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The number one case of pancreatitis in children is:
Explanation Cystic fibrosis is the most common cause of pancreatitis in children. Pancreatitis is inflammation of the pancreas, and in children, it is often associated with cystic fibrosis. Cystic fibrosis is a genetic disorder that affects the lungs, digestive system, and other organs. It causes the production of thick, sticky mucus that can block the pancreatic ducts and lead to pancreatitis. Therefore, it is not surprising that cystic fibrosis is the number one case of pancreatitis in children.
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2.
Patho of acute pancreatitis: ______________ of the pancreas active inside the pancreas and cause acute hemorrhage and necrosis.
Explanation The correct answer is "Enzymes, enzymes." In acute pancreatitis, enzymes produced by the pancreas become activated inside the pancreas itself. This activation leads to the release of these enzymes, causing acute hemorrhage and necrosis in the pancreas.
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3.
The pain from acute pancreatitis starts in the left quadrant with radiation to the back.
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because acute pancreatitis typically causes pain in the left quadrant of the abdomen, which may then radiate to the back. This is a characteristic symptom of acute pancreatitis and helps to differentiate it from other conditions causing abdominal pain.
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4.
Fatty meals, alcohol and lying in recumbent positions does not affect the pain associated with pancreatitis
A.
True
B.
False
Correct Answer
B. False
Explanation All these aggravate the pain,
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5.
Sudden onset of pain that starts in the left quadrant that radiates to back, Cullen's sign, Turner's sign and absent or decreased bowel sounds are all signs of
A.
Gall stones
B.
Acute pancreatitis
C.
Insulinoma
Correct Answer
B. Acute pancreatitis
Explanation The sudden onset of pain that starts in the left quadrant and radiates to the back, along with Cullen's sign (bruising around the belly button) and Turner's sign (bruising on the sides of the abdomen), are all indicative of acute pancreatitis. Additionally, the presence of absent or decreased bowel sounds further supports this diagnosis. Acute pancreatitis is inflammation of the pancreas and can be caused by gallstones, alcohol abuse, or certain medications. It is important to seek medical attention if these symptoms occur, as acute pancreatitis can be a serious condition.
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6.
Signs and symptoms of Acute Pancreatitis: (choose all that apply)
A.
Sudden onset of pain starting in left quad and radiating to back
B.
Pain in joints
C.
Abdominal Guarding
D.
Weight Loss
E.
Blurred Vision
F.
N/V
G.
Steatorrhea
H.
Blood in urine
Correct Answer(s)
A. Sudden onset of pain starting in left quad and radiating to back C. Abdominal Guarding D. Weight Loss F. N/V G. Steatorrhea
Explanation The signs and symptoms of acute pancreatitis include sudden onset of pain starting in the left quad and radiating to the back, abdominal guarding, weight loss, nausea and vomiting, and steatorrhea. These symptoms are commonly associated with acute pancreatitis, while pain in joints, blurred vision, and blood in urine are not typically seen in this condition.
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7.
Which procedure can cause pancreatitis?
A.
ERCP
B.
CT
C.
PET
D.
MRI
Correct Answer
A. ERCP
Explanation It is used to diagnosis pancreatitis but can cause it also!
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8.
Steroid use can cause pancreatitis.
A.
True
B.
False
Correct Answer
A. True
Explanation Steroid use can cause pancreatitis, a condition characterized by inflammation of the pancreas. Steroids can lead to an increase in the production of certain enzymes that can damage the pancreas, causing it to become inflamed. This inflammation can disrupt the normal functioning of the pancreas, leading to symptoms such as severe abdominal pain, nausea, vomiting, and fever. Therefore, it is true that steroid use can cause pancreatitis.
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9.
Which scoring is used for CT scan to diagnosis acute pancreatitis?
A.
APGAR
B.
Glasgow
C.
Balthazar
Correct Answer
C. Balthazar
Explanation Balthazar scoring is used for CT scan to diagnose acute pancreatitis. This scoring system evaluates the severity of pancreatitis based on the presence and extent of certain radiological findings, such as pancreatic inflammation, necrosis, and fluid collections. The Balthazar score helps in determining the appropriate treatment approach and predicting the prognosis of patients with acute pancreatitis.
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10.
Morphine is the number one treatment for acute pancreatitis.
A.
True
B.
False
Correct Answer
B. False
Explanation Demerol (meperdine) or methodone are better choices than morphine because morphine causes spasm of the Sphinter of Oddi
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11.
Suction for NG tube should be high continuous suction
A.
True
B.
False
Correct Answer
B. False
Explanation It should be set for low intermittent suction
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12.
Fluid build up in alveoli causing SOB, labored rapid breathing and low BP (complication of acute pancreatitis)
A.
ARDS
B.
DIC
C.
ERCP
Correct Answer
A. ARDS
Explanation Adult Respire Distress Syndrome
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13.
This prevents the blood from clotting normally. Causes excessive clotting in that clog small blood vessels throughout the body and causes wide spread bleeding. (complication from acute pancreatitis)
Relapse of acute pancreatitis usually occurs within _____ hours after oral intake resumes.
A.
24
B.
48
C.
78
D.
6
Correct Answer
B. 48
Explanation After an episode of acute pancreatitis, it is important to give the pancreas time to heal and recover. Resuming oral intake too soon can put stress on the pancreas and increase the risk of relapse. The correct answer is 48 hours because this is the typical timeframe within which relapse of acute pancreatitis is most likely to occur after oral intake resumes. Waiting for at least 48 hours allows the pancreas to recover and reduces the risk of relapse.
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15.
If there is nausea while a pt has an NG tube, do which first?
A.
Troubleshoot tube for obstruction/placement
B.
Check lab for high Amylase
C.
Check labs for liver function
D.
Check blood sugar level
Correct Answer
A. Troubleshoot tube for obstruction/placement
Explanation If a patient with an NG tube experiences nausea, the first step would be to troubleshoot the tube for any potential obstruction or incorrect placement. This is because an obstructed or improperly placed tube can cause discomfort and lead to complications such as vomiting. Checking lab values for high amylase, liver function, or blood sugar level may be relevant in certain situations, but they would not be the first priority when addressing the immediate concern of nausea related to the NG tube.
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16.
Continued inflammation of the pancreas. Causes tissue necrosis and scar formation.
Explanation Chronic pancreatitis is the correct answer for this question. Chronic pancreatitis refers to the ongoing inflammation of the pancreas, which can lead to tissue necrosis and the formation of scar tissue. This condition is characterized by persistent inflammation that can cause damage to the pancreas over time. It is often associated with long-term alcohol abuse, although other factors such as genetics and certain medical conditions can also contribute to its development. The repeated inflammation and damage to the pancreas can lead to digestive problems and other complications.
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17.
Some pts with chronic pancreatitis experience no pain.
A.
True
B.
False
Correct Answer
A. True
Explanation Some individuals with chronic pancreatitis may not experience any pain. Chronic pancreatitis is a condition characterized by inflammation of the pancreas that persists over time. While pain is a common symptom of this condition, it is not always present in all patients. The severity and frequency of pain can vary among individuals, and some may be fortunate enough to have a form of chronic pancreatitis that does not cause them any pain.
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18.
The pt with chronic pancreatitis will have a mass in the left upper quadrant that feels:
A.
Soft and tender
B.
Hard and mushy
C.
Soft and lumpy
Correct Answer
B. Hard and mushy
Explanation In chronic pancreatitis, the pancreas becomes inflamed and fibrotic, leading to the formation of scar tissue. This scar tissue can cause the pancreas to become hardened and enlarged, resulting in a hard mass in the left upper quadrant. The term "mushy" suggests a soft and pliable texture, which is not characteristic of chronic pancreatitis. Therefore, the answer "Hard and mushy" is incorrect.
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19.
Type of diabetes that is a s/s of chronic pancreastitis.
A.
DM Type 1
B.
DM Type 2
C.
DM Type 3
Correct Answer
A. DM Type 1
Explanation Pt will not be producing insulin so they will be insulin dependent (Type 1)
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20.
S/S of chronic pancreatitis: (choose all that apply)
A.
GERD
B.
Weight loss although appetite remains normal
C.
Anorexia
D.
Janudice
E.
Muscle wasting
F.
Steatorrhea
Correct Answer(s)
B. Weight loss although appetite remains normal D. Janudice E. Muscle wasting F. Steatorrhea
Explanation Chronic pancreatitis is characterized by inflammation and damage to the pancreas over time. The symptoms listed are commonly associated with this condition. Weight loss despite a normal appetite is a common symptom due to the impaired ability of the pancreas to produce digestive enzymes, leading to malabsorption of nutrients. Jaundice occurs when the damaged pancreas obstructs the bile duct, causing a buildup of bilirubin. Muscle wasting can occur due to malnutrition and the body's inability to properly process proteins. Steatorrhea, or fatty stools, is another common symptom due to the impaired digestion of fats.
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21.
One diagnostic test for pancreatitis:
A.
Fecal Elastase
B.
BNP Test
C.
PSA Test
Correct Answer
A. Fecal Elastase
Explanation Fecal Elastase is a diagnostic test for pancreatitis. Pancreatitis is an inflammation of the pancreas, and this test measures the levels of elastase, an enzyme produced by the pancreas, in the feces. Low levels of fecal elastase indicate a dysfunction of the pancreas and can help diagnose pancreatitis. The BNP test is used to diagnose heart failure, while the PSA test is used to screen for prostate cancer. Therefore, Fecal Elastase is the correct answer for diagnosing pancreatitis.
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22.
A decrease of _____ units per gram in the Fecal Elastase measurement in stool indicates pancreatitis.
A.
5
B.
20
C.
60
D.
30
Correct Answer
B. 20
Explanation A decrease of 20 units per gram in the Fecal Elastase measurement in stool indicates pancreatitis. This means that if the Fecal Elastase measurement decreases by 20 units per gram, it is a strong indicator of pancreatitis, which is inflammation of the pancreas.
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23.
What should you educate your pt about when they are using pancreatic enzymes sprinkler on food?
A.
Sprinkle only on fatty meats
B.
Do not inhale enzymes
C.
Sprinkle only on sugary foods
Correct Answer
B. Do not inhale enzymes
Explanation Inhaling the powder will cause the eating away of the lung tissue
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24.
Patients with Chronic pancreatitis should avoid heavy meals and alcohol.
A.
True
B.
False
Correct Answer
A. True
Explanation Patients with chronic pancreatitis should avoid heavy meals and alcohol because these can worsen the symptoms and lead to further damage to the pancreas. Heavy meals can put a strain on the pancreas, causing it to produce more digestive enzymes, which can exacerbate inflammation and pain. Alcohol can also irritate the pancreas and increase the risk of developing complications such as pancreatitis flare-ups and pancreatic cancer. Therefore, it is important for patients with chronic pancreatitis to follow a healthy diet and abstain from alcohol to manage their condition effectively.
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25.
Most common type of pancreatic cancer:
A.
Glucagonoma
B.
Mucinous cystadenoma
C.
Adenocarcinoma
D.
Insulinoma
Correct Answer
C. Adenocarcinoma
Explanation Adenocarcinoma is the most common type of pancreatic cancer. It originates in the cells that line the ducts of the pancreas and is responsible for the majority of pancreatic cancer cases. Adenocarcinoma is an aggressive form of cancer that often spreads rapidly to nearby organs and lymph nodes. It is typically diagnosed at an advanced stage, making it difficult to treat. Surgery, chemotherapy, and radiation therapy are common treatment options for adenocarcinoma.
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26.
Predisposing factors for Pancreatic Adenocarcinoma: (choose all that apply)
A.
Male
B.
Female
C.
African Amercian
D.
Hispanic
E.
Smoking
F.
Obesity
G.
H pylori infection
H.
Large sodium intake
I.
Gingivitis
J.
Diets high in red meats
K.
Diets low in red meats
Correct Answer(s)
A. Male C. African Amercian E. Smoking F. Obesity G. H pylori infection I. Gingivitis J. Diets high in red meats
Explanation The correct answer includes the predisposing factors for Pancreatic Adenocarcinoma. These factors include being male, being African American, smoking, obesity, having H pylori infection, having gingivitis, and having diets high in red meats. These factors have been identified as potential risk factors for developing pancreatic adenocarcinoma.
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27.
Pancreatic cancer usually does not cause symptoms.
A.
True
B.
False
Correct Answer
A. True
Explanation Pancreatic cancer is often referred to as a "silent" disease because it typically does not cause noticeable symptoms in its early stages. By the time symptoms do appear, the cancer has usually progressed to an advanced stage. This is why early detection and screening for pancreatic cancer are challenging. Therefore, the statement that pancreatic cancer usually does not cause symptoms is true.
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28.
Gold standard for diagnosing Pancreatic Adencarcinoma:
A.
Labs
B.
CT
C.
MRI
D.
Biopsy
Correct Answer
D. Biopsy
Explanation Biopsy is considered the gold standard for diagnosing Pancreatic Adenocarcinoma. This is because a biopsy involves the removal of a tissue sample from the pancreas, which can then be examined under a microscope to determine if cancer cells are present. Biopsy provides a definitive diagnosis and allows for further analysis of the tumor, such as determining its stage and grade. While labs, CT scans, and MRI scans can provide important information, they are not as conclusive as a biopsy in confirming the presence of pancreatic adenocarcinoma.
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29.
Types of cystic tumors: (choose all that apply)
A.
Insulin
B.
Mucinous
C.
Serous
D.
Gastrin
E.
Mucinal Ductal Ectasia
F.
Vipoma
Correct Answer(s)
B. Mucinous C. Serous E. Mucinal Ductal Ectasia
Explanation The correct answer includes the types of cystic tumors that are Mucinous, Serous, and Mucinal Ductal Ectasia. These are all types of cystic tumors that can occur in various organs of the body. Mucinous cystic tumors are characterized by the production of mucin, a jelly-like substance. Serous cystic tumors are filled with a watery fluid and are typically benign. Mucinal Ductal Ectasia is a condition where the milk ducts in the breast become dilated and filled with fluid. These types of cystic tumors can have different presentations and may require different treatment approaches.
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30.
Types of endocrine tumors: (choose all that apply)
A.
Insulin
B.
Mucinous
C.
Serous
D.
Gastrin
E.
Mucinal Ductal Ectasia
F.
Vipoma
G.
Glucagon
Correct Answer(s)
A. Insulin D. Gastrin F. Vipoma G. Glucagon
Explanation The correct answer includes Insulin, Gastrin, Vipoma, and Glucagon. These are all types of endocrine tumors. Insulinoma is a tumor of the insulin-producing cells in the pancreas, Gastrinoma is a tumor that produces excessive amounts of gastrin hormone, Vipoma is a tumor that produces vasoactive intestinal peptide, and Glucagonoma is a tumor that produces excessive amounts of glucagon hormone. Mucinous, Serous, and Mucinal Ductal Ectasia are not types of endocrine tumors.
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31.
S/S of insulinoma: (choose all that apply)
A.
Vision abnormalities
B.
Joint pain
C.
Hypoglycemia
D.
Confusion
E.
Headache
Correct Answer(s)
A. Vision abnormalities C. Hypoglycemia D. Confusion E. Headache
Explanation Insulinoma is a rare tumor of the pancreas that produces excessive amounts of insulin. This leads to low blood sugar levels, causing symptoms such as hypoglycemia, confusion, and headache. Vision abnormalities can also occur due to the effects of low blood sugar on the brain and nervous system. Joint pain, however, is not a common symptom of insulinoma.
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32.
Major symptom of Vipoma:
A.
Prolonged massive urination
B.
Prolonged massive vomiting
C.
Prolonged massive diarrhea
Correct Answer
C. Prolonged massive diarrhea
Explanation The major symptom of Vipoma is prolonged massive diarrhea. Vipoma is a rare tumor that affects the pancreas and causes excessive production of vasoactive intestinal peptide (VIP). VIP stimulates the intestines to secrete large amounts of water and electrolytes, leading to watery diarrhea. This can result in dehydration, electrolyte imbalances, and malnutrition. Other symptoms may include abdominal pain, flushing, and weight loss.
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33.
Most distinctive features of Glucagonoma: (choose all that apply)
A.
Brownish red skin rash
B.
Yellowish dead tissue
C.
Smooth shiny bright orange tongue
D.
Black crusty rash
Correct Answer(s)
A. Brownish red skin rash C. Smooth shiny bright orange tongue
Explanation The most distinctive features of Glucagonoma are a brownish red skin rash and a smooth shiny bright orange tongue. These symptoms are characteristic of this rare type of pancreatic tumor. The brownish red skin rash, known as necrolytic migratory erythema, is typically found on the face, groin, buttocks, and lower extremities. The smooth shiny bright orange tongue, known as migratory glossitis, is caused by inflammation and atrophy of the tongue papillae. These two symptoms are often seen together in patients with Glucagonoma and can help in the diagnosis of this condition.
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