Exam 3: MNT for Upper GI Disorders

Question 1

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

Answer 1

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

Question 2

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

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

Answer 2

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

Question 3

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

Answer 3

True

Question 4

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.

Answer 4

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

Question 5

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

Answer 5

True

Question 6

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

Answer 6

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

Question 7

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

Answer 7

peppermint

relax: chocolate, mint,

Question 8

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

Answer 8

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

Question 9

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

Answer 9

True

Question 10

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

Answer 10

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

Question 11

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

Answer 11

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

Question 12

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

Answer 12

decreases gastric acid production.

Block histamine from stimulating stomach to produce acid

Histamine stimulate parietals cells

parietal cells produce HCL and intrinsic factor

Question 13

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

Answer 13

Metoclopramide

Meto = “go in” spanish

you want stomach contents to go

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

Question 14

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,

Answer 14

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

Question 15

Give explanation for each recommendation of GERD and gastroparesis.

• Avoid large meals

Answer 15

• delays gastric emptying and empty slower this means more time of acidity environment at the stomach lining if already damaged and higher chance of being refluxed

Question 16

Give explanation for each recommendation of GERD and gastroparesis.

• Avoid high fat meals

Answer 16

• delays gastric emptying and empty slower

Question 17

Give explanation for each recommendation of GERD and gastroparesis.

• avoid eating at least 2-3 hours before retiring

Answer 17

• gravity helps moves food down

Question 18

Give explanation for each recommendation of GERD and gastroparesis.

• avoid smoking

Answer 18

• lower LES pressure

Question 19

Give explanation for each recommendation of GERD and gastroparesis.

• avoid alcoholic beverages

Answer 19

• mucosal irritant

Question 20

Give explanation for each recommendation of GERD and gastroparesis.

• avoid chocolate and mint

Answer 20

• relax LES pressure

Question 21

Give explanation for each recommendation of GERD and gastroparesis.

• avoid tomato and tomato products

Answer 21

• irritate lining of esophagus

Question 23

Give explanation for each recommendation of GERD and gastroparesis.

• avoid caffeine containing foods and beverages

Answer 23

• lower LES pressure

Question 24

which lower LES pressure. choose all that apply

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

Answer 24

smoking and caffeine

Question 25

Give explanation for each recommendation of GERD and gastroparesis.

• stay up right and avoid rigorous activity soon after eating

Answer 25

gravity helps move food down

Question 26

Give explanation for each recommendation of GERD and gastroparesis.

• avoid tight fitting clothing especially after a meal

Answer 26

reduce intra abdominal pressure

Question 27

• consume a healthy nutritionally complete diet with adequate fiber

Question 28

Give explanation for each recommendation of GERD and gastroparesis.

• avoid acidic and highly spiced foods when inflammation exists

Answer 28

cause pain and irritate when inflammed

Question 29

Give explanation for each recommendation of GERD and gastroparesis.

lose weight if overweight

Answer 29

dec intraabdominal pressure

Question 30

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,

Answer 30

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

Question 31

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

Answer 31

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

Question 32

GERD symptoms include heartburn and ________?

Answer 32

all symptoms:
heartburn, belching, reflux of acidic secretions

Question 33

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

Answer 33

Fundoplication

Question 34

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

Answer 34

Delayed gastric emptying

Question 35

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

Answer 35

Barrett esophagus

Question 36

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

Answer 36

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.

Question 37

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.

Answer 37

ingest liquids or pureed foods

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

Question 38

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

Answer 38

Esophagogastroduodenoscopy

Question 39

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

Answer 39

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

Question 40

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

Answer 40

BE

Question 41

Damage to the vagus nerve can cause?

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

Answer 41

dumping syndrome

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

Question 42

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

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

Answer 42

iron and B12

Book: calcium

Question 43

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

Answer 43

inhibit alpha-glycoside hydrolase and interfere with carbohydrate absorption

Question 44

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

Answer 44

somatostatin analog, inhibits insulin release

Question 45

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

Answer 45

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.

Question 46

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

Answer 46

Nausea, abdominal cramping, and diarrhea

Question 47

Coffee and caffeine stimulate _______ and also may decrease ________.

Answer 47

Acid secretion and LES pressure

Question 48

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.

Answer 48

D) all of the above.

Question 49

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

Answer 49

all

Question 50

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

Answer 50

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

Question 51

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

Answer 51

C) Being underweight

Question 52

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

Answer 52

all

Question 53

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

Answer 53

H pylori

Question 54

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

Answer 54

Vitamin B12 (best absorbed in acidic environment also iron)

Question 55

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

Answer 55

simple CHO

digest faster and increase blood sugar

Question 56

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

Answer 56

within 10 to 30 minutes postprandially

Question 57

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

Answer 57

proton pump inhibitor

Question 58

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

Answer 58

none of the above

all are types of GERD

Question 59

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

Answer 59

answers: GERD, esophagitis, gastritis and peptic ulcer

Question 60

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?

Answer 60

GERD
Esophagitis
Peptic Uler
Gastritis

Question 61

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.

Answer 61

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.

Question 62

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

Answer 62

GERD

Question 63

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

Answer 63

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

Question 64

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

Answer 64

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

Question 65

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

Answer 65

H. Pylori and gastritis

Question 66

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

Answer 66

false

there must not be an obstruction

Question 67

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

Answer 67

daytime GERD

Question 68

Iron Deficiency Anemia

Answer 68

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

Question 69

Pernicious Anemia

Answer 69

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

Question 70

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

Answer 70

increased abdominal pressure

other: pregnancy, COPD, obesity, hiatal hernia

Question 71

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

Answer 71

H2 receptor antagonist

Question 72

Nocturnal GERD is associated significantly with severe

Answer 72

Esophagitis and Barrett esophagus

Question 73

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

Answer 73

gastroparesis

Question 74

Who are the common patients with GERD?

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

Answer 74

all of the above

Question 75

What condition is characterized by inflammation of the esophagus?

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

Answer 75

esophagitis

Question 76

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

Answer 76

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

Question 77

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

Answer 77

Alcohol

Question 78

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?

Answer 78

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

Question 79

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

Answer 79

COPD, pregnancy, and overweight

Question 80

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

Answer 80

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

Question 81

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

Answer 81

gastroparesis

Question 82

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

Answer 82

GERD, Long-term acid reflux

Question 83

What abnormalities are associated with GERD and esophagitis?
Hiatal hernia

Question 84

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.

Question 85

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

Answer 85

Explanations: Obesity- because it increases intragastric pressure

Question 86

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

Answer 86

a nuclear test of gastric emptying.

Question 87

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

Answer 87

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

Question 88

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

Answer 88

Answer: C

Question 89

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

Answer 89

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

Question 90

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

Answer 90

Answer: soluble

Question 91

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.

Answer 91

Answer: B

Question 92

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?

Answer 92

Gastritis

Question 93

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?

Answer 93

H. pylori

Question 94

What are peptic ulcers?

Answer 94

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

Question 95

When diagnosing a peptic ulcer, what will you see?

Answer 95

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

Question 96

Why do surgical procedures cause dumping syndrome?

Answer 96

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

Question 96

What is dumping syndrome?

Answer 96

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

Question 97

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?

Answer 97

GERD

Question 97

What is gastroparesis?

Answer 97

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

Question 98

What are the causes of GERD?

Answer 98

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

Question 99

What are risk factor of GERD?

Answer 99

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

Question 100

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

Question 101

What is a clinical manifestation of GERD

Answer 101

dental corrosion