Question 1

How much lactose can most lactase-deficient people consume without major symptoms?&#10;A) The equivalent to a half cup of milk&#10;B) The equivalent to one cup of milk&#10;C) 12 to 15 g of lactose&#10;D) Lactase-deficient people cannot consume any lactose without experiencing symptoms

Accepted Answer

Most people with lactase deficiency can consume 6 g of lactose or the equivalent of a half cup of milk without experiencing symptoms. Many can ultimately adapt to consuming one whole cup of milk when it is introduced gradually and increased incrementally over the course of several weeks.

Question 2

What condition is associated with the feeling of incomplete evacuation of the bowel?&#10;A) Inflammatory bowel disease&#10;B) Constipation&#10;C) Irritable bowel syndrome&#10;D) Diverticulosis

Accepted Answer

Symptoms of irritable bowel syndrome include abdominal discomfort and altered intestinal motility, including feelings of bloating, incomplete evacuation, presence of mucus in the stool, straining and increased urgency to defecate, and increased GI distress. Inflammatory bowel disease presents with diarrhea, fever, weight loss, anemia, malnutrition, and food intolerances. Constipation is defined by the frequency and quantity of stool, and it may be experienced by patients with IBS. Diverticulosis is often experienced without any symptomatology.

Question 3

What should be in the solution used for fluid replacement for acute diarrhea in infants and small children?&#10;A) Vitamins, minerals, and electrolytes&#10;B) Glucose and electrolytes in water&#10;C) Chemically defined formula&#10;D) Lactose-free formula

Accepted Answer

Oral rehydration therapy solutions for infants and children should contain 2% glucose and sodium and potassium. Additional vitamins and minerals are not included because they would increase the osmolality of the solutions and promote potential intolerance. Chemically defined and lactose-free formulas are usually used for more complete nutrition repletion as opposed to simple rehydration.

Question 4

What is the most common carbohydrate intolerance that affects people of all ages?&#10;A) Lactose intolerance&#10;B) Galactose intolerance&#10;C) Sucrose intolerance&#10;D) Maltose intolerance

Accepted Answer

Lactose intolerance or maldigestion is the most common carbohydrate intolerance. Some carbohydrate intolerances occur in newborns as rare congenital defects. Lactose tolerance is considered to be a genetic mutation that affects peoples in Northern Europe and some ethnic groups in India, Africa, and Mongolia. However, 90% of the world's population has a low tolerance to milk.

Question 5

The most common cause of antibiotic-induced diarrhea is&#10;A) Lactobacillus spp.&#10;B) Saccharomyces boulardii.&#10;C) Escherichia coli.&#10;D) Clostridium difficile.

Accepted Answer

Clostridium difficile is the most common cause of antibiotic-induced diarrhea. Escherichia coli has also been implicated. Lactobacillus and Saccharomyces boulardii are used as a supplement to recolonize the colon with beneficial bacteria.

Question 6

__________ is the preferred fuel for the small intestinal enterocytes and is considered important to adaption after bowel resection.&#10;A) Glucose&#10;B) Glutamine&#10;C) MCT&#10;D) Butyrate

Accepted Answer

Glutamine is the preferred fuel for small intestinal enterocytes and thus may be valuable in enhancing adaptation. Short-chain fatty acids (e.g., butyrate) produced from microbial fermentation of carbohydrate and fibers are the major fuels of colonic epithelium.

Question 7

Which of the following is a risk factor for developing colon cancer?&#10;A) IBS&#10;B) Lactase deficiency&#10;C) Polyps&#10;D) Diverticulitis

Accepted Answer

Colorectal polyps are considered to be precursors of colon cancer. Inflammatory bowel disease is also a risk factor. Diets high in calories, fat, and animal protein and low in fruits, vegetables, and grains are associated with increased risk of colon cancer.

Question 8

Which of the following are NOT included in the gluten-restricted, gliadin-free diet to treat celiac disease?&#10;A) Wheat, rye, barley, and oats&#10;B) Corn, rice, soybeans, and tapioca&#10;C) Potatoes, hydrolyzed vegetable protein, and arrowroot starch&#10;D) Wheat, rice, barley, and corn

Accepted Answer

Wheat, rye, barley, and oat products all contain gluten peptide fractions and should be excluded from the diet. Corn, potatoes, rice, soybeans, tapioca, arrowroot, amaranth, quinoa, millet, and buckwheat are sources of grains that may be used in creating products for people with celiac disease.

Question 9

Why do renal oxalate stones form as a consequence of ileal resection? A) Inadequate intake of dietary fiber and water B) Malabsorption of fat-soluble vitamins C) Malabsorption of calcium, zinc, and magnesium D) Malabsorption of vitamin B₁₂ and intrinsic factor complex

Accepted Answer

The increase in renal oxalate stone formation resulting from ileal resection occurs because of impaired bile salt reabsorption. The ileum is the primary site of bile salt reabsorption, and without it, bile salts are eliminated instead of recycled. This leads to a decrease in bile secretion, which impairs lipid digestion and absorption. The resultant increase in fatty acids in the bowel can combine with divalent cations such as calcium, zinc, and magnesium to form insoluble soaps. Normally, these cations would be free to bind with oxalate to prevent colonic absorption of oxalate. However, with the divalent cations already bound as soaps, the colonic absorption of oxalate increases.

Question 10

Which of the following patients with small bowel resection is the LEAST likely to need long-term parenteral nutrition?&#10;A) 40-year-old man with a jejunal resection&#10;B) 20-year-old woman who had radiation enteritis before resection&#10;C) 60-year-old woman with an almost total ileal resection&#10;D) 50-year-old woman with the ileocecal valve removed

Accepted Answer

Although most patients with significant bowel resection need parenteral nutrition initially to restore and maintain nutritional status, a patient with a jejunal resection adapts to enteral nutrition and oral diet more quickly after surgery because the ileum can adapt to perform the functions of the jejunum. Risk factors for dependence on long-term parenteral nutrition include elderly age, extensive removal of the ileum, loss of the ileocecal valve, and residual disease in the bowel (e.g., radiation enteritis).

Question 11

What is a characteristic difference between Crohn disease and ulcerative colitis?&#10;A) Age at disease onset&#10;B) Segmental versus continuous distribution of the disease throughout the GI tract&#10;C) Clinical features of diarrhea, food intolerance, and dehydration&#10;D) Medical management with steroids and diet

Accepted Answer

The answer of What is a characteristic difference between Crohn...

Question 12

Blind loop syndrome is&#10;A) an abnormal passage between two internal organs.&#10;B) the presence of an excessive amount of gas in the GI tract.&#10;C) a disorder of bacterial overgrowth with resulting malabsorption.&#10;D) a malabsorptive condition resulting from massive bowel resection.

Accepted Answer

The answer of Blind loop syndrome is&#10;A) an abnormal passage...

Question 13

What type of diarrhea may be experienced by a patient with lactase deficiency?&#10;A) Exudative diarrhea&#10;B) Malabsorptive diarrhea&#10;C) Osmotic diarrhea&#10;D) Secretory diarrhea

Accepted Answer

The answer of What type of diarrhea may be experienced...

Question 14

Which of the following should be included in the advice given to a patient regarding eating a high-fiber diet?&#10;A) Increase polyunsaturated fat intake.&#10;B) Make sure to get more vitamin C.&#10;C) Drink at least 2 L of water each day.&#10;D) Make sure to get more iron.

Accepted Answer

The answer of Which of the following should be included...

Question 15

Which of the following statements is TRUE regarding medium-chain triglycerides (MCTs)?&#10;A) MCTs are rapidly hydrolyzed and absorbed in the absence of bile acids.&#10;B) MCTs require pancreatic lipase for digestion.&#10;C) MCTs must be administered intravenously in PN.&#10;D) MCTs are contraindicated in steatorrhea and other malabsorptive conditions.

Accepted Answer

The answer of Which of the following statements is TRUE...

Question 16

What should be included in the initial treatment of diarrhea?&#10;A) Low-fat, low-fiber diet&#10;B) Replacement of lost fluids and electrolytes&#10;C) Increase of high-pectin foods&#10;D) High-fiber diet to increase stool bulk and restore normal bowel motility

Accepted Answer

The answer of What should be included in the initial...

Question 17

Which disease is associated with advanced age?&#10;A) Crohn disease&#10;B) Diverticulitis&#10;C) Ulcerative colitis&#10;D) Tropical sprue

Accepted Answer

The answer of Which disease is associated with advanced age?&#10;A)...

Question 18

What should patients with Crohn disease be monitored for when experiencing diarrhea?&#10;A) Calcium and phosphorus status&#10;B) Magnesium and iron status&#10;C) Zinc and potassium status&#10;D) Iron and selenium status

Accepted Answer

The answer of What should patients with Crohn disease be...

Question 19

The FODMAPs diet is showing success for which group of patients?&#10;A) Patients with diverticulosis&#10;B) Celiac disease patients&#10;C) Crohn disease patients&#10;D) IBS patients

Accepted Answer

The answer of The FODMAPs diet is showing success for...

Question 20

In the MNT for inflammatory bowel disease, which of the following is LEAST likely to be used?&#10;A) Low-residue diet&#10;B) Parenteral nutrition&#10;C) Lactose-free or reduced diet&#10;D) High-fiber diet

Accepted Answer

The answer of In the MNT for inflammatory bowel disease,...

Deck 28: Medical Nutrition Therapy for Lower Gastrointestinal Tract Disorders