front 1 Must follow ____ free diet in celiac disease | back 1 gluten |
front 2 Diet rich in whole ____ can be useful across spectrum of most GI symptoms | back 2 grains |
front 3 Carb digestion requires ____ to convert starches into disaccharides | back 3 amylase |
front 4 ____ absorbed through diffusion or active transport | back 4 Monosaccharides |
front 5 Symptoms: | back 5 Lactose Intolerance |
front 6 The most common form of carbohydrate malabsorption worldwide
is: | back 6 B. Lactose intolerance |
front 7 Lactose intolerance affects approximately what proportion of the
world population? | back 7 D. 70–75% |
front 8 Lactose must be hydrolyzed by lactase into: | back 8 B. Glucose and galactose |
front 9 The primary biochemical defect in most lactose intolerance is: | back 9 C. Suboptimal lactase activity |
front 10 A teenager reports bloating and diarrhea after ice cream but
tolerates small amounts of yogurt. The most likely diagnosis is: | back 10 B. Lactose intolerance |
front 11 Which test can help confirm lactose intolerance? | back 11 C. Lactose hydrogen breath test |
front 12 Another accepted test for confirming lactose intolerance is: | back 12 A. Lactose tolerance test |
front 13 Lactase production typically changes with age by: | back 13 C. Falling with age |
front 14 Reduced lactase production is most appropriately described as: | back 14 D. Pathologic in infants sometimes |
front 15 In most teens and adults, decreased lactase production is: | back 15 A. Usually normal |
front 16 Which factor increases predisposition to lactose intolerance? | back 16 B. Genetic predisposition |
front 17 Severity of lactose intolerance symptoms is often most related
to: | back 17 B. Lactose dose consumed |
front 18 A major nutritional goal in lactose malabsorption is prevention
of: | back 18 B. Secondary bone disease |
front 19 To help prevent skeletal complications, patients with lactose issues
are encouraged to: | back 19 C. Use calcium supplementation |
front 20 Even with lactose malabsorption, dietary guidance encourages: | back 20 B. Three low-fat dairy servings |
front 21 Which dairy products may improve tolerance because they contain
lactic acid bacteria? | back 21 C. Fermented dairy products |
front 22 Which food is most likely to be better tolerated in lactose
malabsorption? | back 22 A. Yogurt |
front 23 Some patients with lactose intolerance may benefit from: | back 23 A. Probiotics |
front 24 A patient with lactose malabsorption wants to maintain calcium intake
while limiting symptoms. The best recommendation is: | back 24 B. Use calcium-fortified foods |
front 25 If supplementation is needed for lactose intolerance, the notes
recommend: | back 25 C. 1000 mg calcium daily |
front 26 A patient avoids milk but tolerates fermented cheese. The best
explanation is: | back 26 C. Lactic acid bacteria help |
front 27 Who has this diet? Encouraged to consume 6-11 servings whole grain or enriched gluten-free grains and 3 servings gluten-free dairy foods per day | back 27 celiac disease |
front 28 Perform LFT, serum iron and ferri0n, RBC folate, vitamin B12, calcium, Vitamin D tests ordered for what patients? | back 28 celiac disease |
front 29 Symptoms: | back 29 fat malabsorption |
front 30 Associated with _____ | back 30 GERD |
front 31 Foods that can cause _____ | back 31 GERD |
front 32 A 24-year-old woman has chronic diarrhea, bloating, and iron
deficiency anemia that worsens after bread and pasta. Which dietary
antigen most likely drives her disease? | back 32 B. Gliadin |
front 33 A patient with suspected celiac disease undergoes endoscopy. Which
biopsy pattern most strongly supports the diagnosis? | back 33 D. Villous atrophy with crypt hyperplasia |
front 34 Celiac disease is defined by chronic inflammation involving which
site? | back 34 A. Small bowel mucosa |
front 35 A patient has positive celiac serologies. What is the most
appropriate next diagnostic step? | back 35 C. Small bowel biopsy |
front 36 Which serologic pair is most appropriate when screening for celiac
disease? | back 36 B. TTG and EMA |
front 37 A patient with untreated celiac disease is most likely to have which
deficiency pattern? | back 37 A. Iron, folate, and B12 |
front 38 Longstanding untreated celiac disease may contribute to which
skeletal complication? | back 38 D. Osteoporosis or osteomalacia |
front 39 Which intake pattern is specifically associated with many gluten-free
diets? | back 39 C. Concentrated sweets and soft drinks |
front 40 Nutritional monitoring is important in celiac disease because most
gluten-free products are: | back 40 A. Non-fortified |
front 41 Beyond malabsorption, untreated celiac disease may also present
with: | back 41 D. Infertility |
front 42 Which laboratory abnormality may occur in untreated celiac
disease? | back 42 B. Elevated transaminases |
front 43 A patient with celiac disease develops gait instability without
weakness. Which neurologic manifestation is specifically associated
with this disorder? | back 43 C. Ataxia |
front 44 Which patient is at highest risk for celiac disease? | back 44 D. Patient with type 1 diabetes |
front 45 Which additional condition is specifically listed as a high-risk
setting for celiac disease? | back 45 A. Turner syndrome |
front 46 Which family history most strongly increases pretest probability for
celiac disease? | back 46 C. Relative with celiac disease |
front 47 Which broad comorbidity category should prompt increased suspicion
for celiac disease? | back 47 B. Autoimmune endocrinopathies |
front 48 Which disorder is best classified as a protein malabsorption syndrome
in this context? | back 48 A. Celiac disease |
front 49 A patient asks which foods should be removed to treat celiac disease.
What is the core dietary target? | back 49 C. Gluten-containing wheat products |
front 50 Which statement best explains why micronutrient deficiencies may
persist even after adopting a gluten-free diet? | back 50 B. Many products lack fortification |
front 51 A patient with bulky, greasy, foul-smelling stools most likely has
which type of malabsorption syndrome? | back 51 B. Fat malabsorption |
front 52 Fat malabsorption often occurs when there is impaired: | back 52 A. Luminal transport of digested products |
front 53 A patient with diffuse small-intestinal injury develops fat
malabsorption. Which mechanism best explains this? | back 53 C. Widespread mucosal injury |
front 54 Which disorder can cause fat malabsorption through widespread mucosal
injury? | back 54 A. Celiac disease |
front 55 Which inflammatory disorder is specifically listed as a cause of fat
malabsorption? | back 55 D. Inflammatory bowel disease |
front 56 Small-bowel bacterial overgrowth may cause fat malabsorption
primarily because it can: | back 56 B. Injure absorptive mucosa |
front 57 A patient with chronic pancreatitis develops greasy stools. The most
direct cause is: | back 57 C. Lipase deficiency |
front 58 Fat malabsorption in cystic fibrosis most commonly reflects: | back 58 D. Maldigestion |
front 59 A patient with cholestatic disease develops steatorrhea despite
normal pancreatic enzymes. The best explanation is: | back 59 A. Lack of emulsification |
front 60 Which condition can cause steatorrhea because of bile salt
deficiency? | back 60 C. Cholestatic biliary disease |
front 61 Which mechanism best distinguishes maldigestion from mucosal fat
malabsorption? | back 61 B. Defective intraluminal breakdown |
front 62 Fat malabsorption can also be seen in which wasting syndrome? | back 62 A. HIV wasting |
front 63 A patient with chronic steatorrhea is most at risk for deficiency
of: | back 63 D. Fat-soluble vitamins |
front 64 To increase caloric intake in fat malabsorption, the diet can be
supplemented with: | back 64 C. Medium-chain triglycerides |
front 65 Medium-chain triglycerides are especially useful because they do not
require: | back 65 B. Bile salts or micelles |
front 66 The caloric content of medium-chain triglycerides is
approximately: | back 66 A. 115 calories per teaspoon |
front 67 A patient with pancreatic insufficiency and fat malabsorption should
receive: | back 67 D. Pancreatic enzyme supplementation |
front 68 Which patient most clearly has steatorrhea from maldigestion rather
than mucosal injury? | back 68 C. Chronic pancreatitis |
front 69 Based on population data, GERD affects approximately what proportion
of people? | back 69 C. Up to 20% |
front 70 Which risk factor from history is most strongly associated with
GERD? | back 70 A. Obesity |
front 71 Which mechanism best explains why obesity increases GERD risk? | back 71 D. Increased intra-abdominal pressure |
front 72 In addition to elevated intra-abdominal pressure, obesity promotes
GERD by increasing: | back 72 B. LES relaxation |
front 73 Which dietary feature most likely contributes to his GERD? | back 73 A. High saturated fat intake |
front 74 High-fat meals worsen GERD in part because they: | back 74 C. delay gastric emptying |
front 75 A patient asks which dietary change may help lower reflux risk over
time. Which recommendation is most supported by the material
provided? | back 75 B. Increase dietary fiber intake |
front 76 these foods _____ gastric acid secretions: coffee, tea, colas, alcohol | back 76 increase |
front 77 these foods are poorly tolerated in _____ _____ disease: | back 77 peptic ulcer |
front 78 A patient with epigastric pain is found to have a duodenal ulcer.
Most gastric and duodenal ulcers are primarily caused by: | back 78 B. Gastric mucosal damage |
front 79 A patient with chronic dyspepsia develops a gastric ulcer after years
of daily analgesic use. Which pair includes the most common causative
agents of peptic ulcer disease? | back 79 D. H pylori and NSAIDs |
front 80 A college student develops 2 days of watery diarrhea after a viral
illness. Most cases of diarrhea are due to: | back 80 A. Self-limited infection |
front 81 A patient reports loose stools for more than 4 weeks. This is best
classified as: | back 81 C. Chronic diarrhea |
front 82 Chronic diarrhea affects approximately what proportion of the
population? | back 82 B. Up to 5% |
front 83 A patient develops diarrhea after drinking milkshakes and eating ice
cream. Which malabsorptive disorder best explains this? | back 83 D. Lactose intolerance |
front 84 A patient with chronic diarrhea, iron deficiency, and villous injury
most likely has which malabsorptive cause? | back 84 A. Celiac disease |
front 85 A patient with chronic diarrhea and intestinal inflammation has
transmural bowel disease. Which listed malabsorptive disorder can
cause diarrhea? | back 85 C. Inflammatory bowel disease |
front 86 A patient develops diarrhea after ingesting a nonabsorbed solute.
This mechanism is most consistent with: | back 86 B. Osmotic diarrhea |
front 87 A patient chewing large amounts of sugar-free gum develops diarrhea.
Which substance most likely caused it? | back 87 D. Sorbitol |
front 88 A patient taking a saline cathartic develops osmotic diarrhea. Which
ingested agent best fits this mechanism? | back 88 A. Magnesium sulfate |
front 89 Ingestion of which poorly absorbed substance may also cause osmotic
diarrhea? | back 89 C. Phosphate |
front 90 A patient with diarrhea feels worse after increasing bran cereal and
other roughage. Which fiber type is most likely aggravating
symptoms? | back 90 B. Insoluble fiber |
front 91 A patient with diarrhea is advised to increase a fiber type that
forms a gel within the intestinal lumen. Which is most likely to
help? | back 91 D. Soluble fiber |
front 92 Which dietary approach is most consistent with using functional foods
to help diarrhea? | back 92 A. Live active cultures |
front 93 Which recommendation best matches the provided material for helping
some patients with diarrhea? | back 93 C. Use yogurt or probiotics |
front 94 Which exposure is a classic peptic ulcer risk factor? | back 94 A. NSAID overuse |
front 95 A patient with a newly diagnosed duodenal ulcer has no NSAID
exposure. Which organism is a common causative agent? | back 95 D. H pylori |
front 96 Definition=less than 2-3 bowel movements per week | back 96 conspitation |
front 97 Dietary sources of ______ fats include fatty fish, walnuts, soy, flaxseed, canola oil, and in small amounts, certain leafy greens | back 97 omega-3 |
front 98 Which demographic pattern is most associated with constipation
risk? | back 98 B. Older women |
front 99 A patient has constipation due to impaired stool propulsion within
the colon, without medication or endocrine triggers. This is best
classified as: | back 99 D. Primary constipation |
front 100 A patient develops constipation after starting an anticholinergic
medication for bladder symptoms. This mechanism is most consistent
with: | back 100 A. Secondary constipation |
front 101 Which outpatient recommendation is most appropriate for uncomplicated
constipation? | back 101 C. Increase fluids and fiber gradually |
front 102 Inflammatory bowel disease is best defined as including: | back 102 B. Crohn disease and ulcerative colitis |
front 103 A patient with patchy transmural intestinal inflammation has disease
involving the terminal ileum and perianal region. Which disorder can
affect any part of the digestive tract? | back 103 A. Crohn disease |
front 104 A patient has continuous inflammatory disease limited to the large
intestine. Which diagnosis best fits disease confined to the
colon? | back 104 C. Ulcerative colitis |
front 105 Which nutritional problem is common in IBD? | back 105 A. Protein malnutrition |
front 106 Which cytokine profile most directly contributes to protein
malnutrition in inflammatory bowel disease? | back 106 D. IL-1, IL-6, TNF-alpha |
front 107 Beyond cytokine effects, which intestinal change contributes to
malnutrition in inflammatory bowel disease? | back 107 C. Decreased absorptive surface area |
front 108 A patient undergoes ileal resection for Crohn disease and later
develops fat malabsorption. Which deficiency most directly explains
this complication? | back 108 B. Bile salt deficiency |
front 109 A patient with IBD is treated with prednisone for a severe flare.
Which metabolic effect is expected? | back 109 A. Reduced calcium absorption |
front 110 High intake of which dietary fat is associated with increased risk of
ulcerative colitis? | back 110 D. Linoleic acid aka omega-6 |
front 111 The increased ulcerative colitis risk associated with linoleic acid
is partly due to its conversion into: | back 111 B. Arachidonic acid |
front 112 Which dietary pattern most increases linoleic acid exposure? | back 112 C. Red meat, oils, margarine |
front 113 Which dietary pattern is associated with increased ulcerative colitis
risk? | back 113 D. High animal protein intake |
front 114 A patient is hospitalized, placed on bowel rest, and is not expected
to resume oral repletion for 7 days. Which nutritional support should
be considered? | back 114 A. Total parenteral nutrition |
front 115 _____ show promise as an adjunctive treatment for mild-to-moderate ulcerative colitis | back 115 Probiotics |
front 116 ______ are specialized, non-digestible plant fibers that pass through the small intestine undigested to reach the colon. There, they act as fuel, selectively stimulating the growth of beneficial gut bacteria to improve digestive and overall health. | back 116 Prebiotics |
front 117 A patient with active inflammatory bowel disease has ongoing diarrhea
and malabsorption. Which diet is most appropriate to help control
symptoms? | back 117 A. Low fat, low fiber, low lactose |
front 118 A patient with inflammatory bowel disease reports worsening cramping
after large meals. Which feeding pattern is most appropriate? | back 118 C. Small, frequent feedings |
front 119 A patient with inflammatory bowel disease develops urgent diarrhea
soon after certain beverages. Which trigger pair is most likely? | back 119 D. Alcohol and caffeine |
front 120 A patient with chronic diarrhea asks which sweetener type commonly
causes bloating and loose stools. Which is most likely? | back 120 A. Sugar alcohols |
front 121 A patient with active inflammatory bowel disease and complications is
losing weight. How should caloric intake generally change? | back 121 B. Increase to meet higher needs |
front 122 A severely malnourished patient with inflammatory bowel disease is
starting nutrition support. What is the safest initial approach? | back 122 D. Begin cautiously to avoid refeeding |
front 123 A patient with active inflammatory bowel disease is started on
prednisone during a flare. How should protein intake generally
change? | back 123 A. Increase, especially with prednisone |
front 124 A patient with inflammatory bowel disease develops nausea,
constipation, and abdominal cramping after starting supplementation.
Which supplement is most likely responsible? | back 124 C. Oral iron |
front 125 A patient with iron deficiency from inflammatory bowel disease is not
responding well to oral iron alone. What addition may improve
absorption? | back 125 B. Ascorbic acid |
front 126 Ascorbic acid helps oral iron therapy mainly by: | back 126 D. Converting ferric to ferrous |
front 127 A patient with inflammatory bowel disease asks where orally
administered iron is mainly absorbed. Which site is most
relevant? | back 127 A. Duodenum |
front 128 A patient with inflammatory bowel disease is treated with
sulfasalazine. Which supplement should routinely be considered? | back 128 C. Folate |
front 129 A patient with Crohn disease is treated with methotrexate. Which
additional supplement is typically recommended? | back 129 B. Folate |
front 130 Which deficiency pattern is especially common in both children and
adults with inflammatory bowel disease? | back 130 D. Vitamin D deficiency |
front 131 A patient with Crohn disease has a narrowed bowel segment and
intermittent obstructive symptoms. Which diet is most
appropriate? | back 131 A. Low-fiber diet |
front 132 Which dietary approach should generally be avoided in a patient with
Crohn disease and bowel strictures? | back 132 D. Fiber-rich diet |
front 133 A patient with fat malabsorption is using medium-chain triglyceride
oil. How should it be introduced? | back 133 A. In small amounts at a time |
front 134 A patient with Crohn disease undergoes ileal resection and later
develops kidney stones. Which stone type is most likely? | back 134 D. Calcium oxalate |
front 135 A patient with Crohn disease has undergone ileal resection and
diverting ileostomy. What postoperative problem increases the risk of
the typical kidney stones seen in this setting? | back 135 D. Bile salt malabsorption |
front 136 characterized by abdominal pain, altered bowel motility, and bloating or abdominal distension | back 136 IBS |
front 137 Irritable Bowel Syndrome (IBS) is a common, chronic functional disorder of the ____ ____ causing chronic abdominal pain, bloating, and diarrhea or constipation | back 137 large intestine |
front 138 _____ malabsorption may precipitate symptoms of IBS | back 138 Carbohydrate |
front 139 A patient undergoing colon evaluation is found to have
diverticulosis. Which location is most commonly involved? | back 139 A. Sigmoid colon |
front 140 An older adult is counseled about diverticulosis risk. Which
age-related change is recognized as a contributing factor? | back 140 B. Changes in the colonic wall |
front 141 A patient with diverticulosis asks about a proposed mechanism behind
the formation of diverticula. Which process is implicated? | back 141 C. Increased colonic intraluminal pressure |
front 142 Which additional colonic abnormality may contribute to
diverticulosis? | back 142 D. Motor dysfunction |
front 143 A patient wants to reduce future diverticulosis risk through diet.
Which pattern is most associated with increased risk? | back 143 A. Inadequate fiber intake |
front 144 A patient asks who is more likely to develop diverticulosis over
time. Which factor increases risk? | back 144 B. Older age |
front 145 Which food pattern best supports dietary treatment of
diverticulosis? | back 145 D. Whole grains, fruits, vegetables |
front 146 A patient with diverticulosis wants one practical long-term plan.
Which is best? | back 146 C. Emphasize fiber-rich foods and hydration |
front 147 Which counseling statement best reflects management of uncomplicated
diverticulosis? | back 147 D. Diet and hydration are key measures |
front 148 ______ is the presence of small, harmless pouches (diverticula) in the colon wall, while ______ occurs when these pouches become inflamed or infected, causing symptoms like fever and severe abdominal pain | back 148 Diverticulosis diverticulitis |
front 149 Biopsy showing hepatic steatosis with minimal inflammation. Which
subtype is most consistent with this finding? | back 149 B. Nonalcoholic fatty liver |
front 150 Biopsy findings of steatosis, inflammation, hepatocyte ballooning,
and fibrosis. Which subtype best fits? | back 150 D. Nonalcoholic steatohepatitis |
front 151 A patient with fatty liver disease asks which subtype has greater
risk of progression to advanced cirrhosis and end-stage liver disease.
Which is most concerning? | back 151 A. Nonalcoholic steatohepatitis |
front 152 Which associated condition pattern is most consistent with
nonalcoholic fatty liver disease? | back 152 C. Obesity and type 2 diabetes |
front 153 A clinician is counseling a patient newly diagnosed with nonalcoholic
fatty liver disease. Which overall weight-loss approach is most
appropriate? | back 153 A. Gradual weight loss |
front 154 A patient with nonalcoholic fatty liver disease asks which dietary
change is part of treatment. Which recommendation is most
appropriate? | back 154 D. Reduce calorie and fat intake |
front 155 A patient with nonalcoholic fatty liver disease wants a nutrition
change beyond reducing fat intake. Which additional recommendation is
most appropriate? | back 155 B. Increase dietary fiber |
front 156 A patient with nonalcoholic fatty liver disease asks which lifestyle
intervention should accompany dietary treatment. Which is most
appropriate? | back 156 C. Increase physical activity |
front 157 A patient with biopsy-proven nonalcoholic steatohepatitis asks which
histologic feature helps distinguish it from simple fatty liver. Which
finding supports steatohepatitis? | back 157 D. Cellular ballooning |
front 158 A patient with simple nonalcoholic fatty liver asks how it differs
from steatohepatitis. Which statement is most accurate? | back 158 A. It has minimal inflammation |
front 159 A patient with advanced cirrhosis has marked muscle wasting and poor
oral intake. Why is protein-calorie malnutrition clinically important
in liver disease? | back 159 C. It is a negative prognostic factor |
front 160 Which complication is associated with poor nutritional status in
cirrhosis? | back 160 A. Hepatorenal syndrome |
front 161 Which additional complication is linked to protein-calorie
malnutrition in cirrhosis? | back 161 D. Refractory ascites |
front 162 A patient with cirrhosis and worsening nutritional status is at
increased risk for which major bleeding complication? | back 162 B. Variceal hemorrhage |
front 163 A patient with decompensated cirrhosis has severe malnutrition. Which
infectious complication is associated with poor nutritional
status? | back 163 A. Spontaneous bacterial peritonitis |
front 164 A patient with cirrhosis asks about everyday dietary choices to
support liver health. Which recommendation is most appropriate? | back 164 C. Increase whole grains and limit sweets |
front 165 A patient with cirrhosis has anorexia and significant malnutrition.
Which nutritional strategy is most appropriate? | back 165 B. Increase calories with energy-dense foods |
front 166 A patient with cirrhosis but no encephalopathy is worried about
protein intake. Which guidance is most appropriate? | back 166 D. Adequate protein is needed to prevent catabolism |
front 167 A patient with cirrhosis develops acute hepatic encephalopathy. How
should protein intake be handled during this period? | back 167 C. Temporary protein restriction may be used |
front 168 A patient with cirrhosis and acute encephalopathy is having protein
adjusted. Which principle is most appropriate? | back 168 A. Avoid making protein excessively low |
front 169 A patient with cirrhosis asks which food should be specifically
avoided because of infection risk. Which is most important to
avoid? | back 169 D. Raw shellfish |
front 170 A patient with cirrhosis develops clinically significant ascites.
Which dietary approach is most appropriate? | back 170 B. Sodium restriction with fluid limitation |
front 171 A middle-aged woman presents with biliary colic and is found to have
gallstones. Which mechanism most directly contributes to
cholelithiasis? | back 171 A. Lithogenic bile and gallbladder stasis |
front 172 A patient with symptomatic gallstones asks which stone type is most
common overall. Which is the best answer? | back 172 C. Cholesterol stones |
front 173 A pregnant patient asks why her clinician is more concerned about
gallstones during pregnancy. Which statement is most accurate? | back 173 B. Pregnancy is a risk factor |
front 174 An older patient with obesity develops recurrent postprandial right
upper quadrant pain and is found to have gallstones. Which additional
factor is a recognized risk factor? | back 174 D. Female sex |
front 175 A patient loses weight rapidly on a very restrictive diet and then
develops gallstones. Which statement best explains this
association? | back 175 A. Rapid weight loss increases risk |
front 176 A patient with new gallstones asks which dietary pattern likely
contributed most. Which is the best answer? | back 176 B. High saturated fat and refined sugars |
front 177 Which additional contributor is specifically associated with
increased gallstone risk? | back 177 A. Certain medications |
front 178 Lower gallstone risk? | back 178 B. Polyunsaturated and monounsaturated fats |
front 179 fat female forty fertile fair | back 179 gallstones |
front 180 Bowel rest is often indicated with gradual diet advancement in (Diverticulitis/Diverticulosis) | back 180 Diverticulitis |