APEA 3P Exam Prep- GI
Questions with Correct
Answers and Explanations
The relationship between colon polyps and colon cancer is those polyps:
eventually, all become malignant.
have a slow progression to colon cancer.
have a rapid progression to colon cancer.
have no relationship to colon cancer.
B.
Colon polyps are usually slow-growing and take a long time to progress to cancer.
This is the reason that a colonoscopy does not need to be repeated annually. While
not all polyps grow slowly, this is the usual progression.
A 5-year-old has been diagnosed with pinworms. He lives with his mother. There are
no other members of the household. How should his mother be managed?
Reassure the mother that if she develops symptoms, she will need to be treated.
Visually assess the mother’s rectum for redness or presence of worms.
Have the mother collect a stool specimen and send it to the laboratory.
Perform the “scotch tape” test and look at the collection under the microscope.
D.
The diagnosis of pinworms (Enterobiasis) is made by using a piece of scotch tape on
a tongue depressor. It is touched against the patient’s rectum. The greatest yield of
eggs will occur during the nighttime or early AM. Eggs will be found here if they are
present. Worms and eggs are rarely found in stool specimens, so this is not a good
plan. When the scotch tape is examined under a low power microscope, the eggs
will be easily visualized since they are large and bean shaped. The finding of an
adult worm would confirm the diagnosis. These are large enough to be seen with
the naked eye. If the mother is symptomatic, she should be treated with or without
a rectal exam. It is very likely she is infected.
,A patient has been diagnosed with hepatitis B. The most commonly reported risk
factor is:
drinking contaminated water.
eating contaminated food.
exposure to blood.
sexual exposure.
D.
Hepatitis B is transmitted by blood and body fluids. While exposure to infected
blood or blood products would significantly increase the risk of infection in
unvaccinated people, this is much less likely than becoming infected via sexual
exposure or IV drug use. Hepatitis A is transmitted via fecal-oral routes. Drinking
contaminated water and eating contaminated food implicate hepatitis A as the
etiologic agent.
The three most common causes of bacterial diarrhea in the US are Salmonella,
Campylobacter, and:
E. coli.
Enterovirus.
Yersinia.
Shigella.
D.
Shigella will be shed continuously in the stool and should be easily identified on
stool culture. When bacterial gastroenteritis is suspected, a stool specimen could be
ordered for confirmation. Generally, these three pathogens are easily identified if
they are present. Enterovirus produces a viral form of diarrhea. Yersinia produces
the deadly disease called bubonic plague. E. coli is a typical colonic pathogen.
An 83-year-old patient is diagnosed with diverticulitis. The most common complaint
is:
rectal bleeding.
bloating and cramping.
left lower quadrant pain.
frequent belching and flatulence.
,C.
Diverticular disease is more common in older adults. About 70% of patients
diagnosed with diverticulitis have left lower quadrant pain. Rectal bleeding may
have varied etiologies, such as rectal carcinoma or hemorrhoids. Bloating and
cramping are often found in patients with diverticular disease (diverticulosis) but
not specifically diverticulitis. Belching and flatulence are not specifically associated
with diverticulosis.
What is true regarding older adults who are overweight?
This is clearly associated with increased mortality in older adults.
Mortality in older adults related to overweight states declines over time.
BMI is a good way to assess nutritional status in older adults.
There are no potential metabolic or functional benefits to weight loss in older adults.
B.
Overweight and obese states are not as important in predicting mortality in older
adults as they are in their younger counterparts. After age 65 years (some studies
demonstrate after age 70), weight is less significant in decreasing risk for mortality
than in younger adults. There are some benefits to weight loss in the obese older
adults. One of them is better balance and decreased risk for falls. Others include
less sleep apnea, decreased risk of diabetes, and decreased rates of shortness of
breath with respiratory and cardiac diseases.
What medication used to treat patients who have GERD provides the fastest relief of
heartburn symptoms?
Calcium carbonate
Ranitidine
Amantadine
Pantoprazole
A.
Calcium carbonate is an antacid. It provides rapid changes in gastric pH. This
provides relief that can be noticed immediately. The increase in pH lasts for about
30 minutes and corresponds with resolution of symptoms. However, as pH
decreases within 30 minutes, symptoms may return. Ranitidine is an H2 blocker. It
provides relief in 1-2 hours. This usually lasts for about 6-12 hours. Amantadine is
an antiviral not used to treat GERD. Pantoprazole is a proton pump inhibitor. This
provides relief after several hours or days of daily consumption.
, An 84-year-old presents with a stated involuntary weight loss. He states that he’s
lost about 6 pounds in the last 6 or 8 weeks. What statement below is NOT part of
the assessment?
The weight loss should be measured today and again in the next few weeks.
A laboratory evaluation should be performed.
Evaluate his dietary intake.
Evaluate his upper and lower extremity muscle mass.
D.
Involuntary weight loss in older adults is often due to malignancy or disease. The
initial assessment of an older adult who reports involuntary weight loss is to
document the weight loss. If prior measurements are part of the patient’s chart, this
would be helpful. Laboratory assessment should also be performed. Consideration
should be given to performing a CBC, TSH, and metabolic panel. Also consider chest
and abdominal X-rays. If all are normal, he should be monitored and reweighed on
the same scale for comparison. A dietary consult should be ordered. However, even
with negative initial findings, a significant number of patients are later found to
have disease or malignancy
A patient has a positive hepatitis B surface antibody. This means he:
has acute hepatitis B.
has chronic hepatitis B.
is immune to hepatitis B.
needs immunization to hepatitis B.
C.
The hepatitis B surface antibody indicates immunity to hepatitis B virus. Specifically,
if this patient comes in contact with hepatitis B virus, he will not become infected
with hepatitis B. The presence of hepatitis B surface antibody indicates immunity
from immunization or actual infection. It also indicates recovery if the patient was
infected.
A patient with a suspected inguinal hernia should be examined:
in the prone position.
standing.
side-lying.
Questions with Correct
Answers and Explanations
The relationship between colon polyps and colon cancer is those polyps:
eventually, all become malignant.
have a slow progression to colon cancer.
have a rapid progression to colon cancer.
have no relationship to colon cancer.
B.
Colon polyps are usually slow-growing and take a long time to progress to cancer.
This is the reason that a colonoscopy does not need to be repeated annually. While
not all polyps grow slowly, this is the usual progression.
A 5-year-old has been diagnosed with pinworms. He lives with his mother. There are
no other members of the household. How should his mother be managed?
Reassure the mother that if she develops symptoms, she will need to be treated.
Visually assess the mother’s rectum for redness or presence of worms.
Have the mother collect a stool specimen and send it to the laboratory.
Perform the “scotch tape” test and look at the collection under the microscope.
D.
The diagnosis of pinworms (Enterobiasis) is made by using a piece of scotch tape on
a tongue depressor. It is touched against the patient’s rectum. The greatest yield of
eggs will occur during the nighttime or early AM. Eggs will be found here if they are
present. Worms and eggs are rarely found in stool specimens, so this is not a good
plan. When the scotch tape is examined under a low power microscope, the eggs
will be easily visualized since they are large and bean shaped. The finding of an
adult worm would confirm the diagnosis. These are large enough to be seen with
the naked eye. If the mother is symptomatic, she should be treated with or without
a rectal exam. It is very likely she is infected.
,A patient has been diagnosed with hepatitis B. The most commonly reported risk
factor is:
drinking contaminated water.
eating contaminated food.
exposure to blood.
sexual exposure.
D.
Hepatitis B is transmitted by blood and body fluids. While exposure to infected
blood or blood products would significantly increase the risk of infection in
unvaccinated people, this is much less likely than becoming infected via sexual
exposure or IV drug use. Hepatitis A is transmitted via fecal-oral routes. Drinking
contaminated water and eating contaminated food implicate hepatitis A as the
etiologic agent.
The three most common causes of bacterial diarrhea in the US are Salmonella,
Campylobacter, and:
E. coli.
Enterovirus.
Yersinia.
Shigella.
D.
Shigella will be shed continuously in the stool and should be easily identified on
stool culture. When bacterial gastroenteritis is suspected, a stool specimen could be
ordered for confirmation. Generally, these three pathogens are easily identified if
they are present. Enterovirus produces a viral form of diarrhea. Yersinia produces
the deadly disease called bubonic plague. E. coli is a typical colonic pathogen.
An 83-year-old patient is diagnosed with diverticulitis. The most common complaint
is:
rectal bleeding.
bloating and cramping.
left lower quadrant pain.
frequent belching and flatulence.
,C.
Diverticular disease is more common in older adults. About 70% of patients
diagnosed with diverticulitis have left lower quadrant pain. Rectal bleeding may
have varied etiologies, such as rectal carcinoma or hemorrhoids. Bloating and
cramping are often found in patients with diverticular disease (diverticulosis) but
not specifically diverticulitis. Belching and flatulence are not specifically associated
with diverticulosis.
What is true regarding older adults who are overweight?
This is clearly associated with increased mortality in older adults.
Mortality in older adults related to overweight states declines over time.
BMI is a good way to assess nutritional status in older adults.
There are no potential metabolic or functional benefits to weight loss in older adults.
B.
Overweight and obese states are not as important in predicting mortality in older
adults as they are in their younger counterparts. After age 65 years (some studies
demonstrate after age 70), weight is less significant in decreasing risk for mortality
than in younger adults. There are some benefits to weight loss in the obese older
adults. One of them is better balance and decreased risk for falls. Others include
less sleep apnea, decreased risk of diabetes, and decreased rates of shortness of
breath with respiratory and cardiac diseases.
What medication used to treat patients who have GERD provides the fastest relief of
heartburn symptoms?
Calcium carbonate
Ranitidine
Amantadine
Pantoprazole
A.
Calcium carbonate is an antacid. It provides rapid changes in gastric pH. This
provides relief that can be noticed immediately. The increase in pH lasts for about
30 minutes and corresponds with resolution of symptoms. However, as pH
decreases within 30 minutes, symptoms may return. Ranitidine is an H2 blocker. It
provides relief in 1-2 hours. This usually lasts for about 6-12 hours. Amantadine is
an antiviral not used to treat GERD. Pantoprazole is a proton pump inhibitor. This
provides relief after several hours or days of daily consumption.
, An 84-year-old presents with a stated involuntary weight loss. He states that he’s
lost about 6 pounds in the last 6 or 8 weeks. What statement below is NOT part of
the assessment?
The weight loss should be measured today and again in the next few weeks.
A laboratory evaluation should be performed.
Evaluate his dietary intake.
Evaluate his upper and lower extremity muscle mass.
D.
Involuntary weight loss in older adults is often due to malignancy or disease. The
initial assessment of an older adult who reports involuntary weight loss is to
document the weight loss. If prior measurements are part of the patient’s chart, this
would be helpful. Laboratory assessment should also be performed. Consideration
should be given to performing a CBC, TSH, and metabolic panel. Also consider chest
and abdominal X-rays. If all are normal, he should be monitored and reweighed on
the same scale for comparison. A dietary consult should be ordered. However, even
with negative initial findings, a significant number of patients are later found to
have disease or malignancy
A patient has a positive hepatitis B surface antibody. This means he:
has acute hepatitis B.
has chronic hepatitis B.
is immune to hepatitis B.
needs immunization to hepatitis B.
C.
The hepatitis B surface antibody indicates immunity to hepatitis B virus. Specifically,
if this patient comes in contact with hepatitis B virus, he will not become infected
with hepatitis B. The presence of hepatitis B surface antibody indicates immunity
from immunization or actual infection. It also indicates recovery if the patient was
infected.
A patient with a suspected inguinal hernia should be examined:
in the prone position.
standing.
side-lying.
