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Your patient is a 12-year-old male who is conscious and alert and complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. Any of the following could be therapeutic EXCEPT:


A) diazepam.
B) Compazine.
C) IV of NaCl or lactated Ringer's solution.
D) Zofran.

E) B) and C)
F) A) and C)

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Your 43-year-old male patient is alert and oriented and complaining of abdominal pain. He states that he is experiencing nausea and has vomited twice. Which of the following is the most appropriate follow-up question?


A) "What were you doing when the vomiting started?"
B) "Do you drink more than three alcoholic beverages a day?"
C) "Did you become dizzy or faint while you were vomiting?"
D) "What did the material you vomited look like?"

E) A) and C)
F) None of the above

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Which of the following statements about hepatitis is TRUE?


A) Hepatitis is caused by a wide range of potential causes.
B) All types of hepatitis are typically fatal within six months to two years.
C) The most common cause of hepatitis is alcohol abuse.
D) All types of hepatitis lead to chronic liver disease.

E) B) and C)
F) A) and C)

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While palpating the lower abdomen of a 63-year-old male complaining of back pain, you note a pulsating mass. You should:


A) ask the patient to take a deep breath, then palpate the mass while he exhales.
B) ask your partner to confirm the finding.
C) determine if the mass is fixed or freely mobile in the abdomen.
D) stop palpating.

E) A) and B)
F) All of the above

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A Mallory-Weiss tear is a disorder of the:


A) stomach.
B) liver.
C) rectum.
D) esophagus.

E) B) and D)
F) B) and C)

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Persistent abdominal pain is considered a surgical emergency when lasting longer than:


A) 2 days.
B) 2 hours.
C) 6 days.
D) 6 hours.

E) C) and D)
F) A) and B)

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The main purpose of the GI tract is:


A) to convert food into nutrients for the body.
B) to expel waste products.
C) to facilitate metabolism.
D) glucogenolysis.

E) A) and B)
F) A) and C)

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Which of the following best explains the underlying problem in diverticulitis?


A) Infection in an outpouching of the distal colon
B) Ulceration of the lining of the colon
C) Increased motility of the colon with increased mucus production
D) The presence of polyps in the sigmoid colon

E) A) and B)
F) A) and C)

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Which of the following properly accounts for the differences between visceral and somatic pain?


A) Spilled organ contents and bacteria can result in visceral pain, while somatic pain is caused by organ distension.
B) Visceral pain originates in the walls of hollow organs, while somatic pain originates in skeletal muscle.
C) The nerves that carry somatic pain impulses enter the spinal column at various levels, while the nerves that carry visceral impulses enter the spinal column via specific nerve routes.
D) The nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes.

E) All of the above
F) B) and D)

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Abdominal pain that is originating in a region other than where it is felt is known as:


A) referred pain.
B) somatic pain.
C) visceral pain.
D) Kehr's sign.

E) B) and D)
F) C) and D)

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A 56-year-old female is conscious and alert and complaining of diarrhea and nausea. The patient describes a two-day history of her symptoms and states that the pain is "all over her abdomen." All four quadrants are tender to palpation. She also describes hematochezia. PMH includes CAD, and she recently began taking 325 mg of ASA once a day. Of the following, which is the most likely cause of her clinical condition?


A) Diverticulitis
B) Peptic ulcer
C) Acute pancreatitis
D) Acute gastroenteritis

E) All of the above
F) B) and C)

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Your patient is a 22-year-old female in mild distress that is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be least helpful when determining the etiology of her abdominal pain?


A) "When did the pain start?"
B) "How would you describe the pain: dull, sharp, constant, intermittent?"
C) "Are you having any vomiting or diarrhea?"
D) "Have you ever had a sexually transmitted disease?"

E) A) and C)
F) A) and B)

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You are examining a patient who is exhibiting signs of hypovolemia. Upon inspection of the patient's flank, you notice ecchymosis. This is known as:


A) Grey Turner's sign.
B) Cullen's sign.
C) Edwards' sign.
D) rigidity sign.

E) B) and D)
F) None of the above

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Your patient is a 46-year-old male truck driver who is sitting on a toilet complaining of bleeding with defecation. He states that he had to strain significantly to produce a bowel movement, then noted blood on his stool afterward. He claims no significant medical history, has had no recent illness, and takes no medications. You note the presence of bright red blood on the surface of his stool. Of the following, which is the most likely cause of his clinical condition?


A) Crohn's disease
B) Colitis
C) Upper GI bleed
D) Hemorrhoids

E) All of the above
F) A) and C)

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Gastrointestinal emergencies account for ________ percent of emergency room visits annually.


A) 5
B) 10
C) 2.5
D) 7.5

E) A) and B)
F) B) and D)

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McBurney's point, a common site of pain secondary to appendicitis, is located:


A) at the midway point of a line from 1 to 2 inches above the right iliac crest to the umbilicus.
B) 2 inches above the umbilicus in the midline.
C) 1 to 2 inches above the iliac crest in the right midaxillary line.
D) at the midway point of a line from the symphysis pubis to the right anterior, superior iliac crest.

E) A) and D)
F) A) and C)

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The mortality rate of ruptured esophageal varices is ________ percent.


A) over 35
B) 10 to 15
C) 20 to 30
D) 15

E) C) and D)
F) A) and C)

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The cause of esophageal varices can be attributed to:


A) pulmonary hypertension.
B) portal hypertension.
C) pulmonary hypotension.
D) portal hypotension.

E) B) and D)
F) None of the above

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You respond to a patent who complains of having dark, tarry stools. Upon arrival, you notice that the patient is pale, cool, and clammy. After initiation of two large-bore IVs, your initial fluid bolus should be:


A) 10 mL/kg.
B) 20 mL/kg.
C) 250 mL.
D) 1000 mL.

E) None of the above
F) A) and C)

Correct Answer

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Increased hepatic resistance to blood flow, as happens in cirrhosis, results in:


A) hepatic arterial hypertension and obstruction of the common bile duct.
B) portal vein hypertension and esophageal varices.
C) portal artery hypertension and ascites.
D) hepatic vein hypertension and hepatic vein aneurysm.

E) B) and C)
F) None of the above

Correct Answer

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