Medical nutritional therapy for upper and lower GI disorders

Question 1

two main function of the GI

Answer 1

assimilating nutrients and eliminating waste

Question 2

what does the stomach secrete

Answer 2

intrinsic factors for vitamin B12 absorption

Question 3

function of the small intestine

Answer 3

where most nutrient absorption occurs

Question 4

function of the ileum

Answer 4

better suited for absorbing bile acids and vitamin B12

Question 5

what is inside the colon

Answer 5

dense bacterial colonization

Question 6

recommendation after tonsillectomy

Answer 6

day 1: pureed foods
day 2: warm fluids and soft foods
day 3-7: advance back to normal diet

Question 7

what is the first thing you check if a patient is unresponsive to treatment

Answer 7

compliance

Question 8

what is functional heartburn

Answer 8

unresponsive to therapy and without signs of increased reflux or symptom correlation to reflux episodes

Question 9

Barrett esophagus

Answer 9

normal squamous epithelium is replaced by metaplastic columnar epithelium

Question 10

what does Barrett esophagus increase the risk of

Answer 10

esophageal adenocarcinoma

Question 11

Most common cause of pill-induced esophagitis

Answer 11

NSAIDs, biphosphonate, potassium chloride, iron, vitamin c

Question 12

signs and symptoms of pill induced esophagitis

Answer 12

retrosternal CP, odynophagia and dysphagia ; often beginning several hours after taking pill

Question 13

what kind of patients are at higher risk of pill induced esophagitis

Answer 13

hospitalized or bed bound patients

Question 14

Achalasia

Answer 14

loss of peristalsis in the distal 2/3 of the esophagus + impaired relaxation of the LES

Question 15

what is the goal for achalasia

Answer 15

lower distal esophageal pressure

Question 16

indications for esophagectomy

Answer 16

esophageal cancer, Barrett’s esophagus with high grade dysplasia

Question 17

Post Op gastric pull up can experience____

Answer 17

dumping syndrome

Question 18

early dumping

Answer 18

10-30 minutes after eating

Question 19

late dumping

Answer 19

1-3 hours after eating

Question 20

gastritis

Answer 20

histological inflammation on mucosal biopsy

Question 21

complication with gastritis

Answer 21

ongoing inflammation can lead to atrophy, metaplasia and dysplasia = development of gastric cancer

Question 22

cause of atrophic gastritis

Answer 22

autoimmune, H.pylori

Question 23

what kind of malabsorption is associated with pernicious anemia

Answer 23

B12

Question 24

two causes of PUD

Answer 24

NSAIDs and H.pylori

Question 25

gastroparesis

Answer 25

delayed gastric emptying

Question 26

complications associated with gastrectomy

Answer 26

obstruction, dumping syndrome, abdominal discomfort, diarrhea, weight loss

Question 27

what are some chronic conditions that can develop after gastrectomy

Answer 27

anemia, osteoporosis, vitamin/mineral deficiencies

Question 28

cause of gastric cancer

Answer 28

more than 80% of the causes have been attributed to H.pylori

Question 29

what is used to diagnose constipation

Answer 29

ROME IV

Question 30

how is the Rome criteria fulfilled

Answer 30

last 3 months with symptoms onset at least 6 months prior to diagnosis

Question 31

what constitutes diarrhea

Answer 31

3 or more loose or liquid stools per day

Question 32

management for diarrhea

Answer 32

oral rehydration therapy, BRAT diet

Question 33

is resting gut better than early feeding

Answer 33

no

Question 34

soluble fiber

Answer 34

oat bran, barley, buts, seeds, bean, lentils, peas, some fruits and veg

Question 35

insoluble fiber

Answer 35

whole grains, veg, wheat bran

Question 36

initial management of strictures and obstructions

Answer 36

aggressive fluis resuscitation, NG decompression, analgesics, antiemics

Question 37

treatment for strangulation

Answer 37

surgical intervention

Question 38

celiac disease

Answer 38

autoimmune inflammation in response to gluten, loss of vili and absorption area

Question 39

gold standard testing for celiac disease

Answer 39

small bowel biopsy

Question 40

does cigarette smoking improve US

Answer 40

Yes

Question 41

IBS

Answer 41

chronic, idiopathic disorder characterized by abdominal pain associated with altered bowel habits

Question 42

criteria for IBS

Answer 42

1) related to defecation
2) associated with change in bowel frequency
3) associated with change in stool form

Question 43

first line therapy for IBS

Answer 43

FODMAP elimination diet