NUR 5461/NUR5461 Module 5 V1 |
Digestive System Q&A with Rationale |
William Paterson University
1. Which mechanism is primarily responsible for the development of Gastroesophageal Reflux
Disease (GERD)?
A. Excessive production of gastric acid
B. Rapid gastric emptying into the duodenum
C. Transient relaxation of the lower esophageal sphincter (LES)
D. Increased esophageal peristalsis
Correct Answer: C
Expert Explanation: The primary cause of GERD is the spontaneous or transient
relaxation of the lower esophageal sphincter, which allows gastric contents to reflux into
the esophagus. This relaxation can be triggered by certain foods, medications, or increased
abdominal pressure. Chronic exposure to acid leads to mucosal damage and potential
metaplasia known as Barrett’s esophagus.
2. A patient with Crohn’s disease is likely to exhibit which of the following pathological
features?
A. Transmural inflammation with skip lesions
B. Inflammation localized strictly to the sigmoid colon
,C. Continuous ulceration limited to the mucosal layer
D. Absence of granulomas in biopsy samples
Correct Answer: A
Expert Explanation: Crohn’s disease is characterized by transmural inflammation that can
affect any part of the gastrointestinal tract from the mouth to the anus. A hallmark feature
is the presence of ‘skip lesions,’ where areas of diseased tissue are separated by healthy
segments. This deep inflammation can lead to complications such as fistulas and strictures.
3. What is the primary role of Helicobacter pylori in the development of peptic ulcer disease?
A. It directly digests the mucosal lining with proteolytic enzymes
B. It produces urease to neutralize stomach acid and secretes toxins that damage the
mucosa
C. It increases the production of protective prostaglandins
D. It causes systemic immunosuppression allowing other bacteria to invade
Correct Answer: B
Expert Explanation: H. pylori produces the enzyme urease, which converts urea into
ammonia to create a localized neutral pH environment for the bacteria. The bacteria then
release toxins and induce an inflammatory response that degrades the protective mucus
layer. This process leaves the gastric or duodenal epithelium vulnerable to damage from
hydrochloric acid and pepsin.
, 4. Which lab finding is most specific for diagnosing acute pancreatitis?
A. Elevated serum alanine aminotransferase (ALT)
B. Decreased white blood cell count
C. Elevated serum lipase
D. Increased serum albumin
Correct Answer: C
Expert Explanation: Serum lipase is more specific than amylase for diagnosing acute
pancreatitis because it remains elevated longer and is primarily produced by the pancreas.
Lipase levels usually rise within 24 hours of onset and can remain high for up to 14 days.
Amylase can be elevated in other conditions such as mumps or intestinal perforation,
making lipase the preferred diagnostic marker.
5. In the context of portal hypertension, which complication is most likely to result in life-
threatening hemorrhage?
A. Splenomegaly
B. Esophageal varices
C. Ascites
D. Caput medusae
Correct Answer: B
Digestive System Q&A with Rationale |
William Paterson University
1. Which mechanism is primarily responsible for the development of Gastroesophageal Reflux
Disease (GERD)?
A. Excessive production of gastric acid
B. Rapid gastric emptying into the duodenum
C. Transient relaxation of the lower esophageal sphincter (LES)
D. Increased esophageal peristalsis
Correct Answer: C
Expert Explanation: The primary cause of GERD is the spontaneous or transient
relaxation of the lower esophageal sphincter, which allows gastric contents to reflux into
the esophagus. This relaxation can be triggered by certain foods, medications, or increased
abdominal pressure. Chronic exposure to acid leads to mucosal damage and potential
metaplasia known as Barrett’s esophagus.
2. A patient with Crohn’s disease is likely to exhibit which of the following pathological
features?
A. Transmural inflammation with skip lesions
B. Inflammation localized strictly to the sigmoid colon
,C. Continuous ulceration limited to the mucosal layer
D. Absence of granulomas in biopsy samples
Correct Answer: A
Expert Explanation: Crohn’s disease is characterized by transmural inflammation that can
affect any part of the gastrointestinal tract from the mouth to the anus. A hallmark feature
is the presence of ‘skip lesions,’ where areas of diseased tissue are separated by healthy
segments. This deep inflammation can lead to complications such as fistulas and strictures.
3. What is the primary role of Helicobacter pylori in the development of peptic ulcer disease?
A. It directly digests the mucosal lining with proteolytic enzymes
B. It produces urease to neutralize stomach acid and secretes toxins that damage the
mucosa
C. It increases the production of protective prostaglandins
D. It causes systemic immunosuppression allowing other bacteria to invade
Correct Answer: B
Expert Explanation: H. pylori produces the enzyme urease, which converts urea into
ammonia to create a localized neutral pH environment for the bacteria. The bacteria then
release toxins and induce an inflammatory response that degrades the protective mucus
layer. This process leaves the gastric or duodenal epithelium vulnerable to damage from
hydrochloric acid and pepsin.
, 4. Which lab finding is most specific for diagnosing acute pancreatitis?
A. Elevated serum alanine aminotransferase (ALT)
B. Decreased white blood cell count
C. Elevated serum lipase
D. Increased serum albumin
Correct Answer: C
Expert Explanation: Serum lipase is more specific than amylase for diagnosing acute
pancreatitis because it remains elevated longer and is primarily produced by the pancreas.
Lipase levels usually rise within 24 hours of onset and can remain high for up to 14 days.
Amylase can be elevated in other conditions such as mumps or intestinal perforation,
making lipase the preferred diagnostic marker.
5. In the context of portal hypertension, which complication is most likely to result in life-
threatening hemorrhage?
A. Splenomegaly
B. Esophageal varices
C. Ascites
D. Caput medusae
Correct Answer: B
