Ch 29 GI Flashcards

1
Q

Which is an atypical sign of reflux?

A.) Chronic cough
B.) Hoarse voice
C.) Asthma
D.) All of the above

A

All of the above

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2
Q

Which food should be avoided in patients with GERD, as it increases gastric acidity?

A.) chocolate
B.) mint
C.) decaf coffee
D.) fried chicken

A

decaf coffee

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3
Q

Which supplement should NOT be recommended for a patient with GERD who is taking Prilosec?

A.) Vit B6
B.) Vit B12
C.) Ca+ carbonate
D.) Ca+ citrate

A

Ca+ carbonate

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4
Q

A patient presents with a history of previous peptic ulcers. She has not been to a gastroenterologist in 10 years. She complains of frequent heartburn and has developed a chronic cough. After adjusting her multiple times, The pain persists. Therefore, you should refer her to a gastroenterologist.

True or False

A

true

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5
Q

Uncontrolled gastric reflux puts a patient at risk for which of the following?

A.) Peptic ulcers
B.) esophageal cancer
C.) gastric lymphoma
D.) all of the above

A

all of the above

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6
Q

A patient reports currently taking Prilosec to control her reflux. What supplements may be indicated in this patient?

A.) iron, calcium, and B12
B.) D, E, K
C.) iron, B6, and folic acid
D.) niacin, thiamin, and riboflavin

A

A.) iron, calcium and B12

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7
Q

What is the main etiology for excessive gas production?

A

carb malabsorption

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8
Q

Cereal, rice, applesauce, and milk are used to help treat complications associated with which disorder?

A

diarrhea

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9
Q

A patient with _____ malabsorption has an increased risk of developing kidney stones.

A

lipid

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10
Q

A 17 year old male presents with unintended weight loss, extreme fatigue, steatorrhea and a cachectic appearance. He also shows you a small lesion on his ankle that has not healed since he injured it 3 weeks ago. You suspect the patient has celiac disease. You want to do some testing. Does he need to consume gluten at the time of testing?

A

yes

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11
Q

You recently diagnosed your patient with celiac disease. Which nutritional intervention is required initially?

A.) gluten-free
B.) lactose-free
C.) low fructose
D.) all of the above

A

D.) all of the above

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12
Q

Which grain is okay to recommend to your celiac patient?

A.) spelt
B.) orzo
C.) commercial oatmeal
D.) quinoa

A

D.) quinoa

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13
Q

Most gluten-free diets are nutritionally adequate?

True or False

A

false

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14
Q

Wheat allergies are diagnosed using serum-specific IgA.

True or FAlse

A

false

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15
Q

Which disorder is associated with decreased B12 absorption?

A.) kidney stones
B.) chrohn’s disease
C.) ulcerative colitis
D. IBS

A

B.) chron’s disease

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16
Q

Which probiotic has been shown to decrease intestinal permeability?

A.) Saccharomyces
B.) Lactobacilli
C.) Streptococcus
D.) Prevotella

A

Lactobacilli

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17
Q

Which micronutrients are the most important for maintaining proper intestinal permeability?

A.) protein and fat
B.) iron and copper
C.) calcium and Vit D
D.) zinc and magnesium

A

D.) zinc magnesium

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18
Q

Gluten-free diets are often low in __________.

A

B vitamins

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19
Q

You suspect your patient has leaky gut. What test should you order to confirm your diagnosis?

A

lactulose:mannitol challenge

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20
Q

A patient reports repeated bouts of frothy, odorous stools. Which supplement(s) may be the MOST helpful in correcting the situation?

A.) water-soluble forms of ADEK
B.) lactase
C.) pancreatic enzymes and bile salts
D.) zinc and iron

A

pancreatic enzymes and bile salts

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21
Q

A patient reports repeated bouts of frothy, odorous stools. Which dietary recommendation should you make?

A.) limit protein to 30-45 g/d
B.) limit fat to < 20 g/d
C.) limit carbs to < 35 g/d
D.) limit fat to 30-45 g/d

A

D.) limit fat to 30-45 g/d

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22
Q

Which is condition is LEAST likely to present with steatorrhea?

A.) A patient with stage 4 pancreatic cancer.

B.) A patient with a recurrent gallstones.

C.) A patient newly diagnosed with celiac disease.

D.) A patient with a previous diagnosis of ulcerative colitis.

A

D.) A patient with a previous diagnosis of ulcerative colitis

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23
Q

A 17 year old male presents with unintended weight loss, extreme fatigue, steatorrhea and a cachectic appearance. He also shows you a small lesion on his ankle that has not healed since he injured it 3 weeks ago. You suspect the patient has celiac disease. Which test would you begin with?

A.) H2 breath test
B.) upper endoscopy and biopsy
C.) serum antibody panel
D.) lactulose:mannitol challenge

A

C.) serum antibody panel

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24
Q

A 17 year old male presents with unintended weight loss, extreme fatigue, steatorrhea and a cachectic appearance. He also shows you a small lesion on his ankle that has not healed since he injured it 3 weeks ago. You suspect his wound is not healing due to a _______ deficiency and you recommend increasing his __________ intake to correct the imbalance.

A

zinc; seafood

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25
Q

Your newest patient is a 39 year old female that reports a history of Crohn’s disease. She accidentally had a soda yesterday that triggered a flare. She currently weighs 118 pounds. What should her daily protein intake be during her flare? (1 kg = 2.2 lb.)

A

(118/2.2) X 1.5 = 80 g/day protein

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26
Q

Your newest patient is a 12 year old female that reports a history of Crohn’s disease. She accidentally had a small piece of chocolate yesterday that triggered a flare. She currently weighs 71 pounds. What should her daily protein intake be during her flare? (1 kg = 2.2 lb.)

A

(71/2.2) X 2 = 54 g/day protein

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27
Q

A patient presents with abdominal discomfort and bloating, which you suspect is due to small intestinal bacterial overgrowth. Which micronutrient deficiency are they most likely to have?

A

B12

28
Q

Which gastrointestinal disorder is LEAST likely to respond well to the FODMAP diet?

A.) IBS
B.) SIBO
C.) Chronic cholecystitis
D.) Kidney stones

A

Kidney stones

29
Q

Which meal contains only foods allowed for a patient following the FODMAP diet?

A.) Spinach salad with tomatoes, avocado, apples, almonds, raspberry vinegarette dressing

B.) Baked chicken with a side of sweet potatoes mashed with cinnamon and honey

C.) Broiled salmon with a side of roasted carrots and fruit salad containing cantaloupe, pineapple and blueberries

D.) Smoothie made of kale, almond milk, banana, cherries, plain nonfat yogurt

A

C.) Broiled salmon with a side of roasted carrots and fruit salad containing cantaloupe, pineapple and blueberries

30
Q

Where is most B12 absorbed in vivo?

A.) ileum
B.) stomach
C.) duodenum
D.) jejunum

A

ileum

31
Q

What nutritional deficiencies are associated w/ GERD?

A

Ca, B12, Fe

32
Q

What is the most common cause of gas?

A

lactose intolerance

33
Q

what are the 3 most common gas producing foods?

A

legumes, wheat, cruciferous veggies

34
Q

What are 2 nutritional strategies for women?

A

8-10 cups/day fluids

25 g/day fiber

35
Q

What are 2 nutritional strategies for men?

A

8-10 cups/day fluids

38 g/day fiber

36
Q

What are 5 nutritional strategies would you recommend for your patients w/ diarrhea?

A
increase fluids
decrease simple sugars
decrease alcohol
decrease caffeine
decrease sugar alcohols
37
Q

what are 4 foods that thicken stools?

A

cereal
rice
applesauce
milk

38
Q

what probiotic decreases diarrhea episodes?

A

sachromyces boyardi

39
Q

If someone has fat malabsorption, what should they restrict fat intake to?

A

30-45 g/day

40
Q

What supplements should someone w/ fat malabsorption take?

A

PERT or bile salts

–(increase lipid absorption)

41
Q

What is the most common cause of carb malabsorption?

A

lactose intolerance

42
Q

How is carb malabsorption diagnosed?

A

lactose H breath test

43
Q

What compound causes an inflammatory response in celiac disease?

A

gliadin

44
Q

What genes are associated w/ celiacs?

A

HLA-DQ2 and DQ8

45
Q

What age should gluten be introduced?

A

< 4 or > 6 months

46
Q

What antibody is associated w/ diagnosing celiacs?

A

IgA serology

47
Q

what are 5 nutritional deficiences associated w/ celiacs?

A

fiber, folate, niacin, riboflavin, b12

48
Q

What nutritional intervention is performed following diagnosis of celiacs?

A

month 1: eliminate gluten, lactose and fructose

Post month 1: eliminate gluten

49
Q

After a month of so, how much gluten can someone w/ celiacs have per day?

A

50 g/day

50
Q

What are some gluten-free options?

A
    • > 5 servings fuits/veggies

- - meat, fish, dairy

51
Q

What antibody is associated w/ wheat allergy?

A

IgE

52
Q

At what age should you introduce wheat to kids?

A

> 6 months

53
Q

how is NON-celiac gluten sensitivity difference from celiacs?

A

NON-celiac = gluten ingestion causes symptoms w/out change in IgA

–(no correlation b/w gluten intake and GI symptoms)

54
Q

Which type of diarrhea is limited to the colon, but continuous?

A

ulcerative collitis

55
Q

Which type of diarrhea is mostly in ileum and colon, but random?

A

chron’s

56
Q

What is the peak onset for Ulcerative collitis and chron’s?

A
UC = 20-30
chrons = teens to 20's
57
Q

What nutritional deficiency is associated w/ chron’s?

A

B12

58
Q

W/ chron’s flareups, how much protein should adults and kids get?

A
adults = 1.5
kids = 2
59
Q

What are 5 supplements to have w/ chron’s flareups?

A
    • Multivitamin
    • B12
    • Mg/Zn
    • Ca
    • Vit D
60
Q

What is the cause of diarrhea predominate IBS?

A

increased serotonin

61
Q

What is the cause of constipation predominate IBS?

A

decreased serotonin

62
Q

What are the worst 3 FODMAP foods?

A

garlic, onion, wheat

63
Q

What is the key sign/symptom of SIBO?

A

chronic diarrhea from fat malabsorption

–(distention and bloating)

64
Q

Leaky gut can lead to what 4 diseases?

A
    • food allergies
    • inflammatory disorders
    • autoimmune disorders
    • insullin resistance
65
Q

How is leaky gut diagnosed?

A

lactulose:mannitol challenge

66
Q

What 2 supplements are needed w/ leaky gut?

A

magnesium and zinc