GIT Assessment Flashcards
In fever, which is not a pyrogen? • acetylcholine • interleukin • TNF • interferon
acetylcholine
Removal of the entire colon would be expected to cause:
Decrease urinary urobilinogen
The most frequent cause of emergency abdominal surgery is:
Appendicitis
Which is not included in the physiologic parameters used in the definition of SIRS?
- Systolic blood pressure lower than 90 mm Hg
- Temperature lower than 36° C
- Respiratory rate greater than 20 breaths/min
- Paco2 less than 32 mm Hg
Systolic blood pressure lower than 90 mm Hg
Peristaltic waves in the small intestine are characterized by the following statement except:
- They are controlled primarily by extrinsic innervation
- None of the above
- They occur in response to distention of the wall.
- Can be abolished by local application of cocaine
They are controlled primarily by extrinsic innervation
Colonic motility is stimulated by the following except:
- Gastro-colic reflex
- Duodeno-colic reflex
- Colono-colic reflex
- All of the above
Colono-colic reflex
All of the following are symptoms of peptic ulcer except:
- Pain is unrelenting and quickly worsens
- Pain is relieved by antacids
- Pain occurs at night when the stomach is empty
- Pain is relieved by eating
Pain occurs at night when the stomach is empty
Regarding peritonitis, which of the following statements is not true?
- Multiple organisms are commonly cultured from peritoneal dialysis catheters
- Primary peritonitis is usually monomicrobial
- Chemical peritonitis often precedes bacterial contamination
- Primary peritonitis is more common in children with nephrosis and adults with cirrhosis than in patients without such condition
Chemical peritonitis often precedes bacterial contamination
True statement about TNF-alpharelease.
- Does not have any beneficial effects in the early phases of the inflammatory response
- Can be effectively blocked by anti–TNF-antibodies to halt systemic inflammatory response syndrome (SIRS)
- Is primarily from leukocytes
- Promotes polymorphonuclear (PMN) cell adherence and further cytokine release
- Is always deleterious
Promotes polymorphonuclear (PMN) cell adherence and further cytokine release
Which of the following does not trigger visceral pain? • distention • traction • inflammation • heat • ischemia
Heat
Rhythmic segmentation of small intestine is characterized by the following except:
• Its main function is to mix chyme with the digestive juice
• It is myogenic
• Its frequency is determined by BER
• It is due to local axon reflex
It is due to local axon reflex
The most common symptoms of gastric disease is? • pain • fever • nausea • anorexia • vomiting
Pain
An 18-year-old man has a 12-hour history of vague, periumbilical abdominal pain, anorexia, and nonbilious vomiting. The pain has now localized to the right lower quadrant. On examination he is found to have tenderness over the McBurney point along with involuntary muscle rigidity. Which of the following best explains the localization of pain?
- Pain over the McBurney point is caused by distention of the appendiceal lumen
- The somatic pain fibers course through spinal nerve roots L3-5.
- Unmyelinated fibers carry pain signals with the thoracic and lumbar spinal nerves
- Inflammation of the visceral peritoneum produces localizing pain.
- Movement of the inflamed parietal peritoneum induces rebound tenderness
The somatic pain fibers course through spinal nerve roots L3-5.
Strategies that have been suggested to decrease the risk for postoperative pulmonary complications include all of the following except:
- Preoperative smoking cessation
- Routine nasogastric tube decompression
- Lung expansion maneuvers
- Postoperative epidural anesthesia
- Use of intraoperative short-acting neuromuscular blocking agents
Routine nasogastric tube decompression
Which of the following is NOT a characteristic of the myenteric ganglia of the enteric nervous system?
- It is interconnected with the submucosal ganglia
- Also known as Auerbach’s plexus
- Contains both excitatory and inhibitory motor nerves to the smooth muscle fibers.
- Contains most of the motor neurons to circular and longitudinal muscles of the intestinal tract
- It is smaller than the submucousal ganglia and most prominent in the small and large intestine
It is smaller than the submucousal ganglia and most prominent in the small and large intestine
Mass movement in the colon after meal is due to the following except: • Duodenocolic reflex • Gastrin hormone • Gastrocolic reflex • Secretine hormone
Secretine hormone
The parasympathetic supply of the distal colon is: • The lesser splanchnic nerve • Pelvic nerve • Vagus nerve • The pudendal nerve
Pelvic nerve
Which Cytokines are not involved in the initial proinflammatory response? • Interleukin-8 • Interleukin-10 • Interleukin-6 • Tumor necrosis factor
Interleukin-10
In post op patient with anorexia and diarrhea?
Decreased level of zinc
Rectal mucosa is sensitive to:
Pain
Not included in the factors that contribute anorexia?
• Imbalance in plasma and brain amino acids
• change in rate of lipid metabolism
• Change in glucose utilization rate
• alteration in gut peptides
alteration in gut peptides
With regards to C fibers and visceral peritoneal innervation, which of the following statements is true?
- Their stimulation is interpreted as localized, sharp pain
- They travel bilaterally with the sympathetic chains
- They are myelinated, polymodal nociceptors
- They refer pain to dermatomes
- They conduct rapidly (0.5 m/s)
They travel bilaterally with the sympathetic chains
Which is not true of somatic pain? • Stimulated by pressure • Transmitted by A-delta fibers • Well localized • Characterized by crampy gnawing pain • Receptors are found in muscle and skin
Characterized by crampy gnawing pain
Pain is defined as?
• An unpleasant sensation, occurring in varying degrees of severity as a consequence of injury, disease, or
emotional disorder
• Both A and B are correct
• Neither A and B are correct
• An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
A and B
Fecal continence requires:
- All of the above
- Intact innervations of anorectal region
- Sensation of rectum and anal mucosa
- Tone of the internal and external anal sphincter
All
Which of the following most likely contributes to GERD?
- LES resting pressure of 12 mmHg
- Intra-abdominal LES length of 3 cm
- Thirty percent tertiary waveforms
- Total LES length of 5 cm
- Attachment of the phrenoesophageal ligament 4 cm above the GE junction
Thirty percent tertiary waveforms
Which is the most common cause of lower GI bleed under 50 years of age?
- Diverticulosis
- Inflammatory bowel disease
- Benign polyps
- Hemorrhoids
- Anal fissures
Hemorrhoids
True of patients … hypothalamus?
- weight gain
- Obesity
- anorexia
- Hyperphagia
anorexia
It is the result of afferent neurons that innervate 2 separate anatomically distinct structure that have a common embryologic origin.
Referred Pain
