaging modality is the most effective for detection of carcinoma of the pancreas?

a.	Ultrasound
b.	Nuclear medicine
c.	MRI
d.	CT

 

 

ANS:   D

Whereas ultrasound is often the screening modality for suspected pancreatic carcinoma, CT is the most effective imaging modality for diagnosis of pancreatic cancer.

 

REF:    p. 212

 

69. Which of the following is a sign of perforation of the GI tract?

a.	Acute pancreatitis
b.	Pneumoperitoneum
c.	Pseudocysts
d.	Localized ileus

 

 

ANS:   B

Pneumoperitoneum, or free air in the peritoneal cavity, is a sign of a perforation of the GI tract.

 

REF:    p. 213

 

70. Which imaging modality is the preferred method for the detection of pyloric stenosis?

a.	Ultrasound
b.	MRI
c.	CT
d.	Radiography

 

 

ANS:   D

In today’s imaging arena, ultrasound is the modality of choice due to the high sensitivity and specificity, an accuracy approaching 100%. Pyloric stenosis will appear as a thickened pyloric muscle width greater than 3 mm and an elongated pyloric canal (greater than 1.2 cm) on the longitudinal sonogram.

 

REF:    p. 204

 

71. Pyloric stenosis usually results in:

a.	perforation of the pylorus
b.	malabsorption syndrome
c.	atrophy of the gastric mucosa
d.	obstruction that prevents food from entering the duodenum

 

 

ANS:   D

Pyloric stenosis causes a complete or near-complete obstruction preventing food from entering into the duodenum. .

 

REF:    p. 157

 

72. Refer to the image. This disorder is caused by a loss of bowel motility. What disorder is demonstrated in this abdominal radiograph?

a.	Mechanical obstruction
b.	Adynamic ileus
c.	Volvulus
d.	Intussusception

 

 

ANS:   B

This image demonstrates an adynamic ileus, which is caused by a loss of bowel motility or peristalsis. The dilated loops of bowel are filled with gas and fluid.

 

REF:    p. 160

 

TRUE/FALSE

 

1. Ascites is a common complication of liver cirrhosis.
2. True
3. False

 

ANS:   T

Ascites, or accumulation of fluid in the peritoneal cavity, is a common complication of cirrhosis.

 

REF:    p. 163

 

2. Esophageal atresia and TE fistula are often associated with other congenital malformations of the skeletal, cardiovascular, and gastrointestinal systems.
3. True
4. False

 

ANS:   T

It is common that congenital malformations are accompanied by other developmental anomalies.

 

REF:    p. 165

 

3. GERD is a common complication of hiatal hernia.
4. True
5. False

 

ANS:   T

Reflux of the stomach contents into the esophagus is a common complication of hiatal hernia.

 

REF:    p. 166

 

4. Esophageal carcinoma is often detected early and carries a good prognosis.
5. True
6. False

 

ANS:   F

Esophageal cancer does not usually produce early symptoms, so it is often diagnosed late and has a poor prognosis.

 

REF:    p. 172

 

5. Esophageal varices are most commonly caused by a malfunction of the lower esophageal sphincter.
6. True
7. False

 

ANS:   F

Varices are usually caused by portal hypertension secondary to cirrhosis.

 

REF:    p. 175

 

6. Hiatal hernia is the most common disorder diagnosed on upper GI exams.
7. True
8. False

 

ANS:   T

This is a true statement in that hiatal hernias occur in almost 50% of the population, and UGI exams are the most common imaging procedure used to diagnose this condition.

 

REF:    p. 177

 

7. Peptic ulcer disease most commonly occurs in the duodenum.
8. True
9. False

 

ANS:   T

Duodenal ulcers are more common than gastric ulcers.

 

REF:    p. 177

 

8. Gastric cancer is relatively rare in the United States.
9. True
10. False

 

ANS:   T

This is a true statement. Whereas stomach cancer is common in other countries, such as Japan, it is relatively rare in the United States.

 

REF:    p. 178

 

9. Crohn’s disease most commonly occurs in geriatric patients.
10. True
11. False

 

ANS:   F

Crohn’s disease most commonly occurs in young adults.

 

REF:    p. 183

 

10. The cause of regional enteritis is unknown.
11. True
12. False

 

ANS:   T

Regional enteritis, or Crohn’s disease, is an inflammatory condition of unknown cause. Diseases of unknown cause are classified as idiopathic diseases.

 

REF:    p. 196

 

11. Small bowel obstructions are usually caused by intraluminal neoplasms.
12. True
13. False

 

ANS:   F

Small bowel obstructions are most commonly the result of fibrous adhesions from previous surgeries or peritonitis.

 

REF:    p. 202

 

12. Telescoping of one part of the intestinal tract into another is called volvulus.
13. True
14. False

 

ANS:   F

Intussusception is the term for telescoping of one part of the bowel into another.

 

REF:    p. 205

 

13. The twisting of the bowel on itself is called a volvulus.
14. True
15. False

 

ANS:   T

A volvulus is when a portion of the bowel twists upon itself.

 

REF:    p. 207

 

14. Porcelain gallbladder increases the risk of gallbladder carcinoma.
15. True
16. False

 

ANS:   T

There is an increased incidence of gallbladder cancer in patients with porcelain gallbladder.

 

REF:    p. 211

 

15. Hepatocellular carcinoma is more common in persons with cirrhosis.
16. True
17. False

 

ANS:   T

Primary liver cancer is more common in persons with diffuse hepatocellular disease, such as alcoholic or postnecrotic cirrhosis.

 

REF:    p. 213

 

16. Primary liver cancer is more common than liver metastasis.
17. True
18. False

 

ANS:   F

Liver metastasis is the most common cancer of the liver.

 

REF:    p. 172

 

17. About 60% of pancreatic cancers occur in the tail of the pancreas.
18. True
19. False

 

ANS:   F

Most pancreatic cancers occur in the head of the pancreas.

 

REF:    p. 172

 

18. Pneumoperitoneum is a sign of perforation of the GI tract.
19. True
20. False

 

ANS:   T

Free air in the abdominal cavity, pneumoperitoneum, is a sign of a perforation in the GI tract.

 

REF:    p. 189

 

MATCHING

 

Match the disease to the cause.

a.	Obstruction of cystic duct by an impacted gallstone
b.	Perforation of GI tract
c.	Inflammation or necrosis
d.	Excessive alcohol consumption

 

 

1. Pneumoperitoneum

 

2. Acute pancreatitis

 

3. Pancreatic pseudocyst

 

4. Acute cholecystitis

 

1. ANS:   B                     REF:    p. 213

NOT:   Rationale: Pneumoperitoneum is a sign of a perforated GI tract. Acute pancreatitis is most commonly caused by excessive alcohol consumption. Pancreatic pseudocysts are caused by inflammation, necrosis, and hemorrhage associated with trauma or acute pancreatitis. Acute cholecystitis is caused by obstruction of the cystic duct by an impacted gallstone.

 

2. ANS:   D                     REF:    p. 208

NOT:   Rationale: Pneumoperitoneum is a sign of a perforated GI tract. Acute pancreatitis is most commonly caused by excessive alcohol consumption. Pancreatic pseudocysts are caused by inflammation, necrosis, and hemorrhage associated with trauma or acute pancreatitis. Acute cholecystitis is caused by obstruction of the cystic duct by an impacted gallstone.

 

3. ANS:   C                     REF:    p. 210

NOT:   Rationale: Pneumoperitoneum is a sign of a perforated GI tract. Acute pancreatitis is most commonly caused by excessive alcohol consumption. Pancreatic pseudocysts are caused by inflammation, necrosis, and hemorrhage associated with trauma or acute pancreatitis. Acute cholecystitis is caused by obstruction of the cystic duct by an impacted gallstone.

 

4. ANS:   A                     REF:    p. 201

NOT:   Rationale: Pneumoperitoneum is a sign of a perforated GI tract. Acute pancreatitis is most commonly caused by excessive alcohol consumption. Pancreatic pseudocysts are caused by inflammation, necrosis, and hemorrhage associated with trauma or acute pancreatitis. Acute cholecystitis is caused by obstruction of the cystic duct by an impacted gallstone.

 

Match the disease to its definition or cause.

a.	Esophageal cancer
b.	Barrett’s esophagus
c.	Hepatocellular carcinoma
d.	Colon cancer

 

 

5. Preexisting polyps

 

6. Cirrhosis

 

7. GERD

 

8. Excessive smoking and alcohol intake

 

5. ANS:   D                     REF:    p. 193

NOT:   Rationale: Preexisting polyps are usually the cause of colon cancer. Hepatocellular carcinoma most often occurs in persons with diffuse liver disease, such as cirrhosis. GERD is the cause of Barrett’s esophagus. Esophageal cancer is linked to excessive alcohol intake and heavy smoking.

 

6. ANS:   C                     REF:    p. 205

NOT:   Rationale: Preexisting polyps are usually the cause of colon cancer. Hepatocellular carcinoma most often occurs in persons with diffuse liver disease, such as cirrhosis. GERD is the cause of Barrett’s esophagus. Esophageal cancer is linked to excessive alcohol intake and heavy smoking.

 

7. ANS:   B                     REF:    p. 160

NOT:   Rationale: Preexisting polyps are usually the cause of colon cancer. Hepatocellular carcinoma most often occurs in persons with diffuse liver disease, such as cirrhosis. GERD is the cause of Barrett’s esophagus. Esophageal cancer is linked to excessive alcohol intake and heavy smoking.

 

8. ANS:   A                     REF:    p. 163

NOT:   Rationale: Preexisting polyps are usually the cause of colon cancer. Hepatocellular carcinoma most often occurs in persons with diffuse liver disease, such as cirrhosis. GERD is the cause of Barrett’s esophagus. Esophageal cancer is linked to excessive alcohol intake and heavy smoking.

 

Match the disease with the most effective imaging modality.

a.	CT
b.	Ultrasound
c.	Nuclear medicine
d.	Double-contrast fluoroscopy exam

 

 

9. Pancreatic cancer

 

10. Cholelithiasis

 

11. Esophageal cancer

 

12. Liver metastasis

 

9. ANS:   A                     REF:    p. 212

NOT:   Rationale: CT is the most effective imaging modality for detection of pancreatic cancer and liver metastasis. Ultrasound is now the gold standard for imaging of the gallbladder, including cholelithiasis. Esophageal cancers are easily detected on double-contrast barium swallow studies, using fluoroscopy.

 

10. ANS:   B                     REF:    p. 200

NOT:   Rationale: CT is the most effective imaging modality for detection of pancreatic cancer and liver metastasis. Ultrasound is now the gold standard for imaging of the gallbladder, including cholelithiasis. Esophageal cancers are easily detected on double-contrast barium swallow studies, using fluoroscopy.

 

11. ANS:   D                     REF:    p. 163

NOT:   Rationale: CT is the most effective imaging modality for detection of pancreatic cancer and liver metastasis. Ultrasound is now the gold standard for imaging of the gallbladder, including cholelithiasis. Esophageal cancers are easily detected on double-contrast barium swallow studies, using fluoroscopy.

 

12. ANS:   A                     REF:    p. 207

NOT:   Rationale: CT is the most effective imaging modality for detection of pancreatic cancer and liver metastasis. Ultrasound is now the gold standard for imaging of the gallbladder, including cholelithiasis. Esophageal cancers are easily detected on double-contrast barium swallow studies, using fluoroscopy.