Deck 14: Diseases of the Upper Gastrointestinal Tract

Question 1

Saliva is produced in the mouth by three pairs of salivary glands: the parotid, submandibular, and:​

A) ​occipital.
B) ​sublingual.
C) ​supramandibular.
D) ​lingual.
E) ​maxillary.

Answer 1

B

Question 2

The innermost layer of the esophagus is called the:​

A) ​muscle layer.
B) ​mucosa.
C) ​adventitia.
D) ​secretory layer.
E) ​submucosa.

Answer 2

B

Question 3

Which intervention is most appropriate for preventing "baby bottle tooth decay?"​

A) ​Taking a child to the dentist by the time he is 6 months old
B) ​Weaning a child from the bottle by 24 months of age
C) ​Removing a bottle from the child's mouth during sleep
D) ​Brushing the baby's teeth at least once per week
E) ​Offering juice instead of formula

Answer 3

C

Question 4

Which best describes the pharyngeal phase of swallowing?​

A) ​The involuntary swallowing reflux begins and the bolus is carried through the throat to the top of the esophagus
B) ​There is rapid passage of large amounts of food into the small intestine
C) ​Esophageal peristalsis carries the bolus through the esophagus and LES and into the stomach
D) ​The tongue moves the bolus to the back of the throat
E) ​The food is chewed and prepared as a bolus by the tongue, teeth, and mandible

Question 5

Which activity may increase the risk of development of dental caries?​
​

A) ​drinking liquid while eating
B) ​eating whole grain bread
C) ​chewing sugarless gum
D) ​sipping sugared beverages for prolonged periods
E) ​consuming extra fruit

Question 6

Control of gastric secretions is accomplished through complementary actions of the nervous and endocrine systems, and involves four major chemical messengers: acetylcholine, histamine, gastrin, and:​

A) ​serotonin.
B) ​nitric oxide.
C) ​somatostatin.
D) ​substance P.
E) ​neuropeptide Y.

Question 7

Hydrochloric acid and intrinsic factor are secreted in the stomach by:​

A) ​the pylorus.
B) ​histamine.
C) ​somatostatin.
D) ​parietal cells.
E) ​mucous cells.

Question 8

Inflammation of the oral mucosa that is often associated with fungal infections or with herpes-like viruses is called:​

A) ​stomatitis.
B) ​gingivitis.
C) ​cheilosis.
D) ​glossitis.
E) ​xerostomia.

Question 9

Which is considered a true statement regarding hiatal hernia?​

A) ​Most cases of hiatal hernia are considered type 2 (rolling).
B) ​Symptoms of hiatal hernia are similar to those of Crohn's disease.
C) ​Incidence of hiatal hernia decreases with age.
D) ​Pregnancy may increase the risk of hiatal hernia.
E) ​Surgery for hiatal hernia involves Roux-en-Y gastric bypass.

Question 10

A dietitian is providing nutrition information to a patient with a jaw fracture who has had a maxillomandibular fixation. Which type of food would the dietitian most likely tell the client to avoid?

A) ​rye bread
B) ​2% milk
C) ​bananas
D) ​pasta
E) ​soft-cooked eggs

Question 11

What is an example of a change in gastrointestinal physiology that occurs with aging?​

A) ​Increased upper esophageal pressure
B) ​Atrophy of the small intestine mucosa
C) ​Enhanced excretion of hydrochloric acid in the stomach
D) ​Increased incidences of diarrhea
E) ​Overproduction of saliva in the mouth

Question 12

A jaw fracture that results in multiple pieces of bone is called a:

A) ​comminuted fracture.
B) ​open fracture.
C) ​closed fracture.
D) ​incomplete fracture.
E) ​complete fracture.

Question 13

What is an example of a nutrition intervention recommended for stomatitis?​

A) ​Increase intake of carbonated beverages
B) ​Consume no more than 2 alcoholic drinks per day
C) ​Avoid extremes of hot or cold food temperatures
D) ​Use alcohol-based mouth rinses to keep the mouth clean
E) ​Avoid oral topical anesthetics

Question 14

A patient with dysphagia aspirates food approximately 10% of the time while eating and has no cough reflex. According to the Dysphagia Severity Scale, which level of severity would this​ patient be classified as having?

A) ​2
B) ​3
C) ​4
D) ​5
E) ​6

Question 15

Which medication is classified as a proton pump inhibitor?​

A) ​Mylanta
B) ​Gaviscon
C) ​Pepcid AC
D) ​Nexium
E) ​Reglan

Question 16

Which is a true statement regarding eosinophilic esophagitis?​

A) ​EoE has only been recognized within the past 20 years.
B) ​Immune cells involved with EoE include B cells and white blood cells.
C) ​EoE has no connection to food intake.
D) ​Symptoms of EoE in adults include nausea, vomiting, and abdominal pain.
E) ​Metoclopramide is the standard form of treatment for EoE.

Question 17

Food storage occurs primarily in which part of the stomach?

A) ​corpus
B) ​antrum
C) ​fundus
D) ​pyloric canal
E) ​cardia

Question 18

What best describes a nutrition intervention for xerostomia?​

A) ​Using a de-humidifier at bedtime
B) ​Avoiding sour and tart foods
C) ​Adding extra sauces and gravies to foods
D) ​Increasing intake of hot foods and fluids
E) ​Limiting caffeine to 3 servings per day

Question 19

Which complication is most likely associated with Barrett's esophagus?

A) ​irritable bowel syndrome
B) ​esophageal cancer
C) ​diverticulitis
D) ​pyloric stenosis
E) ​atrophic gastritis

Question 20

Which is an example of a factor that contributes to lower esophageal sphincter incompetence?​

A) ​renal artery stenosis
B) ​increased secretion of aldosterone
C) ​cardiomyopathy
D) ​cigarette smoking
E) ​increased secretion of cortisol

Question 21

The gold standard for diagnosis of gastroparesis is the:​

A) ​upper GI endoscopy.
B) ​endoscopic retrograde cholangiopancreatography (ERCP).
C) ​endoscopic ultrasound.
D) ​esophagography test.
E) ​scintigraphic gastric emptying test.

Question 22

LK would most likely be at risk of which nutrient deficiency?​

A) ​vitamin B6
B) ​niacin
C) ​iron
D) ​potassium
E) ​phosphorus

Question 23

Which medication would most likely be prescribed for LK's condition?​

A) ​clarithromycin
B) ​atorvastatin calcium
C) ​niacin
D) ​bevacizumab
E) ​amlodipine

Question 24

Which gastrointestinal condition is not associated with dysphagia?​

A) ​dumping syndrome
B) ​achalasia
C) ​hiatal hernia
D) ​gastroparesis
E) ​GERD

Question 25

Which complication would most commonly be associated with dysphagia?​

A) ​ageusia
B) ​eructation
C) ​syncope
D) ​flatulence
E) ​aspiration

Question 26

What describes the mechanism of action of metoclopramide in managing nausea?

A) ​Blocking dopamine, which affects the vomiting center in the brain
B) ​Increasing the effectiveness of other antiemetics
C) ​Strengthening the pyloric sphincter to increase gastric emptying
D) ​Reducing the effect of prostaglandins
E) ​Blocking substance P in the brain, which has a direct effect on the vomiting center

Question 27

A patient is having a procedure that involves passing a tube through the oral pharynx into the stomach and recording barometric pressure through a transducer. This procedure most accurately describes a(n):

A) ​endoscopy.
B) ​barium radiology study.
C) ​esophageal manometry study.
D) ​Bernstein test.
E) ​urea breath test.

Question 28

What describes an appropriate nutrition intervention for a patient following gastric surgery?​

A) ​Instruct the patient to lie down after eating
B) ​Increase progression to solid food to avoid dumping syndrome
C) ​Reduce intake from six meals per day to three
D) ​Supplement with folate and vitamin B6
E) ​Advise the patient to consume liquids with meals

Question 29

Which is a component of nutrition therapy for peptic ulcer disease?​

A) ​Lying down after eating
B) ​Restricting acidic juices
C) ​Increasing sodium intake
D) ​Drinking extra milk
E) ​Eating small, frequent meals

Question 30

The most common surgical procedure used for refractory GERD is:​

A) ​a videofluoroscopy swallowing procedure.
B) ​the Roux-en-Y procedure.
C) ​agastroduodenostomy.
D) ​the Nissen fundoplication.
E) ​a partial gastrectomy with a reconstruction.

Question 31

Which nutritional recommendation would be most appropriate for LK?

A) ​Restricting foods that irritate the gastric mucosa
B) ​Allowing plenty of fluids with meals
C) ​Eating 1-3 large meals each day
D) ​Supplementing with folate and magnesium
E) ​Avoiding all desserts and sweets

Question 32

Which describes the purpose of vagotomy?​

A) ​To enlarge the pyloric sphincter
B) ​To eliminate cholinergic stimulation of the stomach
C) ​To anastomose the jejunum to the stomach
D) ​To lower the pressure on the lower esophageal sphincter
E) ​To prevent dumping syndrome

Question 33

The most common symptom related to peptic ulcer disease is:​

A) ​nausea.
B) ​belching.
C) ​epigastric pain.
D) ​anorexia.
E) ​vomiting.

Question 34

Which foods would the dietitian most likely recommend for LK?​

A) ​scrambled eggs
B) ​ham
C) ​2% milk
D) ​red wine
E) ​peanut butter

Question 35

Which is a correct statement regarding late dumping syndrome?​

A) ​It occurs 30-60 minutes after a meal.
B) ​It is especially common after eating protein.
C) ​It increases the risk of hypoglycemia.
D) ​It causes gas, cramping, and diarrhea.
E) It results in sweating, flushing, and dizziness.

Question 36

Which is considered a symptom of gastroesophageal reflux in infants?

A) ​constipation
B) ​increased food intake
C) ​dry mucous membranes
D) ​irritability
E) ​diarrhea

Question 37

Which type of food would most likely be recommended during the recovery period after gastric surgery?

A) ​whole grains
B) ​potatoes without the skin
C) ​lunch meat
D) ​chocolate milk
E) ​fruit juice

Question 38

What is the most likely cause of LK's persistent diarrhea?

A) ​hiatal hernia
B) ​dumping syndrome
C) ​dehydration
D) ​gastroesophageal reflux
E) ​gastroparesis

Question 39

Major innervation for the enteric nervous system is supplied by parasympathetic and sympathetic fibers of the autonomic nervous system.

Question 40

The most common symptoms of gastroparesis are:​

A) ​abdominal pain and hematemesis.
B) ​nausea, vomiting, and postprandial fullness.
C) ​abdominal distention, nausea, and flatulence.
D) ​epigastric pain and blood in the stool.
E) ​heartburn and food impaction.

Question 41

The post-gastrectomy diet encourages a well-balanced diet slightly higher in protein and fat than what is recommended by the U.S. Dietary Guidelines.

Question 42

Partially digested food in a semi-fluid state that enters the stomach and small intestine is called _______________.

Question 43

Several different types of bacteria commonly found in the mouth colonize the surface of the tooth to form plaque.

Question 44

Major innervation for the enteric nervous system is supplied by parasympathetic and sympathetic fibers of the autonomic nervous system. Parasympathetic impulses are carried by the _______________.

Question 45

Medicines for high blood pressure and depression often are causes of xerostomia.

Question 46

Most medications are absorbed in the _______________.

Question 47

Pharyngeal and esophageal phases of swallowing take only 3-5 minutes under normal conditions.

Question 48

Medications called _______________, which act to block the effect of acetylcholine, reduce the amount of saliva production as a major side effect.

Question 49

The description called "spoon-thick liquids" by the National Dysphagia Diet Task Force allows all liquids, including water, ice, milk, juice, coffee, tea, frozen desserts, and gelatin.

Question 50

The symptoms of eosinophilic esophagitis experienced by a patient depend on the phase of swallowing that is impaired.

Question 51

The Nissen fundoplication for treatment of GERD involves taking the fundus of the _______________ and wrapping it around the lower esophagus.

Question 52

Zollinger-Ellison (ZE) syndrome is similar in symptoms to PUD, but is typically unresponsive to​  standard therapy.

Question 53

_______________ ingested when teeth are developing is incorporated into the structure of the enamel and protects it against the action of acids.

Question 54

The term _______________ refers to an individual without any teeth.

Question 55

For the patient with maxillomandibular fixation, all foods must be prepared so that each easily moves through a _______________.

Question 56

There is a strong association between obesity and gastroesophageal reflux disease.

Question 57

Dysgeusia is the complete inability to taste; it is also called "mouth blindness."​

Question 58

Control of gastric secretions is accomplished through complementary actions of the nervous and _______________ systems.

Question 59

_______________ is fissuring and scaling at the corners or angles of the mouth that may be a sign/symptom of riboflavin, folate, niacin, pyridoxine, vitamin B12, or iron deficiency.

Question 60

The outer layer, or _______________, of tissue for the esophagus is connective tissue and has no additional outer covering.

Question 61

Describe the purpose of the National Dysphagia Diet and list examples of foods to include from each level.

Question 62

List three examples each of dietary factors that increase risk of dental caries and those that decrease risk of dental caries.

Question 63

The dysplastic cellular changes associated with Barrett's esophagus are considered to be a precursor to _______________.

Question 64

Explain manifestations, clinical diagnosis, and treatment interventions of gastroesophageal reflux among infants.

Question 65

A(n) _______________ occurs when a negative consequence is linked to a particular food and a person chooses to avoid eating that food.

Question 66

Meals of _______________ quantity tend to stimulate more acid production, delay gastric emptying, and increase the risk of reflux with GERD.

Question 67

Discuss nutrition therapy used for jaw fracture; include examples of recommended foods.

Question 68

For those individuals who are unable to safely swallow or to consume adequate nutrition orally because of dysphagia, _______________ feedings should be considered.

Question 69

Forceful vomiting can either rupture the esophagus, called _______________, or tear the lower esophageal sphincter, called a Mallory-Weiss tear.

Question 70

Name the four chemical messengers in the stomach that are used to control gastric secretions.

Question 71

List the seven functions of saliva in the oral cavity.

Question 72

Describe the process of swallowing as food moves from the oral cavity to the stomach; include the processes of the four phases of swallowing.

Question 73

Selective _______________ is a surgical procedure that eliminates innervations from the vagus nerve to parietal cells, resulting in decreased acid production and a decreased response to gastrin.

Question 74

Type A gastritis is a condition most often related to _______________.

Question 75

_______________, or dyspepsia, is not considered to be a specific condition but may involve symptoms of abdominal pain, gas, bloating, nausea, or gastroesophageal reflux.

Question 76

Describe the process of a focused assessment of the upper gastrointestinal tract for a client, including relevant measurements and subjective data.

Question 77

Name four different types of diagnostic procedures that may be used in identifying upper GI pathology.

Question 78

Describe clinical manifestations of GERD.

Question 79

_______________ is an inflammatory condition characterized by infiltration of eosinophils within the esophageal mucosa.

Question 80

The purposes of mastication are to break food down into smaller pieces, to mix food with saliva, and:​

A) ​to move food from the front of the mouth to the pharynx.
B) ​to regulate speech patterns.
C) ​to facilitate an immune reaction.
D) ​to provide antibacterial protection.
E) ​to stimulate taste buds.