Exam 18: Nutrition and Lower Gastrointestinal Disorders

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Which condition is most likely associated with fat malabsorption in the gastrointestinal tract?

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A high-fiber diet increases stool weight and fecal water content.

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What negative effects have been shown to be associated with stimulant laxatives?

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Most cases of Crohn's disease affect which part of the gastrointestinal tract?

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Identify the possible causes of diarrhea and describe its appropriate treatment.

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What best describes the protein needs of a patient with chronic pancreatitis?

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Daily exercise has been proven to cure constipation by stimulating peristalsis.

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Much of the research investigating probiotics and intestinal illness has focused on the prevention and treatment of:

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Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat.   Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium. Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin. Current Chief Complaints: A.R.'s current problems include constipation and dry skin. Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.  To follow a fat-restricted diet, A.R. should:

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Acute pancreatitis can result from high blood triglycerides.

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Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease. The gastrointestinal symptoms Kelly is experiencing are due to:

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Non-digestible substances in foods that stimulate the growth of nonpathogenic bacteria within the large intestine are called:

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To help control diarrhea, a patient with an ostomy should consume:

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Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease. Kelly should be instructed to avoid _____ until her intestine has recovered. 

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Psyllium may be helpful in the treatment of diarrhea because it reduces the liquidity of the stool.

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