Module 8: Diseases of the Biliary Tract and Exocrine Pancreas

Question 1

Cholelithiasis AKA

Answer 1

gallstones

Question 2

Gallstones are associated with obesity, rapid wt loss, type 2 diabetes, and even __________, or sometimes they’re just idiopathic.

Answer 2

pregnancy

Question 3

Biliary Dyskinesia is a spasm of Sphincter of Oddi that prevents ______ release.

Answer 3

bile

Question 4

Cholecystitis is the total obstruction of ________ with gall bladder inflammation or blockage by _______________.

Answer 4

bile, gallstones

Question 5

Cholestasis is sludge build-up in the _______ _____________.

Answer 5

gall bladder

Question 6

Gallstones are made from what?

Answer 6

cholesterol + bilirubin + calcium salts

Question 7

Choledocholithiasis is bile duct obstruction by a ___________ that causes abdominal pain and cramping.

Answer 7

stone

Question 8

T/F: Choledocholithiasis may cause fat malabsorption due to no emulsifying fat and steatorrhea.

Answer 8

T

Question 9

The main pigment in bile is _______, which gives feces the dark color.

Answer 9

bilirubin

Question 10

T/F: Backup of bile from choledocholithiasis could lead to jaundice and liver damage.

Answer 10

T

Question 11

MNT for acute cholecystitis may need NPO and a diet in ________ or MCT to stop gallbladder contractions.

Answer 11

low-fat

Question 12

Cholecystectomy is the surgical removal of the ___________.

Answer 12

gallbladder

Question 13

T/F: It’s okay to have excessive amounts of fat after having a cholecystectomy.

Answer 13

F

Question 14

T/F: You DON’T NEED to have a gallbladder.

Answer 14

T

Question 15

The pancreas is a ___________ organ.

Answer 15

glandular

Question 16

The pancreas has endocrine and ________ glands.

Answer 16

exocrine

Question 17

The endocrine glands in the pancreas are ductless and secrete hormones into the ___________.

Answer 17

bloodstream

Question 18

The exocrine glands in the pancreas secretes ________ enzymes and ________ rich fluid through _______ (i.e. intestinal lumen) that lead to the primary pancreatic duct.

Answer 18

digestive, bicarbonate, ducts

Question 19

Cephalic stimulation is mediated by the ________ nerve that signals the pancreas to release digestive juices.

Answer 19

vagus

Question 20

Through cephalic stimulation, sight, smell, taste or the thought of ______ can trigger the secretion of __________ and pancreatic enzymes.

Answer 20

food, bicarbonate

Question 21

Gastric distention (food in the stomach) can stimulate _________ secretion from the pancreas.

Answer 21

enzyme

Question 22

The major stimulus for pancreatic secretion is when _______ reaches the _______.

Answer 22

food, duodenum

Question 23

When food reaches the duodenum, the SI release _____ and __________ which travel through the blood to the pancreas.

Answer 23

CCK, secretin

Question 24

Secretin stimulates the release of __________ rich fluid to neutralize the acidic chyme.

Answer 24

bicarbonate

Question 25

CCK stimulates the release of _________ enzymes.

Answer 25

pancreatic

Question 26

Pancreatitis is inflammation of the _________.

Answer 26

pancreas

Question 27

T/F: Pancreatitis can lead to premature activation of _______ enzymes in the pancreas instead of the duodenum.

Answer 27

zymogen

Question 28

Pancreatic proteases are secreted as _________ into the SI.

Answer 28

zymogens

Question 29

T/F: Pancreatitis can cause severe abdominal pain.

Answer 29

T

Question 30

You can see elevated levels of pancreatic enzymes (of CHO and fat digestion) of serum ________ and ________in someone with pancreatitis.

Answer 30

amylase, lipase

Question 31

T/F: About 25% of acute pancreatitis will go on to chronic pancreatitis

Answer 31

T

Question 32

T/F: Low levels of triglycerides can lead to pancreatitis.

Answer 32

F (high levels)

Question 33

T/F: Excessive alcohol intake can lead to pancreatitis.

Answer 33

T

Question 34

T/F: Gallstones can lead to pancreatitis.

Answer 34

T

Question 35

MNT for acute pancreatitis may be _____ on IV fluids for a couple of days and _______ feeding (parenteral nutrition) may be issued within a few days.

Answer 35

NPO, tube

Question 36

Those with pancreatitis may need _____PRO needs in their diet.

Answer 36

higher

Question 37

T/F: It is important to NOT OVERFEED patients with pancreatitis.

Answer 37

T

Question 38

T/F: Those with pancreatitis may have low blood glucose.

Answer 38

F (high blood glucose)

Question 39

T/F: Somatostatin can be added in MNT for pancreatitis to inhibit pancreatic secretion.

Answer 39

T

Question 40

__________ nutrition is always preferable to parenteral nutrition for MNT of pancreatitis.

Answer 40

Enteral

Question 41

For severe cases of pancreatitis, MNT may be using _______ tube feedings to bypass the gastric phase of pancreatic secretion.

Answer 41

jejunal

Question 42

______ is the most potent stimulus for the release of pancreatic enzymes.

Answer 42

CCK

Question 43

______ is the most potent stimulus for CCK release.

Answer 43

Fat

Question 44

Chronic pancreatitis is usually presented as current flare-ups of ________ ____________.

Answer 44

acute pancreatitis

Question 45

T/F: Chronic pancreatitis could be idopathic.

Answer 45

T

Question 46

Chronic pancreatitis could lead to secondary _________ because it could lead to damage of the _______ cells that secrete insulin.

Answer 46

diabetes, beta

Question 47

The most common cause chronic pancreatitis is what?

Answer 47

Heavy alcohol consumption

Question 48

MNT for chronic pancreatitis includes ________ diet, small & frequent meals, supplemental pancreatic enzymes taken before meals, ______-chain triglycerides, antacids, H2 blockers or PPIs to reduce stomach acid,

Answer 48

low-fat, medium

Question 49

Vitamin deficiencies in B12, A, D, E, and K must be monitored in patients with ______ pancreatitis.

Answer 49

chronic