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Pathophysiology Midterm 2 - 2023
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Pathophysiology Midterm 2 - 2023

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Questions and Answers

Which of the following statements regarding the 15-year-old man with abdominal pain and bloody diarrhea is correct?

  • This is disease exclusively involving the colon, the disease process does not usually involve other parts of the gastrointestinal tract
  • The majority of patients are positive for perinuclear antineutrophil cytoplasmic antibody (P-ANCA)
  • The disease can cause malabsorption of nutrients that can affect growth and development
  • The disease causes complications such as toxic megacolon (correct)
  • There are no genetic predisposing factors for this disease
  • Which crystal is most likely to be seen in large numbers on microscopic urinalysis in the 55-year-old woman with fever and right-sided flank pain?

  • Cystine
  • Magnesium ammonium phosphate (correct)
  • Calcium phosphate dihydrate
  • Uric acid
  • Calcium oxalate
  • What does the ABG (arterial blood gas) results indicate for Baby Angela with elevated respiratory rate?

  • Metabolic Acidosis, Fully Compensated
  • Metabolic Acidosis, Partially Compensated
  • Respiratory Alkalosis, Fully Compensated (correct)
  • Respiratory Acidosis, Uncompensated
  • Respiratory Acidosis, Fully Compensated
  • What is the characteristic histologic feature of the 29-year-old female's duodenal biopsy after excluding wheat and rye from her diet?

    <p>Villus shortening and intraepithelial lymphocytosis</p> Signup and view all the answers

    Which laboratory test finding is most likely to be present in the 43-year-old man with mid epigastric pain and a gastric antral ulcer?

    <p>Gastric achlorhydria</p> Signup and view all the answers

    Which complications are associated with cirrhosis?

    <p>coagulopathies (bleeding disorders)</p> Signup and view all the answers

    Which of the following is a risk factor for the development of black pigment gallstones?

    <p>Hereditary Spherocytosis</p> Signup and view all the answers

    Which of the following statements regarding the 15-year-old man's condition is correct?

    <p>The majority of patients are positive for perinuclear antineutrophil cytoplasmic antibody (P-ANCA)</p> Signup and view all the answers

    Which crystals are most likely to be seen in large numbers on microscopic urinalysis in the 55-year-old woman?

    <p>Magnesium ammonium phosphate</p> Signup and view all the answers

    What is the characteristic histologic feature of the 29-year-old female's biopsy?

    <p>Villus shortening and intraepithelial lymphocytosis</p> Signup and view all the answers

    What does the ABG results of Baby Angela indicate?

    <p>Respiratory Alkalosis, Fully Compensated</p> Signup and view all the answers

    Which laboratory test finding is most likely to be present in the 43-year-old man with the gastric ulcer?

    <p>Positive urea breath test</p> Signup and view all the answers

    Which is a risk factor for the development of black pigment gallstones?

    <p>Hereditary Spherocytosis</p> Signup and view all the answers

    Which complications are associated with cirrhosis?

    <p>Hepatic encephalopathy</p> Signup and view all the answers

    What is the most likely diagnosis of the 31-year-old man with skin yellowing and scleral icterus?

    <p>Jaundice or Hepatitis</p> Signup and view all the answers

    What is the characteristic histological feature of the 15-year-old man's colonic biopsy?

    <p>Mucosal architectural alteration with chronic inflammation</p> Signup and view all the answers

    What is the most likely complication of the 15-year-old man's disease?

    <p>Toxic megacolon</p> Signup and view all the answers

    What is the likely pathogen causing the 55-year-old woman's urinary tract infection?

    <p>Proteus vulgaris</p> Signup and view all the answers

    What type of crystal is most likely to be seen in the 55-year-old woman's urinalysis?

    <p>Magnesium ammonium phosphate</p> Signup and view all the answers

    What is the likely diagnosis of Baby Angela's symptoms?

    <p>Infectious enteritis</p> Signup and view all the answers

    What is a possible long-term consequence of the 15-year-old man's disease?

    <p>Growth retardation</p> Signup and view all the answers

    What is the likely cause of the 15-year-old man's bloody diarrhea?

    <p>Inflammatory bowel disease</p> Signup and view all the answers

    What is the characteristic laboratory feature of the 55-year-old woman's urinary tract infection?

    <p>Presence of WBCs and WBC casts in the urine</p> Signup and view all the answers

    What is the interpretation of the ABG results with pH 7.39, PaCO2 = 27 mmHg, and HCO3 = 19 mEq/L?

    <p>Metabolic Acidosis, Partially Compensated</p> Signup and view all the answers

    What is the characteristic histologic feature of the duodenal biopsy in the 29-year-old female with weight loss, fatigue, and diarrhea?

    <p>Villus shortening and intraepithelial lymphocytosis</p> Signup and view all the answers

    What is the most likely laboratory test finding in the 43-year-old man with mid epigastric pain and a gastric antral ulcer?

    <p>Positive urea breath test</p> Signup and view all the answers

    Which of the following is a risk factor for the development of black pigment gallstones?

    <p>Hereditary Spherocytosis</p> Signup and view all the answers

    What is the most likely diagnosis in the 29-year-old female with weight loss, fatigue, and diarrhea who responds to a gluten-free diet?

    <p>Celiac disease</p> Signup and view all the answers

    What is the most likely complication of the 43-year-old man's gastric antral ulcer?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

    What is the pathogenesis of black pigment gallstones?

    <p>Increased bilirubin excretion into the bile</p> Signup and view all the answers

    What is the most likely underlying cause of the 43-year-old man's gastric antral ulcer?

    <p>Helicobacter pylori infection</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Tract

    • A 15-year-old man with abdominal pain and bloody diarrhea for 6 months is likely to have Crohn's disease, characterized by mucosal architectural alteration, chronic inflammation, deep lymphoid aggregates, and deep fissures extending into the muscularis propria, with multiple granulomas identified within the lamina propria.
    • The disease is not exclusively limited to the colon, can involve other parts of the gastrointestinal tract, and is associated with perinuclear antineutrophil cytoplasmic antibody (P-ANCA).
    • Complications of the disease include toxic megacolon, and it can cause malabsorption of nutrients affecting growth and development.

    Urinary Tract Infections

    • A 55-year-old woman with fever and right-sided flank pain is likely to have a urinary tract infection, with a radiopaque calculus that forms a cast of a dilated right renal collecting system.
    • The presence of magnesium ammonium phosphate crystals in the urine is suggestive of a urinary tract infection, with Proteus vulgaris as the likely causative organism.

    Acid-Base Balance

    • A baby with irritability, difficulty breastfeeding, and diarrhea may have an underlying acid-base imbalance, with elevated respiratory rate and ABG results showing pH 7.39, PaCO2 = 27 mmHg, and HCO3 = 19 mEq/L, indicating partial compensation for metabolic acidosis.

    Gastrointestinal Disorders

    • A 29-year-old female with weight loss, fatigue, and diarrhea is likely to have celiac disease, characterized by villus shortening and intraepithelial lymphocytosis on duodenal biopsy, and responds to a gluten-free diet that excludes wheat and rye.

    Gastric Ulcers

    • A 43-year-old man with mid-epigastric pain and nausea is likely to have a gastric ulcer, with a solitary sharply demarcated 2-cm shallow gastric antral ulcer on upper GI endoscopy.
    • The presence of Helicobacter pylori, as detected by a positive urea breath test, is a likely contributing factor to the development of the ulcer.

    Gallstones

    • Black pigment gallstones are associated with hereditary spherocytosis, obesity, pregnancy, bile infection, and hyperlipidemia.

    Complications of Cirrhosis

    • Complications of cirrhosis include ascites, hepatic encephalopathy, coagulopathies (bleeding disorders), and perianal/rectal varices.

    Liver Function

    • A 31-year-old man with scleral icterus but no abdominal pain or fever is likely to have a liver function disorder, with a possible diagnosis of viral hepatitis.

    Gastrointestinal Tract

    • A 15-year-old man with abdominal pain and bloody diarrhea for 6 months is likely to have Crohn's disease, characterized by mucosal architectural alteration, chronic inflammation, deep lymphoid aggregates, and deep fissures extending into the muscularis propria, with multiple granulomas identified within the lamina propria.
    • The disease is not exclusively limited to the colon, can involve other parts of the gastrointestinal tract, and is associated with perinuclear antineutrophil cytoplasmic antibody (P-ANCA).
    • Complications of the disease include toxic megacolon, and it can cause malabsorption of nutrients affecting growth and development.

    Urinary Tract Infections

    • A 55-year-old woman with fever and right-sided flank pain is likely to have a urinary tract infection, with a radiopaque calculus that forms a cast of a dilated right renal collecting system.
    • The presence of magnesium ammonium phosphate crystals in the urine is suggestive of a urinary tract infection, with Proteus vulgaris as the likely causative organism.

    Acid-Base Balance

    • A baby with irritability, difficulty breastfeeding, and diarrhea may have an underlying acid-base imbalance, with elevated respiratory rate and ABG results showing pH 7.39, PaCO2 = 27 mmHg, and HCO3 = 19 mEq/L, indicating partial compensation for metabolic acidosis.

    Gastrointestinal Disorders

    • A 29-year-old female with weight loss, fatigue, and diarrhea is likely to have celiac disease, characterized by villus shortening and intraepithelial lymphocytosis on duodenal biopsy, and responds to a gluten-free diet that excludes wheat and rye.

    Gastric Ulcers

    • A 43-year-old man with mid-epigastric pain and nausea is likely to have a gastric ulcer, with a solitary sharply demarcated 2-cm shallow gastric antral ulcer on upper GI endoscopy.
    • The presence of Helicobacter pylori, as detected by a positive urea breath test, is a likely contributing factor to the development of the ulcer.

    Gallstones

    • Black pigment gallstones are associated with hereditary spherocytosis, obesity, pregnancy, bile infection, and hyperlipidemia.

    Complications of Cirrhosis

    • Complications of cirrhosis include ascites, hepatic encephalopathy, coagulopathies (bleeding disorders), and perianal/rectal varices.

    Liver Function

    • A 31-year-old man with scleral icterus but no abdominal pain or fever is likely to have a liver function disorder, with a possible diagnosis of viral hepatitis.

    Gastrointestinal Pathophysiology

    • A 15-year-old man with abdominal pain and bloody diarrhea for 6 months has colon biopsy showing mucosal architectural alteration, chronic inflammation, deep lymphoid aggregates, and deep fissures extending into the muscularis propria, and multiple granulomas in the lamina propria.
    • The disease is not exclusively involving the colon, can involve other parts of the gastrointestinal tract.
    • Most patients are positive for perinuclear antineutrophil cytoplasmic antibody (P-ANCA).
    • The disease can cause complications such as toxic megacolon and malabsorption of nutrients affecting growth and development.

    Urinary Tract Infection

    • A 55-year-old woman with fever and right-sided flank pain has a urinalysis revealing normal specific gravity, pH 7.5, and many WBCs and WBC casts.
    • Abdominal radiograph reveals a radiopaque calculus that forms a cast of a dilated right renal collecting system.
    • Urine culture grows Proteus vulgaris, which can form magnesium ammonium phosphate crystals.

    Acid-Base Balance

    • A baby with irritability, difficulty breastfeeding, and diarrhea has an ABG result showing pH 7.39, PaCO2 = 27 mmHg, and HCO3 = 19 mEq/L, indicating metabolic acidosis, partially compensated.

    Celiac Disease

    • A 29-year-old female with weight loss, fatigue, and diarrhea has a duodenal biopsy showing villus shortening and intraepithelial lymphocytosis.
    • The patient is put on a special diet excluding wheat and rye, and shows significant improvement.

    Peptic Ulcer Disease

    • A 43-year-old man with mid epigastric pain and nausea has a gastric antral ulcer on upper GI endoscopy.
    • The patient is likely to have a positive urea breath test, indicating H. pylori infection.

    Gallstone Risks

    • Risk factors for black pigment gallstones include hereditary spherocytosis, but not obesity, pregnancy, bile infection, or hyperlipidemia.

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    A 15-year-old patient with abdominal pain and bloody diarrhea is diagnosed with a specific condition. Identify the correct statement about this case. A pathophysiology midterm exam question.

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