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Infernal Diagnosis – Test II study guide1.WOF should be true regarding hx of pt presenting w/ a fluid wave on an abdominal exam?
(MA)
a.
Hx-alcoholism (M/C cause of fluid wave is ascites
portal HTN)
 b.Hx-smokingc.
Yellow skin
d.
Easy bruising
2.Visible abdominal peristalsis is associated w/ adynamic ileus & early bowel obstruction.a.
False
3.You suspect from hx that your pt might have an infectious esophagitits. WOF might you also suspect tofind
(MA)
a.
Substernal chest pain
 b.
Immunocompromise
c.
CMV infection
d.Fluid wave on abdominal exam4.Your 16 yr old female pt that you have been tx for 3 months for IBD complains of an enlarging painfulmass in the LLQ of abdomen. She started noticing it month ago but was afraid to tell u. she has low-grade fever. WOF concerns you?a.Crohn’s disease or abscess formation b.
Colon cancer
c.Appendicitis w/ abscess formationd.
Diverticulitis w/ abscess formation
5.Pt complains of abdominal bloating, diarrhea, IBD. Plain lumbar film x-ray demonstrates loss of bonedensity WOF is most consistent w/ these?a.Peritonitis b.
Gluten intolerance (vit D malabsorption)
c.Diverticulitis w/ perforationd.UC6.WOF involves the use of a manometer a.Barium swallow w/ small bowel follow thru b.
EGD
c.Retrograde pyelogramd.Esophagram (barium swallow)7.WOF most typically cause radiating pain into
right 
shoulder region?a.
Gallbladder disease
 b.Prostatitis (hope not.)c.Appendicitisd.Crohn's8.Pt has 3 small scars on the mid abdomen in RUQ on abdominal exam. WOF would be on top of your listfor reason of these scars?
(MA)
a.
cholecystectomy (Classic) – 1 scope, 1 light, 1 insuflation
 b.
laparoscopy
c.laparotomyd.manometry (EGD)
 
9.WOF is the M/C type of abdominal hernia?a.Inguinal (M/C by far) b.Umbilicalc.Femorald.
Dystrophic cranial rectal inversion
10.26 yr old female present w/ bright red blood per rectum 3x/wk. WOF could cause this indication?a.
Hemorrhoids -yes
 b.Diverticulitis - noc.Esophageal CA - nod.
UC – yes
e.
A & B
11.WOF is associated w/ rectal pain & itchinga.
Fistula or fissure
 b.Colon CAc.Diverticulosisd.Cholelithiasis ("Gallstones")12.WOF are
untrue
regarding normal esophageal Peristalsis?a.
UT = waves from swallowing are called secondary peristalsis
 b.
UT = curling is a normal finding
(not uncommon, but
not normal 
)c.Primary peristalsis is initiated by swallowingd.
UT = peristalsis is slightly quicker in elderly
13.DES (diffuse esophageal spasm) is pero(?) relaxation to lower esophageal sphincter w/ dysphagia(difficulty swallowing) and odynophagia (painful swallowing) typically in younger pts.a.
False
14.Achalasia effects the esophagus by causing relaxation which leads to dilation typically in pts w/ DSSa.
False
(dilation is d/t obstruction stricture)15.58 yr old male colorectal Ca. pt reports an enlarging mass in his L groin over last few months. WOF ismost likely to associated w/:a.Stage 1 b.Stage 2c.
Stage 3
(regional lymphadenopathy) – 
Correct Answer per DW!
d.Stage 416.65 yr old female pt has acute IBD that is unchanged by changing her body position. She feels very tiredand wants to sleep. WOF is most primary concern?a.Post lat disc protrusion b.
AAA
c.Colorectal carcinomad.Malingering17.Testing confirms your pt has fecal occult blood where could the blood be coming from?
(MA)
a.
Sigmoid colon
(can come from anywhere from sigmoid and up) b.
Esophagus
c.
Mouth
d.
Stomach
 
18.Regarding PUD:
(MA)
a.Multiple ulcers are seen with Zollinger Ellison syndrome. b.It is unnecessary to biopsy ulcers when performing EGDc.
Eating may relieve pain or aggravate pain depending upon location
d.
Manipulation may be a beneficial part of treatment
19.You suspect your pt has a hiatus hernia. WOF would NOT be commonly found w/ this condition?a.GERD b.Remission & exacerbation of symptomsc.
Younger pt
d.Gurgling feeling in chest20.Dyspepsia that begins 30-60 min after eating is M/C associated w/ WOF?
(MA)
a.Esophageal achalasia – (No! Stricture prevents anything from going back up) b.
GERD
c.
Esophageal Chalasia
d.PUD –(No! Dyspepsia means "burning in chest")21.Itching is associated w/ WOF condition:a.
Jaundice
 b.EtOH cirrhosis – No!c.Splenomegalyd.Ascites22.WOF is M/C location for stomach CAa.Pylorus b.Fundusc.Lesser curvatured.
Greater curvature
23.WOF are risk factors for gastric CA?
(MA)
a.Hepatitis A b.
Eating lots smoked foods
c.
Over 40 yr old
d.
Cigarette smoking
24.Presence of multiple peptic ulcers should be an indication to consider WOF?a.Duodenal malignancy b.
 
Zollinger Ellison syndrome - Yesc.Incredible poor dietd.Gastronoma - Yese.
Both B & D
25.Most esophageal masses are benign where as most stomach masses are maligna.
False – 
it's backwards26.Presence of supraclavicular lymphdenopathy in a 68 yr old male typically indicates WOF?a.Cirrhosis b.Portal HTNc.
GI malignancy w/ mets
d.Achalasia
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