Question 1

A patient with gastroparesis may benefit by which of these drugs?&#10;A)Metoclopramide&#10;B)Aspirin&#10;C)Acarbose&#10;D)Simethicone

Accepted Answer

Metoclopramide is prokinetic agent.It increases the contractility of the stomach and shortens gastric emptying time.

Question 2

Which of the following statements is NOT associated with Helicobacter pylori?&#10;A)H.pylori increases the risk of atrophic gastritis and gastric cancer.&#10;B)H.pylori is a viral infection found in the intestine.&#10;C)H.pylori is a bacterial infection found in the gastric mucosa.&#10;D)H.pylori infection may be treated with antibiotics and acid suppression therapies.

Accepted Answer

Helicobacter pylori are gram-negative bacteria that have been associated with increased risk of atrophic gastritis, peptic ulcer, and gastric cancer.Treatment of an infection usually involves a combination of antibiotics and acid suppression medications.

Question 3

What nutrient has been associated with prevention of GI cancers?&#10;A)Vitamin C&#10;B)Red wine&#10;C)Selenium&#10;D)Protein

Accepted Answer

Whereas consumption of fruits, vegetables, and selenium appears to have a modest role in the prevention of GI cancers, alcohol consumption and being overweight increase the risk.

Question 4

What is the major difference between gastric and duodenal ulcers?&#10;A)Gastric ulcers can develop with low acid output, and duodenal ulcers develop with high acid secretions.&#10;B)Gastric ulcers develop with high acid secretion, and duodenal ulcers develop with low acid output.&#10;C)H.pylori is the primary cause of gastric ulcers.&#10;D)Gastric ulcers are treated with proton pump inhibitors, and duodenal ulcers are treated with H2-receptor antagonists.

Accepted Answer

Because gastric ulcers occur most frequently along the lesser curvature of the stomach, they may develop even when acid secretions are decreased.Duodenal ulcers occur as a result of constant exposure to high acid secretion.H.pylori are involved with the development of both types of ulcers.Because the activity of both proton pump inhibitors and H₂-receptor antagonists is to decrease acid secretion, either may be used in the treatment of both gastric and duodenal ulcers.

Question 5

What symptoms of dumping syndrome follow the total or subtotal removal of the stomach?&#10;A)Nausea, abdominal cramping, and diarrhea&#10;B)Elevated blood pressure, headache, and substernal pain&#10;C)Heartburn, vomiting blood, and hypoglycemia&#10;D)Decreased saliva production, steatorrhea, and bloating

Accepted Answer

Signs and symptoms in the early stage of dumping syndrome include abdominal fullness and nausea within 10 to 20 minutes after eating, flushing, rapid heartbeat, faintness, and sweating.In the intermediate stage of dumping syndrome, 20 to 60 minutes after eating, symptoms include abdominal bloating, flatulence, cramping pains, and diarrhea.In the late stage, 1 to 3 hours after eating, patients experience reactive hypoglycemia, which is exhibited through sweating and feelings of anxiety, weakness, or hunger.

Question 6

Which of the following is a condition involving the cells lining the distal esophagus becoming abnormal and premalignant?&#10;A)Gastroesophageal reflux disease&#10;B)Esophageal stricture&#10;C)Hiatal hernia&#10;D)Barrett's esophagus

Accepted Answer

Barrett's esophagus is partly responsible for the development of adenocarcinoma of the esophagus, although esophageal cancer may develop in the absence of Barrett's esophagus.GERD is also a risk factor for esophageal cancer; however, the condition does not necessarily involve the histologic changes seen in Barrett's esophagus.An esophageal stricture may result from a variety of conditions that lead to decreased esophageal tone and narrowing of the esophageal lumen.Hiatal hernia involves an outpouching of the stomach through the diaphragm.

Question 7

What types of foods should be avoided in a patient with GERD because they decrease LES pressure?&#10;A)High-acid foods&#10;B)Low-fat milk and yogurt&#10;C)High-protein foods&#10;D)Peppermint

Accepted Answer

Peppermint is known to decrease the lower esophageal sphincter pressure, contributing to the development of esophageal reflux.High-acid foods may cause pain in the esophagus when it is already inflamed.Milk, yogurt, and high-protein foods may temporarily buffer gastric secretions, but they also stimulate the secretion of gastrin, pepsin, and acid.

Question 8

Which of the following is NOT associated with dyspepsia?&#10;A)Diet&#10;B)Abnormal gastric emptying&#10;C)Being underweight&#10;D)Upper abdominal discomfort

Accepted Answer

Dyspepsia refers to nonspecific, persistent upper abdominal discomfort or pain.The discomfort may be related to organic causes such as esophageal reflux, gastritis, peptic ulcer, gallbladder disease, or other identifiable pathology.Diet, stress, and other lifestyle factors may contribute to the symptoms.An underlying mechanism may be altered gastric motility.

Question 9

Evaluation of which of the following should be included in the nutritional assessment of patients with atrophic gastritis?&#10;A)Essential fatty acid deficiency&#10;B)Vitamin B6 status&#10;C)Vitamin B12 status&#10;D)Iron-deficiency anemia

Accepted Answer

Atrophic gastritis results in achlorhydria and decreased intrinsic factor production.Both stomach acid and intrinsic factor are necessary for the adequate absorption of vitamin B₁₂.If an upper GI bleeding is noted, in addition, iron status should be assessed.

Question 10

Which of the following dietary modifications minimize the problems associated with a gastrectomy with a vagotomy?&#10;A)Increasing carbohydrate intake, particularly simple sugars, and decreasing fat and protein&#10;B)Decreasing intake of liquids and simple sugars with meals&#10;C)Reducing the intake of fiber from fruits and vegetables&#10;D)Increasing the intake of milk at mealtimes and between meals

Accepted Answer

Dumping syndrome is a common problem that occurs after a gastrectomy with a vagotomy.Dietary management for dumping syndrome focuses on limiting hypertonic simple sugars, which can draw fluids into the gastrointestinal system and produce the side effects of the dumping syndrome.Because of the smaller stomach capacity and impaired control of gastric emptying, the intake of fluids with meals could promote rapid gastric emptying.A high-protein, moderate-fat diet including fibrous foods and complex carbohydrates is recommended.Patients may experience lactose intolerance after these surgeries; therefore, milk and dairy portions should be limited in quantity.

Question 11

The gastrointestinal effects of smoking include&#10;A)reduction of LES pressure.&#10;B)lower duodenal pH.&#10;C)inhibition of pancreatic bicarbonate secretion.&#10;D)all of the above.

Accepted Answer

The answer of The gastrointestinal effects of smoking include&#10;A)reduction of...

Question 12

Which of the following surgeries would be used to treat a patient with GERD?&#10;A)Billroth I&#10;B)Billroth II&#10;C)Fundoplication&#10;D)Roux-en-Y procedure

Accepted Answer

The answer of Which of the following surgeries would be...

Question 13

What causes the hypoglycemia that occurs after meals in patients who have had a gastrectomy?&#10;A)Poor dietary intake&#10;B)Rapid digestion and absorption of sugars and elevation of insulin levels&#10;C)Pancreatic insufficiency&#10;D)Elevated levels of secretin and pancreozymin

Accepted Answer

The answer of What causes the hypoglycemia that occurs after...

Question 14

Which of the following contributes to nighttime GERD?&#10;A)Delayed gastric emptying&#10;B)Increased swallowing&#10;C)Decreased digestive secretions&#10;D)Increased saliva production

Accepted Answer

The answer of Which of the following contributes to nighttime...

Question 15

A recommendation to a patient with gastroparesis who needs to gain weight would be:&#10;A)increase the amount of dietary fiber.&#10;B)ingest liquids or pureed foods.&#10;C)eat more high fat foods.&#10;D)eat meals and avoid snacks.

Accepted Answer

The answer of A recommendation to a patient with gastroparesis...

Question 16

When an H&#8322; blocker is used in the treatment of peptic ulcer disease, the patient may be at risk for deficiency of which nutrient?&#10;A)Vitamin A&#10;B)Vitamin B6&#10;C)Vitamin B12&#10;D)Vitamin D

Accepted Answer

The answer of When an H&#8322; blocker is used in...

Question 17

When a gastrectomy is performed with an accompanying vagotomy, what physiologic changes occur?&#10;A)Antral and pyloric dysfunction, poor peristalsis, and diminished gastric acid secretion&#10;B)Antral and pyloric dysfunction, poor peristalsis, and high gastric acid secretion&#10;C)Impaired digestion leading to the need for parenteral nutrition almost all the time&#10;D)Dysphagia because of a relaxed LES

Accepted Answer

The answer of When a gastrectomy is performed with an...

Question 18

Which type of gastric surgery seems to have the most post-surgical complications?&#10;A)Billroth I&#10;B)Billroth II&#10;C)Vagotomy&#10;D)Roux-en-Y procedure

Accepted Answer

The answer of Which type of gastric surgery seems to...

Question 19

Treating esophagitis with cimetidine, a histamine H&#8322;-receptor blocking agent, is effective because it&#10;A)provides a viscous protective barrier.&#10;B)decreases gastric acid production.&#10;C)increases LES pressure.&#10;D)promotes gastric emptying.

Accepted Answer

The answer of Treating esophagitis with cimetidine, a histamine H&#8322;-receptor...

Question 20

Which of the following is NOT one of the benefits of using pectin to manage dumping syndrome?&#10;A)Reduced upper gastrointestinal tract transit time&#10;B)Reduced glycemic load and decreased insulin response&#10;C)Increased glucose absorption and insulin response&#10;D)Slow carbohydrate absorption

Accepted Answer

The answer of Which of the following is NOT one...

Deck 28: Medical Nutrition Therapy for Upper Gastrointestinal Tract Disorders