Deck 30: Medical Nutrition Therapy for Liver, Biliary System, and Exocrine Pancreas Disorders

Question 1

Enteral nutrition is preferred over parenteral nutrition when treating patients with severe, acute pancreatitis because:

A)Enteral nutrition is more expensive.
B)Enteral nutrition can prevent pseudocysts from developing.
C)Failure to use the gastrointestinal tract exacerbates the stress response.
D)It is not the preferred route of nutrition.

Answer 1

C
The optimal route of nutrition in acute pancreatitis has been the subject of much controversy over the years.Failure to use the GI tract in patients with acute pancreatitis may exacerbate the stress response and disease severity, leading to more complications and prolonged hospitalization; thus, enteral nutrition is preferred for nutrition therapy.The cause of pseudocysts is unclear.

Question 2

Which of the following may be provided to a patient with chronic pancreatitis to minimize steatorrhea?

A)Water-soluble form of fat-soluble vitamins
B)Pancreatic enzyme replacements
C)Antacids
D)Proton pump inhibitors

Answer 2

B
Pancreatic enzyme replacement therapy provides dosages of lipase that are consumed at meal times.This allows for the lipase to aid in the digestion of fat in the diet to promote improved absorption, thus reducing steatorrhea.Fat-soluble vitamins are supplemented in water-soluble form to ensure against potential deficiencies.Because pancreatic bicarbonate secretion is impaired, antacids and proton pump inhibitors may be provided to reduce or neutralize stomach acids to restore the optimal pH in the duodenum for digestive enzyme actions.

Question 3

Which of the following is characterized by the presence of gallstones in the common bile duct?

A)Cholangitis
B)Cholecystitis
C)Choledocholithiasis
D)Cirrhosis

Answer 3

C
Choledocholithiasis occurs when stones slip from the gallbladder into the bile ducts.Cholangitis or inflammation of the bile ducts can occur as a result of choledocholithiasis.Cholecystitis is an inflammation of the gallbladder, which can also be caused by gallstones.Cirrhosis is the final stage of liver deterioration, which involves the scarring and formation of fibrous tissue that interferes with the liver's normal structure.

Question 4

Increased serum aromatic amino acids and decreased serum branched-chain amino acids is associated with

A)sclerosing cholangitis.
B)acute pancreatitis.
C)hepatic encephalopathy.
D)cholecystis.

Question 5

How is serum alkaline phosphatase used to diagnose liver disease

A)It is decreased in cholestasis.
B)It is increased in cholestasis.
C)It indicates prolonged bleeding time.
D)It precedes jaundice.

Question 6

Which of the following laboratory measures is NOT included in Ranson's criteria to classify severity of pancreatitis?

A)WBC
B)Blood glucose
C)Serum calcium
D)Serum amylase

Question 7

Which of the following, when consumed by a patient with chronic pancreatitis, may cause symptoms to worsen?

A)Fried foods, foods with a high sucrose content, and caffeine
B)Carbohydrates, low-fat dairy products, and coffee
C)Large meals, fatty foods, and alcohol
D)Red meat, sweets, and coffee

Question 8

A deficiency of which nutrient is associated with Wernicke's encephalopathy?

A)Copper
B)Essential fatty acid
C)Tryptophan
D)Thiamin

Question 9

Which of the following foods would be recommended to be avoided by a patient with Wilson's disease, in which excretion of copper from the body becomes impaired?

A)Dried beans, dried fruits, and shellfish
B)Eggs, milk, and cheese
C)Sweet potato, rice, and oatmeal
D)Butter, cream, oil, and salad dressing

Question 10

Which of the following is a common sign of portal hypertension secondary to cirrhosis?

A)Ascites
B)Cardiac arrhythmias
C)Increased gastrointestinal motility and peristalsis
D)Pulmonary fibrosis

Question 11

Which type of immunosuppressant drug used in the treatment of liver transplant is most likely to promote sodium retention, hyperglycemia, and impaired absorption of calcium?

A)Azathioprine
B)Cyclosporine
C)Glucocorticoid
D)Tacrolimus

Question 12

Which of the following symptoms appears when pancreatitis progresses to where the ability to secrete a sufficient quantity of enzymes is impaired?

A)Constipation
B)Hypervitaminosis A
C)Steatorrhea
D)Elevated serum ammonia

Question 13

Which of the following herbal supplements is used to treat liver disease?

A)Milk thistle
B)Centella asiatica
C)ephedra
D)Kava

Question 14

Which of the following biochemical measures is a test of the liver's excretion?

A)Serum alkaline phosphatase
B)Direct serum bilirubin
C)Alanine aminotransferase
D)Prothrombin time

Question 15

Which of the following, when eaten by a patient with cholecystitis, may cause pain?

A)High-protein foods
B)High-fat foods
C)Complex carbohydrates
D)Simple carbohydrates

Question 16

Which is the most common hepatitis virus that is primarily transmitted by blood and body fluids?

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

Question 17

Which of the following recommendations should be included in the nutrition care plan for a patient in the acute post liver transplant phase?

A)Calorie restriction
B)Increased sodium
C)Decreased protein
D)Increased protein

Question 18

Which of the following is used in the medical treatment of ascites?

A)Shunt placement
B)Whipple procedure
C)Paracentesis
D)Shock-wave lithotripsy

Question 19

In liver disease, which factor(s) affect the interpretation of serum albumin values?

A)Increased synthesis of albumin by the liver
B)Increased synthesis of albumin by the liver and increased nitrogen retention
C)Decreased synthesis of albumin by the liver and increased urinary nitrogen excretion
D)Decreased synthesis of albumin by the liver and the presence of edema and ascites

Question 20

Which of the following parameters is included in Subjective Global Assessment?

A)Change in weight
B)Nitrogen balance
C)Fluid intake and output
D)Liver enzyme levels