Deck 27: Medical Nutrition Therapy for Upper Gastrointestinal Tract Disorders

Question 1

Evaluation of which of the following should be included in the nutritional assessment of patients with atrophic gastritis?

A)Essential fatty acid deficiency
B)Vitamin B6 status
C)Vitamin B12 status
D)Iron deficiency anemia

Answer 1

C
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 upper GI bleeding is noted, in addition, iron status should be assessed.

Question 2

Which of the following statements is NOT associated with Helicobacter pylori?

A)H.pylori increases the risk of atrophic gastritis and gastric cancer.
B)H.pylori is a viral infection found in the intestine.
C)H.pylori is a bacterial infection found in the gastric mucosa.
D)H.pylori infection may be treated with antibiotics and acid suppression therapies.

Answer 2

B
Helicobacter pylori is a gram-negative bacterium that has 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

Which of the following is NOT one of the benefits of using pectin to manage dumping syndrome?

A)Reduced upper gastrointestinal tract transit time
B)Reduced glycemic load and decreased insulin response
C)Increased glucose absorption and insulin response
D)Slow carbohydrate absorption

Answer 3

C
Pectin and guar gums used in the treatment of patients with dumping syndrome provide the benefits of reducing upper GI transit time, slowing down or decreasing the rate of glucose absorption and the glycemic load, and decreasing the insulin response.A potential caution in regard to using pectin or bulk fiber sources is in regard to the development of intestinal obstructions from using large amounts.

Question 4

What type(s) of foods should be avoided in a patient with GERD because it(they) decrease(s) LES pressure?

A)High-acid foods
B)Low-fat milk and yogurt
C)High-protein foods
D)Peppermint

Question 5

When a gastrectomy is performed with an accompanying vagotomy, what physiologic changes occur?

A)Antral and pyloric dysfunction, poor peristalsis, and diminished gastric acid secretion
B)Antral and pyloric dysfunction, poor peristalsis, and high gastric acid secretion
C)Impaired digestion leading to the need for parenteral nutrition almost all the time
D)Dysphagia because of a relaxed LES

Question 6

What is the major difference between gastric and duodenal ulcers?

A)Gastric ulcers can develop with low acid output, and duodenal ulcers develop with high acid secretion.
B)Gastric ulcers develop with high acid secretion, and duodenal ulcers develop with low acid output.
C)H.pylori is the primary cause of gastric ulcers.
D)Gastric ulcers are treated with proton pump inhibitors, and duodenal ulcers are treated with H2-receptor antagonists.

Question 7

Which of the following dietary modifications minimize the problems associated with a gastrectomy with a vagotomy?

A)Increasing carbohydrate intake, particularly simple sugars, and decreasing fat and protein
B)Decreasing intake of liquids and simple sugars with meals
C)Reducing the intake of fiber from fruits and vegetables
D)Increasing the intake of milk at mealtimes and between meals

Question 8

Which of the following is NOT true for diet recommendations after Nissen fundoplication?

A)Start with clear liquid diet.
B)Advance to full liquid diet.
C)Consume multiple, small meals.
D)Avoid dry, hard foods.

Question 9

Treating esophagitis with cimetidine, a histamine H₂-receptor blocking agent, is effective because it

A)provides a viscous protective barrier.
B)decreases gastric acid production.
C)increases LES pressure.
D)promotes gastric emptying.

Question 10

A patient with gastroparesis may benefit by which of these drugs?

A)Metoclopramide
B)Aspirin
C)Acarbose
D)Simethicone

Question 11

What causes the hypoglycemia that occurs after meals in patients who have had a gastrectomy?

A)Poor dietary intake
B)Rapid digestion and absorption of sugars and elevation of insulin levels
C)Pancreatic insufficiency
D)Elevated levels of secretin and pancreozymin

Question 12

Which of the following surgeries would be used to treat a patient with GERD?

A)Billroth I
B)Billroth II
C)Fundoplication
D)Roux-en-Y procedure

Question 13

Which of the following contributes to nighttime GERD?

A)Delayed gastric emptying
B)Increased swallowing
C)Decreased digestive secretions
D)Increased saliva production

Question 14

Which of the following is a condition involving the cells lining the distal esophagus becoming abnormal and premalignant?

A)Gastroesophageal reflux disease
B)Esophageal stricture
C)Hiatal hernia
D)Barrett esophagus

Question 15

When an H₂ blocker is used in the treatment of peptic ulcer disease, the patient may be at risk for deficiency of which nutrient?

A)Vitamin A
B)Vitamin B6
C)Vitamin B12
D)Vitamin D

Question 16

A recommendation to a patient with gastroparesis who needs to gain weight would be:

A)increase the amount of dietary fiber.
B)ingest liquids or pureed foods.
C)eat more high-fat foods.
D)eat meals and avoid snacks.

Question 17

What symptoms of dumping syndrome follow the total or subtotal removal of the stomach?

A)Nausea, abdominal cramping, and diarrhea
B)Elevated blood pressure, headache, and substernal pain
C)Heartburn, vomiting blood, and hypoglycemia
D)Decreased saliva production, steatorrhea, and bloating

Question 18

The gastrointestinal effects of smoking include

A)reduction of LES pressure.
B)lower duodenal pH.
C)inhibition of pancreatic bicarbonate secretion.
D)all of the above.

Question 19

Which factor has been associated with developing gastric cancer?

A)Smoking
B)Obesity
C)A diet high in salt and fat
D)All of the above

Question 20

Which of the following is NOT associated with dyspepsia?

A)Diet
B)Abnormal gastric emptying
C)Being underweight
D)Upper abdominal discomfort