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Continuing Medical Education Questions: January 2013

DeVault, Kenneth R MD, FACG; Albeldawi, Mazen MD; Mehta, Paresh MD; Kumaravel, Arthi MD; Macaron, Carole MD

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American Journal of Gastroenterology: January 2013 - Volume 108 - Issue 1 - p 38
doi: 10.1038/ajg.2012.437
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  1. Which one of the following statements is correct regarding the diagnosis of gastroparesis?
    • A. Upper endoscopy is not necessary to make the diagnosis of gastroparesis.
    • B. Medications that affect gastric emptying should be stopped 24 hours prior to diagnostic testing.
    • C. Shorter duration solid emptying or sole liquid emptying by scintigraphy are associated with lower diagnostic sensitivity.
    • D. Both wireless capsule motility testing and 13C breath testing using octanoate or spirulina are now considered alternates to scintigraphy.
  2. Which one of following statements is correct regarding diet and nutrition in gastroparesis?
    • A. For patients unable to maintain nutrition with oral intake, enteral gastric feeding should be recommended.
    • B. Parenteral nutrition is preferable to enteral feeding.
    • C. Frequent small volume meals that are high-fat and low-fiber optimize gastric emptying and calorie intake.
    • D. Enteral nutrition should be considered in patients with unintentional weight loss of 10% during a period of at least 3 months, and/or repeated hospitalizations for refractory symptoms.
  3. Which one of the following statements is correct regarding the management of gastroparesis?
    • A. For patients with refractory symptoms, intra-pyloric injection of botulinum toxin should be recommended.
    • B. Metoclopramide is the only FDA-approved medication for the treatment of gastroparesis.
    • C. Gastric electric stimulation (GES) improves symptom severity and gastric emptying in gastroparesis of all etiologies.
    • D. The risk of tardive dyskinesia in patients taking metoclopramide is estimated to be less than 10%.
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