Deck 15: Diseases of the Lower Gastrointestinal Tract

Question 1

Which of the following would indicate an abnormal fecal fat result?

A)3 grams
B)4 grams
C)15 grams

Answer 1

C

Question 2

Which of the following supplements has been recommended for the treatment of constipation?

A)pro- and prebiotics
B)calcium and magnesium
C)valerian root and St.John's wort
D)B-complex and iron

Answer 2

A

Question 3

The most common type of carbohydrate malabsorption is _____ malabsorption

A)xylose
B)lactose
C)glucose

Answer 3

B

Question 4

After chylomicrons are formed in the _____, they enter the _____ via passive diffusion

A)enterocyte, lymphatic system
B)lumen, lymphatic system
C)enterocyte, circulatory system
D)lumen, circulatory system

Question 5

An abnormal amount of fat in the stool is a condition known as:

A)exudate.
B)steatorrhea.
C)diarrhea.
D)stomatorrhea.

Question 6

Common problems that occur secondary to diarrhea include all of the following except:

A)hyperkalemia.
B)acid-base imbalance.
C)dehydration.
D)malnutrition.

Question 7

What is the purpose of the D-xylose test?

A)testing for abnormalities in blood glucose
B)distinguishing the site for fat malabsorption
C)diagnosis of celiac disease

Question 8

The absorption of B12 can only occur in the:

A)ileum.
B)jejunum.
C)duodenum.
D)fundus.

Question 9

All of the following are examples of foods containing resistant starch except:

A)potato.
B)banana.
C)legumes.
D)corn.

Question 10

Which of the following valves/sphincters is responsible for protecting the small intestine from bacteria translocation from the large intestine?

A)pyloric sphincter
B)cardiac sphincter
C)sphincter of Oddi
D)ileocecal sphincter

Question 11

The hormone _____ is responsible for initiating the process of segmentation within the duodenum

A)leptin
B)cholecystokinin
C)secretin
D)gastrin

Question 12

The fermentation of fiber and sugar alcohols within the colon produces _____, which are used directly by the bacteria and by the colon for its own tissue growth

A)amino acids
B)long-chain fatty acids
C)short-chain fatty acids
D)sterols

Question 13

All of the following enzymes are responsible for protein digestion within the small intestine except:

A)trypsinogen.
B)procarboxypeptidases.
C)elastase.
D)pepsinogen.

Question 14

Which of the following vitamins are endogenously produced within the colon?

A)vitamin K and vitamin D
B)vitamin K and biotin
C)vitamin D and biotin
D)vitamin D and pantothenic acid

Question 15

Individuals with celiac disease should not be exposed to _____ as it will result in damage to the intestinal mucosa

A)lactose
B)gluten
C)caffeine
D)phenylalanine

Question 16

Your patient has been experiencing diarrhea for a few days The best possible nutrition therapy for this patient is to re-introduce foods with which type of diet?

A)clear-liquid diet
B)full-liquid diet
C)low-residue diet
D)high-fiber diet

Question 17

Which of the following statements is false regarding secretory diarrhea?

A)It results from excessive fluid and electrolyte secretions into the intestines.
B)Diarrhea resolves when the patient is NPO.
C)Medications and excessive amounts of bile acid in the colon can be the potential cause.
D)Bacterial infections are often the cause of this type of diarrhea.

Question 18

All of the following are parts that compose the small intestine except the:

A)duodenum.
B)jejunum.
C)colon.
D)ileum.

Question 19

Two important recommendations dietitians should enforce when encouraging fiber intake are:

A)to increase fiber intake to the recommended 30 grams ASAP, and to limit consumption of fiber supplements.
B)to increase consumption of water to 16 eight-ounce glasses of a day, and to get most fiber intake from fruits and vegetables.
C)to consume fiber supplements, and increase consumption of fiber-rich food.
D)to slowly increase fiber consumption, and maintain adequate water intake.

Question 20

Nutrition therapy for fat malabsorption includes supplementation with _____ because it is absorbed directly into the _____

A)SFA oil, lymphatic system
B)MCT oil, circulatory system
C)SFA oil, circulatory system
D)MCT oil, lymphatic system

Question 21

Why are steroids often used to treat Crohn's and ulcerative colitis?

A)to increase muscle tissue
B)for their anti-inflammatory properties
C)to stimulate the immune system

Question 22

The use of sulfasalazine for treatment of IBD interferes with the metabolism of which of the following vitamins or minerals?

A)iron
B)folate
C)niacin
D)selenium

Question 23

All of the following classes of drugs are used to treat IBS except:

A)anti-diarrheal agents.
B)bulking agents.
C)serotonin reuptake inhibitors.
D)statins.

Question 24

Your patient has been admitted to the hospital with an exacerbation of Crohn's disease The physician has prescribed corticosteroids to control the inflammation Which of the following is not a complication of this medication?

A)hyperglycemia
B)nitrogen wasting
C)osteoporosis
D)increased lipogenesis

Question 25

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
Which of the following medications would be prescribed to RD during an acute flair-up?

A)biologic therapies
B)immunosuppressants
C)corticosteroids
D)purine antagonists

Question 26

Patients with IBD are at high risk for being deficient in _____ due to typical damage of the _____

A)iron, jejunum
B)B12, ileum
C)niacin, colon
D)magnesium, jejunum

Question 27

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
What is a common complication of Crohn's that may require surgery?

A)toxic megacolon
B)fistulas
C)intestinal mucosal damage
D)diarrhea

Question 28

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
Due to RD's weight loss, what kcalorie intake is the most appropriate?

A)1300 kcal
B)1500 kcal
C)1800 kcal
D)2600 kcal

Question 29

Diverticulosis probably originates because of

A)excessive fiber intake.
B)age.
C)inadequate fiber intake.

Question 30

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
How would you estimate RD's protein needs?

A)0.8-1.0 g/kg
B)1.0-1.25 g/kg
C)1.2-1.5 g/kg
D)1.5-1.75 g/kg

Question 31

A colostomy involves the removal of:

A)the colon.
B)the colon and rectum.
C)the jejunum and rectum.
D)the rectum.

Question 32

Which of the following statements is not true about Crohn's disease?

A)It can affect any portion of the GI tract from mouth to anus.
B)It most commonly affects the ileum and colon.
C)Damage involves only the mucosal layers of the intestine.
D)The inflammatory process is characterized by the formation of fistulas.

Question 33

Nutrition therapy for diverticulitis includes a:

A)regular diet.
B)diet low in residue.
C)diet omitting gastric stimulants.
D)diet high in fiber.

Question 34

Nutrition therapy during remission of Crohn's will be

A)low residue.
B)high fiber.
C)lactose free.
D)a return to normal diet.

Question 35

Gluten is found in all of the following foods, except for:

A)wheat.
B) rye.
C)rice.
D)barley.

Question 36

The risk of short bowel syndrome occurs with loss of _____ of the small intestine

A)45%
B)25 %
C)> 70%
D)< 35%

Question 37

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
Which of the following medications would require RD to be on a folate supplement due to their interaction?

A)aminosalicylates
B)corticosteroids
C)metronidazole
D)immodium

Question 38

IBS may be related to altered synthesis, release, or transport of:

A)aldosterone.
B)insulin.
C)CCK.
D)serotonin.

Question 39

Inflammatory bowel diseases include _____ and _____

A)UC, Crohn's disease
B)IBS, UC
C)IBS, Crohn's disease
D)celiac disease, Crohn's disease

Question 40

You have a patient who has been diagnosed with diverticulitis and is beginning to feel better after beginning antibiotic treatment Which type of solid food diet would be the most appropriate for this patient initially?

A)low intake of MCT oils
B)high intake of fiber
C)low intake of fiber
D)moderate sodium intake

Question 41

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
The registered dietitian should recommend how much fiber?

A)6-10 grams
B)15-25 grams
C)25-35 grams
D)31-41 grams

Question 42

Case Study Multiple Choice
RD is a 29 yo F admitted with intractable diarrhea and abdominal pain.She has a PMH of Crohn's disease and has had two previous resections of the small bowel.She frequently has pain in the RLQ after eating.She claims the pain often gets so bad that she is afraid to eat and has been progressively consuming below her caloric needs.She currently takes Asacol and Lomotil to manage the symptoms of Crohn's disease.After undergoing a colonoscopy, an obstruction resulting from stricture in the terminal ileum was discovered.Emergency sgy was performed to remove the obstruction and a resection was done with the remaining intestine.RD's gastroenterologist recommends bowel rest and expects her to have a full recovery.
HT: 5'4" WT: 110# UBW: 122#
Diet: NPO Meds: Asacol, Lomotil
Alb.2.7 Pre-Alb.17
Na: 138 Cl: 98 BUN: 5
Glucose: 80
K: 3.6 CO₂: 25 Cr: 0.8
Because of RD's diarrhea, which of the following electrolytes becomes of concern?

A)Fe
B)K
C)Zn
D)Mg

Question 43

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
The registered dietitian may also prescribe what supplement to assist in symptom management?

A)pro- and prebiotics
B)zinc
C)vitamins
D)simple sugars

Question 44

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
What type of diet is prescribed for patients who have diverticulitis?

A)low residue
B)low fat, high carbohydrate
C)high fiber
D)diet as tolerated

Question 45

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
What is one potential cause of BT's diagnosis?

A)obesity
B)history of constipation
C)his high-fiber diet
D)gender

Question 46

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
What type of diet is prescribed for patients who have diverticulosis?

A)low residue
B)low fat, high carbohydrate
C)high fiber
D)diet as tolerated

Question 47

BT is a 70 yo M admitted to the ER with dull abdominal pain and no passage of stools for 5 days.He reported that he is usually constipated but "now it had gotten really bad with a sensation of fullness over my stomach." He had previously been admitted to the hospital twice in 1 year with intestinal obstruction.A colonoscopy revealed diverticulitis of the transverse colon.
Ht: 5' 11" (180 cm) Wt: 179# IBW: 172#
With the diet in question #___, what is also important for the registered dietitian to recommend to patients?

A)vitamins and minerals
B)additional fluids
C)short chain fatty acids
D)low oxalate