SGNA Pathophysiology of GI Disorders 2 — Questions and Answers
Question 1: Hyperplastic polyps of the colon are generally considered to carry which level of malignant potential?
- High malignant potential similar to villous adenomas
- Low or negligible malignant potential (Correct answer)
- Moderate malignant potential
- Equal malignant potential to tubular adenomas
Correct answer: Low or negligible malignant potential
Hyperplastic polyps are generally considered to have low or negligible malignant potential, unlike adenomatous polyps which are true precancerous lesions.
Question 2: What histological type accounts for approximately 95% of all colorectal cancers?
- Squamous cell carcinoma
- Adenocarcinoma (Correct answer)
- Carcinoid tumor
- Signet ring cell carcinoma
Correct answer: Adenocarcinoma
Adenocarcinoma accounts for approximately 95% of colorectal cancers, arising from the glandular epithelial cells that line the colon and rectum.
Question 3: In the pathogenesis of acute pancreatitis, which enzyme's premature intrapancreatic activation initiates the cascade of autodigestion?
- Amylase
- Lipase
- Trypsin (Correct answer)
- Elastase
Correct answer: Trypsin
Premature activation of trypsinogen to trypsin within pancreatic acinar cells is the key initiating event in acute pancreatitis, as trypsin then activates other digestive enzymes causing autodigestion.
Question 4: Charcot's triad, the classic presentation of acute cholangitis, consists of fever, jaundice, and which third finding?
- Abdominal distension
- Right upper quadrant pain (Correct answer)
- Nausea and vomiting
- Clay-colored stools
Correct answer: Right upper quadrant pain
Charcot's triad consists of fever, jaundice, and right upper quadrant pain, representing biliary obstruction with superimposed bacterial infection of the biliary system.
Question 5: In liver cirrhosis, esophageal varices develop as a direct consequence of which pathophysiological process?
- Increased hepatic arterial inflow
- Portosystemic collateral circulation formation (Correct answer)
- Decreased plasma oncotic pressure
- Hepatic vein thrombosis
Correct answer: Portosystemic collateral circulation formation
Portal hypertension from cirrhosis forces blood through portosystemic collateral channels, including submucosal esophageal veins, which become engorged, dilated, and susceptible to rupture.
Question 6: Hepatitis B virus is primarily transmitted through which routes?
- Fecal-oral route and contaminated water
- Airborne respiratory droplets
- Parenteral exposure, sexual contact, and perinatal transmission (Correct answer)
- Insect vectors and contaminated food
Correct answer: Parenteral exposure, sexual contact, and perinatal transmission
Hepatitis B is transmitted through blood-to-blood contact (parenteral), sexual intercourse, and vertical (mother-to-infant) transmission, not through the fecal-oral route like hepatitis A.
Question 7: Esophageal varices most commonly develop in which location of the esophagus?
- Upper third of the esophagus
- Middle third of the esophagus
- Lower third of the esophagus (Correct answer)
- Throughout the esophagus equally
Correct answer: Lower third of the esophagus
Esophageal varices predominantly develop in the lower third of the esophagus where the portal and systemic venous systems communicate through submucosal veins, making this the highest-risk site for hemorrhage.
SGNA Pathophysiology of GI Disorders 2
Hyperplastic polyps of the colon are generally considered to carry which level of malignant potential?