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A patient with an obstruction of the common bile duct has clay-colored fatty stools, among other manifestations. What is the pathophysiologic change that causes this clinical manifestation?
- A. Soluble bilirubin in the blood excreted into the urine
- B. Absence of bile salts in the intestine and duodenum, preventing fat emulsion and digestion
- C. Contraction of the inflamed gallbladder and obstructed ducts, stimulated by cholecystokinin when fats enter the duodenum
- D. Obstruction of the common duct prevents bile drainage into the duodenum, resulting in congestion of bile in the liver and subsequent absorption into the blood
Correct Answer: B
Rationale: The absence of bile salts in the intestine due to obstruction prevents fat emulsification and digestion, leading to fatty stools (steatorrhea).
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The mucosal cells of the human colon perform the following functions:
- A. Converting primary bile acids into secondary bile acids
- B. Converting bilirubin into stercobilinogen +
- C. Absorption of Na
- D. Absorption of aromatic amino acids
Correct Answer: C
Rationale: Rationale:
1. The mucosal cells of the colon absorb Na to maintain electrolyte balance.
2. Na absorption is crucial for water reabsorption.
3. This process helps regulate stool consistency and prevent dehydration.
Summary:
A: Incorrect - Bile acid conversion primarily occurs in the liver.
B: Incorrect - Bilirubin breakdown mainly occurs in the liver and intestines.
D: Incorrect - Aromatic amino acid absorption occurs mainly in the small intestine.
Which two regions of a tooth contain living cells?
- A. dentin and enamel
- B. anatomical crown and cementum
- C. enamel and cementum
- D. dentin and cementum
Correct Answer: D
Rationale: The correct answer is D. Dentin and cementum are the two regions of a tooth that contain living cells. Dentin is the hard tissue beneath the enamel and cementum that forms the bulk of the tooth structure. It contains living cells called odontoblasts responsible for dentin formation. Cementum is the hard tissue covering the tooth root and is essential for anchoring the tooth in the jawbone. Cementum contains living cells called cementoblasts responsible for cementum formation. Therefore, both dentin and cementum are vital regions of a tooth that house living cells involved in tooth development and maintenance.
A: Dentin and enamel - Enamel is the outermost layer of the tooth and does not contain living cells.
B: Anatomical crown and cementum - Anatomical crown is not a region of the tooth containing living cells.
C: Enamel and cementum - Enamel does not contain living cells, only mineralized structures.
The _____ are vessels that project into the villi and absorb fatty substances.
- A. lacteals
- B. lymphatics
- C. veins
- D. arteries
Correct Answer: A
Rationale: The correct answer is A: lacteals. Lacteals are specialized lymphatic vessels located in the villi of the small intestine. They are responsible for absorbing dietary fats and fat-soluble vitamins. Lymphatics (choice B) are a broader term for lymphatic vessels and nodes. Veins (choice C) are blood vessels that carry deoxygenated blood back to the heart. Arteries (choice D) are blood vessels that carry oxygenated blood away from the heart. Therefore, only lacteals specifically project into the villi and absorb fatty substances, making them the correct choice.
The home health nurse is caring for a patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect?
- A. Gallstones
- B. Liver disorders
- C. Bleeding ulcers
- D. Esophagitis
Correct Answer: B
Rationale: The correct answer is B: Liver disorders. Rifampin and isoniazid are known to cause hepatotoxicity as a potential side effect. The combination of these two medications can lead to liver damage, making it crucial for the nurse to monitor liver function tests regularly. Gallstones (A), bleeding ulcers (C), and esophagitis (D) are not typically associated with rifampin and isoniazid therapy. Monitoring for liver disorders is essential due to the risk of hepatotoxicity with these medications.
The secretion of the exocrine pancreas is increased by the following except:
- A. Vagal stimulation
- B. Acetylcholine
- C. Secretin
- D. CCK
Correct Answer: A
Rationale: The correct answer is A: Vagal stimulation. Vagal stimulation does not directly increase the secretion of the exocrine pancreas. Acetylcholine, Secretin, and CCK are known to stimulate pancreatic secretion through various mechanisms. Acetylcholine acts through muscarinic receptors, Secretin is released in response to acidic chyme in the duodenum, and CCK is released in response to fat and proteins in the duodenum, all leading to increased pancreatic enzyme secretion. Vagal stimulation plays a role in the parasympathetic nervous system but does not directly stimulate pancreatic secretion.