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MULTIPLE CHOICE
2. What is mastication?
a. Chewing.
b. Swallowing.
c. Solid waste excretion.
d. Rhythmic contractions that move digestive contents through the GI tract.
ANS: A
Mastication is the medical term for chewing.
3. Deglutition is defined as
a. rhythmic contractions that move digestive contents through the GI tract
b. chewing
c. liquid waste excretion
d. swallowing
ANS: D
Deglutition is the medical term for swallowing.
5. Smooth muscle contractions that move the contents of the digestive system along the GI tract
are called
a. peristalsis
b. deglutition
c. mastication
d. emulsification
ANS: A
Peristalsis is the term that refers to the smooth muscle contractions that move the contents of
the digestive system through the GI tract.
6. Which of the following is an emulsifier that aids in the breakdown of fats during digestion?
a. Bile.
b. Trypsin.
c. Pepsin.
d. Chyme.
ANS: A
Bile is an emulsifier that aids in the breakdown of fats during digestion.
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: B
Trypsin and chymotrypsin are digestive enzymes secreted by the pancreas. Chyme is the term
applied to the milky white substance that is formed in the stomach when chewed food is
mixed with hydrochloric acid and pepsin.
11. An increase in glucose in the blood stimulates the beta cells in the _____ to secrete _____.
a. pancreas; insulin
b. pancreas; glucagon
c. liver; glycogen
d. liver; insulin
ANS: A
Blood glucose levels in the blood are maintained by the secretion of insulin and glucagon by
the pancreas. When there is an increase in glucose, the pancreas secretes insulin. When
glucose is low, the pancreas secretes glucagon to accelerate glycogen breakdown by the liver.
14. Failure of a satisfactory esophageal lumen to develop separate from the trachea is termed
a. tracheoesophageal fistula
b. achalasia
c. Barrett’s esophagus
d. hiatal hernia
ANS: A
Tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea
caused by a failure of the two structures to develop separately.
20. Which organisms are most often responsible for infectious esophagitis?
a. Streptococcal bacteria and herpesvirus.
b. Helicobacter pylori bacteria and Candida fungus.
c. Herpesvirus and H. pylori bacteria.
d. Candida fungus and herpesvirus.
ANS: D
Infectious esophagitis is most often caused by the Candida fungus and herpesvirus.
25. Which type of esophageal diverticulum contains all layers of the wall?
a. Traction.
b. Pulsion.
c. Zenker’s.
d. Epiphrenic.
ANS: A
A traction or true diverticulum contains all layers of the esophageal wall.
26. Which type of diverticulum arises from the posterior wall of the cervical esophagus?
a. Traction.
b. Pulsion.
c. Zenker’s.
d. Epiphrenic.
ANS: C
Zenker’s diverticula arise from the posterior wall of the cervical esophagus.
29. What is the most common cause of dilated veins in the walls of the esophagus?
a. Abnormal function of the lower esophageal sphincter.
b. Reflux of abdominal contents into the esophagus.
c. Portal hypertension.
d. Weakness in the vessel wall.
ANS: C
Dilated veins of the esophagus, termed varices, are usually caused by portal hypertension.
30. Which imaging procedure is used to demonstrate dilated veins in the walls of the esophagus?
a. Upper GI.
b. Barium enema.
c. MRI.
d. Double-contrast barium swallow.
ANS: D
A double-contrast barium swallow best demonstrates the wormlike filling defect that is
evidence of esophageal varices.
33. Refer to the image. This esophageal pathologic condition is described as resembling beads on
a rosary. What pathologic condition is evident in this image?
a. Varices.
b. Hiatal hernia.
c. Esophageal diverticula.
d. Gastric ulcer.
ANS: A
The wormlike filling defect demonstrated in the image is described as resembling beads on a
rosary. Esophageal varices are demonstrated in this image.
34. Perforation of the esophagus may be a complication of all of the following except
a. neoplasm
b. instrumentation
c. peptic ulcer
d. hiatal hernia
ANS: D
Perforation of the esophagus may be a complication of esophagitis, peptic ulcer, neoplasm,
external trauma, or instrumentation.
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: D
Hemorrhage, obstruction, and perforation are all complications of peptic ulcer disease.
41. A chronic inflammatory disorder of unknown cause that often affects the terminal ileum is
called
a. Crohn’s disease
b. malabsorption syndrome
c. diverticulosis
d. gastritis
ANS: A
Crohn’s disease, or regional enteritis, is a chronic inflammatory disorder of unknown cause
and has a wide range of symptoms. The terminal ileum is usually the area most often affected.
43. A common disorder of intestinal motor activity in which fluid and gas do not progress
normally through an unobstructed bowel is called
a. regional enteritis
b. adynamic ileus
c. intussusception
d. ischemic colitis
ANS: B
Adynamic ileus is a common disorder in which the lack of peristalsis, or motor activity in the
intestine, causes fluid and gas to not progress through the intestines.
48. A condition of acquired herniations of mucosa and submucosa through muscular layers at
points of weaknesses of the bowel wall is known as
a. diverticulosis
b. ulcerative colitis
c. Crohn’s colitis
d. volvulus
ANS: A
Diverticulosis is a condition of acquired herniations of the mucosa and submucosa through
muscular layers at points of weaknesses in the bowel wall. Almost 50% of patients over age
60 have diverticulosis.
49. Refer to the image below. This typical saw-tooth configuration demonstrated on a barium
enema exam is evidence of
a. ulcerative colitis
b. diverticulosis
c. appendicitis
d. intussusception
ANS: B
Diverticulosis demonstrates on barium enema with a saw-tooth configuration as demonstrated
in this image.
50. Progressive shortening and rigidity of the colon and absent haustral patterns are radiographic
evidence of
a. appendicitis
b. diverticulosis
c. diverticulitis
d. chronic ulcerative colitis
ANS: D
Chronic ulcerative colitis demonstrates radiographically with progressive shortening and
rigidity of the colon and absent haustral patterns caused by ulcer healing and subsequent
reepithelization.
53. Which of the following is one of the most typical forms of primary colon cancer?
a. Polypoid.
b. Fungating.
c. Ulcerative.
d. Annular.
ANS: D
Annular carcinoma of the colon is one of the most typical forms of primary colon cancer.
Because of its characteristic appearance on a barium enema exam, it is also called
“apple-core” or “napkin-ring” carcinoma.
54. What is one of the most common causes of obstruction in the large bowel?
a. Intussusception.
b. Primary colon cancer.
c. Volvulus.
d. Appendicitis.
ANS: B
About 70% of large bowel obstructions are due to primary colonic cancers. Diverticulitis and
volvulus account for most of the remaining cases of obstruction.
55. Which of the following technical adjustments is required when imaging a patient with known
obstruction of the large bowel?
a. Increase in kVp.
b. Decrease in kVp.
c. Increase in kVp and double mAs.
d. Decrease in kVp and half mAs.
ANS: B
Obstruction causes the bowel to expand with accumulated gas, which requires less radiation to
penetrate. A decrease in kVp is needed when imaging a patient with an obstruction.
57. A twisting of the bowel on itself that may lead to obstruction is termed
a. intussusception
b. colitis
c. appendicitis
d. volvulus
ANS: D
A volvulus is a twisting of the bowel on itself and can cause obstruction.
58. Varicose veins of the lower end of the rectum that cause symptoms of pain, itching, and
bleeding are
a. volvulus
b. intussusception
c. hemorrhoids
d. Crohn’s disease
ANS: C
Hemorrhoids are varicose veins of the lower end of the rectum with symptoms of pain,
itching, and bleeding.
60. What is the current imaging modality of choice for the gallbladder?
a. Nuclear medicine.
b. Ultrasound.
c. Radiography.
d. CT.
ANS: B
Ultrasound is now the imaging modality of choice for the gallbladder. Oral cholecystogram
was the gold imaging standard in the past.
62. What condition results from chronic cholecystitis in which the gallbladder becomes fibrotic
and calcified?
a. Cholecystectomy.
b. Pseudocyst.
c. Biliary carcinoma.
d. Porcelain gallbladder.
ANS: D
Porcelain gallbladder results from chronic cholecystitis and causes extensive calcification and
fibrosis of the walls. The name is derived from the bluish discoloration and brittle consistency
of the gallbladder.
66. Which of the following is appropriate when imaging a patient with known liver cirrhosis
complicated by ascites?
a. Increase in kVp.
b. Decrease in kVp.
c. Increase in kVp and decrease in mAs by half.
d. Double mAs.
ANS: A
Fluid attenuates radiation, so an increase in kVp is necessary to penetrate the accumulated
fluid in ascites.
68. Which imaging modality is the most effective for detection of carcinoma of the pancreas?
a. Ultrasound.
b. Nuclear medicine.
c. MRI.
d. CT.
ANS: D
Whereas ultrasound is often the screening modality for suspected pancreatic carcinoma, CT is
the most effective imaging modality for diagnosis of pancreatic cancer.
70. Which imaging modality is the preferred method for the detection of pyloric stenosis?
a. Ultrasound.
b. MRI.
c. CT.
d. Radiography.
ANS: A
In today’s imaging arena, ultrasound is the modality of choice due to the high sensitivity and
specificity, an accuracy approaching 100%. Pyloric stenosis will appear as a thickened pyloric
muscle width greater than 3 mm and an elongated pyloric canal (>1.2 cm) on the longitudinal
sonogram.
72. Refer to the image. This disorder is caused by a loss of bowel motility. What disorder is
demonstrated in this abdominal radiograph?
a. Mechanical obstruction.
b. Adynamic ileus.
c. Volvulus.
d. Intussusception.
ANS: B
This image demonstrates an adynamic ileus, which is caused by a loss of bowel motility or
peristalsis. The dilated loops of bowel are filled with gas and fluid.
TRUE/FALSE
ANS: T
Ascites, or accumulation of fluid in the peritoneal cavity, is a common complication of
cirrhosis.
2. Esophageal atresia and TE fistula are often associated with other congenital malformations of
the skeletal, cardiovascular, and gastrointestinal systems.
ANS: T
It is common that congenital malformations are accompanied by other developmental
anomalies.
ANS: T
Reflux of the stomach contents into the esophagus is a common complication of hiatal hernia.
ANS: F
Esophageal cancer does not usually produce early symptoms, so it is often diagnosed late and
has a poor prognosis.
5. Esophageal varices are most commonly caused by a malfunction of the lower esophageal
sphincter.
ANS: F
Varices are usually caused by portal hypertension secondary to cirrhosis.
ANS: T
This is a true statement in that hiatal hernias occur in almost 50% of the population, and UGI
exams are the most common imaging procedures used to diagnose this condition.
ANS: T
Duodenal ulcers are more common than gastric ulcers.
ANS: T
This is a true statement. Whereas stomach cancer is common in other countries, such as Japan,
it is relatively rare in the United States.
ANS: T
Regional enteritis, or Crohn’s disease, is an inflammatory condition of unknown cause.
Diseases of unknown cause are classified as idiopathic diseases.
ANS: F
Small bowel obstructions are most commonly the result of fibrous adhesions from previous
surgeries or peritonitis.
12. Telescoping of one part of the intestinal tract into another is called volvulus.
ANS: F
Intussusception is the term for telescoping of one part of the bowel into another.
ANS: T
A volvulus is when a portion of the bowel twists upon itself.
ANS: T
There is an increased incidence of gallbladder cancer in patients with porcelain gallbladder.
ANS: T
Primary liver cancer is more common in persons with diffuse hepatocellular disease, such as
alcoholic or postnecrotic cirrhosis.
17. About 60% of pancreatic cancers occur in the tail of the pancreas.
ANS: F
Most pancreatic cancers occur in the head of the pancreas.
ANS: T
Free air in the abdominal cavity, pneumoperitoneum, is a sign of a perforation in the GI tract.
MATCHING
1. Pneumoperitoneum
2. Acute pancreatitis
3. Pancreatic pseudocyst
4. Acute cholecystitis
5. Preexisting polyps
6. Cirrhosis
7. GERD
8. Excessive smoking and alcohol intake
9. Pancreatic cancer
10. Cholelithiasis
11. Esophageal cancer
12. Liver metastasis