Gastrointestinal Disorders Quiz: Zollinger-Ellison Syndrome and Gastric Ulcers
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Questions and Answers

Which age group is more frequently affected by eosinophilic esophagitis?

  • Elderly individuals
  • Adolescents
  • Young children (correct)
  • Middle-aged adults

What do adults with eosinophilic esophagitis usually describe?

  • Feeding difficulties and regurgitation
  • Abdominal pain and vomiting
  • Odynophagia and stenosis
  • Dysphagia and food impaction (correct)

What pathological feature is revealed by endoscopic examination in eosinophilic esophagitis?

  • Mucosal rings and furrows (correct)
  • Erythema and dyspepsia
  • Granularity and feeding difficulties
  • Vomiting and regurgitation

What is the main microscopic finding in eosinophilic esophagitis?

<p>Marked increase in intraepithelial eosinophils (≥15/hpf) (C)</p> Signup and view all the answers

What causes reflux esophagitis (GERD)?

<p>Reflux of acidic gastric juice into the lower esophagus (C)</p> Signup and view all the answers

What symptoms are often seen in infants and children with eosinophilic esophagitis?

<p>Feeding difficulties, regurgitation, dyspepsia (C)</p> Signup and view all the answers

What is the primary cause of most gastric ulcers?

<p>Decreased resistance to acid (A)</p> Signup and view all the answers

What is the result of erosion of a blood vessel by the ulcer in about 30% of peptic ulcer patients?

<p>Bleeding (A)</p> Signup and view all the answers

What is the cause of celiac disease?

<p>Abnormal sensitivity to gluten (D)</p> Signup and view all the answers

Which test is the first-line test for celiac disease?

<p>Evaluation of titer of IgA anti-tissue transglutaminase (anti-TTG) (C)</p> Signup and view all the answers

Which condition usually affects the terminal ileum and can result in deep transverse ileal ulcers?

<p>Intestinal tuberculosis (D)</p> Signup and view all the answers

What may be required for complications or to obtain tissue for diagnosis in intra-abdominal tuberculosis?

<p>Surgery (D)</p> Signup and view all the answers

What is the primary inflammation pattern seen in Crohn's disease?

<p>Granulomatous (C)</p> Signup and view all the answers

What are the potential long-term complications of celiac disease?

<p>Both A and B (C)</p> Signup and view all the answers

What causes atrophy of small intestinal villi in celiac disease?

<p>Abnormal sensitivity to gluten (D)</p> Signup and view all the answers

What may be present in nearly all patients with chronic duodenal ulcer and approximately 75% of patients with chronic gastric ulcer?

<p>H. pylori infection (B)</p> Signup and view all the answers

What type of ulcerative process may extend through the full thickness of the gut wall into adjacent organ?

<p>Chronic peptic ulcer (D)</p> Signup and view all the answers

What is believed to be the primary cause of peptic ulceration in Zollinger-Ellison syndrome?

<p>High gastrin levels (C)</p> Signup and view all the answers

Which drug can cause a Celiac-like enteropathy that is not responsive to gluten withdrawal from the diet, but disappears after cessation of the drug?

<p>Olmesartan (D)</p> Signup and view all the answers

Which condition is characterized by a lack of normal ganglion cells in the myenteric plexus of part of the bowel?

<p>Hirschsprung's Disease (C)</p> Signup and view all the answers

Which drug can cause a pattern of colitis that can mimic Crohn’s disease?

<p>Mycophenolate Mofetil (CellCept) (D)</p> Signup and view all the answers

What is a condition characterized by protrusion of part of the wall of the rectum into the anal canal, most commonly seen in women?

<p>Solitary rectal ulcer syndrome (Rectal mucosal prolapse syndrome) (D)</p> Signup and view all the answers

What can be identified on biopsy by a characteristic pattern of crypt hyperplasia and congestion, fibrosis, and muscularization of the lamina propria?

<p>Solitary rectal ulcer syndrome (Rectal mucosal prolapse syndrome) (D)</p> Signup and view all the answers

Which group of drugs can cause various patterns of colitis?

<p>NSAID (D)</p> Signup and view all the answers

Which condition is due to the failure of migration of primitive neuroblasts into the developing gut?

<p>Hirschsprung's Disease (D)</p> Signup and view all the answers

1

<p>Solitary rectal ulcer syndrome (Rectal mucosal prolapse syndrome) (D)</p> Signup and view all the answers

What is a potential complication of long-standing ulcerative colitis?

<p>Dysplasia and neoplastic change (A)</p> Signup and view all the answers

Which type of inflammatory bowel disease is associated with non-caseating granulomas in 60% of biopsies?

<p>Crohn's disease (C)</p> Signup and view all the answers

What is a characteristic histological feature of Crohn's disease?

<p>Transmural inflammation with submucosal oedema and ulcers (C)</p> Signup and view all the answers

Where does Crohn's disease particularly affect in the gastrointestinal tract?

<p>The terminal ileum (B)</p> Signup and view all the answers

Which type of inflammatory bowel disease presents with a cobblestone pattern in the bowel mucosa due to submucosal oedema and deep fissured ulcers?

<p>Crohn's disease (D)</p> Signup and view all the answers

What is a potential direct local complication of ulcerative colitis?

<p>Toxic dilatation and perforation of the colon (A)</p> Signup and view all the answers

Which type of inflammatory bowel disease can lead to the formation of fistulas and sinuses, especially in the perianal region?

<p>Crohn's disease (B)</p> Signup and view all the answers

Approximately what percentage of patients with ulcerative colitis have chronic quiescent colitis with infrequent episodes of relapse?

<p>80% (D)</p> Signup and view all the answers

What characterizes the histology of ulcerative colitis during active acute disease?

<p>Shallow ulceration in the mucosa and lamina propria (C)</p> Signup and view all the answers

What is a potential cause of antibiotic-associated colitis?

<p>Overgrowth of Clostridium difficile in the colon following suppression of normal bowel flora by antibiotics (A)</p> Signup and view all the answers

What is a feature of indeterminate colitis?

<p>Non-caseating granulomas present in biopsies (A)</p> Signup and view all the answers

Which condition is characterized by hyperplasia of the basal cells of the squamous epithelium to more than 15% of mucosal thickness?

<p>Reflux esophagitis (A)</p> Signup and view all the answers

What is the most common cause of Barrett's esophagus?

<p>Metaplasia of the esophageal epithelium (A)</p> Signup and view all the answers

What is the main difference between the rolling type and sliding type of hiatal hernia?

<p>Loss of normal cardioesophageal angle (A)</p> Signup and view all the answers

Which factor is associated with acute erosive gastropathy?

<p>NSAIDs (A)</p> Signup and view all the answers

What type of chronic gastritis is primarily associated with Helicobacter pylori infection?

<p>Type B (B)</p> Signup and view all the answers

Which condition results from failure of vitamin B12 absorption caused by lack of intrinsic factor due to autoimmune chronic gastritis?

<p>Pernicious anemia (C)</p> Signup and view all the answers

What is the most common cause of acute erosive gastropathy?

<p>Ethyl alcohol (D)</p> Signup and view all the answers

Which type of hiatal hernia is characterized by herniation of the gastric cardia into the thorax alongside the normal esophagus?

<p>Rolling type (D)</p> Signup and view all the answers

What is the characteristic appearance of acute erosive gastropathy endoscopically?

<p>Diffuse hyperemia of the mucosa with multiple small, superficial erosions and ulcers. (A)</p> Signup and view all the answers

Which condition is characterized by protrusion of part of the stomach through the diaphragmatic hiatus?

<p>Hiatal hernia (A)</p> Signup and view all the answers

What are the three serum autoantibodies associated with autoimmune chronic gastritis?

<p>Anti-parietal cell antibody, anti-intrinsic factor antibody, anti-gastric mucosa antibody (B)</p> Signup and view all the answers

What is the most common cause of type B chronic gastritis?

<p>H. pylori infection (B)</p> Signup and view all the answers

What is the functional result of failure of secretion of acid in autoimmune chronic gastritis?

<p>Increase in serum gastrin level (B)</p> Signup and view all the answers

What is the main histologic finding in patients with reactive gastropathy?

<p>Foveolar hyperplasia and corkscrew appearance of gastric pits (A)</p> Signup and view all the answers

What is a common cause of reactive gastropathy?

<p>Chronic aspirin or NSAID use (B)</p> Signup and view all the answers

What is the main difference in the preferred site of involvement between type A and type B chronic gastritis?

<p>Type A involves the antrum, type B involves the fundic and body mucosa (A)</p> Signup and view all the answers

What is the risk associated with type B chronic gastritis?

<p>Increased risk of gastric adenocarcinoma (A)</p> Signup and view all the answers

What is the putative cause for reactive gastropathy?

<p>Chronic alcohol intake (C)</p> Signup and view all the answers

What can be seen in early cases of type B chronic gastritis?

<p>Lymphoplasmacytic infiltration in the superficial gastric mucosa (A)</p> Signup and view all the answers

What is a notable finding in patients with autoimmune chronic gastritis?

<p>High-grade dysplasia in biopsy specimen (A)</p> Signup and view all the answers

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