Deck 15: Diseases of the Lower Gastrointenstinal Tract

Question 1

What best describes the action of opiate anti-diarrheal medications?​

A) ​They enter bacteria and destroy DNA
B) ​They decrease fluid secretions and reduce stool output
C) ​They decrease intestinal muscle tone and peristalsis of the GI tract
D) ​They inhibit acetylcholine and decrease peristalsis
E) ​They work as anti-inflammatory and immune suppressant agents in the colon

Answer 1

D

Question 2

The most likely cause of steatorrhea is:​

A) ​increased levels of pancreatic lipase.
B) ​too little vitamin B12 absorbed in the ileum.
C) ​the excretion of bile acids.
D) ​low-density lipoproteins broken down into the stool.
E) ​lipids that are not digested or absorbed correctly.

Answer 2

E

Question 3

Bright red blood on the surface of the stool is called:​

A) ​melena.
B) ​occult blood.
C) ​hematochezia.
D) ​steatorrhea.
E) ​exudate.

Answer 3

C

Question 4

What is an example of a resistant starch?​

A) ​yogurt
B) ​bread
C) ​potatoes
D) ​hot dogs
E) ​dried fruit

Question 5

Recommendations for the prevention of diarrhea worldwide include strategies such as:

A) ​washing hands with soap after touching food.
B) ​promoting hygiene education.
C) ​exclusive formula feeding for infants.
D) ​preventing weaning practices.
E) ​immunizing all adults.

Question 6

A dietitian is working with a client to help her improve her fiber intake. Which recommendation would the dietitian most likely give?​

A) ​Use white flour for baking and cooking
B) ​Increase fiber intake by 20 g per day until tolerated
C) ​Avoid dried beans and peas
D) ​Choose fruit and vegetable juices over fresh produce
E) ​Use brown or wild rice instead of white rice or potatoes

Question 7

Which is an example of a true statement regarding osmotic diarrhea?​

A) ​It is typically caused by lack of dietary fiber.
B) ​It often occurs from endotoxins released by bacteria.
C) ​Its most common type is traveler's diarrhea.
D) ​It develops from an underlying disease.
E) ​It stops when the causative agent is removed.

Question 8

The primary enzyme involved in starch digestion is:​

A) ​motilin.
B) ​pancreatic amylase.
C) ​vasoactive intestinal polypeptide.
D) ​substance P.
E) ​cholecystokinin.

Question 9

The standard first step in reducing symptoms of fat malabsorption would be to:​

A) ​increase intake of fat-soluble vitamins.
B) ​restrict carbohydrate intake.
C) ​limit fluids.
D) ​restrict fat intake.
E) ​decrease protein intake.

Question 10

Current practice of nutrition therapy for diarrhea involves:​

A) ​making the patient NPO.
B) ​feeding clear liquids.
C) ​enteral nutrition for 3 days.
D) ​parenteral nutrition until diarrhea resolves.
E) ​feeding a normal diet of tolerable foods.

Question 11

Which best describes the migrating motility complex (MMC)?​

A) ​Weak contractions that rid the small intestine of leftover bacteria or waste
B) ​Segmentation motility that mixes chyme with digestive secretions
C) ​A hormone called gastrin that stimulates the onset of segmental contractions
D) ​A muscular valve that controls the rate of movement of food from the ileum
E) ​A substance that neutralizes the very acidic chyme as it enters from the stomach

Question 12

Which condition would most likely be a possible cause of malabsorption?​

A) ​glomerulosclerosis
B) ​amyloidosis
C) ​appendicitis
D) ​albuminuria
E) ​colon polyps

Question 13

Which describes the correct location of stem cells and enterocytes of the small intestine?​

A) ​Within the folds of Keckring
B) ​On the outside of the villi
C) ​On the surface of the brush border
D) ​In the crypts between the villi
E) ​Within the cells of the microvilli

Question 14

Which substances are released in the large intestine and play a role in electrolyte and fluid absorption?​

A) ​Bile salts and pancreatic lipase
B) ​Triglycerides and chylomicrons
C) ​Potassium and bicarbonate
D) ​Hydrogen and sodium
E) ​Aminopeptidases and chloride

Question 15

Which foods would be most appropriate for an infant with diarrhea who has started on solids?​

A) ​fish
B) ​carrots
C) ​bananas
D) ​strained peas
E) ​beef broth

Question 16

Which medication would be classified as an anticholinergic anti-diarrheal medication?​

A) ​hyoscyamine
B) ​pectin
C) ​kaolin
D) ​metronidazole
E) ​olsazine

Question 17

How much fiber is recommended for adults daily?​

A) ​10-15 g
B) ​20-25 g
C) ​25-35 g
D) ​40-50 g
E) ​50-60 g

Question 18

Which sphincter or valve protects the small intestine from bacteria translocation from the large intestine?​

A) ​pyloric sphincter
B) ​ileocecal valve
C) ​sphincter of Oddi
D) ​lower esophageal sphincter
E) ​internal anal sphincter

Question 19

What symptom is included as part of the Rome III Criteria for diagnosing constipation?​

A) ​blood in the stools
B) ​abdominal pain
C) ​sensation of incomplete evacuation
D) ​fewer than 6 defecations per week
E) ​flatulence

Question 20

The primary function of the large intestine is to:​

A) ​inhibit gastric emptying and post-prandial glucagon release.
B) ​provide a site for reabsorption of water, electrolytes, and some vitamins.
C) ​stimulate acid secretion and pancreatic HCO3 secretion.
D) ​provide enzymatic digestion before defecation.
E) ​provide sodium, iron, and water for chyme production.

Question 21

A dietitian is counseling a client with irritable bowel syndrome about how best to avoid gas-producing foods. Which food would the dietitian most likely suggest that the client avoid?​

A) ​beets
B) ​artichokes
C) ​mushrooms
D) ​okra
E) ​green peas

Question 22

Which condition is most likely a cause of short bowel syndrome among children?​

A) ​obesity treatment
B) ​necrotizing enterocolitis
C) ​volvulus
D) ​strangulated hernia
E) ​surgical bypass

Question 23

Which is a true statement regarding diverticulosis?​

A) ​Diverticulosis most commonly begins in adolescence and progresses into adulthood.
B) ​Diverticulosis is asymptomatic for most people.
C) ​Factors associated with diverticulosis include lactose and gluten intolerance.
D) ​Diverticulosis develops because of low fiber intake.
E) ​People with a history of constipation are more likely to develop diverticulosis.

Question 24

Which condition would most likely place RD at risk of folate deficiency?​

A) ​anorexia
B) ​healing after surgery
C) ​medication use
D) ​high-volume diarrhea
E) ​blood loss

Question 25

Which best describes bacterial overgrowth syndrome?​

A) ​The patient is exposed to contaminated instruments during surgery
B) ​Cross-contamination of bacteria occurs between the colon and the small intestine
C) ​The colon is perforated and bacteria enter the peritoneum
D) ​The surgical incision becomes infected with overgrowth of bacteria
E) ​The patient passes excess bacteria from the stomach into the small intestine

Question 26

What food should be included in a low-FODMAP diet?​

A) ​apples
B) ​ice cream
C) ​sweet potatoes
D) ​eggs
E) ​baked beans

Question 27

Which is the most appropriate treatment of celiac disease?​

A) ​Symptomatic management with anti-diarrheal medications
B) ​Supplementation with probiotics
C) ​Lifelong adherence to a gluten-free diet
D) ​Antibiotics and immunomodulator medications
E) ​Total colectomy

Question 28

Following surgery that results in short bowel syndrome, what should be the first items offered for the patient to eat or drink?​

A) ​low-residue full liquids
B) ​hypotonic clear liquids
C) ​lactose-free milk or dairy
D) ​isotonic clear liquids
E) ​yogurt with probiotics

Question 29

Which types of foods would the nutritionist suggest for RD in rehabilitation during a period of remission?​

A) ​foods high in oxalate
B) ​low-residue foods
C) ​foods that contain antioxidants
D) ​lactose-free foods
E) ​foods without glutamine

Question 30

Which symptoms are most indicative of ulcerative colitis?​

A) ​nausea and vomiting, and headache
B) ​epigastric pain and abdominal fullness
C) ​nausea, bloating, and steatorrhea
D) ​abdominal pain, bloody diarrhea, and tenesmus
E) ​nausea,constipation, and flatulence

Question 31

What is a common complication of Crohn's disease that may require surgery?​

A) ​weight loss
B) ​diarrhea
C) ​perforation
D) ​tenesmus
E) ​muscle wasting

Question 32

RD's frequent diarrhea most likely puts her at risk of which nutrient deficiency?​

A) ​calcium
B) ​iron
C) ​vitamin D
D) ​vitamin B12
E) ​magnesium

Question 33

Which food would a patient with celiac disease most likely need to avoid?​

A) ​popcorn
B) ​chicken tenders
C) ​butter
D) ​white rice
E) ​processed cheese

Question 34

Damage to intestinal mucosa through celiac disease occurs with exposure to which substance?​

A) ​gliadin
B) ​lactate dehydrogenase
C) ​glycophorin
D) ​fibronectin
E) ​selectin

Question 35

Which condition is associated with irritable bowel syndrome?​

A) ​pernicious anemia
B) ​Graves' disease
C) ​systemic lupus erythematosus
D) ​type 1 diabetes
E) ​temporomandibular joint (TMJ) syndrome

Question 36

A patient has just undergone surgical removal of the colon and rectum. This would most likely result in a(n):​

A) ​gastrostomy.
B) ​jejunostomy.
C) ​colostomy.
D) ​urostomy.
E) ​ileostomy.

Question 37

Which type of medication would most likely be prescribed for RD during the acute phase of Crohn's disease?​

A) ​proton pump inhibitors
B) ​biologic therapies
C) ​corticosteroids
D) ​purine antagonists
E) ​H2 receptor agonists

Question 38

A patient with inflammatory bowel disease is taking medication to manage his acute symptoms. What must the dietitian consider when planning nutrition interventions for this patient?​

A) ​The patient may have increased nutrient requirements.
B) ​The patient should remain NPO during periods of exacerbation of symptoms.
C) ​The patient will need parenteral nutrition in addition to medication.
D) ​The patient will have decreased fluid requirements.
E) ​The patient will experience nausea, which will impact food intake.

Question 39

A patient with Crohn's disease is undergoing a sigmoidoscopy. Which best describes this procedure?​

A) ​Imaging of the stomach, liver, and pancreas
B) ​Evaluation of the colon and distal ileum
C) ​Assessment of the small intestine
D) ​Imaging of the colon up to the splenic fixture
E) ​Evaluation of the esophagus, stomach, and duodenum

Question 40

What recommendations should the dietitian make for the client with a newly placed ostomy?​

A) ​Eat the largest meal of the day in the evening to reduce output overnight.
B) ​Limit dairy products to reduce odor in output.
C) ​Drink at least 4-5 cups of fluid every day.
D) ​Choose foods that can thicken stools, such as peanut butter, margarine, and yogurt.
E) ​Avoid spicy or fried foods, which can cause diarrhea.

Question 41

Damage to the anatomy and physiology of the small intestine due to disease is the most common cause of malabsorption.

Question 42

Haustration in the large intestine is accomplished by alternating waves of relaxation and con- traction of smooth muscle lasting for several minutes.

Question 43

Treatment for diverticulosis involves only nutrition therapy, with a specific focus on fiber intake.

Question 44

More than 50% of the small intestine has to be removed before any significant reduction in its capability is observed.

Question 45

_______________ is a dark stool caused by contamination with blood from the upper GI tract.

Question 46

Approximately 95% of patients with ulcerative colitis have disease only involving the rectum.

Question 47

During a fecal microbiota transplantation, stool is obtained from a healthy donor and is infused into the patient, usually via _______________.

Question 48

Celiac disease is often associated with other chronic, infectious diseases, including hepatitis, varicella, and cytomegalovirus.

Question 49

_______________ is a hormone secreted by the small intestine that assists in the control of the migrating motility complex.

Question 50

Substances in food that stimulate the beneficial flora of the large intestine are called _______________.

Question 51

The _______________ is the primary site for reabsorption of bile acids.

Question 52

_______________ starch is defined as starch components that enter the large intestine undigested.

Question 53

Normal osmolality of the gastrointestinal tract is approximately _______________ mOsm/L.

Question 54

Gastric juices provide the primary digestive enzymes in the small intestine.

Question 55

_______________ absorption is much more difficult due to its insolubility in water.

Question 56

When defecation relieves cramping, diarrhea is generally from the small intestine.

Question 57

The _______________ colon ends in the rectum where another sphincter (the anal sphincter) controls voluntary release of intestinal contents.

Question 58

At least two-thirds of IBS patients associate the signs and symptoms they experience with characteristics of the foods that they eat.

Question 59

Consumption of fructans or fructooligosaccharides (FOS) has been shown to soften feces and to assist in relieving constipation.

Question 60

The _______________ absorption test assists in distinguishing between pancreatic dysfunction and small bowel malabsorption.

Question 61

Absorption of _______________ is of specific concern with short bowel syndrome because it requires adequate ileal receptors and a normal transit time.

Question 62

Describe the FODMAP diet and give examples of foods included in a low-FODMAP diet plan.

Question 63

Explain etiological factors that have been associated with the development of IBS, including communication between body systems, GI tract function and environment, and GI symptoms.

Question 64

Explain the differences between ulcerative colitis and Crohn's disease in terms of clinical manifestations and medical treatment.

Question 65

Bacterial overgrowth syndrome is treated by both correcting the underlying cause and administering medications such as _______________.

Question 66

Briefly describe the process of restriction and reintroduction of dairy products in clients with lactose malabsorption.

Question 67

Define each of the four components currently under investigation to maintain health of the colon: resistant starches, prebiotics, probiotics, and synbiotics.

Question 68

One nutritional intervention for treating IBS is the use of a traditional _______________ diet, which eliminates all possible foods related to the patient's symptoms.

Question 69

The most common surgical procedure in ulcerative colitis is a _______________.

Question 70

The only current recommendation for fiber supplementation in IBS patients is the use of ispaghula husk, which is more commonly known as _______________.

Question 71

Explain the nutrition assessment for the lower gastrointestinal tract, including the components of client history, anthropometric measurements, and biochemical data, and giving examples of each component.

Question 72

Describe the process of lipid digestion and absorption in the small intestine.

Question 73

With chronic ulcerative colitis, the intestinal wall can become so thin that the mucosa is ulcerated, which is referred to as _______________.

Question 74

_______________ supplements, which are triglycerides that contain primarily caprylic (C8) and capric (C10) fatty acids, can be used to increase caloric intake.

Question 75

A(n) _______________ is a surgically created artificial opening into the abdomenfrom which waste products can be excreted.

Question 76

Describe how a dietitian would teach a client to increase fiber in his diet, listing examples of foods to include.

Question 77

It is understood that approximately 50% of the duodenum and jejunum can be resected without significant nutrition deficits. If less than _______________ cm of the small intestine is left, malabsorption is inevitable.

Question 78

_______________ symptoms that can occur in the absence of GI problems of a person with celiac disease include bone and joint pain, muscle cramping, fatigue, and peripheral neuropathy.

Question 79

Briefly describe segmentation associated with digestion in the small intestine.

Question 80

List four components of the Rome III Consensus Criteria for diagnosing constipation.