Deck 25: Liver Disease and Gallstones

Question 1

Diets for persons with hepatitis who are experiencing steatorrhea should limit fat to less than ____ percent of total kcalories.

A)10
B)20
C)30
D)40

Answer 1

C

Question 2

The usual treatment for fatty liver is ____.

A)eliminating causative factors
B)surgically resecting the damaged portions of the liver
C)administering anti-inflammatory drugs
D)administering frequent transfusions of packed red blood cells

Answer 2

A

Question 3

The hepatic portal vein and hepatic arteries together supply approximately ____ mL of blood to the liver each minute.

A)100
B)500
C)900
D)1500

Answer 3

D

Question 4

Outbreaks of hepatitis ____ are often associated with natural disasters such as floods.

A)A
B)B
C)C
D)D

Question 5

Hepatitis B has infected _____ of the world's population.

A)less than 10 percent
B)one-quarter
C)one-third
D)one-half

Question 6

What percentage of U.S. adults is affected by fatty liver?

A)5
B)10
C)15
D)33

Question 7

An example of a drug that may be used to treat hepatitis C is ____.

A)lamivudine
B)acyclovir
C)fomivirsen
D)ritonavir

Question 8

What diet recommendation is most appropriate for a patient with hepatitis who is experiencing abdominal discomfort?

A)regular diet
B)small, frequent meals
C)high-kcalorie tube feedings
D)NPO

Question 9

If bile obstruction occurs with cirrhosis, the patient will most likely develop ____.

A)hypertension
B)pruritus
C)diaphoresis
D)urinary retention

Question 10

The primary symptom of new-onset liver disease that often goes unnoticed is ____.

A)anorexia
B)weight loss
C)fatigue
D)weight gain

Question 11

Which blood vessel is responsible for returning blood to the heart from the liver?

A)hepatic artery
B)hepatic vein
C)GI tract vein
D)portal vein

Question 12

A number of herbal remedies are reported to cause hepatitis, including ____.

A)St. John's wort
B)ma huang
C)Echinacea
D)ginseng

Question 13

Laboratory findings associated with fatty liver include ____.

A)decreased creatinine
B)elevated blood urea nitrogen
C)decreased white blood cells
D)elevated alanine aminotransferase

Question 14

The characteristic yellowing of the skin associated with jaundice is caused by the accumulation of ____ in the blood.

A)bilirubin
B)bile
C)triglycerides
D)alkaline phosphatase

Question 15

Fatty liver disease associated with inflammation is known as ____.

A)hepatomegaly
B)steatohepatitis
C)steatorrhea
D)hepatic encephalopathy

Question 16

Normal blood ammonia levels are ____ µg N/dL .

A)15  to  45
B)45  to  60
C)60  to  75
D)greater than 75

Question 17

When foodservice workers don't follow good hygiene practices, which strain of hepatitis virus can be transmitted?

A)hepatitis A virus
B)hepatitis B virus
C)hepatitis C virus
D)hepatitis D virus

Question 18

The normal range for bilirubin in the bloodstream is ____ mg/dL.

A)0-2.0
B)3.4-4.8
C)15-45
D)> 55

Question 19

Diets for persons with cirrhosis should include ____ grams of protein per kilogram of body weight each day.

A)0.5 to 0.8
B)0.8 to 1.0
C)1.0 to 1.5
D)1.5 to 1.9

Question 20

One of the two most common causes of cirrhosis in the United States is ____.

A)bile duct blockage
B)heart disease
C)environmental toxins
D)hepatitis C infection

Question 21

In what ways do immunosuppressant drugs given after liver transplant impact nutrition?

A)by increasing sodium excretion
B)by causing gastroparesis
C)by causing abdominal pain and mouth sores
D)by altering calcium absorption

Question 22

When blood flow through the portal vein is obstructed, blood travels through smaller vessels around the liver called ____.

A)ascites
B)collaterals
C)bypass
D)varices

Question 23

Branched-chain amino acids may be supplemented in the diets of clients with hepatic encephalopathy because they ____.

A)increase the synthesis of albumin
B)reduce bilirubin levels
C)may improve neurological functioning
D)prevent a false positive test for occult blood in stool

Question 24

Which type of medication would most likely be administered to a patient with cirrhosis to control ascites?

A)diuretics
B)anti-inflammatories
C)antibiotics
D)pancreatic enzyme supplements

Question 25

Isabella is being evaluated for liver transplant surgery. The dietitian finds it difficult to assess her nutritional needs because ____.

A)she may have fluid retention
B)her intake may be inadequate due to esophageal varices
C)she is receiving nutrients via parenteral nutrition
D)she is suffering from steatorrhea

Question 26

John has severe ascites due to advanced cirrhosis. He is scheduled to undergo a procedure that will use a surgical puncture to draw excess fluid out of his abdomen. What is this procedure called?

A)shock-wave lithotripsy
B)paracentesis
C)peritoneovenous shunt
D)peristenotic aspiration

Question 27

Which nutritional intervention should be encouraged for a client with cirrhosis and steatorrhea?

A)Increase  intake of polyunsaturated fat.
B)Reduce  kcalorie intake by 20 percent.
C)Limit vitamin B intake.
D)Limit fat intake and use MCT oil.

Question 28

Which measure may be normal or decreased in patients with liver disease?

A)ammonia
B)gamma-glutamyl transpeptidase
C)blood urea nitrogen
D)alanine aminotransferase

Question 29

Within 10 years of onset of cirrhosis, approximately ____ percent of patients will develop ascites.

A)10
B)35
C)50
D)80

Question 30

In patients with cirrhosis, the restricted blood flow within the liver stimulates the release of ____ in nearby blood vessels.

A)vasodilators
B)bile acids
C)insulin
D)pancreatic enzymes

Question 31

What type of dietary interaction has been seen with appetite stimulants such as dronabinol?

A)Licorice root interferes with its effects.
B)It may potentiate the effects of alcohol.
C)Grapefruit juice can raise its concentrations.
D)Its effectiveness may be reduced by calcium and magnesium supplements.

Question 32

Elizabeth had a liver transplant two weeks ago. She is on immunosuppressive therapy. What side effect of these medications might interfere with her nutrition status?

A)steatorrhea
B)orthostatic hypotension
C)gastroesophageal reflux
D)abdominal pain

Question 33

Which condition is associated with stage 3 hepatic encephalopathy?

A)somnolence
B)depression
C)tremor
D)mood changes

Question 34

In a cirrhotic liver, portal hypertension is the result of ____.

A)increased pressure in the hepatic artery
B)increased pressure in the portal vein
C)normal pressure
D)blood flow through the liver

Question 35

A patient with ascites should decrease his intake of ____ in his diet.

A)sodium
B)potassium
C)calcium
D)magnesium

Question 36

Mild hepatic encephalopathy is characterized by ____.

A)forgetfulness
B)a shortened attention span
C)inappropriate behavior
D)staggering gait

Question 37

Patients with stable cirrhosis usually require ____ kcal/kg of energy per day.

A)5 to 15
B)15 to 25
C)25 to 35
D)35 to 45

Question 38

The blood loss associated with ruptured varices in patients with liver disease is ____.

A)rarely serious
B)common and rarely clinically important
C)less problematic given current treatment regimens
D)exacerbated by the liver's reduced production of clotting factors

Question 39

What condition is thought to play a key role in hepatic encephalopathy?

A)elevated blood ammonia levels
B)prolonged plasma prothrombin time
C)decreased levels of alkaline phosphatase
D)increased blood urea nitrogen levels

Question 40

Vitamin ____ status may be affected by steatorrhea related to liver damage.

A)C
B)A
C)B₁₂
D)B₆

Question 41

Pharmacological management of gallstones with ursodeoxycholic acid may require ____ until the cholesterol crystals dissolve.

A)3  to  6 weeks
B)6  to  10 weeks
C)3  to  6 months
D)6  to  18 months

Question 42

Karen Bauman is a 27-year-old employed in the cosmetic and fashion industry. Lately, she has reported feeling fatigued. She feels her long hours and hectic schedule are the main contributors. Her past medical history includes type 1 diabetes. She returns to her doctor due to abnormal lab results from her last physical. Ms. Bauman's doctor explains that she will need to ____.

A)control her blood glucose
B)have gastric bypass surgery
C)increase her alcohol intake
D)start TPN

Question 43

Black pigment gallstones are caused primarily by ____.

A)bacterial infection
B)collections of concentrated bile
C)excessive red blood cell breakdown
D)rapid weight loss following gastric bypass

Question 44

Karen Bauman is a 27-year-old employed in the cosmetic and fashion industry. Lately, she has reported feeling fatigued. She feels her long hours and hectic schedule are the main contributors. Her past medical history includes type 1 diabetes. She returns to her doctor due to abnormal lab results from her last physical. Ms. Bauman is surprised to be diagnosed with fatty liver disease. Which laboratory value would you expect to be elevated?

A)potassium
B)triglycerides
C)albumin
D)essential fatty acids

Question 45

The dietitian evaluates a patient whose status is post liver transplant. Her education plan should include ____.

A)food safety
B)blood glucose monitoring
C)portion control
D)hepatitis information

Question 46

The most common type of anemia affecting hospitalized patients and those with long-term illness is ____.

A)aplastic anemia
B)macrocytic anemia
C)anemia of chronic disease
D)iron-deficiency anemia

Question 47

Which type of anemia is characterized by failure of stem cells to develop into RBCs and may be due to immune disease, viruses, drugs and toxins, or genetic defects?

A)aplastic anemia
B)macrocytic anemia
C)hemolytic anemia
D)thalassemia

Question 48

A patient who has undergone cholecystectomy is at risk for ____ due to an increased amount of bile in the large intestine.

A)constipation
B)dyspepsia
C)diarrhea
D)jaundice

Question 49

A type of anemia that results in premature destruction of red blood cells is ____.

A)aplastic anemia
B)anemia of chronic disease
C)macrocytic anemia
D)hemolytic anemia

Question 50

Pigment gallstones are primarily made up of which substance?

A)the calcium salt of bilirubin
B)excess pancreatic enzymes
C)phospholipids
D)inorganic salts

Question 51

Which ethnicity is at much higher risk of developing cholesterol gallstones than any other?

A)Asian American
B)Native Hawaiian/Pacific Islander
C)African American
D)Native American

Question 52

The five-year survival rate for patients with liver transplantation may be as high as ____ percent.

A)60
B)70
C)80
D)90

Question 53

Recurrence rates after pharmacologic dissolution of stones are as high as ____ percent within 5 years after treatment.

A)10
B)30
C)50
D)70

Question 54

What test is used to study the number and shapes of red blood cells?

A)peripheral blood smear
B)hemoglobin
C)mean corpuscular volume
D)hematocrit

Question 55

What is the role of stem cells?

A)to differentiate into red blood cells
B)to secrete erythropoietin
C)to aid in the production of additional vitamin B₁₂
D)to carry hemoglobin and oxygen to body tissues

Question 56

The majority of gallstones are composed primarily of ____.

A)cholesterol
B)bile pigment
C)chloride salts
D)uric acid

Question 57

Which substance has been shown to reduce the risk of gallstone formation during rapid weight loss?

A)mucin proteins
B)bile salts
C)statin medications
D)estrogen

Question 58

Where does erythropoiesis take place?

A)in the stomach
B)in the small intestines
C)in the bone marrow
D)in the large intestine

Question 59

Gallstone pain is most frequently described as ____.

A)steady, severe abdominal pain
B)intermittent, burning pain
C)pain that radiates to the chest, jaw, or head
D)excruciating pain that limits activities of daily living

Question 60

Karen Bauman is a 27-year-old employed in the cosmetic and fashion industry. Lately, she has reported feeling fatigued. She feels her long hours and hectic schedule are the main contributors. Her past medical history includes type 1 diabetes. She returns to her doctor due to abnormal lab results from her last physical. If liver damage and scarring develop, Ms. Bauman will be at risk for ____.

A)amputation
B)cancer
C)hepatitis
D)immune suppression

Question 63

Veronica Riley-O'Brien is a 30-year-old mother of two young boys (Tyler, 4 years old, and Ethan, 6 weeks old). Veronica is 5 feet, 4 inches tall and weighs 126 pounds. She is having difficulty sleeping due to pain in her abdomen and back. She calls her doctor this morning because the pain has intensified. Which factor places Ms. Riley-O'Brien most at risk for gallstones?

A)African American race
B)relatively young age
C)recent pregnancy
D)normal weight

Question 64

Karen Bauman is a 27-year-old employed in the cosmetic and fashion industry. Lately, she has reported feeling fatigued. She feels her long hours and hectic schedule are the main contributors. Her past medical history includes type 1 diabetes. She returns to her doctor due to abnormal lab results from her last physical. Although Ms. Bauman has shown few symptoms of fatty liver, some people have symptoms of ____.

A)ascites
B)steatohepatitis
C)diarrhea
D)hepatic encephalopathy

Question 71

Veronica Riley-O'Brien is a 30-year-old mother of two young boys (Tyler, 4 years old, and Ethan, 6 weeks old). Veronica is 5 feet, 4 inches tall and weighs 126 pounds. She is having difficulty sleeping due to pain in her abdomen and back. She calls her doctor this morning because the pain has intensified. Riley-O'Brien is diagnosed with gallstones. In addition to abdominal pain, what other symptom might she experience?

A)edema
B)confusion
C)headache
D)vomiting

Question 74

Veronica Riley-O'Brien is a 30-year-old mother of two young boys (Tyler, 4 years old, and Ethan, 6 weeks old). Veronica is 5 feet, 4 inches tall and weighs 126 pounds. She is having difficulty sleeping due to pain in her abdomen and back. She calls her doctor this morning because the pain has intensified. What is a complication of gallstones that can lead to infection?

A)cirrhosis
B)ascites
C)edema
D)cholecystitis

Question 75

Karen Bauman is a 27-year-old employed in the cosmetic and fashion industry. Lately, she has reported feeling fatigued. She feels her long hours and hectic schedule are the main contributors. Her past medical history includes type 1 diabetes. She returns to her doctor due to abnormal lab results from her last physical. To improve her health status, Karen will need to ____.

A)adjust her diet and exercise regimen
B)avoid travel to areas in which HBV is common
C)change her job to one that involves fewer hours
D)get on a liver transplant list as soon as possible

Question 76

Veronica Riley-O'Brien is a 30-year-old mother of two young boys (Tyler, 4 years old, and Ethan, 6 weeks old). Veronica is 5 feet, 4 inches tall and weighs 126 pounds. She is having difficulty sleeping due to pain in her abdomen and back. She calls her doctor this morning because the pain has intensified. Ms. Riley-O'Brien's gallstone risk was high during her recent pregnancy due to hormonal changes that affect the conversion of cholesterol into ____.

A)bile
B)estrogen
C)progesterone
D)bilirubin

Question 79

Veronica Riley-O'Brien is a 30-year-old mother of two young boys (Tyler, 4 years old, and Ethan, 6 weeks old). Veronica is 5 feet, 4 inches tall and weighs 126 pounds. She is having difficulty sleeping due to pain in her abdomen and back. She calls her doctor this morning because the pain has intensified. An appropriate treatment for Ms. Riley-O'Brien's gallbladder disease would be ____.

A)hormone replacement
B)a low-fat/low-cholesterol diet
C)surgery
D)cholesterol-lowering medications