TEST BANK FOR MEDICAL PHYSIOLOGY, UPDATED, 2ND EDITION, WALTER F. BORON, ISBN-10: 1437717535, ISBN-13: 9781437717532

Boron: Medical Physiology, 2nd Updated Edition Test Bank MULTIPLE CHOICE 1. A 47-year-old woman with a longstanding history of heartburn complains of severe heartburn. You make the diagnosis of gastroesophageal reflux disease (GERD). An upper endoscopy study is positive for Barrett’s esophagus. Which of the following correctly describes Barrett’s esophagus? A. Replacement of the squamous epithelium of the esophagus with columnar epithelium B. Replacement of the columnar epithelium of the esophagus with squamous epithelium C. The presence of moderate-to-high grade dysplasia in the esophagus D. The presence of low-to-moderate grade dysplasia in the esophagus E. The presence of any stricture within the esophagus Answer A – Replacement of the squamous epithelium of the esophagus with columnar epithelium is correct. Barrett’s esophagus appears when the squamous epithelium of the esophagus is replaced by brownish metaplastic columnar epithelium extending up from the stomach in a tongue-like or circumferential fashion. Barrett’s esophagus is present in up to 10% of patients with chronic reflux and is associated with an increased risk of neoplasia. Other choices B – Replacement of the columnar epithelium of the esophagus with squamous epithelium is incorrect. Normal esophageal epithelium is squamous, and not columnar. C – The presence of moderate-to-high grade dysplasia in the esophagus is incorrect. Esophageal dysplasia is thought to be premalignant, progressing from low to moderate to high grade dysplasia to carcinoma in situ, but does not describe Barrett’s esophagus. D – The presence of low-to-moderate grade dysplasia in the esophagus is incorrect. Low or moderate grade dysplasia is not associated with Barrett’s esophagus. E – The presence of any stricture within the esophagus is incorrect. Barrett’s esophagus is not described by esophageal stricture. 2. A 65-year-old woman with a history of congestive heart failure, osteoarthritis, and hypertension presents with pain and tenderness, which is relieved by food or antacids. Upper endoscopy reveals a gastric ulcer. Her current medications include digoxin, metoprolol, lisinopril, aspirin, and hydrochlorothiazide. Which of her medications is most likely to have contributed to her peptic ulcer disease? A. Digoxin B. Metoprolol C. Lisinopril D. Aspirin E. Hydrochlorothiazide