Question 1

Which of the following symptoms would not typically be experienced by the individual with hepatitis?

Accepted Answer

A) anorexia 
B) nausea and vomiting 
C) light-colored urine 
D) jaundice 
A) anorexia 
B) nausea and vomiting 
C) light-colored urine 
D) jaundice

Question 2

_____ is a syndrome of impaired mental status and abnormal neuromuscular function resulting from major failure of liver function

Accepted Answer

A) Hepatic stenosis 
B) Hepatic encephalopathy 
C) Fulminant hepatic failure 
D) Hepatomegaly 
A) Hepatic stenosis 
B) Hepatic encephalopathy 
C) Fulminant hepatic failure 
D) Hepatomegaly

Question 3

Your patient has ascites due to cirrhosis The treatment consists of all of the following except:

Accepted Answer

A) restricting the daily sodium intake to less than 2 g/day. 
B) adequate kcal to meet energy requirements. 
C) diuretics. 
D) decreasing intake of protein. 
A) restricting the daily sodium intake to less than 2 g/day. 
B) adequate kcal to meet energy requirements. 
C) diuretics. 
D) decreasing intake of protein.

Question 4

Cystic fibrosis is an inherited disorder of epithelial transport and is one of the most common lethal inherited disorders of which ethnic group?

Accepted Answer

A) Caucasians 
B) African-Americans 
C) Hispanics 
D) Native-Americans 
A) Caucasians 
B) African-Americans 
C) Hispanics 
D) Native-Americans

Question 5

Cholelithiasis is:

Accepted Answer

A) an infection of the gallbladder. 
B) a complication that occurs when the sphincter of Oddi fails to open properly. 
C) the formation of gallstones. 
A) an infection of the gallbladder. 
B) a complication that occurs when the sphincter of Oddi fails to open properly. 
C) the formation of gallstones.

Question 6

Traditionally, we have made the patient with pancreatitis NPO in order to minimize the stimulation to the pancreas Recent research indicates that enteral feeding during pancreatitis may be beneficial Why?

Accepted Answer

A) promote negative nitrogen balance 
B) reduce complications and infections 
C) decrease release of pancreatic enzymes 
D) all of the above 
A) promote negative nitrogen balance 
B) reduce complications and infections 
C) decrease release of pancreatic enzymes 
D) all of the above

Question 7

Which of the following values is typically elevated among patients with fatty liver?

Accepted Answer

A) serum albumin 
B) red blood cell count 
C) blood sugar levels 
D) serum transaminases 
A) serum albumin 
B) red blood cell count 
C) blood sugar levels 
D) serum transaminases

Question 8

In a hospital that follows the traditional practice, the initial diet order for someone with acute pancreatitis is most likely to be

Accepted Answer

A) low fat. 
B) clear liquids. 
C) NPO. 
D) high fiber. 
A) low fat. 
B) clear liquids. 
C) NPO. 
D) high fiber.

Question 9

SB is a 60-year-old retired sales associate.SB c/o abdominal pain, often severe, nausea, and vomiting.She then began to experience back pain and reports seeing a little oil in her stool.SB says that she is unable to eat anything because she just vomits it back up.Because of SB's persistent symptoms, she checked into the hospital and an ultrasound and CT scan was administered.SB was diagnosed with severe acute pancreatitis.SB was NPO until symptoms ceased and was given Demerol.By day 5, SB's N/V had not yet been alleviated.SB was scheduled for a nasogastric suctioning.
Ht: 5'5"      Wt: 145#     UBW: 175#
Dx: severe acute pancreatitis
PMH: cholelithiasis s/p shock-wave lithotripsy
Labs:
             Ser Ca: 5 mg/dL       Amy: 122 U/L       Alb: 3.0 g/dL       Hct: 34%               Mg: 1.4 mEq/L       Lip: 65 U/L       Transferrin: 210 mg/dL       Hb: 12.3               TG: 387 mg/dL                           
Meds: Demerol
Diet: NPO
-SB is not tolerating gastric feeds What will the registered dietitian now attempt?

Accepted Answer

A) nasojejunal EN 
B) PN 
C) NPO 
D) nasogastric feedings with motility agent 
A) nasojejunal EN 
B) PN 
C) NPO 
D) nasogastric feedings with motility agent

Question 10

What treatment can we use for both HBV and HCV?

Accepted Answer

A) steroids 
B) immunosuppressants 
C) interferon 
D) neomycin 
A) steroids 
B) immunosuppressants 
C) interferon 
D) neomycin

Question 11

The liver is responsible for the conversion of _____ to urea

Accepted Answer

A) ammonia 
B) glucose 
C) amino acids 
D) fatty acids 
A) ammonia 
B) glucose 
C) amino acids 
D) fatty acids

Question 12

The primary cause of chronic pancreatitis in US adults is

Accepted Answer

A) diabetes. 
B) cystic fibrosis. 
C) alcohol ingestion. 
D) smoking. 
A) diabetes. 
B) cystic fibrosis. 
C) alcohol ingestion. 
D) smoking.

Question 13

Which of the following is typically elevated as a result of pancreatitis?

Accepted Answer

A) weight 
B) serum amylase and lipase 
C) serum ammonia 
D) urine output 
A) weight 
B) serum amylase and lipase 
C) serum ammonia 
D) urine output

Question 14

Case Study
JB is a 53 yo male who was recently divorced.He has experienced periods of depression and decreased appetite.Family reports history of heavy drinking habits and 15# weight lost.He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed.Mr.JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times.His abdomen is sore to touch and feels swollen.Mr.JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight.Mr.JB also c/o pain when swallowing food.Because of JB's persistent symptoms, he's been admitted to the hospital.
A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended.By day 2 Mr.JB still c/o of nausea and no po intake has been reported.The MD rx'd dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO.
Ht: 5'11''      Wt: 145#       UBW: 163#
Dx: End-stage liver cirrhosis, dysphagia
PMH: alcoholic cirrhosis, portal hypertension
Labs:
             Na: 134       Cl: 101       BUN: 4       Alb: 2.3      TG: 305        Transferrin: 101      NH4: 53                Glu: 139       AST: 45       ALT 48       Alk Phos: 40       Billirubin: 2.1                             K: 5.2       CO2       Cr: 1.8       H/H: 11/35                           
Diet: NPO
Meds: Neomycin, Aldactone, Lasix, Reglan
-How will the registered dietitian determine JB's caloric needs?

Accepted Answer

A) 20-25 kcal/kg IBW 
B) 25-30 kcal/kg UBW 
C) 30-35 kcal/kg current body weight 
D) 35-40 kcal/kg current body weight 
A) 20-25 kcal/kg IBW 
B) 25-30 kcal/kg UBW 
C) 30-35 kcal/kg current body weight 
D) 35-40 kcal/kg current body weight

Question 15

In the liver, ethanol is metabolized to _____ that is then converted to _____

Accepted Answer

A) acetate, alcohol 
B) acetaldehyde, acetate 
C) alcohol, acetaldehyde 
D) acetaldehyde, alcohol 
A) acetate, alcohol 
B) acetaldehyde, acetate 
C) alcohol, acetaldehyde 
D) acetaldehyde, alcohol

Question 16

SB is a 60-year-old retired sales associate.SB c/o abdominal pain, often severe, nausea, and vomiting.She then began to experience back pain and reports seeing a little oil in her stool.SB says that she is unable to eat anything because she just vomits it back up.Because of SB's persistent symptoms, she checked into the hospital and an ultrasound and CT scan was administered.SB was diagnosed with severe acute pancreatitis.SB was NPO until symptoms ceased and was given Demerol.By day 5, SB's N/V had not yet been alleviated.SB was scheduled for a nasogastric suctioning.
Ht: 5'5"      Wt: 145#     UBW: 175#
Dx: severe acute pancreatitis
PMH: cholelithiasis s/p shock-wave lithotripsy
Labs:
             Ser Ca: 5 mg/dL       Amy: 122 U/L       Alb: 3.0 g/dL       Hct: 34%               Mg: 1.4 mEq/L       Lip: 65 U/L       Transferrin: 210 mg/dL       Hb: 12.3               TG: 387 mg/dL                           
Meds: Demerol
Diet: NPO
-The registered dietitian can attempt to introduce an oral diet when what changes in SB's case?

Accepted Answer

A) patient verbalizes desire to eat 
B) there is no more fat in the stool 
C) albumin normalizes 
D) amylase and lipase normalize 
A) patient verbalizes desire to eat 
B) there is no more fat in the stool 
C) albumin normalizes 
D) amylase and lipase normalize

Question 17

Gallstones are made of

Accepted Answer

A) protein, bilirubin, and calcium salts. 
B) triglycerides, bilirubin, and calcium salts. 
C) cholesterol, bilirubin, and calcium salts. 
A) protein, bilirubin, and calcium salts. 
B) triglycerides, bilirubin, and calcium salts. 
C) cholesterol, bilirubin, and calcium salts.

Question 18

Delta cells of the pancreas are responsible for secreting:

Accepted Answer

A) somatostatin. 
B) glucagon. 
C) insulin. 
D) amylase. 
A) somatostatin. 
B) glucagon. 
C) insulin. 
D) amylase.

Question 19

In the absence of encephalopathy, what daily protein range is appropriate in liver failure?

Accepted Answer

A) 0.8-1 g/kg of dry body weight 
B) 1.0-1.2 g/kg of dry body weight 
C) 1.2-1.5 g/kg of dry body weight 
D) 2 g/kg of dry body weight 
A) 0.8-1 g/kg of dry body weight 
B) 1.0-1.2 g/kg of dry body weight 
C) 1.2-1.5 g/kg of dry body weight 
D) 2 g/kg of dry body weight

Question 20

The leading cause of liver transplantation is:

Accepted Answer

A) hepatitis A. 
B) hepatitis B. 
C) hepatitis C. 
D) hepatitis D. 
A) hepatitis A. 
B) hepatitis B. 
C) hepatitis C. 
D) hepatitis D.

Ser Ca: 5 mg/dL	Amy: 122 U/L	Alb: 3.0 g/dL	Hct: 34%
Mg: 1.4 mEq/L	Lip: 65 U/L	Transferrin: 210 mg/dL	Hb: 12.3
TG: 387 mg/dL

Na: 134	Cl: 101	BUN: 4	Alb: 2.3	TG: 305	Transferrin: 101	NH4: 53
Glu: 139	AST: 45	ALT 48	Alk Phos: 40	Billirubin: 2.1
K: 5.2	CO₂	Cr: 1.8	H/H: 11/35

Exam 16: Diseases of the Liver, Gallbladder, and Exocrine Pancreas

Which of the following symptoms would not typically be experienced by the individual with hepatitis?

_____ is a syndrome of impaired mental status and abnormal neuromuscular function resulting from major failure of liver function

Your patient has ascites due to cirrhosis The treatment consists of all of the following except:

Cystic fibrosis is an inherited disorder of epithelial transport and is one of the most common lethal inherited disorders of which ethnic group?

Cholelithiasis is:

Traditionally, we have made the patient with pancreatitis NPO in order to minimize the stimulation to the pancreas Recent research indicates that enteral feeding during pancreatitis may be beneficial Why?

Which of the following values is typically elevated among patients with fatty liver?

In a hospital that follows the traditional practice, the initial diet order for someone with acute pancreatitis is most likely to be

What treatment can we use for both HBV and HCV?

The liver is responsible for the conversion of _____ to urea

The primary cause of chronic pancreatitis in US adults is

Which of the following is typically elevated as a result of pancreatitis?

In the liver, ethanol is metabolized to _____ that is then converted to _____

Gallstones are made of

Delta cells of the pancreas are responsible for secreting:

In the absence of encephalopathy, what daily protein range is appropriate in liver failure?

The leading cause of liver transplantation is:

Role of the Dietitian in the Health Care System

The Nutrition Care Process

Nutrition Assessment: Foundation of the Nutrition Care Process

Nutrition Intervention

Enteral and Parenteral Nutrition Support

Documentation of the Nutrition Care Process

Fluid and Electrolyte Balance

Acid-Base Balance

Cellular and Physiological Response to Injury:The Role of the Immune System

Nutritional Genomics

Pharmacology

Energy Balance and Body Weight

Diseases of the Cardiovascular System

Diseases of the Upper Gastrointestinal Tract

Diseases of the Lower Gastrointestinal Tract

Diseases of the Endocrine System

Diseases of the Renal System

Diseases of the Hematological System

Diseases and Disorders of the Neurological System

Diseases of the Respiratory System

Metabolic Stress and the Critically Ill

Neoplastic Disease

Hiv and Aids

Diseases of the Musculoskeletal System

Metabolic Disorders

Filters

In the liver, ethanol is metabolized to _ that is then converted to _