Exam 3: MNT for Upper GI Disorders Flashcards

1
Q

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

A

Vitamin B12 status

gastritis may result in atrophy and loss of stomach parietal cells, with a loss of HCl secretion (achlorhydria) and intrinsic factor, resulting in pernicious anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dumping syndrome may occur as a result of which surgical procedure?

A. gastrectomy
B. phlebotomy
C. liposuction
D. fundoplotomy

A

correct answers: total or partial gastrectomy, manipulation of the pylorus, fundoplication, vagotomy, and some gastric bypass procedures for obe- sity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Gastroparesis is a syndrome of delayed gastric emptying without evidence of mechanical obstruction and is a complex and potentially debilitating condition
A. True
B. False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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.

A

H.pylori is a viral infection found in the intestine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gastroesophageal reflux disease (GERD) is a more serious, chronic form of GER, with symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, and even into the oral cavity (including larynx) or lung
A. True
B. False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

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

A

Reduced upper gastrointesnal tract transit time

pectin is a soluble fiber. (apples, plums) used to manage dumping syndrome because it slows down movement of food through GI by forming a gell like substance with water. empty more slowly. slows CHO leading to reduced glycemic load and decreased insulin response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type(s) of foods should be avoided in a patient with GERD because it(they) relax LES pressure?
A) High-acid foods
B) Low-fat milk and yogurt
C) High-protein foods
D) Peppermint

A

peppermint

relax: chocolate, mint,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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

A

Antral and pyloric dysfunction, poor peristalsis, and diminished gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

acidic and spicy do not cause but can irritate esophagitis
True
False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The dumping syndrome is a complex GI and vasomotor response to the presence of large quantities of hypertonic foods and liquids in the proximal small intestine. Dumping syndrome usually occurs as a result of ?
A. surgical procedures that do not allow excessive amounts of liquid or solid foods to enter the small intestine in a concentrated form
B. surgical procedures that allow excessive amounts of liquid or solid foods to enter the large intestine in a concentrated form
C.surgical procedures that allow excessive amounts of liquid or solid foods to enter the small intestine in a diluted form
D. surgical procedures that allow excessive amounts of liquid or solid foods to enter the small intestine in a concentrated form

A

surgical procedures that allow excessive amounts of liquid or solid foods to enter the small intestine in a concentrated form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

Decreasing intake of liquids and simple sugars with meals

dumping syndrome can result from most gastric surgeries. intervention involves slowing down movement. liquids can make food go faster and simple sugar (monosaccharides) are digested fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

decreases gastric acid production.

Block histamine from stimulating stomach to produce acid

Histamine stimulate parietals cells

parietal cells produce HCL and intrinsic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A patient with gastroparesis may benefit by which of these drugs?
A) Metoclopramide
B) Aspirin
C) Acarbose
D) Simethicone

A

Metoclopramide

Meto = “go in” spanish

you want stomach contents to go

Metoclopramide and erythromycin are medications that may be used to promote gastric motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cristina has gastroparesis and Meredith has GERD, as their RD what is your behavioral modification recommendation?
A. avoid eating at least 2-3 hours before retiring, avoid smoking, stay up right and avoid vigorous activity soon after eating, avoid tight fitting clothing especially after a meal, lose weight if overweight
B. Avoid large high fat meals, avoid eating at least 2-3 hours before retiring, avoid smoking, avoid alcoholic beverages,
C. avoid chocolate mint tomatoes and tomato products, avoid caffeine containing foods and beverages, stay up right and avoid vigorous activity soon after eating,
D. avoid tight fitting clothing especially after a meal, consume a healthy nutritionally complete diet with adequate fiber, avoid acidic and highly spiced foods when inflammation exists, lose weight if overweight,

A

avoid eating at least 2-3 hours before retiring, avoid smoking, stay up right and avoid vigorous activity soon after eating, avoid tight fitting clothing especially after a meal, lose weight if overweight

key word: BEHAVIORAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • Avoid large meals
A
  • delays gastric emptying and empty slower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • Avoid high fat meals
A
  • delays gastric emptying and empty slower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid eating at least 2-3 hours before retiring
A
  • gravity helps moves food down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid smoking
A
  • lower LES pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid alcoholic beverages
A
  • mucosal irritant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid chocolate and mint
A
  • relax LES pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid tomato and tomato products
A
  • irritate lining of esophagus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid caffeine containing foods and beverages
A
  • lower LES pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which lower LES pressure. choose all that apply

A. chocolate
B. caffeine
C mint
D. smoking
E. alcohol

A

smoking and caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • stay up right and avoid rigorous activity soon after eating
A

gravity helps move food down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid tight fitting clothing especially after a meal
A

reduce intra abdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

  • consume a healthy nutritionally complete diet with adequate fiber
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Give explanation for each recommendation of GERD and gastroparesis.

  • avoid acidic and highly spiced foods when inflammation exists
A

cause pain and irritate when inflammed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Give explanation for each recommendation of GERD and gastroparesis.

lose weight if overweight

A

dec intraabdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cristina has gastroparesis and Meredith has GERD, as their RD what is your nutrition therapy recommendation?
A. avoid eating at least 2-3 hours before retiring, avoid smoking, stay up right and avoid vigorous activity soon after eating, avoid tight fitting clothing especially after a meal, lose weight if overweight
B. Avoid large high fat meals, avoid eating at least 2-3 hours before retiring, Avoid large, high fat meals, avoid chocolate, mint, tomatoes, and tomato products, avoid caffeine containing foods and beverages, especially after a meal, consume a healthy nutritionally complete diet with adequate fiber, avoid acidic and highly spiced foods when inflammation exists,
C. stay up right and avoid vigorous activity soon after eating,
avoid tight fitting clothing especially after a meal, consume a healthy nutritionally complete diet with adequate fiber, avoid acidic and highly spiced foods when inflammation exists,
D. Avoid large, high fat meals, avoid chocolate, mint, tomatoes, and tomato products, avoid caffeine containing foods and beverages, especially after a meal, lose weight if overweight,

A

Avoid large, high fat meals, avoid chocolate, mint, tomatoes, and tomato products, avoid caffeine containing foods and beverages, especially after a meal, consume a healthy nutritionally complete diet with adequate fiber, avoid acidic and highly spiced foods when inflammation exists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

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

A

Rapid digestion and absorption of sugars and elevation of insulin levels

gastric surgeries can result in dumping syndrome. food contents move too quickly into small intestine causing rapid absorption of sugars which trigger large insulin release. this overreactive insulin response can cause decrease blood sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

GERD symptoms include heartburn and ________?

A

all symptoms:
heartburn, belching, reflux of acidic secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

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

A

Fundoplication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which of the following contributes to nighttime GERD?
A) Delayed gastric emptying
B) Increased swallowing
C) Decreased digestive secretions
D) Increased saliva production

A

Delayed gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

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

A

Barrett esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

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

A

B12 and possibly iron

gastritis/peptic ulcer are characterised by increased acid secretion/presence… may result in atrophy and loss of stomach parietal cells, these cell produce HCL and intrinsic factor. with a loss of HCl secretion (achlorhydria) and intrinsic factor, resulting in pernicious anemia. iron and B12 needs acidic environment and Hx blocker will decrease acidic environment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

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.

A

ingest liquids or pureed foods

remember: gastroparesis occur because food contents is not moving properly. want to promote motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which procedure uses a fiber-optic endo- scope to directly visualize and examine the esophagus, stomach, and duodenum to classify the severity of diseases?
A. Esophagogastrodenoscopy
B. Esophagogastroduodenoscopy
C. Esophagogastrobuodenoscopy
D. None of the above

A

Esophagogastroduodenoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the primary medical treatment of esophageal reflux?
A. The suppression of acid secretion
B. The suppression of intrinsic factor
C. The suppression of MALT
D. The suppression of GABA

A

the suppression of acid secretion

GERD occurs when stomach acid flows back into the esophagus, leading to symptoms like heartburn and discomfort. The primary approach to treating GERD focuses on reducing the amount of acid produced by the stomach. symptom relief, esophageal healing, prevent complication, improve quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

The following are risk factor for: prolonged history of GERD, middle aged, white male, obesity, smoking, and family history adenocarcinoma at esophagus

A. GERD
B. Esophagitis
C. BE
D. all of the above

A

BE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Damage to the vagus nerve can cause?

A. GERD
B. Dumping syndrome
C. Esophagitis
D. All of the above

A

dumping syndrome

The vagus nerve plays a crucial role in regulating digestive processes, so its impairment can disrupt normal gastric emptying and digestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Low acid states may reduce the absorption of _______ because gastric acid enhances bioavailability?

a. iron
b. B12
c. calcium
d. all of the above

A

iron and B12

Book: calcium

43
Q

Acarbose is prescribed to dumping syndrome patient because it?
A. inhibit alpha-glycoside hydrolase and interfere with carbohydrate absorption
B. promote gastric content motility
C. increases insulin
D. none of the above

A

inhibit alpha-glycoside hydrolase and interfere with carbohydrate absorption

44
Q

Octreotide is prescribed for dumping syndrome because it?
a. somatostatin analog, inhibits insulin release

A

somatostatin analog, inhibits insulin release

45
Q

Why do you want to interfere with carbohydrate absorption and inhibit insulin release in patients with dumping syndrome?

A

Prevent Rapid Blood Sugar Spikes: When carbohydrates are rapidly absorbed, they can cause a quick increase in blood sugar levels, leading to hyperglycemia. This is often followed by a surge in insulin release, which can then cause a rapid drop in blood sugar (reactive hypoglycemia). By slowing carbohydrate absorption, these spikes can be minimized.

46
Q

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

A

Nausea, abdominal cramping, and diarrhea

47
Q

Coffee and caffeine stimulate _______ and also may decrease ________.

A

Acid secretion and LES pressure

48
Q

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.

A

D) all of the above.

49
Q

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

A

all

50
Q

What property of soluble fiber supplements, particularly pectin or gums (e.g., guar) can be beneficial in managing dumping syndrome?

A

pectin is a soluble fiber. (apples, plums) used to manage dumping syndrome because it slows down movement of food through GI by forming a gell like substance with water. empty more slowly. slows CHO leading to reduced glycemic load and decreased insulin response

51
Q

Which of the following is NOT associated with dyspepsia?
A) Diet
B) Abnormal gastric emptying
C) Being underweight
D) Upper abdominal discomfort

A

C) Being underweight

52
Q

One of the best ways to reduce esophageal reflux is to
A. Maintain healthy body weight
B. Avoid eating late evening meals
C. Avoid caffeine and alcohol
D. All of the above

A

all

53
Q

The most common cause of peptic ulcers is
A. Overweight
B. High intake of spicy foods and caffeine
C. Abuse of antacid medications
D. Helicobacter pylori infection

A

H pylori

54
Q

Patients with chronic gastritis causing atrophy and loss of stomach parietal cells may have low serum levels of
A. Vitamin B12
B. Homocysteine
C. Vitamin C
D. Zinc

A

Vitamin B12 (best absorbed in acidic environment also iron)

55
Q

Patient with dumping syndrome should minimize their intake of
A. Omega 6 fatty cids
B. Simple CHO
C. Complex CHO
D. Dietary fiber

A

simple CHO

digest faster and increase blood sugar

56
Q

Early dumping syndrome occurs?
A. within 10 to 30 minutes postprandially
B. within 30 minutes to 1 hour postprandially
C. within 1 hour to 3 hours postprandially
D. none of the above

A

within 10 to 30 minutes postprandially

57
Q

________ medication decrease acid production by the gastric parietal cell have been associated with superior healing rates and decreased relapses?

A

proton pump inhibitor

58
Q

Which of the following are not types of GERD?
a. Erosive disease
b. nonerosive reflux disease
c. nocturnal GERD
d. None of the above

A

none of the above

all are types of GERD

59
Q

Which upper GI disorder requires vitamin B12 and Iron supplementation?
A. Gastritis and peptic ulcers
B. Gastritis and gastroparesis
C. Gastroparesis and GERD
D. Peptic ulcers and gastroparesis

A

answers: GERD, esophagitis, gastritis and peptic ulcer

60
Q

Esophagogastroduodenoscopy (EGD) uses a fiber-optic endo- scope to directly visualize and examine the esophagus, stomach, and duodenum to classify the severity of which diseases?

A

GERD
Esophagitis
Peptic Uler
Gastritis

61
Q

What function of the stomach is affected by (omeprazole) ?
A. Parietal cells secrete gastric acid
B. Gastric acid activates pepsinogen to pepsin.
C. Parietal cells secrete gastric acid and intrinsic factor.
D. Parietal cells secrete intrinsic factor.

A

parietal cells secrete gastric acid

Omeprazole is an over the counter PPI (proton pump inhibitor) that blocks the activity of the H+-K+-ATPase and leads to less acid production. H+ from water inside the parietal cell is pumped into the stomach lumen in exchange for K+ entering the cell. Cl- enter and the parietal cell secrete HCl into the stomach and bicarbonate is removed into the interstitial fluid. Other drugs available are Lansoprazole, Esomeprazole, Pantoprazole, Dexlansoprazole, and Rabeprazole. Other groups of medications are H2 blocker, Antacids and Prokinetic.

62
Q

Which GI condition involves transient relaxation of the LES independent of swallowing, with symptoms or complications from the reflux or reverse flow of gastric contents into the esophagus or beyond, and even into the oral cavity (including larynx) or lung?

A. Gastroparesis
B. GERD
C. GER
D. Peptic ulcers

A

GERD

63
Q

For reflux to take place, pressure in the proximal stomach must be greater than the pressure in the esophagus, what physiological components are involved in GERD

A. increased abdominal pressure, decreased LES pressure, Delayed gastric emptying, Hiatal hernia
B. decreased salivation, transient LES relaxation, reduced LES pressure, impaired peptic acid clearance
C. increased esophageal sensitivity, acid pocket, increased intraabdominal pressure, delayed ileum emptying
D. increased esophageal sensitivity, acid pocket, increased intra chest pressure, delayed gastric emptying

A

Possible answers: decreased salivation, transient LES relaxation, reduced LES pressure, impaired esophageal acid clearance, increased esophageal sensitivity, acid pocket, increased intraabdominal pressure, delayed gastric emptying, impaired mucosal barrier function, Hiatal hernia

64
Q

Early dumping (within 10 to 30 minutes postprandially) is characterized by GI and vasomotor symptoms, which include ?

A. abdominal fullness and nausea
B. bloating and nausea
C. vomiting and diarrhea,
D. headache and flushing

A

abdominal fullness and nausea (fluids shift from circulation to bowles) first 30min

65
Q

Causes of refractory iron deficiency anemia cases may be the presence of _________?

A

H. Pylori and gastritis

66
Q

Gastroparesis is a syndrome of delayed gastric emptying with evidence of mechanical obstruction and is a complex and potentially debilitating condition
True
False

A

false

there must not be an obstruction

67
Q

Which is not a type of GERD?
A. Non Erosive reflux disease NERD
B. Erosive disease ERD
C. Nocturnal GERD
D. Daytime GERD

A

daytime GERD

68
Q

Iron Deficiency Anemia

A

Caused by a lack of iron, which is necessary for hemoglobin production. This can result from inadequate dietary intake, chronic blood loss (e.g., from menstruation, ulcers), or malabsorption

69
Q

Pernicious Anemia

A

Caused by an inability to absorb vitamin B12 due to a deficiency of intrinsic factor, a protein produced by the stomach. This condition is often autoimmune in nature

70
Q

A 25 year old female with 6 months of pregnancy is experiencing heartburn, after her check up the doctor diagnosed her with GERD, what is the main cause of her condition?
A. increased abdominal pressure
B. decreased LES pressure
C. Delayed gastric emptying
D. Hiatal hernia

A

increased abdominal pressure

other: pregnancy, COPD, obesity, hiatal hernia

71
Q

_______ a type of histamine receptor on the gastric parietal cell?
A. H2 receptor agonist
B. H2 receptor antagonist
C. Acarbose
D. Simethicone

A

H2 receptor antagonist

72
Q

Nocturnal GERD is associated significantly with severe

A

Esophagitis and Barrett esophagus

73
Q

Clinical symptoms of which disorder may include abdominal bloating, decreased appetite and anorexia, nausea and vomiting, fullness, early satiety, halitosis, and postprandial hypoglycemia?

A

gastroparesis

74
Q

Who are the common patients with GERD?

a. Pregnancy
b. COPD
c. Obesity
d. All of the above
e. None of the above

A

all of the above

75
Q

What condition is characterized by inflammation of the esophagus?

a. Barrett esophagus
b. Hiatal hernia
c. Esophagitis
d. Gastritis

A

esophagitis

76
Q

How does esophagitis differ from GERD, in that esophagitis is…?
A. Reflux of gastric acid and/or intestinal contents through the lower esophageal sphincter and into the esophagus or beyond
B. Reflux of gastric acid and/or intestinal contents through the lower esophageal sphincter and into the esophagus causing irritation and inflammation of the esophagus
C. Reflux of gastric acid and/or intestinal contents through the lower esophageal sphincter
D. Reflux of gastric acid and/or intestinal contents through the lower esophageal sphincter causing a hiatal hernia at the base of the LES

A

Reflux of gastric acid and/or intestinal contents through the lower esophageal sphincter and into the esophagus causing irritation and inflammation of the esophagus

77
Q

Consumption of large amounts of _________ may cause superficial mucosal damage and may worsen existing disease or interfere with treatment of peptic ulcer?
A. water
B. simple carbohydrates
C. Alcohol
D. Marijuana

A

Alcohol

78
Q

You are am RD at Grey Sloan Memorial Hospital, you were assigned a patient with symptoms of painful, burning sensation that radiates up behind the sternum of fairly short duration and regurgitation. Patient describes these symptoms typically occurring at night causing her sleep disturbance. After initial nutritional assessment, BMI=38, waist circumference >35, BP>130/85, and TTG>150. Patient is not pregnant What is your diagnosis, how would you confirm, and why?

A

GERD and Esophagogastroduodenoscopy, patient is not pregnant but is experiencing heartburn. She meets 3 of the 5 criteria for metabolic syndrome and she is obese. Obesity can increased intra abdominal pressure. pressure in the proximal stomach is greater than the pressure in the esophagus resulting in LES relaxation and allowing gastric contents into the esophagus and causing damage to the the lining

79
Q

Following up in the question above, what other patient would have similar symptoms and diagnosis?

A

COPD, pregnancy, and overweight

80
Q

In persons with gastritis, vitamin B12 status should be evaluated because?

A

gastritis may result in atrophy and loss of stomach parietal cells, with a loss of HCl secretion (achlorhydria) and intrinsic factor, resulting in pernicious anemia

Lack of intrinsic factor and gastric acid results in malabsorption of this vitamin

81
Q

For which disorder is scintigraphy considered the gold-standard measure?

A

gastroparesis

82
Q

Barrett esophagus a precancerous condition in which the normal squamous epithelium of the esophagus is replaced by an abnormal columnar-lined epithelium known as specialized intestinal metaplasia, what is a major risk factor and why?
A. Obesity, Increased abdominal pressure
B. GERD, Long-term acid reflux
C. Smoking, associated with a higher risk
D. Family history, Genetic predisposition

A

GERD, Long-term acid reflux

83
Q

What abnormalities are associated with GERD and esophagitis?
Hiatal hernia

A
84
Q

Risk factors for BE include prolonged history of GERD-related symptoms (more than 5 years), middle age, white male, obesity, smok- ing, and family history of BE or adenocarcinoma of the esophagus.

A
85
Q

Mr. Bean has a BMI of 45, he presents with heartburn, severe chest pain, retching, vomiting, and hematemesis (vomiting of blood). Which upper GI disorder does he have? Explain why he would be experiencing this
Hiatal hernia
GERD
Gastritis
Gastroparesis

A

Explanations: Obesity- because it increases intragastric pressure

86
Q

The gold-standard measure of gastric emptying rate is scintigraphy?

A

a nuclear test of gastric emptying.

87
Q

Which disorder occurs because of the rapid influx of hyperosmolar contents into the duodenum or small intestine?

A

Early stage of dumping syndrome involves the rapid influx of hyperosmolar contents into the duodenum or small intestine. A subsequent fluid shift from the intravascular compartment to the intestinal lumen occurs, resulting in small intestine distention, potentially causing cramps and bloating

88
Q

What condition is a nonspecific term literally meaning inflammation of the stomach?
Hiatal hernia
GERD
Gastritis
Gastroparesis

A

Answer: C

89
Q

This specific disorder can cause hypoglycemia. Explain the pathophysiology behind this?

A

Late- reactive hypoglycemia (1-3hr, develop low blood sugar, bc quick movement fo food to GI cause quick spike in blood sugar and overreactive insulin response which cause dec in blood sugar, symp dizzy, shakiness, weakness, rapid heart beat, anxiety dificulty concentrating

90
Q

Which type of fiber supplements, particularly pectin or gums (e.g., guar) can be beneficial in managing dumping syndrome because of fiber’s ability to form gels with carbohydrates and fluids and delay GI transit?
Soluble
Insoluble
Total
All of the above

A

Answer: soluble

91
Q

What is the difference between acute and chronic gastritis?
Acute: onset of inflammation and symptoms and Chronic: gastritis may occur over a period of days to weeks, with recurrent symptoms.
Acute: rapid onset of inflammation and symptoms and Chronic: gastritis may occur over a period of months to decades, with recurrent symptoms.
There is a difference between both
There is no difference between both.

A

Answer: B

92
Q

Mr. Bean is a professional football player, due to the amount of physical activity he performs on a daily basis he takes aspirin and alternates it with ibuprofen to manage muscle soreness. Mr. Bean is at risk of developing what?

A

Gastritis

93
Q

Mr. Bean is a professional football player, due to the amount of physical activity he performs on a daily basis he takes aspirin and alternates it with ibuprofen to manage muscle soreness. Other than these medications, what is another cause for gastritis?

A

H. pylori

94
Q

What are peptic ulcers?

A

when open sores (peptic ulcers) form as a result of the breakdown of the normal defense and repair mechanisms and are differentiated as either gastric or duodenal, depending on location

95
Q

When diagnosing a peptic ulcer, what will you see?

A

Peptic ulcers typically show evidence of chronic inflammation and repair processes surrounding the lesion.

96
Q

Why do surgical procedures cause dumping syndrome?

A

Dumping syndrome usually occurs as a result of sur- gical procedures that allow excessive amounts of liquid or solid foods to enter the small intestine in a concentrated form

96
Q

What is dumping syndrome?

A

complex GI and vasomotor response to the presence of large quantities of hypertonic foods and liquids in the proxi- mal small intestine.

97
Q

Princess Pea has been experiencing heartburn, belching, and regurgitation, during the night time. After your nutritional assessment, princess pea mentions she has had to buy XL dresses and has been mainly eating double cheeseburgers everyday, and has had difficulty swallowing (dysphagia). What is your nutritional diagnosis?

A

GERD

97
Q

What is gastroparesis?

A

syndrome of delayed gastric emptying without evidence of mechanical obstruction and is a complex and potentially debilitating condition.

98
Q

What are the causes of GERD?

A

Decreased salivation
* Transient LES relaxation
* Reduced LES pressure
* Impaired esophageal acid clearance
* Increased esophageal sensitivity
* Acid pocket
* Increased intraabdominal pressure
* Delayed gastric emptying

99
Q

What are risk factor of GERD?

A

Chest pain,
Clinical: dental corrosion, dysphagia, heartburn (painful, burning sensation that radiates up behind the sternum of fairly short durations), odynophagia, regurgitation, noncardiac chest pain, extraesophageal

Lecture: heartburn, belching, reflux of acidic secretions

100
Q

What are appropriate acid-suppressive regimen for peptic ulcers and gastritis?

A
101
Q

What is a clinical manifestation of GERD

A

dental corrosion

102
Q
A