Deck 14: Diseases of the Upper Gastrointestinal Tract

Question 1

Parietal cells are responsible for secreting _____

A)intrinsic factor
B)pepsin
C)trypsin
D)gastrin

Answer 1

A

Question 2

_____ converts pepsinogen (inactive) to pepsin (active)

A)Hydrochloric acid
B)Carbonic acid
C)Gastrin
D)Bicarbonate

Answer 2

A

Question 3

The parasympathetic system innervates the GI system and sends impulses via the _____

A)hypoglossal nerve
B)trigeminal nerve
C)vagus nerve
D)oculomotor nerve

Answer 3

C

Question 4

Which of the following neurotransmitters inhibit the closure of the LES, allowing it to relax?

A)dopamine and serotonin
B)acetylcholine and noradrenaline
C)GABA and glycine
D)nitric oxide and VIP

Question 5

Which of the following proteins found in saliva is capable of destroying bacteria in the mouth?

A)amylase
B)lysozyme
C)lipase
D)mucin

Question 6

All of the following are primary neurotransmitters involved in the neuroregulation of the GI tract except:

A)acetylcholine.
B)nitric oxide.
C)dopamine.
D)substance P.

Question 7

Intrinsic factor is necessary for the absorption of _____

A)vitamin B12
B)iron
C)folic acid
D)amino acids

Question 8

Which portion of the stomach is involved in mixing foodstuffs?

A)pylorus
B)antrum
C)fundus

Question 9

Chief cells of the stomach secrete all of the following except _____

A)zymogen
B)pepsinogen
C)gastric lipase
D)intrinsic factor

Question 10

Which of the following is not considered a region/portion of the stomach?

A)fundus
B)corpus
C)antrum
D)paracrine

Question 11

Which of the following is not one of phases of gastric secretion?

A)cephalic
B)gastric
C)intestinal
D)esophageal

Question 12

Which of the following statements is false in regards to digestion in the stomach?

A)Pepsin is the primary enzyme responsible for chemical digestion in the stomach.
B)Among macronutrients, proteins are subjected to the most active chemical digestion in the stomach.
C)Carbohydrate digestion is unlimited in the stomach.
D)Salivary amylase is inactivated by HCl.

Question 13

The chief function of the esophagus is:

A)digestion.
B)lubrication.
C)motility.

Question 14

Which of the following is not a function of HCl?

A)activates pepsinogen
B)kills microorganisms
C)denatures protein
D)relaxes the pyloric sphincter

Question 15

Which of the following sphincters is responsible for controlling the release of a bolus into the stomach?

A)sphincter of Oddi
B)pyloric sphincter
C)ileocecal sphincter
D)lower esophageal sphincter

Question 16

Which of the following is the correct order of phases that occur with each swallow?

A)pharyngeal, oral preparatory, oral transit, and esophageal
B)oral transit, oral preparatory, esophageal, and pharyngeal
C)esophageal, pharyngeal, oral transit, and oral preparatory
D)oral preparatory, oral transit, pharyngeal, and esophageal

Question 17

Cheilosis and glossitis are both inflammatory symptoms of the oral cavity that are associated with deficiencies of all of these vitamins except:

A)riboflavin.
B)niacin.
C)pyridoxine.
D)biotin.

Question 18

After food is chewed and mixed with saliva it then forms a:

A)solution.
B)bolus.
C)barrier.
D)buffer.

Question 19

What is a common medication/supplement that can be absorbed in the stomach?

A)steroids
B)aspirin
C)calcium

Question 20

_____ is secreted by D cells in the pylorus and is responsible for _____ gastric secretion

A)Somatostatin, inhibiting
B)Somatostatin, stimulating
C)Histamine, inhibiting
D)Histamine, stimulating

Question 21

The goals of care for GERD include:

A)decreasing LES competence.
B)increasing gastric acidity.
C)improving clearance of contents from the esophagus.
D)increasing irritation of the esophagus.

Question 22

Your patient has stomatitis Which of the following may be helpful in reducing his symptoms?

A)encourage hot beverages
B)use carbonated beverages
C)avoid rinsing the mouth
D)suggest oral glutamine supplements

Question 23

The procedure that removes the lower portion of the stomach and a small part of the duodenum and then creates an anastomosis of the jejunum to the stomach is called:

A)highly selective parietal cell vagotomy.
B)vagotomy and antrectomy.
C)vagotomy and pyloroplasty.
D)Billroth I (gastroduodenostomy).
E)Billroth II (gastrojejunostomy).

Question 24

Gastritis can be caused by an infection with _____

A)H.pylori
B)E.coli
C)C.difficile
D)S.aureus

Question 25

Zollinger-Ellison syndrome is a condition of:

A)somatostatin hypersecretion.
B)gastric acid hypersecretion.
C)histamine hyposecretion.
D)HCl hyposecretion.

Question 26

What groups of foods affect LES pressure?

A)high-fat foods
B)foods containing cinnamon
C)spicy foods
D)highly salted foods

Question 27

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
The registered dietitian assesses LK's diet and determines that it is lower in _____ than is recommended for her condition

A)fat
B)protein
C)fluids
D)carbohydrate

Question 28

Treatment of achalasia includes the use of _____, which is/are responsible for prolonging the relaxation of the LES

A)antihistamines
B)botulinum toxin
C)epinephrine
D)proton pump inhibitors

Question 29

Following removal of two-thirds of the stomach, the patient may report experiencing the "dumping syndrome" Typical symptoms of this condition would include:

A)nausea, abdominal cramping, and diarrhea.
B)elevated blood pressure, headache, and substernal pain.
C)decreased salivation, steatorrhea, and bloating.
D)hyperglycemia, sweating, and weakness.

Question 30

A reduction in the amount of saliva produced is a common side effect of which of the following medications?

A)antiemetics
B)antinflammatory
C)antihistamines
D)anticholinergics

Question 31

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
Which of the following is not a nutritional recommendation that the registered dietitian will suggest for LK?

A)plenty of fluids with meals
B)small, frequent meals
C)avoid lactose
D)supplement with calcium and vitamin D

Question 32

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
What % IBW is LK?

A)122%
B)156%
C)133%
D)158%

Question 33

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
What is the likely cause of LK's persistent diarrhea?

A)outlet obstruction
B)hiatal hernia
C)dumping syndrome
D)dehydration

Question 34

The post-gastrectomy or "anti-dumping" diet encourages which of the following?

A)well-balanced diet slightly higher in protein and fat than recommended by U.S.Dietary Guidelines
B)well-balanced diet slightly lower in protein and fat than recommended by U.S.Dietary Guidelines
C)well-balanced diet as recommended by U.S.Dietary Guidelines
D)well-balanced diet slightly higher in protein and carbohydrates

Question 35

Late dumping syndrome is caused by oversecretion of which hormone?

A)glucagon
B)insulin
C)secretin
D)gastrin

Question 36

All of the following foods decrease LES pressure except:

A)chocolate.
B)peppermint.
C)caffeine.
D)milk.

Question 37

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
Calculate and describe LK's % weight loss

A)9%, intentional
B)10%, intentional
C)9%, unintentional
D)10%, unintentional

Question 38

The purpose of a vagotomy is to:

A)stimulate the stomach to produce more acid.
B)increase cholinergic stimulation of the stomach.
C)eliminate the cholinergic stimulation of the stomach.
D)stimulate enzyme production.

Question 39

All of the following foods increase acid secretion except for _____

A)black and red pepper
B)coffee
C)sugar
D)ethanol

Question 40

Postgastrectomy and post-vagotomy patients will have fewer problems with eating if they will make which of the following adjustments in their diet?

A)increase the carbohydrate intake, particularly the simple sugars; decrease the fat and protein
B)decrease simple carbohydrates and consume liquids between meals
C)reduce fiber from fruits and vegetables
D)increase the amount of milk at mealtimes and between meals

Question 41

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
One week post op, the registered dietitian would recommend which diet?

A)regular
B)dysphagia pureed
C)dysphagia mechanically altered
D)dysphagia advanced

Question 42

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
What is HK's percent UBW?

A)110%
B)93%
C)96%
D)107%

Question 43

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
What is HK's % weight loss?

A)7.1%
B)7.6%
C)6.7%
D)5%

Question 44

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
The registered dietitian will recommend which type of diet after the above procedure?

A)regular
B)dysphagia pureed
C)dysphagia mechanically altered
D)dysphagia advanced

Question 45

Case Study Multiple Choice
LK is a 40 yo F s/p gastric resection 2 weeks ago due to a perforated ulcer from complicated PUD.Prior to her surgery, she was experiencing severe pain and upset stomach.She is now complaining of persistent diarrhea after she eats.
HT: 5'4" WT: 170# UBW: 187#
Usual intake: Diet: NPO
AM juice and fruit
Snack toast with butter
Noon half a tuna sandwich
Snack granola bar, Gatorade
PM mashed potatoes with gravy
Snack ice cream
Labs:
Na: 151 Cl: 107 BUN: 8
Glucose: 140
K: 3.5 CO₂: 28 Cr: 1.1
The registered dietitian may prescribe which vitamin due to the reduction in surface area of the stomach?

A)C
B)pyridoxine
C)folate
D)B12

Question 46

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
What surgical procedure might the MD recommend for HK?

A)botulinum toxin
B)esophagectomy
C)esophageal myotomy
D)gastrectomy

Question 47

HK is a 60 yo M who has been diagnosed with achalasia.He has a history of Chagas disease and has been complaining of "food getting stuck in his throat." The registered dietitian consults with HK and finds that he has been afraid to eat due to his symptoms and has experienced a 13# unintentional weight loss.
HT: 5'8" WT: 170#
Which of the following foods is allowed on this diet?

A)chocolate cake
B)walnut bread
C)whole-kernel corn
D)peanut butter