The Medical Transcription Workbook, 3rd ed. Sample Chapter

The MedicalTranscriptionWorkbookHEALTH PROFESSIONS INSTITUTE

Third Edition

Section 1. Style and Usage

Section 2. Clinical Review A. Overview and General Review B. Integumentary System

C. Gastrointestinal System

D. Cardiovascular and Respiratory System

E. Ears, Nose, and Throat; Ophthalmology

F. Pediatrics, Genetics, and Immune System

G. Genitourinary and Male Reproductive System

H. Obstetrics and Gynecology; Endocrine System

I. Musculoskeletal System

J. Neurology and Psychiatric

K. Surgery

Section 3.Section 3. Professional Issues

The MedicalTranscriptionWorkbook

Third Edition

Health Professions InstituteModesto, California

Acknowledgments . . . . . . . . . . . . . . . . v

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Section

1. Style & Usage . . . . . . . . . . . . . . . . . . . 1

Grammar, Punctuation, and Style . . . . . . . . . 1Abbreviations . . . . . . . . . . . . . . . . . . . . . . . 2

Worksheet . . . . . . . . . . . . . . . . . . . . . . 4Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . 5Agreement of Subject and Verb . . . . . . . . . . . . 5

Worksheet . . . . . . . . . . . . . . . . . . . . . . 7Apostrophes . . . . . . . . . . . . . . . . . . . . . . . . 8

Worksheet . . . . . . . . . . . . . . . . . . . . . . 9Articles: A, An, The . . . . . . . . . . . . . . . . . . . 10Blood Pressure . . . . . . . . . . . . . . . . . . . . . . 10Brief Forms and Medical Slang . . . . . . . . . . . . 10

Acceptable or equivocal brief forms . . . . . . 11Unacceptable medical slang . . . . . . . . . . . . 11Worksheet . . . . . . . . . . . . . . . . . . . . . . 12

Capitalization . . . . . . . . . . . . . . . . . . . . . . 12Worksheet . . . . . . . . . . . . . . . . . . . . . . 13

Classifications . . . . . . . . . . . . . . . . . . . . . . 13Worksheet . . . . . . . . . . . . . . . . . . . . . . 14

Colons . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Worksheet . . . . . . . . . . . . . . . . . . . . . . 16

Commas . . . . . . . . . . . . . . . . . . . . . . . . . . 17Worksheet . . . . . . . . . . . . . . . . . . . . . . 20

Contractions . . . . . . . . . . . . . . . . . . . . . . . . 21Dashes . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Worksheet . . . . . . . . . . . . . . . . . . . . . . 22Dates . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Department Names as Entities . . . . . . . . . . . . 22Diacritical Marks . . . . . . . . . . . . . . . . . . . . 22Editing . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Worksheet . . . . . . . . . . . . . . . . . . . . . . 24Eponyms . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Worksheet . . . . . . . . . . . . . . . . . . . . . . 25Flagging Report . . . . . . . . . . . . . . . . . . . . . 25Format . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Worksheet . . . . . . . . . . . . . . . . . . . . . . 28

1. Style & Usage (continued)

Genus and Species . . . . . . . . . . . . . . . . . . . . 28Hyphens . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Worksheet . . . . . . . . . . . . . . . . . . . . . . 31Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Worksheet . . . . . . . . . . . . . . . . . . . . . . 35Obstetrics Terms . . . . . . . . . . . . . . . . . . . . . 37Parentheses . . . . . . . . . . . . . . . . . . . . . . . . 38

Worksheet . . . . . . . . . . . . . . . . . . . . . . 38Periods . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Worksheet . . . . . . . . . . . . . . . . . . . . . . 38Plurals . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Post, Status Post . . . . . . . . . . . . . . . . . . . . . 39Pronouns . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Worksheet . . . . . . . . . . . . . . . . . . . . . . 40Proofreading . . . . . . . . . . . . . . . . . . . . . . . 41Question Marks . . . . . . . . . . . . . . . . . . . . . 41

Worksheet . . . . . . . . . . . . . . . . . . . . . . 41Quotation Marks . . . . . . . . . . . . . . . . . . . . . 41Ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Score . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Semicolons . . . . . . . . . . . . . . . . . . . . . . . . 42

Worksheet . . . . . . . . . . . . . . . . . . . . . . 42Slang . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43Slash Mark . . . . . . . . . . . . . . . . . . . . . . . . 43Spelling and Usage . . . . . . . . . . . . . . . . . . . 43

Worksheet . . . . . . . . . . . . . . . . . . . . . . 46Subject-Verb Agreement . . . . . . . . . . . . . . . . 47Subscripts and Superscripts . . . . . . . . . . . . . . 47Suture Sizes . . . . . . . . . . . . . . . . . . . . . . . . 48Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Worksheet . . . . . . . . . . . . . . . . . . . . . . 49Templates . . . . . . . . . . . . . . . . . . . . . . . . . 49Tense . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49That, Which . . . . . . . . . . . . . . . . . . . . . . . . 49Units of Measure . . . . . . . . . . . . . . . . . . . . 49Verbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Vertebrae . . . . . . . . . . . . . . . . . . . . . . . . . 49Virgule . . . . . . . . . . . . . . . . . . . . . . . . . . . 50Visual Acuity . . . . . . . . . . . . . . . . . . . . . . . 50

ix

Contents

Section

2. Clinical Review . . . . . . . . . . . . . . . . . 51

A. Overview and GeneralReview . . . . . . . . . . . . . . . . . . . . . . . 53

Anatomy & PhysiologyBody Organization . . . . . . . . . . . . . . 53

Medical TerminologyGeneral Suffixes and Prefixes . . . . . . . 54Plurals . . . . . . . . . . . . . . . . . . . . . 54Slang Terms . . . . . . . . . . . . . . . . . . 55General Medical Terminology Challenge 55Radiology Imaging Terminology

Challenge . . . . . . . . . . . . . . . . . 56General Laboratory . . . . . . . . . . . . . . . 57General Pathology . . . . . . . . . . . . . . . . 60General Radiology . . . . . . . . . . . . . . . . 61General Pharmacology . . . . . . . . . . . . . 62Abbreviations . . . . . . . . . . . . . . . . . . . 62

Credentials, Degrees, and OrganizationAbbreviations . . . . . . . . . . . . . . 62

Measurement, Dosage, and TimeAbbreviations . . . . . . . . . . . . . . 63

General Medical Abbreviations . . . . . . 63Radiology Imaging Abbreviations . . . . . 64Laboratory and Pathology Abbreviations 65

Radiology Drugs . . . . . . . . . . . . . . . . . 66

B. Integumentary System . . . . . . . 69

Anatomy & Physiology of Cells and Tissues . . 69Anatomy & Physiology of the Integumentary

System . . . . . . . . . . . . . . . . . . . . . 69Integumentary System Terminology

Challenge . . . . . . . . . . . . . . . . . . . 71Pathophysiology of the Integumentary System . 72Integumentary System Laboratory . . . . . . . . 73Integumentary System Drugs . . . . . . . . . . 75

C. Gastrointestinal System . . . . . . 77

Anatomy & Physiology of the GastrointestinalSystem . . . . . . . . . . . . . . . . . . . . . 77

Gastrointestinal System TerminologyChallenge . . . . . . . . . . . . . . . . . . . 79

Gastrointestinal System Abbreviations . . . . . 80Pathophysiology of the Gastrointestinal System 81Gastrointestinal System Laboratory . . . . . . . 83Gastrointestinal System Drugs . . . . . . . . . . 84

C. Cardiovascular & RespiratorySystem . . . . . . . . . . . . . . . . . . . . . . . 87

Anatomy & Physiology of the CardiovascularSystem . . . . . . . . . . . . . . . . . . . . . 88

Anatomy & Physiology of the RespiratorySystem . . . . . . . . . . . . . . . . . . . . . 88

Cardiovascular System TerminologyChallenge . . . . . . . . . . . . . . . . . . . 89

Cardiovascular System Abbreviations . . . . . 91Respiratory System Terminology Challenge . 91Respiratory System Abbreviations . . . . . . . 93Pathophysiology of the Cardiovascular System 94Pathophysiology of the Respiratory System . . 96Cardiovascular System Laboratory . . . . . . . 98Respiratory System Laboratory . . . . . . . . . 99Cardiovascular System Drugs . . . . . . . . . 100Respiratory System Drugs . . . . . . . . . . . . 101

E. Otorhinolaryngology &Ophthalmology . . . . . . . . . . . . . . . 103

Anatomy & Physiology of the Ears, Nose,and Throat . . . . . . . . . . . . . . . . . . . 103

Anatomy & Physiology of the Eyes . . . . . . 104Otorhinolaryngology Terminology

Challenge . . . . . . . . . . . . . . . . . . . . 105Ophthalmology Abbreviations . . . . . . . . . . 108Pathophysiology of the Ears, Nose, and

Throat . . . . . . . . . . . . . . . . . . . . . . 108Pathophysiology of the Eyes . . . . . . . . . . . 110Otorhinolaryngology Laboratory . . . . . . . . 111Ophthalmology Laboratory . . . . . . . . . . . . 112Otorhinolaryngology Drugs . . . . . . . . . . . 112Ophthalmology Drugs . . . . . . . . . . . . . . . 114

F. Pediatrics, Genetics, &Immune System . . . . . . . . . . . . . . 117

Anatomy & Physiology of the Immune System 117Immune System, Genetics, & Oncology

Terminology Challenge . . . . . . . . . . . . . 118Immune System, Genetics, & Oncology

Abbreviations . . . . . . . . . . . . . . . . . . . 120Pathophysiology of the Immune System . . . . . 120Immune System, Oncology, and Genetics

Laboratory . . . . . . . . . . . . . . . . . . . . 122Immune System Drugs . . . . . . . . . . . . . . . . 123

x

G. Genitourinary & MaleReproductive System . . . . . . . . . 125

Anatomy & Physiology of the Urinary System . 125Anatomy & Physiology of the Male

Reproductive System . . . . . . . . . . . . . . 126Urinary System Terminology Challenge . . . . . 127Male Reproductive System Terminology

Challenge . . . . . . . . . . . . . . . . . . . . . 129Genitourinary System Abbreviations . . . . . . . 129Pathophysiology of the Genitourinary

System . . . . . . . . . . . . . . . . . . . . . . . 129Genitourinary System Laboratory . . . . . . . . . 131Genitourinary System Drugs . . . . . . . . . . . . 132

H. Obstetrics & Gynecology;Endocrine System . . . . . . . . . . . . 135

Anatomy & Physiology of the FemaleReproductive System . . . . . . . . . . . . . . 135

Anatomy & Physiology of the EndocrineSystem . . . . . . . . . . . . . . . . . . . . . . . 137

Female Reproductive System TerminologyChallenge . . . . . . . . . . . . . . . . . . . . . 138

Female Reproductive System Abbreviations . . . 139Endocrine System Terminology Challenge . . . 140Endocrine System Abbreviations . . . . . . . . . . 140Pathophysiology of the Female Reproductive

System . . . . . . . . . . . . . . . . . . . . . . . 141Pathophysiology of the Endocrine System . . . . 143Female Reproductive System Laboratory . . . . 145Endocrine System Laboratory . . . . . . . . . . . 146Female Reproductive System Drugs . . . . . . . 147Endocrine System Drugs . . . . . . . . . . . . . . 148

I. Musculoskeletal System . . . . . . 151

Anatomy & Physiology of the MusculoskeletalSystem . . . . . . . . . . . . . . . . . . . . . . 151

Musculoskeletal System TerminologyChallenge . . . . . . . . . . . . . . . . . . . . . 153

Musculoskeletal System Abbreviations . . . . . . 155Pathophysiology of the Musculoskeletal

System . . . . . . . . . . . . . . . . . . . . . . . 155Musculoskeletal System Laboratory . . . . . . . . 157Musculoskeletal System Drugs . . . . . . . . . . . 158

J. Neurology & Psychiatric . . . . . . 161

Anatomy & Physiology of the NervousSystem . . . . . . . . . . . . . . . . . . . . . . . 161

Nervous System Terminology Challenge . . . . . 163Nervous System Abbreviations . . . . . . . . . . . 164Psychiatric Terminology . . . . . . . . . . . . . . . 164Psychiatric Abbreviations . . . . . . . . . . . . . . 165Pathophysiology of the Nervous System . . . . . 166Nervous System Laboratory . . . . . . . . . . . . 168Pathophysiology of the Psyche . . . . . . . . . . . 169Nervous System Drugs . . . . . . . . . . . . . . . . 170

K. Surgery . . . . . . . . . . . . . . . . . . . . . . 173

General Surgery . . . . . . . . . . . . . . . . . . 173Anesthesia . . . . . . . . . . . . . . . . . . . . . . 175Anesthesia Drugs . . . . . . . . . . . . . . . . . 175Surgery on the Integumentary System . . . . . 177Surgery on the Genitourinary System . . . . . 178Surgery on the Gastrointestinal System . . . . 179Surgery on the Musculoskeletal System . . . . 181Surgery on the Cardiovascular System . . . . 182Surgery on the Respiratory System . . . . . . 184Surgery on the Female Reproductive System 185Surgery on the Ears, Nose, and Throat . . . . 187Surgery on the Eyes . . . . . . . . . . . . . . . . 188Surgery on the Nervous System . . . . . . . . 190

3. Professional Issues . . . . . . . . . . . . . 193

The Medical Transcription Professional . . . . . 193Worksheet . . . . . . . . . . . . . . . . . . . . . . 194

The Healthcare Record . . . . . . . . . . . . . . . . 194Purpose of the Healthcare Record . . . . . . . 194Entries in the Healthcare Record . . . . . . . . 195Reports in the Healthcare Record . . . . . . . 196Worksheet . . . . . . . . . . . . . . . . . . . . . 196

Confidentiality of the Healthcare Record . . . . 197HIPAA (Health Insurance Portability and

Accountability Act) . . . . . . . . . . . . . 197HIPAA Compliance by Elaine Olson . . . . . 198Worksheet . . . . . . . . . . . . . . . . . . . . . . 199Case Studies in Confidentiality . . . . . . . . . 199Worksheet . . . . . . . . . . . . . . . . . . . . . . 201

xi

3. Professional Issues (continued)

Dictated Medical Reports . . . . . . . . . . . . . . 202Physician Office and Clinic Reports . . . . . . 202

Sample Initial Evaluation . . . . . . . . . . 202The History . . . . . . . . . . . . . . . . . . . . . 203

Sample Chart Notes . . . . . . . . . . . . . 203Typical Standard Outline for History

and Physical Examination Report . . 204The Physical Examination . . . . . . . . . . . . 205

Sample History and Physical Report . . . 207Worksheet . . . . . . . . . . . . . . . . . . . . . . 209Surgery and the Operative Report . . . . . . . 210

Sample Operative Report . . . . . . . . . . 212Worksheet . . . . . . . . . . . . . . . . . . . . . . 213

Transcription Practices . . . . . . . . . . . . . . . . 214Dictation and Transcription:

Adventures in Thought Transferenceby John H. Dirckx, M.D. . . . . . . . . . . . 214

Worksheet . . . . . . . . . . . . . . . . . . . . . . 216Pronounced Differences

by John H. Dirckx, M.D. . . . . . . . . . 217Worksheet . . . . . . . . . . . . . . . . . . . . . . 219Transcribing for the ESL Dictator

by Susan Dooley and Ellen Drake . . . . 220Sounds to Listen For . . . . . . . . . . . . 221

Worksheet . . . . . . . . . . . . . . . . . . . . . . 222Risk Management . . . . . . . . . . . . . . . . . 222

Incident . . . . . . . . . . . . . . . . . . . . . 223Leaving a Blank . . . . . . . . . . . . . . . 224How to Edit . . . . . . . . . . . . . . . . . . 225

Worksheet . . . . . . . . . . . . . . . . . . . . . . 225Proofreading and Editing . . . . . . . . . . . . . 226

Clear Communication . . . . . . . . . . . . 226Editing Tips . . . . . . . . . . . . . . . . . . 227The Final Report . . . . . . . . . . . . . . . 228

Flagging Medical Documents . . . . . . . . . . 229Sample Preprinted Flag . . . . . . . . . . . 230

Quality Assurance . . . . . . . . . . . . . . . . . 230Worksheet . . . . . . . . . . . . . . . . . . . . . . 230

Quality . . . . . . . . . . . . . . . . . . . . . 231

3. Professional Issues (continued)

Transcription Practices (continued)Productivity . . . . . . . . . . . . . . . . . . . . . 231

Tracking Productivity . . . . . . . . . . . . 232Compensation . . . . . . . . . . . . . . . . . . . . 232

Does Money Matter? . . . . . . . . . . . . 233Worksheet . . . . . . . . . . . . . . . . . . . . . . 233

Electronic Resources . . . . . . . . . . . . . . . . . 234Developing Critical Literacy

by Georgia Green . . . . . . . . . . . . . . 234Worksheet . . . . . . . . . . . . . . . . . . . . . . 235There’s Something About E-mail

by Georgia Green . . . . . . . . . . . . . . 235E-mail Do’s and Don’ts . . . . . . . . . . . . . 238E-mail Security and Encryption Basics

by Mike DeTuri . . . . . . . . . . . . . . . 239Security Is Not a Four-letter Word

by Mike DeTuri . . . . . . . . . . . . . . . 241E-Sense: What You Don’t Know CAN

Hurt You! by Julianne Weight . . . . . . . 242Worksheet . . . . . . . . . . . . . . . . . . . . . . 244

Health in the Workplace . . . . . . . . . . . . . . . 245Avoiding Work-Related Injuries

by Elaine Aamodt Abba . . . . . . . . . . . 245How to Avoid Carpal Tunnel Syndrome 246

Worksheet . . . . . . . . . . . . . . . . . . . . . . 247In the Slalom of Living, Balance Is Direction

by Adrienne C. Yazijian . . . . . . . . . . 247Zen and the Art of Medical Transcription

by Kathryn Stewart . . . . . . . . . . . . . 248Working . . . A Lot More Than a Necessary

Evil by Adrienne C. Yazijian . . . . . . . 249Worksheet . . . . . . . . . . . . . . . . . . . . . . 250

Professionalism at Its Best . . . . . . . . . . . . . . 250Your Professional Image . . . . . . . . . . . . . 250Networking . . . . . . . . . . . . . . . . . . . . . 251Worksheet . . . . . . . . . . . . . . . . . . . . . . 252

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . 253

xii

Anatomy & Physiologyof the Gastrointestinal System

Arrange the following anatomic structures in order to showthe pathway of digestion. Begin with the oral cavity.

oral cavity pharynx duodenumsigmoid colon stomach ileumjejunum descending colon rectumesophagus cecum anusascending colon transverse colon

1. oral cavity

2. _______________________________________________

3. _______________________________________________

4. _______________________________________________

5. _______________________________________________

6. _______________________________________________

7. _______________________________________________

8. _______________________________________________

9. _______________________________________________

10. _______________________________________________

11. _______________________________________________

12. _______________________________________________

13. _______________________________________________

14. _______________________________________________

77

Fill in the blanks with the correct answer. Some answersmay require more than one word.

15. The ______________________________ serves as a

common passageway for air moving from the nose to the

trachea and for food moving from the oral cavity to the

stomach.

16. The opening that leads from the mouth and into the

oropharynx is called the_________________________.

17. The two sphincters in the wall of the anal canal that

guard the anal opening are called

______________________________________________

______________________________________________

18. The pancreas is both an ________________________

and an ____________________________ gland.

19. The three glands that release saliva are

______________________________________________

______________________________________________

______________________________________________

20. Millions of microscopic fingerlike __________________

line the walls of the small intestine.

Gastrointestinal System

C MEDICAL

TRANSCRIPTION

Match the letter of the definitions in the right columnwith the correct anatomy words in the left column.

____ 21. colon

____ 22. deglutition

____ 23. appendix

____ 24. bile

____ 25. common bile duct

____ 26. duodenum

____ 27. bowel

____ 28. ileum

____ 29. sigmoid colon

____ 30. esophagus

____ 31. stomach

____ 32. pharynx

____ 33. gallbladder

____ 34. liver

____ 35. jejunum

____ 36. feces

____ 37. insulin

____ 38. pancreas

____ 39. anus

____ 40. bilirubin

____ 41. cecum

____ 42. parotid

____ 43. enzyme

____ 44. amino acids

____ 45. mastication

____ 46. saliva

78CLINICAL REVIEW

Choose the letter of the correct answer in each of the fol-lowing multiple-choice questions.

____ 47. The hormone that stimulates the gallbladder tocontract and release bile isA. insulinB. lipaseC. cholecystokininD. maltase

____ 48. The liver removes excess glucose from thebloodstream, storing it in liver cells asA. pepsinB. fatty acidsC. glycogenD. triglycerides

____ 49. The parotid gland is locatedA. near the earB. behind the liverC. under the tongueD. next to the pancreas

____ 50. The substance produced by the stomach that isnecessary for digestion isA. hydrochloric acidB. dentinC. amylaseD. chyme

____ 51. The vermiform appendixA. digests cellulose in vegetablesB. is a vestigial structureC. stores vital appendicolithsD. incubates bacteria that can break down food

particles

____ 52. Which of the following is NOT a function of thelarge intestine?A. absorption of sodium and waterB. incubation of bacteriaC. elimination of wastesD. storage of iron and other vitamins

____ 53. What is the function of a sphincter?A. to close a passageB. to act as a catalystC. to release nutrientsD. to open a valve

____ 54. Most chemical digestion takes place within theA. mouthB. duodenumC. small bowelD. large bowel

A. lower part of the colonshaped like an S.

B. organ that stores bileC. the large intestineD. first part of large intestineE. digestive juice produced

by salivary glandsF. produces insulinG. swallowingH. pigment in bileI. salivary gland near earJ. blind pouch hanging

from first part of colonK. throatL. hormone that transports

sugar into cellsM. speeds up reactions

between substancesN. digestive juice made

in liverO. building blocks of

proteinsP. second part of small

intestineQ. third part of small

intestineR. tube connecting the

throat and stomachS. organ that receives food

from the esophagusT. first part of small

intestineU. intestineV. opening of digestive tract

to outside of the bodyW. chewingX. carries bile from liver

and gallbladder to duo-denum

Y. another word for “stool”Z. organ that secretes bile

and destroys old red cells

79

The suffix -itis refers to inflammation. Change each of theentries below to indicate inflammation of the anatomicstructure.

27. jejunum jejunitis

28. kidney ___________________________

29. colon ___________________________

30. duodenum ___________________________

31. esophagus ___________________________

32. gallbladder ___________________________

33. ileum ___________________________

34. liver ___________________________

35. stomach ___________________________

36. pancreas ___________________________

37. appendix ___________________________

38. peritoneum ___________________________

39. common bile duct ___________________________

40. spleen ___________________________

41. bowel ___________________________

42. stomach + intestines ___________________________

43. tongue ___________________________

44. pharynx ___________________________

45. rectum ___________________________

Choose the correct answer in each of the following multiple-choice questions. Write the letter of your answer in thespace provided.

____ 46. The term for the serosal membrane that lines theabdominopelvic walls isA. perineumB. pterionC. peroniaD. peritoneum

____ 47. A papilla is aA. tiny hair-like projectionB. nipple-like elevationC. ridgeD. blind pouch

____ 48. Which of the following is the medical term for arumbling, gurgling noise in the stomach andintestines?A. borborygmusB. belchC. flatusD. eructation

Gastrointestinal SystemTerminology Challenge

Match the prefix in the left column with a related term in

the right column.

____ 1. cheilo-

____ 2. colo-

____ 3. procto-

____ 4. pharyngo-

____ 5. hepato-

____ 6. oro-

____ 7. duodeno-

____ 8. ceco-

____ 9. sigmoido-

____10. celio-

____ 11. colono-

____12. pancreato-

____13. bucco-

____14. peritoneo-

____15. laparo-

____16. jejuno-

____17. stomato-

____18. gastro-

____19. esophago-

____20. bili-

____21. litho-

____22. steato-

____23. amylo-

____24. ileo-

____25. chole-

____26. entero-

GASTROINTESTINAL SYSTEM

A. peritoneum

B. abdomen or belly

C. cecum

D. bile

E. small intestine

F. cheek

G. esophagus

H. lip

I. throat

J. fat

K. colon or large intestine

L. stomach

M. anus

N. stone

O. ileum

P. duodenum

Q. sigmoid colon

R. liver

S. pancreas

T. mouth

U. jejunum

V. starch

W. esophagus

Gastrointestinal System Abbreviations

Translate the following abbreviations and brief forms.

1. alk phos alkaline phosphatase

2. GE reflux ___________________________________

3. BE ___________________________________

4. ALT ___________________________________

5. LFTs ___________________________________

6. PUD ___________________________________

7. UGI ___________________________________

8. GE junction ___________________________________

9. EGD ___________________________________

10. NG ___________________________________

11. GB ___________________________________

12. GERD ___________________________________

13. GI ___________________________________

14. IBD ___________________________________

15. AST ___________________________________

16. LDH ___________________________________

17. CAT scan ___________________________________

18. ERCP ___________________________________

19. n.p.o. ___________________________________

20. NSAIDs ___________________________________

21. BRAT diet ___________________________________

22. TPN ___________________________________

23. CBD ___________________________________

24. KUB ___________________________________

25. O&P ___________________________________

26. RUQ ___________________________________

27. RLQ ___________________________________

28. LUQ ___________________________________

29. LLQ ___________________________________

30. CEA ___________________________________

31. IBS ___________________________________

80CLINICAL REVIEW

____ 49. Choose the best definition for the word celiacA. pertaining to the stomachB. pertaining to the small intestineC. pertaining to part of the large intestineD. pertaining to the abdomen

____ 50. The adjective that describes a fluid wave in theabdomen isA. asceticB. acidicC. asthenicD. ascitic

____ 51. Rugae areA. projectionsB. contractionsC. ringsD. wrinkles

____ 52. Postprandial pain is experienced afterA. wakingB. sleepingC. eatingD. belching

____ 53. The movement that propels food from the esophagusto the stomach is termedA. peristalsisB. deglutitionC. absorptionD. digestion

Fill in the blanks with the correct answers. Some answersmay require more than one word.

27. Diarrhea often results in rapid transit of food through the

______________________________.

28. A patient with constipation is usually advised to eat foods

that are high in __________________________________.

29. ________________________________________ is a

disease manifested by chronic inflammation of the colon

with the presence of ulcers.

30. Inflammation of the liver caused by a virus is

_________________________________________.

31. A diet high in animal fat, postulated to cause the pro-

duction of certain carcinogens, is suspected of causing

_________________________________________cancer.

32. _____________________ is the medical term for vomiting.

33. Projectile vomiting in an infant during feeding is sympto-

matic of the condition ____________________________.

34. Peptic ulcers were once thought to be caused by stress and

lifestyle. However, today we know that most peptic ulcers

are caused by __________________________.

35. ________________ is the burning sensation caused by the

regurgitation of hydrochloric acid from the stomach into the

esophagus.

36. A condition that occurs when the upper part of the stom-

ach protrudes through the esophageal opening in the

diaphragm, often causing symptoms of gastroesophageal

reflux, is ______________________________________.

37. The pain that results when a gallstone blocks the excretion

of bile is called biliary ____________________________.

38. When a patient receives nourishment other than through

the alimentary canal, it is referred to as _______________

nutrition.

39. A fecalith is a stonelike mass of hardened

____________________________________________.

40. Fever, tachycardia, and rebound tenderness over

McBurney point are symptomatic of _________________.

Pathophysiology of theGastrointestinal System

Match the terms in the left column with their correct def-initions in the right column.

____ 1. anorexia

____ 2. diarrhea

____ 3. ascites

____ 4. melena

____ 5. hematochezia

____ 6. reflux

____ 7. flatus

____ 8. dysphagia

____ 9. colic

____ 10. jaundice

____ 11. nausea

____ 12. polyposis

____ 13. achalasia

____ 14. fistula

____ 15. stomatitis

____ 16. diverticulum

____ 17. esophagealvarices

____ 18. ulcer

____ 19. cholelithiasis

____ 20. hemorrhoids

____ 21. hernia

____ 22. cirrhosis

____ 23. volvulus

____ 24. ileus

____ 25. irritable bowelsyndrome

____ 26. intussusception

81 GASTROINTESTINAL SYSTEM

A. gas expelled per rectumB. a feeling as if one is going

to vomitC. prolonged esophageal tight-

eningD. loss of appetiteE. twisting of intestine upon

itselfF. varicose veins in the anal

regionG. bright red blood per rectumH. dilated veins at lower end of

esophagusI. abnormal passageway near

the anusJ. painful swallowingK. intestinal obstructionL. abnormal outpouching in

intestinal wallM. spastic colonN. abnormal accumulation of

fluid in the abdomenO. telescoping of the intestinesP. erosion of tissueQ. backward flow of solids and

fluidsR. very loose stoolsS. protrusion of organ through

muscleT. small growths protruding

from colonic membraneU. inflammation of the mouthV. tarry stools containing bloodW. degeneration of liver cellsX. icterusY. gallstonesZ. acute abdominal pain

____ 47. Most cases of this disease occur in alcoholics or inpersons with chronic biliary tract disease such ascholelithiasis and cholecystitis:A. cirrhosisB. pancreatitisC. hepatitisD. peritonitis

____ 48. A common hernia of infancy in which the abdomi-nal contents protrude at the navel is classified as atype ofA. hiatal herniaB. femoral herniaC. esophageal herniaD. abdominal hernia

____ 49. Transformation of normal esophageal squamousepithelium into columnar epithelium is character-istic ofA. esophageal refluxB. esophageal strictureC. Barrett esophagusD. esophageal varices

____ 50. A pancreatic tumor that produces excessive amountsof the hormone gastrin, thus causing hypersecretionof gastric acid, is characteristic ofA. Cronkhite-Canada syndromeB. Zollinger-Ellison syndromeC. Courvoisier-Terrier syndromeD. Budd-Chiari syndrome

____ 51. Which of the following is a pseudo-obstruction ofthe bowel?A. Ogilvie syndromeB. volvulusC. intussusceptionD. mechanical ileus

____ 52. The treatment of choice for peptic ulcer diseasecaused by Helicobacter pylori isA. restB. antibioticsC. ulcer dietD. antacids

____ 53. Congenital megacolon (dilatation and hypertrophyof the colon) is also known asA. Treacher-Collins syndromeB. Zenker diverticulumC. Crohn diseaseD. Hirschsprung disease

82CLINICAL REVIEW


____ 41. Which form of hepatitis is acute but self-limitedand not likely to cause complications or serioussequelae?A. hepatitis AB. hepatitis BC. hepatitis CD. hepatitis D

____ 42. In a patient with a bleeding peptic ulcer, one wouldexpect the patient’s stools to beA. streaked with bright red bloodB. clay-coloredC. blackD. chalky

____ 43. A chronic relapsing disease that causes inflamma-tion with diarrhea, cramping, and fever, and whichaffects the terminal ileum isA. Crohn diseaseB. irritable bowel syndromeC. diverticulitisD. dysentery

____ 44. A chronic disorder of the liver characterized byinflammation of secretory cells followed by nodu-lar regeneration and fibrosis is named for whichperson?A. LasègueB. LhermitteC. LaugierD. Laënnec

____ 45. Increase in pressure in the portal vein is known asA. choledochoceleB. portacaval syndromeC. choledochochitisD. portal hypertension

____ 46. A 40-year-old overweight female with a long his-tory of yo-yo dieting presents with severe, acutecolicky pain in the right upper quadrant and epi-gastric area radiating through to her back. This issymptomatic of what digestive system disease?A. chronic pancreatitisB. acute cholecystitisC. chronic hepatitisD. acute appendicitis

Gastrointestinal System Laboratory

Match the disease with the description of the diagnosticfindings by filling in the blank with the correct letter.

A. hepatitis CB. irritable bowel syndromeC. appendicitisD. gastroesophageal reflux diseaseE. chronic pancreatitisF. Crohn diseaseG. acute peritonitisH. adynamic ileus

____ 1. Patient has recurrent bouts of left upper quadrantpain. Sugar is elevated in both urine and blood as aresult of diabetes mellitus due to slow destruction ofpancreatic tissue. Pancreatic lipase and amylase areelevated. Abdominal x-ray shows widening of thecurve of the duodenum due to pancreatic edema.

____ 2. Abdominal x-ray shows distended loops of smallbowel and fluid levels. Bowel sounds are absent.

____ 3. Patient gives a long history of pyrosis. Imagingstudies confirm reflux of swallowed barium fromthe stomach, with ulceration and stricture.Endoscopy gives visual proof of inflammation.

____ 4. Patient gives history of being hit violently in theabdomen with resultant acute abdominal pain. WBCis elevated; blood studies show electrolyte imbal-ance and anemia. Fluid obtained via paracentesisshows amylase or lipase. Imaging identifies intra-abdominal catastrophe.

____ 5. Carriers of this chronic disease are identified byserologic testing.

____ 6. Patient gives history of bowel urgency and diarrheaafter meals, worse with caffeine ingestion. Stoolexams, barium enema, colonoscopy, and blood stud-ies are all negative.

____ 7. Patient gives history of recurrent crampy abdominalpain and fatty stools. WBC and ESR are elevated.Barium enema shows “string sign.” Endoscopyshows inflammation and “skip” areas.

____ 8. Patient has exquisite right lower quadrant pain.WBC is elevated with shift to the left. Abdominalimaging shows opacity in the appendiceal lumen.Barium per rectum fails to fill the appendix.



____ 9. In hepatitis A infection, which antibody appearsearly in the course of the disease and then disap-pears; which develops later and persists indefi-nitely?A. IgE appears early; IgM appears laterB. IgM appears early; IgE appears laterC. IgM appears early; IgG develops laterD. IgE appears early; IgG develops later

____ 10. The presence of HBSAg after the acute phase ofwhich illness suggests chronic infection?A. hepatitis AB. hepatitis BC. hepatitis CD. hepatic cirrhosis

____ 11. Which of the following is NOT a pathogen?A. protozoaB. fungiC. toxinsD. viruses

____ 12. Infestation with the pathogen Campylobacter is knownto cause severe diarrhea, fever, nausea, and vomiting.By which route is this pathogen transmitted?A. fecal-oralB. airborneC. sexualD. droplet

____ 13. The pathogen Giardia lamblia, which causes vom-iting and diarrhea and can disseminate in personswith AIDS, is aA. bacteriumB. parasiteC. fungusD. yeast

____ 14. Stool for ova and parasites would be ordered forsuspicion ofA. hepatitis CB. peptic esophagitisC. GERDD. amebiasis

____ 15.What food should be avoided to prepare for occultblood test of the stool?A. fibrous vegetablesB. milk productsC. meatD. nuts and seeds

Gastrointestinal System Drugs

The following gastrointestinal drugs are listed by brandname. In the space provided, list the corresponding genericname and short description of the drug.

1. Tagamet cimetidine—H2 antagonist

2. Zelnorm _______________________________________

3. Donnatal ______________________________________

4. Levsin ________________________________________

5. Anusol-HC suppository __________________________

6. Mylanta _______________________________________

7. Phenergan______________________________________

8. Tigan suppository _______________________________

9. Mylicon _______________________________________

10. Lomotil _______________________________________

11. Nexium _______________________________________

12. Reglan ________________________________________

13. Dulcolax tablets ________________________________

14. Azulfidine _____________________________________

15. Surfak ________________________________________

16. Carafate _______________________________________

17. Metamucil _____________________________________

18. Axid __________________________________________

19. Prevacid _______________________________________

20. Prilosec _______________________________________

21. Pepcid AC _____________________________________

22. Di-Gel ________________________________________

23. Transderm Scop _________________________________

24. Maalox ________________________________________

25. Zantac ________________________________________


____ 26. H2 blockers work byA. neutralizing stomach acidB. preventing the release of stomach acidC. slowing peristalsisD. inhibiting the formation of prostaglandins

84CLINICAL REVIEW

____ 16. In which gastrointestinal disorder is the AST likelyto be elevated?A. hemorrhoidsB. pancreatitisC. herniaD. gastroesophageal reflux

____ 17. Lactic dehydrogenase, which is elevated in somegastrointestinal disorders, is normally belowA. 110 U/LB. 150 U/LC. 180 U/LD. 200 U/L

____ 18. The low normal for the ALT enzyme isA. 8B. 80C. 180D. 280

____ 19. The alkaline phosphatase level is normallyA. undetectable in childrenB. undetectable in adultsC. lower in children than adultsD. higher in children than adults

____ 20. Significant change in the serum amylase level isdiagnostic of a disorder of which organ?A. liverB. gallbladderC. bile ductD. pancreas

____ 21. Which of the following is an abnormal finding onmicroscopic examination of stool?A. helminthsB. bacteriaC. muscle fibersD. fat

____ 22. A finding of excessive fat in the feces on stool spec-imen suggestA. starvationB. intestinal bleedingC. malabsorptionD. peptic ulcer disease

____ 27. An example of a laxative isA. GavisconB. PrilosecC. TagametD. Senokot

____ 28. A common therapeutic gastrointestinal side effectof opiate drugs isA. gastroesophageal refluxB. diarrheaC. constipationD. coffee grounds emesis

____ 29. Scopolamine is NOT used to treatA. esophageal varicesB. motion sicknessC. stomach distressD. irritable colon

____ 30. Aluminum, magnesium, and calcium salts areactive ingredients inA. antiemeticsB. antacidsC. anthelminticsD. antidiarrheals

____ 31. The active ingredient in a Fleet enema isA. bariumB. sodium phosphatesC. potassiumD. aspidium

____ 32. Tucks pads are used forA. cleansing the perianal areaB. colostomy coveringC. wound dressingD. truss padding

____ 33. The active ingredient in Preparation H rectal suppos-itories isA. witch hazelB. lidocaineC. benzocaineD. shark liver oil

____ 34. Which of the following is NOT an indication forPepto-Bismol?A. constipationB. nausea and vomitingC. indigestionD. traveler’s diarrhea

____ 35. Compazine is indicated forA. constipationB. diarrheaC. nausea and vomitingD. indigestion

____ 36. Gastrointestinal infestation with Giardia lamblia maybe treated withA. VermoxB. FlagylC. BiaxinD. Azulfidine

____ 37. Treatment of Crohn’s disease includes low-fiber diet,specific anti-inflammatory drugs, and medication toA. reduce intestinal motilityB. increase intestinal motilityC. stop gastroesophageal refluxD. prevent vomiting

____ 38. Which of the following drugs would NOT be used totreat nausea and vomiting caused by cancerchemotherapy?A. AloxiB. CesametC. EmendD. Mexitil

____ 39. An example of a bulk-producing laxative isA. Phillips Milk of MagnesiaB. Dulcolax tabletsC. CitrucelD. Ex-Lax

____ 40. The active ingredient in Tums antacid isA. sodiumB. calcium carbonateC. magnesiumD. aluminum

____ 41. Which of the following drugs would NOT be part ofa chemotherapy regimen to eradicate Helicobacterpylori?A. BiaxinB. HelidacC. Pilopine HSD. Zegerid


Anatomy & Physiologyof the Gastrointestinal System

Arrange the following anatomic structures in order to showthe pathway of digestion. Begin with the oral cavity.

oral cavity pharynx duodenumsigmoid colon stomach ileumjejunum descending colon rectumesophagus cecum anusascending colon transverse colon

1. oral cavity

2. _______________________________________________

3. _______________________________________________

4. _______________________________________________

5. _______________________________________________

6. _______________________________________________

7. _______________________________________________

8. _______________________________________________

9. _______________________________________________

10. _______________________________________________

11. _______________________________________________

12. _______________________________________________

13. _______________________________________________

14. _______________________________________________

77

Fill in the blanks with the correct answer. Some answersmay require more than one word.

15. The ______________________________ serves as a

common passageway for air moving from the nose to the

trachea and for food moving from the oral cavity to the

stomach.

16. The opening that leads from the mouth and into the

oropharynx is called the_________________________.

17. The two sphincters in the wall of the anal canal that

guard the anal opening are called

______________________________________________

______________________________________________

18. The pancreas is both an ________________________

and an ____________________________ gland.

19. The three glands that release saliva are

______________________________________________

______________________________________________

______________________________________________

20. Millions of microscopic fingerlike __________________

line the walls of the small intestine.

Gastrointestinal System

C MEDICAL

TRANSCRIPTION

Match the letter of the definitions in the right columnwith the correct anatomy words in the left column.

____ 21. colon

____ 22. deglutition

____ 23. appendix

____ 24. bile

____ 25. common bile duct

____ 26. duodenum

____ 27. bowel

____ 28. ileum

____ 29. sigmoid colon

____ 30. esophagus

____ 31. stomach

____ 32. pharynx

____ 33. gallbladder

____ 34. liver

____ 35. jejunum

____ 36. feces

____ 37. insulin

____ 38. pancreas

____ 39. anus

____ 40. bilirubin

____ 41. cecum

____ 42. parotid

____ 43. enzyme

____ 44. amino acids

____ 45. mastication

____ 46. saliva

78CLINICAL REVIEW

Choose the letter of the correct answer in each of the fol-lowing multiple-choice questions.

____ 47. The hormone that stimulates the gallbladder tocontract and release bile isA. insulinB. lipaseC. cholecystokininD. maltase

____ 48. The liver removes excess glucose from thebloodstream, storing it in liver cells asA. pepsinB. fatty acidsC. glycogenD. triglycerides

____ 49. The parotid gland is locatedA. near the earB. behind the liverC. under the tongueD. next to the pancreas

____ 50. The substance produced by the stomach that isnecessary for digestion isA. hydrochloric acidB. dentinC. amylaseD. chyme

____ 51. The vermiform appendixA. digests cellulose in vegetablesB. is a vestigial structureC. stores vital appendicolithsD. incubates bacteria that can break down food

particles

____ 52. Which of the following is NOT a function of thelarge intestine?A. absorption of sodium and waterB. incubation of bacteriaC. elimination of wastesD. storage of iron and other vitamins

____ 53. What is the function of a sphincter?A. to close a passageB. to act as a catalystC. to release nutrientsD. to open a valve

____ 54. Most chemical digestion takes place within theA. mouthB. duodenumC. small bowelD. large bowel

A. lower part of the colonshaped like an S.

B. organ that stores bileC. the large intestineD. first part of large intestineE. digestive juice produced

by salivary glandsF. produces insulinG. swallowingH. pigment in bileI. salivary gland near earJ. blind pouch hanging

from first part of colonK. throatL. hormone that transports

sugar into cellsM. speeds up reactions

between substancesN. digestive juice made

in liverO. building blocks of

proteinsP. second part of small

intestineQ. third part of small

intestineR. tube connecting the

throat and stomachS. organ that receives food

from the esophagusT. first part of small

intestineU. intestineV. opening of digestive tract

to outside of the bodyW. chewingX. carries bile from liver

and gallbladder to duo-denum

Y. another word for “stool”Z. organ that secretes bile

and destroys old red cells

79

The suffix -itis refers to inflammation. Change each of theentries below to indicate inflammation of the anatomicstructure.

27. jejunum jejunitis

28. kidney ___________________________

29. colon ___________________________

30. duodenum ___________________________

31. esophagus ___________________________

32. gallbladder ___________________________

33. ileum ___________________________

34. liver ___________________________

35. stomach ___________________________

36. pancreas ___________________________

37. appendix ___________________________

38. peritoneum ___________________________

39. common bile duct ___________________________

40. spleen ___________________________

41. bowel ___________________________

42. stomach + intestines ___________________________

43. tongue ___________________________

44. pharynx ___________________________

45. rectum ___________________________


____ 46. The term for the serosal membrane that lines theabdominopelvic walls isA. perineumB. pterionC. peroniaD. peritoneum

____ 47. A papilla is aA. tiny hair-like projectionB. nipple-like elevationC. ridgeD. blind pouch

____ 48. Which of the following is the medical term for arumbling, gurgling noise in the stomach andintestines?A. borborygmusB. belchC. flatusD. eructation

Gastrointestinal SystemTerminology Challenge

Match the prefix in the left column with a related term in

the right column.

____ 1. cheilo-

____ 2. colo-

____ 3. procto-

____ 4. pharyngo-

____ 5. hepato-

____ 6. oro-

____ 7. duodeno-

____ 8. ceco-

____ 9. sigmoido-

____10. celio-

____ 11. colono-

____12. pancreato-

____13. bucco-

____14. peritoneo-

____15. laparo-

____16. jejuno-

____17. stomato-

____18. gastro-

____19. esophago-

____20. bili-

____21. litho-

____22. steato-

____23. amylo-

____24. ileo-

____25. chole-

____26. entero-

GASTROINTESTINAL SYSTEM

A. peritoneum

B. abdomen or belly

C. cecum

D. bile

E. small intestine

F. cheek

G. esophagus

H. lip

I. throat

J. fat

K. colon or large intestine

L. stomach

M. anus

N. stone

O. ileum

P. duodenum

Q. sigmoid colon

R. liver

S. pancreas

T. mouth

U. jejunum

V. starch

W. esophagus

Gastrointestinal System Abbreviations

Translate the following abbreviations and brief forms.

1. alk phos alkaline phosphatase

2. GE reflux ___________________________________

3. BE ___________________________________

4. ALT ___________________________________

5. LFTs ___________________________________

6. PUD ___________________________________

7. UGI ___________________________________

8. GE junction ___________________________________

9. EGD ___________________________________

10. NG ___________________________________

11. GB ___________________________________

12. GERD ___________________________________

13. GI ___________________________________

14. IBD ___________________________________

15. AST ___________________________________

16. LDH ___________________________________

17. CAT scan ___________________________________

18. ERCP ___________________________________

19. n.p.o. ___________________________________

20. NSAIDs ___________________________________

21. BRAT diet ___________________________________

22. TPN ___________________________________

23. CBD ___________________________________

24. KUB ___________________________________

25. O&P ___________________________________

26. RUQ ___________________________________

27. RLQ ___________________________________

28. LUQ ___________________________________

29. LLQ ___________________________________

30. CEA ___________________________________

31. IBS ___________________________________

80CLINICAL REVIEW

____ 49. Choose the best definition for the word celiacA. pertaining to the stomachB. pertaining to the small intestineC. pertaining to part of the large intestineD. pertaining to the abdomen

____ 50. The adjective that describes a fluid wave in theabdomen isA. asceticB. acidicC. asthenicD. ascitic

____ 51. Rugae areA. projectionsB. contractionsC. ringsD. wrinkles

____ 52. Postprandial pain is experienced afterA. wakingB. sleepingC. eatingD. belching

____ 53. The movement that propels food from the esophagusto the stomach is termedA. peristalsisB. deglutitionC. absorptionD. digestion

Fill in the blanks with the correct answers. Some answersmay require more than one word.

27. Diarrhea often results in rapid transit of food through the

______________________________.

28. A patient with constipation is usually advised to eat foods

that are high in __________________________________.

29. ________________________________________ is a

disease manifested by chronic inflammation of the colon

with the presence of ulcers.

30. Inflammation of the liver caused by a virus is

_________________________________________.

31. A diet high in animal fat, postulated to cause the pro-

duction of certain carcinogens, is suspected of causing

_________________________________________cancer.

32. _____________________ is the medical term for vomiting.

33. Projectile vomiting in an infant during feeding is sympto-

matic of the condition ____________________________.

34. Peptic ulcers were once thought to be caused by stress and

lifestyle. However, today we know that most peptic ulcers

are caused by __________________________.

35. ________________ is the burning sensation caused by the

regurgitation of hydrochloric acid from the stomach into the

esophagus.

36. A condition that occurs when the upper part of the stom-

ach protrudes through the esophageal opening in the

diaphragm, often causing symptoms of gastroesophageal

reflux, is ______________________________________.

37. The pain that results when a gallstone blocks the excretion

of bile is called biliary ____________________________.

38. When a patient receives nourishment other than through

the alimentary canal, it is referred to as _______________

nutrition.

39. A fecalith is a stonelike mass of hardened

____________________________________________.

40. Fever, tachycardia, and rebound tenderness over

McBurney point are symptomatic of _________________.

Pathophysiology of theGastrointestinal System

Match the terms in the left column with their correct def-initions in the right column.

____ 1. anorexia

____ 2. diarrhea

____ 3. ascites

____ 4. melena

____ 5. hematochezia

____ 6. reflux

____ 7. flatus

____ 8. dysphagia

____ 9. colic

____ 10. jaundice

____ 11. nausea

____ 12. polyposis

____ 13. achalasia

____ 14. fistula

____ 15. stomatitis

____ 16. diverticulum

____ 17. esophagealvarices

____ 18. ulcer

____ 19. cholelithiasis

____ 20. hemorrhoids

____ 21. hernia

____ 22. cirrhosis

____ 23. volvulus

____ 24. ileus

____ 25. irritable bowelsyndrome

____ 26. intussusception


A. gas expelled per rectumB. a feeling as if one is going

to vomitC. prolonged esophageal tight-

eningD. loss of appetiteE. twisting of intestine upon

itselfF. varicose veins in the anal

regionG. bright red blood per rectumH. dilated veins at lower end of

esophagusI. abnormal passageway near

the anusJ. painful swallowingK. intestinal obstructionL. abnormal outpouching in

intestinal wallM. spastic colonN. abnormal accumulation of

fluid in the abdomenO. telescoping of the intestinesP. erosion of tissueQ. backward flow of solids and

fluidsR. very loose stoolsS. protrusion of organ through

muscleT. small growths protruding

from colonic membraneU. inflammation of the mouthV. tarry stools containing bloodW. degeneration of liver cellsX. icterusY. gallstonesZ. acute abdominal pain

____ 47. Most cases of this disease occur in alcoholics or inpersons with chronic biliary tract disease such ascholelithiasis and cholecystitis:A. cirrhosisB. pancreatitisC. hepatitisD. peritonitis

____ 48. A common hernia of infancy in which the abdomi-nal contents protrude at the navel is classified as atype ofA. hiatal herniaB. femoral herniaC. esophageal herniaD. abdominal hernia

____ 49. Transformation of normal esophageal squamousepithelium into columnar epithelium is character-istic ofA. esophageal refluxB. esophageal strictureC. Barrett esophagusD. esophageal varices

____ 50. A pancreatic tumor that produces excessive amountsof the hormone gastrin, thus causing hypersecretionof gastric acid, is characteristic ofA. Cronkhite-Canada syndromeB. Zollinger-Ellison syndromeC. Courvoisier-Terrier syndromeD. Budd-Chiari syndrome

____ 51. Which of the following is a pseudo-obstruction ofthe bowel?A. Ogilvie syndromeB. volvulusC. intussusceptionD. mechanical ileus

____ 52. The treatment of choice for peptic ulcer diseasecaused by Helicobacter pylori isA. restB. antibioticsC. ulcer dietD. antacids

____ 53. Congenital megacolon (dilatation and hypertrophyof the colon) is also known asA. Treacher-Collins syndromeB. Zenker diverticulumC. Crohn diseaseD. Hirschsprung disease

82CLINICAL REVIEW


____ 41. Which form of hepatitis is acute but self-limitedand not likely to cause complications or serioussequelae?A. hepatitis AB. hepatitis BC. hepatitis CD. hepatitis D

____ 42. In a patient with a bleeding peptic ulcer, one wouldexpect the patient’s stools to beA. streaked with bright red bloodB. clay-coloredC. blackD. chalky

____ 43. A chronic relapsing disease that causes inflamma-tion with diarrhea, cramping, and fever, and whichaffects the terminal ileum isA. Crohn diseaseB. irritable bowel syndromeC. diverticulitisD. dysentery

____ 44. A chronic disorder of the liver characterized byinflammation of secretory cells followed by nodu-lar regeneration and fibrosis is named for whichperson?A. LasègueB. LhermitteC. LaugierD. Laënnec

____ 45. Increase in pressure in the portal vein is known asA. choledochoceleB. portacaval syndromeC. choledochochitisD. portal hypertension

____ 46. A 40-year-old overweight female with a long his-tory of yo-yo dieting presents with severe, acutecolicky pain in the right upper quadrant and epi-gastric area radiating through to her back. This issymptomatic of what digestive system disease?A. chronic pancreatitisB. acute cholecystitisC. chronic hepatitisD. acute appendicitis

Gastrointestinal System Laboratory

Match the disease with the description of the diagnosticfindings by filling in the blank with the correct letter.

A. hepatitis CB. irritable bowel syndromeC. appendicitisD. gastroesophageal reflux diseaseE. chronic pancreatitisF. Crohn diseaseG. acute peritonitisH. adynamic ileus

____ 1. Patient has recurrent bouts of left upper quadrantpain. Sugar is elevated in both urine and blood as aresult of diabetes mellitus due to slow destruction ofpancreatic tissue. Pancreatic lipase and amylase areelevated. Abdominal x-ray shows widening of thecurve of the duodenum due to pancreatic edema.

____ 2. Abdominal x-ray shows distended loops of smallbowel and fluid levels. Bowel sounds are absent.

____ 3. Patient gives a long history of pyrosis. Imagingstudies confirm reflux of swallowed barium fromthe stomach, with ulceration and stricture.Endoscopy gives visual proof of inflammation.

____ 4. Patient gives history of being hit violently in theabdomen with resultant acute abdominal pain. WBCis elevated; blood studies show electrolyte imbal-ance and anemia. Fluid obtained via paracentesisshows amylase or lipase. Imaging identifies intra-abdominal catastrophe.

____ 5. Carriers of this chronic disease are identified byserologic testing.

____ 6. Patient gives history of bowel urgency and diarrheaafter meals, worse with caffeine ingestion. Stoolexams, barium enema, colonoscopy, and blood stud-ies are all negative.

____ 7. Patient gives history of recurrent crampy abdominalpain and fatty stools. WBC and ESR are elevated.Barium enema shows “string sign.” Endoscopyshows inflammation and “skip” areas.

____ 8. Patient has exquisite right lower quadrant pain.WBC is elevated with shift to the left. Abdominalimaging shows opacity in the appendiceal lumen.Barium per rectum fails to fill the appendix.



____ 9. In hepatitis A infection, which antibody appearsearly in the course of the disease and then disap-pears; which develops later and persists indefi-nitely?A. IgE appears early; IgM appears laterB. IgM appears early; IgE appears laterC. IgM appears early; IgG develops laterD. IgE appears early; IgG develops later

____ 10. The presence of HBSAg after the acute phase ofwhich illness suggests chronic infection?A. hepatitis AB. hepatitis BC. hepatitis CD. hepatic cirrhosis

____ 11. Which of the following is NOT a pathogen?A. protozoaB. fungiC. toxinsD. viruses

____ 12. Infestation with the pathogen Campylobacter is knownto cause severe diarrhea, fever, nausea, and vomiting.By which route is this pathogen transmitted?A. fecal-oralB. airborneC. sexualD. droplet

____ 13. The pathogen Giardia lamblia, which causes vom-iting and diarrhea and can disseminate in personswith AIDS, is aA. bacteriumB. parasiteC. fungusD. yeast

____ 14. Stool for ova and parasites would be ordered forsuspicion ofA. hepatitis CB. peptic esophagitisC. GERDD. amebiasis

____ 15.What food should be avoided to prepare for occultblood test of the stool?A. fibrous vegetablesB. milk productsC. meatD. nuts and seeds

Gastrointestinal System Drugs

The following gastrointestinal drugs are listed by brandname. In the space provided, list the corresponding genericname and short description of the drug.

1. Tagamet cimetidine—H2 antagonist

2. Zelnorm _______________________________________

3. Donnatal ______________________________________

4. Levsin ________________________________________

5. Anusol-HC suppository __________________________

6. Mylanta _______________________________________

7. Phenergan______________________________________

8. Tigan suppository _______________________________

9. Mylicon _______________________________________

10. Lomotil _______________________________________

11. Nexium _______________________________________

12. Reglan ________________________________________

13. Dulcolax tablets ________________________________

14. Azulfidine _____________________________________

15. Surfak ________________________________________

16. Carafate _______________________________________

17. Metamucil _____________________________________

18. Axid __________________________________________

19. Prevacid _______________________________________

20. Prilosec _______________________________________

21. Pepcid AC _____________________________________

22. Di-Gel ________________________________________

23. Transderm Scop _________________________________

24. Maalox ________________________________________

25. Zantac ________________________________________


____ 26. H2 blockers work byA. neutralizing stomach acidB. preventing the release of stomach acidC. slowing peristalsisD. inhibiting the formation of prostaglandins

84CLINICAL REVIEW

____ 16. In which gastrointestinal disorder is the AST likelyto be elevated?A. hemorrhoidsB. pancreatitisC. herniaD. gastroesophageal reflux

____ 17. Lactic dehydrogenase, which is elevated in somegastrointestinal disorders, is normally belowA. 110 U/LB. 150 U/LC. 180 U/LD. 200 U/L

____ 18. The low normal for the ALT enzyme isA. 8B. 80C. 180D. 280

____ 19. The alkaline phosphatase level is normallyA. undetectable in childrenB. undetectable in adultsC. lower in children than adultsD. higher in children than adults

____ 20. Significant change in the serum amylase level isdiagnostic of a disorder of which organ?A. liverB. gallbladderC. bile ductD. pancreas

____ 21. Which of the following is an abnormal finding onmicroscopic examination of stool?A. helminthsB. bacteriaC. muscle fibersD. fat

____ 22. A finding of excessive fat in the feces on stool spec-imen suggestA. starvationB. intestinal bleedingC. malabsorptionD. peptic ulcer disease

____ 27. An example of a laxative isA. GavisconB. PrilosecC. TagametD. Senokot

____ 28. A common therapeutic gastrointestinal side effectof opiate drugs isA. gastroesophageal refluxB. diarrheaC. constipationD. coffee grounds emesis

____ 29. Scopolamine is NOT used to treatA. esophageal varicesB. motion sicknessC. stomach distressD. irritable colon

____ 30. Aluminum, magnesium, and calcium salts areactive ingredients inA. antiemeticsB. antacidsC. anthelminticsD. antidiarrheals

____ 31. The active ingredient in a Fleet enema isA. bariumB. sodium phosphatesC. potassiumD. aspidium

____ 32. Tucks pads are used forA. cleansing the perianal areaB. colostomy coveringC. wound dressingD. truss padding

____ 33. The active ingredient in Preparation H rectal suppos-itories isA. witch hazelB. lidocaineC. benzocaineD. shark liver oil

____ 34. Which of the following is NOT an indication forPepto-Bismol?A. constipationB. nausea and vomitingC. indigestionD. traveler’s diarrhea

____ 35. Compazine is indicated forA. constipationB. diarrheaC. nausea and vomitingD. indigestion

____ 36. Gastrointestinal infestation with Giardia lamblia maybe treated withA. VermoxB. FlagylC. BiaxinD. Azulfidine

____ 37. Treatment of Crohn’s disease includes low-fiber diet,specific anti-inflammatory drugs, and medication toA. reduce intestinal motilityB. increase intestinal motilityC. stop gastroesophageal refluxD. prevent vomiting

____ 38. Which of the following drugs would NOT be used totreat nausea and vomiting caused by cancerchemotherapy?A. AloxiB. CesametC. EmendD. Mexitil

____ 39. An example of a bulk-producing laxative isA. Phillips Milk of MagnesiaB. Dulcolax tabletsC. CitrucelD. Ex-Lax

____ 40. The active ingredient in Tums antacid isA. sodiumB. calcium carbonateC. magnesiumD. aluminum

____ 41. Which of the following drugs would NOT be part ofa chemotherapy regimen to eradicate Helicobacterpylori?A. BiaxinB. HelidacC. Pilopine HSD. Zegerid
