ANSWER KEY NUTR 157: Upper GI Quiz This quiz is worth 10 points, please read the questions carefully.

1. Describe 5 functions of saliva (3 points). 1. Moistening and lubricating food and facilitate swallowing 2. Initiating digestion of carbohydrates 3. Providing antibacterial protection with lysozyme and by rinsing away food from the oral cavity 4. Enhancing taste by providing a solution that can interact with taste buds 5. Serves as a buffer to neutralize acids and protects teeth from dental caries 6. Promotes oral hygiene by dissolving food, dead cells and foreign substances 7. Assisting in speech by allowing free movement of tongue and lips.

Definition Please fill in each of the following (1 point each). 2. Somatostatin secretions. , a chemical messenger that inhibits gastric

3. Decreased salvia production and dry mouth is known as xerostomia may also occur as a result of disease process and medical treatment. 4. Briefly describe three medication treatments for GERD and the implications for long-term use of the drugs (3 points). Antacids Alka-Seltzer, Maaloz, Mylanta, Pepto-Bismol, Rolaids, Riopan Foaming Agents Gaviscon, Foamicon H2 Antagonists Pepcid AC, Zantac, nizatidine, cimetidine PPI Prilosec, Protonix, Lansoprazole, Nexium Based on basic salts: Mg+, Ca+, and Al+ with hydroxide or bicarbonate to neutralize HCL. Combinations of Al+, Mg+, Na bicarbonate Block histamine receptors that are a component of the stimulatory paths for acid secretions Inhibits or blocks H+, K+ ATPpase enzyme, components for HCL Diarrhea, constipation

Provides short term relief, should not be used for more than a few weeks at a time.

ANSWER KEY production Helps strengthen the pyloric sphincter and increase speed of gastric emptying

Prokinetics Reglan, bethanechol

May have frequent side effects

Implications for long term use is impaired CA and B12 absorption 5. If patients with pyloric ulcer disease or other gastric malignancy are not responding to drug therapy, gastric resection is often recommended. Due to the reduced capacity of the stomach, there are potential nutritional implications. Please describe what may be of concern for patients with gastric surgery (2 points). Decreased oral intake, maldigestion/mal absorption when the stomach is resected. Vitamin and mineral deficiencies there many be a reduction or absence of intrinsic factor secretion prevent normal B12 absorption therefore leading to increased risk for B12 deficiency. Prophylactic injection of B12 is often recommended for patients. Iron deficiency is also common in patients with bariatric surgery due to decreased HCl production, decreased dietary intake and possible malabsorption Risk for osteoporosis Reduce stomach capacity, potential changes in gastric emptying and transit time. Dumping syndrome Increase osmolar load enters the small intestine too quickly from the stomach. Severity depends on the extent of the gastric surgery. When the pyloric portion of the stomach is removed, bypassed or destroyed, the rate of gastric emptying is increased. When the duodenum is bypassed, feedback inhibit is lost. Affects enzymes, hormones and other secretions Dumping syndrome results in hypoglycemia, diarrhea, cramps, dizziness, weakness, tachycardia