(Anwered) 6501 week 5 quiz: correct answers!

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Question 1
An older adult patient with a long history of tobacco and alcohol use presents with progressive dysphagia, unintentional weight loss, and a history of heartburn. A barium swallow shows irregular narrowing and mucosal irregularities in the lower esophagus. What is the most likely cause of the patient’s progressive dysphagia?

  • A. Eosinophilic esophagitis

  • B. Gastroesophageal reflux disease

  • ✅ C. Esophageal narrowing

  • D. Infectious esophagitis

Question 2
Crohn’s disease is classified as an inflammatory bowel disease (IBD). Which of the following best describes the nature of inflammation in Crohn’s disease?

  • ✅ A. Transmural inflammation affecting the entire thickness of the intestinal wall

  • B. Inflammation only in the colon

  • C. Superficial inflammation limited to the mucosa

  • D. Inflammation confined to the submucosa

Question 3
A middle-aged patient with liver disease has laboratory results that show decreased levels of albumin and prolonged prothrombin time. What aspect of liver function do these findings primarily reflect?

  • A. Detoxification

  • B. Bile production

  • ✅ C. Synthesis

  • D. Immune modulation

Question 4
A young adult woman with no significant past medical history presents with dysuria, urgency, and suprapubic discomfort. She reports that these symptoms appeared suddenly 3 days after her most recent episode of sexual intercourse and have persisted for the last two days. Her physical examination is unremarkable, and urinalysis shows pyuria and bacteriuria. What is the most likely major contributor to the pathogenesis of her condition?

  • A. Poor hand hygiene before urination

  • ✅ B. Recent sexual activity

  • C. Defective immune response

  • D. Prior use of antibiotics

Question 5
A patient with chronic gastritis develops vitamin B12 deficiency. Which of the following best explains this association?

  • ✅ A. Gastritis leads to loss of parietal cells, reducing intrinsic factor production necessary for vitamin B12 absorption

  • B. Gastritis causes decreased absorption of vitamin B12 in the duodenum

  • C. Gastritis increases secretion of hydrochloric acid, which destroys vitamin B12

  • D. Gastritis causes direct malabsorption of all vitamins

Question 6
In Crohn’s disease, granulomas are present in the gastrointestinal tract. This feature distinguishes Crohn’s from ulcerative colitis. What is the underlying pathophysiological mechanism responsible for granuloma formation?

  • A. Overexpression of IL-10 leading to an anti-inflammatory response

  • ✅ B. Th1-mediated chronic inflammation with macrophage activation

  • C. B-cell proliferation causing lymphoid hyperplasia

  • D. Eosinophilic infiltration due to parasitic infection

Question 7
A middle-aged patient with a long history of peptic ulcer disease presents with a new complaint of worsening abdominal pain. The patient undergoes esophagogastroduodenoscopy (EGD). Which of the following findings on EGD would suggest malignancy?

  • A. An ulceration with smooth, regular borders and an overlying eschar

  • B. A discrete mucosal lesion with a smooth, punched-out base

  • C. A solitary ulceration with smooth, rounded edges

  • ✅ D. A solitary ulceration with heaped up margins and an irregular edge

Question 8
An older adult patient presents with vague abdominal discomfort and unintentional weight loss. Endoscopy reveals a malignant lesion in the stomach. Biopsy results show infiltrating, mostly individual tumor cells surrounded by dense fibrosis. What type of gastric cancer is most likely in this case?

  • ✅ A. Adenocarcinoma, diffuse type

  • B. Lymphoma

  • C. Gastrointestinal stromal tumor (GIST)

  • D. Carcinoid tumor

Question 9
What best defines isosthenuria, and what leads to this condition?

  • A. Isosthenuria is a normal urine concentration regardless of fluid intake, and it is caused by an increase in papillae.

  • ✅ B. Isosthenuria is the inability to concentrate or dilute urine properly, and it is caused by a loss of papillae.

  • C. Isosthenuria is a symptom of diabetes mellitus, and it is caused by an increase in papillae.

  • D. Isosthenuria is a condition of excessive urine concentration, and loss of papillae leads to increased concentrating ability.

Question 10
Gastric acid production is primarily stimulated by which of the following pathways in the parietal cells?

  • ✅ A. Histamine binding to H2 receptors, gastrin, and acetylcholine stimulation

  • B. Calcium influx from the bloodstream

  • C. Prostaglandin receptor activation

  • D. Sodium-potassium ATPase activation

Question 1 [1 pt]

A 45-year-old male patient presents with recurrent, severe abdominal pain that worsens after consuming alcohol or eating. The pain is often relieved by leaning forward. He also describes having fatty, greasy, and oily stools, associated with weight loss. What condition is most likely responsible for these symptoms?
Correct Answer: ✅ Chronic pancreatitis
Other Options:

  • Peptic ulcer disease

  • Acute pancreatitis

  • Chronic cholecystitis

Question 2 [1 pt]

A 28-year-old male presents with symptoms of bloody diarrhea, abdominal pain, and tenesmus. A colonoscopy reveals a continuous segment of inflammation and superficial ulceration in the rectosigmoid area. A biopsy shows lymphocytic and macrophage-rich infiltrates. Which demographic group(s) is/are most commonly affected by this condition?
Correct Answer: ✅ Late teens and young adults, and adults 50–70 years
Other Options:

  • Children and young teenagers

  • Middle-aged women over 40

  • Elderly individuals over the age of 75

Question 3 [1 pt]

In the renal system, when there is a reduction in urine flow through the tubules, what is the initial event that initiates a series of processes aimed at increasing tubular flow by elevating the glomerular filtration rate (GFR)?
Correct Answer: ✅ Decreased delivery of NaCl to the macula densa
Other Options:

  • Adenosine release by the macula densa

  • Dilation of the efferent arterioles in the kidneys

  • Aldosterone release by the adrenal gland

Question 4 [1 pt]

A young adult woman with no significant past medical history presents with dysuria, urgency, and suprapubic discomfort. These symptoms began 3 days after sexual activity. Urinalysis shows pyuria and bacteriuria. What is the most likely major contributor to the pathogenesis of her condition?
Correct Answer: ✅ Recent sexual activity
Other Options:

  • Poor hand hygiene before urination

  • Defective immune response

  • Prior use of antibiotics

Question 5 [1 pt]

A middle-aged patient with a long history of peptic ulcer disease presents with worsening abdominal pain. EGD reveals which of the following findings that would suggest malignancy?
Correct Answer: ✅ A solitary ulceration with heaped up margins and an irregular edge
Other Options:

  • An ulceration with smooth, regular borders and an overlying eschar

  • A solitary ulceration with smooth, rounded edges

  • A discrete mucosal lesion with a smooth, punched-out base

Question 6 [1 pt]

A 28-year-old female presents with chronic diarrhea, steatorrhea, and anemia. She is diagnosed with celiac disease. What is the primary immunological mechanism leading to villous atrophy?
Correct Answer: ✅ T-cell-mediated immune response to gluten
Other Options:

  • Complement activation due to IgM deposits in the duodenum

  • IgE-mediated allergic reaction to gluten

  • Autoantibody production against parietal cells

Question 7 [1 pt]

What best defines isosthenuria, and what leads to this condition?
Correct Answer: ✅ Isosthenuria is the inability to concentrate or dilute urine properly, and it is caused by a loss of papillae.
Other Options:

  • Isosthenuria is a normal urine concentration regardless of fluid intake, and it is caused by an increase in papillae.

  • Isosthenuria is a symptom of diabetes mellitus, and it is caused by an increase in papillae.

  • Isosthenuria is a condition of excessive urine concentration, and loss of papillae leads to increased concentrating ability.

Question 8 [1 pt]

Which of the following statements about diverticular disease is correct?
Correct Answer: ✅ By the age of 60, about 60% of people will have some diverticulosis.
Other Options:

  • It is more common in the proximal segments of the colon.

  • It is more common in people who eat a low-fat, high-fiber diet.

  • Most diverticula are true diverticula.

Question 9 [1 pt]

Gastric acid production is primarily stimulated by which of the following pathways in the parietal cells?
Correct Answer: ✅ Histamine binding to H2 receptors, gastrin, and acetylcholine stimulation
Other Options:

  • Calcium influx from the bloodstream

  • Prostaglandin receptor activation

  • Sodium-potassium ATPase activation

Question 10 [1 pt]

An older adult patient with a long history of tobacco and alcohol use presents with progressive dysphagia, unintentional weight loss, and a history of heartburn. A barium swallow shows irregular narrowing and mucosal irregularities in the lower esophagus. What is the most likely cause of the patient’s progressive dysphagia?
Correct Answer: ✅ Esophageal narrowing
Other Options:

  • Infectious esophagitis

  • Eosinophilic esophagitis

  • Gastroesophageal reflux disease