APEA 3P EXAM PREP6 GI
QUESTIONS WITH GUARANTEED A+
ANSWERS AND EXPLANATIONS
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.
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 infecte
QUESTIONS WITH GUARANTEED A+
ANSWERS AND EXPLANATIONS
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.
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 infecte
