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Gastrointestinal Disorders-Fitzgerald
Question and answers verified to pass
- The most common anal fissure location is A. posterior midline of the anus B. anterior anal midline C. anterior and posterior anal midline D. transversely across the anal mucosa - correct answer ✔A. posterior midline of the anus
- Rectal bleeding associated with anal fissure is usually described by the patient as A. drops of blood noticed when wiping B. dark brown to black in color and mixed in with normal-appearing stool C. a large amount of brisk red bleeding D. significant blood clots and mucus mixed with stool - correct answer ✔A. drops of blood noticed when wiping
- A 62 year old woman who reports frequent constipation is diagnosed with an anal fissure. First line therapy includes all of the following except A. stool-bulking supplements B. high fiber diet C. intraanal corticosteroids D. the periodic use of oral mineral oil - correct answer ✔C. intraanal corticosteroids
- A 54 year old man with an anal fissure responds inadequately to dietary intervention and standard therapy during the past 2 weeks. Additional treatment options include all of the following except A. intraanal nitroglycerine ointment B. botulinum toxicum injection to the internal anal sphincter C. surgical sphincterotomy D. rubber band ligation of the lesion - correct answer ✔D. rubber band ligation of the lesion
B. vitamin A C. vitamin C D. vitamin B12 - correct answer ✔B. vitamin A
- Rectal bleeding associated with hemorrhoids is usually described as A. streaks of bright red blood on the stool B. dark brown to black in color and mixed in with normal-appearing stool C. a large amount of brisk red bleeding D. significant blood clots and mucus mixed with stool - correct answer ✔A. streaks of bright red blood on the stool
- Therapy for hemorrhoids includes all of the following except A. weight control B. low-fat diet C. topical corticosteroids
D. the use of a stool softener - correct answer ✔B. low-fat diet
- The NP is advising a 58 year old woman about the benefits of a high-fiber diet. Which of the following foods provides the highest fiber content? A. a small banana B. 1 cup of cooked oatmeal C. a 1/2 cup serving of brown rice D. a medium-size blueberry muffin - correct answer ✔B. 1 cup of cooked oatmeal
- A 62 year old man presents with a 2 month history of noting a "bit of dark blood mixed in with my stool most days." Physical exam reveals external hemorrhoids, no rectal mass, and a small amount of dark brown stool on the examining digit. In-office fecal occult blood test is positive, and hemogram reveals a microcytic hypochromic anemia. The next best step in his care is to A. perform in-office anoscopy B. advise the patient use sitz baths post bowel movement C. refer to gastroenterology practice for colonoscopy D. order a double contrast barium enema - correct answer ✔C. refer to gastroenterology practice for colonoscopy
A. a 28 year old woman with symptomatic external hemorrhoids who gave birth 6 days ago B. a 48 year old man with Grade II internal hemorrhoids and improvement with standard medical therapy C. a 44 year old woman who has internal and external hemorrhoids with recurrent prolapse D. a 58 year old man who has Grade I internal hemorrhoids and improvement with psyllium supplements - correct answer ✔C. a 44 year old woman who has internal and external hemorrhoids with recurrent prolapse
- All of the following are typically noted in a young adult with the diagnosis of acute appendicitis except A. epigastric pain B. positive obturator sign C. rebound tenderness D. marked febrile response - correct answer ✔D. marked febrile response
- A 26 year old man presents with acute abdominal pain. As part of the evaluation for acute appendicitis, you order a WBC count with differential and anticipate the following results
A. total WBCs, 4500 mm3; neutrophils, 35%; bands, 2%; lymphocytes, 45% B. total WBCs, 14,000 mm3; neutrophils, 55%; bands, 3%; lymphocytes 38% C. total WBCs, 16,500 mm3; neutrophils, 66%; bands, 8%; lymphocytes, 22% D. total WBCs, 18,100 mm3; neutrophils, 55%; bands, 3%; lymphocytes, 28%
- correct answer ✔C. total WBCs, 16,500 mm3; neutrophils, 66%; bands, 8%; lymphocytes, 22%
- You see a 72 year old woman who reports vomiting and abdominal cramping occurring over the past 24 hours. In evaluating a patient with suspected appendicitis, the clinician considers that A. the presentation can differ according to the anatomical location of the appendix B. this is a common reason for acute abdominal pain in elderly patients C. vomiting before onset of abdominal pain is often seen D. the presentation is markedly different from the presentation of pelvic inflammatory disease - correct answer ✔A. the presentation can differ according to the anatomical location of the appendix
- The psoas sign can be best described as abdominal pain elicited by
B. CT scan C. ultrasound D. flat plate - correct answer ✔B. CT scan
- Which of the following WBC forms is an ominous finding in the presence of severe bacterial infection? A. neutrophil B. lymphocyte C. basophil D. metamyelocyte - correct answer ✔D. metamyelocyte
- Which of the following best represents the peak ages for occurrence of acute appendicitis? A. 1 to 20 years B. 20 to 40 years C. 10 to 30 years
D. 30 to 50 years - correct answer ✔C. 10 to 30 years
- Clinical findings most consistent with appendiceal rupture include all of the following except A. abdominal discomfort less than 48 hours in duration B. fever greater than 102 C. palpable abdominal mass D. marked leukocytosis with total WBC greater than 20,000 mm3 - correct answer ✔A. abdominal discomfort less than 48 hours in duration
- Which of the following imaging studies potentially exposes the patient being evaluated for abdominal pain to the lowest ionizing radiation burden? A. ultrasound B. barium enema C. CT scan D. abdominal flat plate - correct answer ✔A. ultrasound
- Abdominal palpation that yields rebound tenderness is also known as a positive ____ sign A. Markel's B. Murphy's C. Blumberg's D. Nikolsky's - correct answer ✔C. Blumberg's
- Which of the following findings would you expect to encounter in a 33 year old man with appendiceal abscess? A. leukopenia with lymphocytosis B. positive Cullen's sign C. protracted nausea and vomiting D. dullness to percussion in the abdominal right lower quadrant - correct answer ✔D. dullness to percussion in the abdominal right lower quadrant
- A 43 year old woman has a 12 hour history of sudden onset of right upper quadrant abdominal pain with radiation to the shoulder, fever, and chills. She has had similar, milder episodes in the past. Exam reveals marked tenderness to right upper quadrant abdominal palpitation. Her most likely diagnosis is
A. hepatoma B. acute cholecystitis C. acute hepatitis D. cholelithiasis - correct answer ✔B. acute cholecystitis
- Which of the following is usually not seen in the diagnosis of acute cholecystitis? A. elevated serum creatinine B. increased alkaline phosphatase level C. leukocytosis D. elevated aspartate aminotransferase (AST) level - correct answer ✔A. elevated serum creatinine
- Murphy's sign can be best described as abdominal pain elicited by A. right upper quadrant abdominal palpation B. asking the patient to stand on tiptoes and then letting body weight fall quickly onto the heels
D. flat plate - correct answer ✔C. ultrasound of the right upper quadrant
- Which of the following is most likely to be found in a person with acute cholecystitis? A. fever B. vomiting C. jaundice D. palpable gallbladder - correct answer ✔B. vomiting
- Risk factors for the development of cholelithiasis include all of the following except A. rapid weight loss B. male gender C. obesity D. Native American ancestry - correct answer ✔B. male gender
- A gallstone that is not visualized on standard x-ray is said to be
A. radiopaque B. radiolucent C. calcified D. unclassified - correct answer ✔B. radiolucent
- Which of the following is true concerning colorectal cancer? A. most colorectal cancers are found during rectal examination B. rectal carcinoma is more common than cancers involving the colon C. early manifestations include abdominal pain and cramping D. later disease presentation often includes iron-deficiency anemia - correct answer ✔D. later disease presentation often includes iron-deficiency anemia
- According to the American Cancer Society recommendations, which of the following is the preferred method for annual colorectal cancer screening in a 51 year old man? A. digital rectal examination B. fecal occult blood test
- According to current American Cancer Society data, colorectal cancer is the number _____ cause of cancer death in men and women A. 1 B. 3 C. 5 D. 7 - correct answer ✔B. 3
- Colonic diverticulitis most commonly occurs in the walls of the A. ascending colon B. descending colon C. transverse colon D. sigmoid colon - correct answer ✔D. sigmoid colon
- Approximately what percent of the population will develop diverticulosis by the time they reach 50 years of age? A. 10%
B. 20%
C. 33%
D. 50% - correct answer ✔C. 33%
- Which of the following is most consistent with the presentation of a patient with colonic diverticulosis? A. diarrhea and leukocytosis B. constipation and fever C. few or no symptoms D. frank blood in the stool with reduced stool caliber - correct answer ✔C. few or no symptoms
- Which of the following is most consistent with the presentation of a patient with acute colonic diverticulitis? A. cramping, diarrhea, and leukocytosis B. constipation and fever C. right-sided abdominal pain
