NSG 530 Study Guide Questions with Correct
Answers
Displacement of the gastroesophageal (GE) junction above the diaphragm occurs in
which of the following types of hiatal hernias?
Sliding
Which statement best describes the pathophysiology thought to be involved in the
development of a Mallory-Weiss tear?
Sudden increase in intra-abdominal pressure leads to an intramural tear of the distal
esophagus
Histologically, what layers are involved in Zenker's diverticulum?
Mucosa and submucosa
A 6-year-old boy with a history of asthma, GERD, and atopic dermatitis presents with
symptoms of heartburn for the past few months. According to his mother, the patient
has epigastric pain following ingestion of spicy or hot foods and complains of food
getting stuck. Which of the following findings would be expected if a biopsy was taken
of this patient's esophagus?
Stratified squamous epithelial cells with basal zone hyperplasia, papillary lengthening,
increased intraepithelial eosinophils, increased numbers of mast cells and IgE-bearing cells,
and eosinophilic microabscesses
Which best describes the characteristic histopathology of Barrett's esophagus?
Well-spaced, mature columnar cells with properly placed nuclei, in the presence of abundant
mucin, and tortuous, tubular glands composed exclusively of mucous-secreting cells
,Which esophageal disorder is characterized by a triad of dysphagia, iron deficiency
anemia, and esophageal webs?
Plummer-Vinson syndrome
Which condition has its incidence highest in northern Iran, central Asia, and north-
central China due to dietary factors and use of esophageal irritants?
Squamous cell carcinoma
In which esophageal disorder would you see a 'bird's beak' appearance on esophagram?
Achalasia
What characteristic feature is seen on the esophagram in the case of diffuse esophageal
spasms?
Corkscrew appearance
What is the underlying mechanism leading to esophageal dysmotility in CREST
syndrome?
Atrophy and fibrous replacement of the muscularis in the lower esophagus
Which of the following is a differentiating factor between gastric ulcers and duodenal
ulcers?
The pain of duodenal ulcers tends to improve with a food bolus.
Which of the following correctly lists the order of the layers of the intestine wall
(innermost to outermost layer) AND appropriately assigns erosion and ulcers to the
layer they erode to?
Epithelium → lamina propria (erosion) → muscularis mucosa → submucosa (ulcer)
, A 60-year-old man with a history of long-standing GERD presents to his physician with
the complaint of black stools for the past few weeks. His vital signs are within normal
limits, but a STAT CBC reveals a hemoglobin of 9.2 mg/dL. The source of this patient's
gastrointestinal bleeding is most likely to be found at which of the following locations?
Duodenum
Where are most ulcers of peptic ulcer disease found?
Duodenal bulb
A 55-year-old woman with a history of hypothyroidism comes to the physician because
of fatigue and shortness of breath, and is found to have megaloblastic anemia. She has
had long-standing dyspepsia with vague epigastric pain. Laboratory results reveal an
elevated serum gastrin level. Which of the following is the most likely diagnosis?
Autoimmune metaplastic atrophic gastritis
Imatinib is most likely to be effective in the treatment of which of the following gastric
pathologies?
Gastrointestinal stromal tumor
Which of the following pathologies accounts for the majority of gastric cancers?
Which of the following pathologies accounts for the majority of gastric cancers?
Gastric adenocarcinomas tend to initially metastasize to which sites?
Liver, lungs, and ovaries
What is the common pathophysiologic mechanism causing gastroparesis in such a wide
range of conditions, including diabetes, scleroderma, Parkinson's disease, and post-
operatively?
Answers
Displacement of the gastroesophageal (GE) junction above the diaphragm occurs in
which of the following types of hiatal hernias?
Sliding
Which statement best describes the pathophysiology thought to be involved in the
development of a Mallory-Weiss tear?
Sudden increase in intra-abdominal pressure leads to an intramural tear of the distal
esophagus
Histologically, what layers are involved in Zenker's diverticulum?
Mucosa and submucosa
A 6-year-old boy with a history of asthma, GERD, and atopic dermatitis presents with
symptoms of heartburn for the past few months. According to his mother, the patient
has epigastric pain following ingestion of spicy or hot foods and complains of food
getting stuck. Which of the following findings would be expected if a biopsy was taken
of this patient's esophagus?
Stratified squamous epithelial cells with basal zone hyperplasia, papillary lengthening,
increased intraepithelial eosinophils, increased numbers of mast cells and IgE-bearing cells,
and eosinophilic microabscesses
Which best describes the characteristic histopathology of Barrett's esophagus?
Well-spaced, mature columnar cells with properly placed nuclei, in the presence of abundant
mucin, and tortuous, tubular glands composed exclusively of mucous-secreting cells
,Which esophageal disorder is characterized by a triad of dysphagia, iron deficiency
anemia, and esophageal webs?
Plummer-Vinson syndrome
Which condition has its incidence highest in northern Iran, central Asia, and north-
central China due to dietary factors and use of esophageal irritants?
Squamous cell carcinoma
In which esophageal disorder would you see a 'bird's beak' appearance on esophagram?
Achalasia
What characteristic feature is seen on the esophagram in the case of diffuse esophageal
spasms?
Corkscrew appearance
What is the underlying mechanism leading to esophageal dysmotility in CREST
syndrome?
Atrophy and fibrous replacement of the muscularis in the lower esophagus
Which of the following is a differentiating factor between gastric ulcers and duodenal
ulcers?
The pain of duodenal ulcers tends to improve with a food bolus.
Which of the following correctly lists the order of the layers of the intestine wall
(innermost to outermost layer) AND appropriately assigns erosion and ulcers to the
layer they erode to?
Epithelium → lamina propria (erosion) → muscularis mucosa → submucosa (ulcer)
, A 60-year-old man with a history of long-standing GERD presents to his physician with
the complaint of black stools for the past few weeks. His vital signs are within normal
limits, but a STAT CBC reveals a hemoglobin of 9.2 mg/dL. The source of this patient's
gastrointestinal bleeding is most likely to be found at which of the following locations?
Duodenum
Where are most ulcers of peptic ulcer disease found?
Duodenal bulb
A 55-year-old woman with a history of hypothyroidism comes to the physician because
of fatigue and shortness of breath, and is found to have megaloblastic anemia. She has
had long-standing dyspepsia with vague epigastric pain. Laboratory results reveal an
elevated serum gastrin level. Which of the following is the most likely diagnosis?
Autoimmune metaplastic atrophic gastritis
Imatinib is most likely to be effective in the treatment of which of the following gastric
pathologies?
Gastrointestinal stromal tumor
Which of the following pathologies accounts for the majority of gastric cancers?
Which of the following pathologies accounts for the majority of gastric cancers?
Gastric adenocarcinomas tend to initially metastasize to which sites?
Liver, lungs, and ovaries
What is the common pathophysiologic mechanism causing gastroparesis in such a wide
range of conditions, including diabetes, scleroderma, Parkinson's disease, and post-
operatively?
