ALL DOMAINS JEAN INMAN STUDY GUIDE
QUESTIONS AND EXPLANATIONS 2026
CORRECT ANSWERS GRADED A+
⩥ Deficiencies with alcoholic liver disease. Answer: B vitamins (thiamin
and folate)
Vitamin C and Mg
Protein
⩥ Wernicke-Korsakoff syndrome. Answer: a form of dementia found
with chronic alcoholism
Thiamin deficiency
⩥ Hepatic failure =. Answer: ESLD
⩥ ESLD = liver function of. Answer: 25% or less
⩥ In ESLD liver cannot convert.... Answer: ammonia (NH3) in urea -
ammonia accumulates
⩥ In ESLD what 4 symptoms occur?. Answer: Apathy, drowsiness,
confusion, coma (PSE - portal systemic encephalopathy)
,⩥ In ESLD what is a sign of impending coma. Answer: asterixis -
flapping, involuntary jerking motions
⩥ Nutrition Therapy for ESLD. Answer: -if not comatose: moderate to
high levels of pro, increased up to 1-1.5 g/kg as tolerated
-30-35% kcal from fat
-low sodium if ascites
⩥ -altered neurotransmitter theory. Answer: BCAA decrease (used by
muscles for energy)
AAA increase b/c damaged liver is unable to clear them
- adding BCAA - adds kcal and Pro => may not reduce symptoms but
used when std therapy does not work
⩥ With ESLD ADD.... Answer: BCAA !!!!!
⩥ What are the 2 standard treatments of ESLD?. Answer: Lactulose
(removes N) and Neomycin (antibiotic that destroys bacterial flora that
produces ammonia)
⩥ What is NAFLD. Answer: Non-alcoholic fatty liver disease
fat buildup in liver unrelated to alcohol consumption
,⩥ NAFLD is common in those with. Answer: BMI>35
T2DM
Metabolic syndrome
⩥ What is the treatment for NAFLD. Answer: lifestyle
wt loss (7-10% of starting weight GRADUALLY)
Mediterranean diet, low alcohol and avoid SSBs
150+ min aerobic + strength exercise per week
⩥ Cholecystitis: an infection causes.... Answer: excess water to be
absorbed causing cholesterol to precipitate out leading to gallstones -
cholelithiasis
⩥ MNT for gallbladder disease. Answer: low fat diet (30-45g if acute,
25-30% kcal if chronic)
must limit fat for several months after cholecystectomy
⩥ After a cholecystectomy, bile is now secreted from.... Answer: the
liver directly into the intestine (so you don't need a gallbladder!)
⩥ Pancreatitis: inflammation with.... Answer: edema, cellular exudate
(muscle accumulation) and fat necrosis
, ⩥ Pancreatitis may be due to..... Answer: blockage or reflux of the ductal
system; premature activation of enzymes which LEADS TO
AUTODIGESTION - pancreatic enzymes digest the pancreas - very
painful
⩥ Acute pancreatitis:. Answer: -put pancreas at rest, withhold all feeding
-progress as tolerated to easily digested foods WITH A LOW FAT
CONTENT (b/c pancreas secretes lipase)
-elemental (pre-digested) EN into jejunum may be tolerated - b/c don't
want to leave them NPO for too long
⩥ For chronic pancreatitis use.... Answer: PERT - pancreatic enzymes
orally with meals and snacks to minimize fat malabsorption from lack of
pancreatic lipase
antacids if pancreatic bicarb is defective
⩥ For chronic pancreatitis use what type of fat.... Answer: MCTs
because they don't require pancreatic lipase - add to mixed dishes, jams,
and jellies
⩥ In severe and prolonged cases of pancreatitis what might be
necessary?. Answer: PN
⩥ CF is a disease of.... Answer: exocrine glands - secretion of thick
mucus that obstructs gland and ducts
QUESTIONS AND EXPLANATIONS 2026
CORRECT ANSWERS GRADED A+
⩥ Deficiencies with alcoholic liver disease. Answer: B vitamins (thiamin
and folate)
Vitamin C and Mg
Protein
⩥ Wernicke-Korsakoff syndrome. Answer: a form of dementia found
with chronic alcoholism
Thiamin deficiency
⩥ Hepatic failure =. Answer: ESLD
⩥ ESLD = liver function of. Answer: 25% or less
⩥ In ESLD liver cannot convert.... Answer: ammonia (NH3) in urea -
ammonia accumulates
⩥ In ESLD what 4 symptoms occur?. Answer: Apathy, drowsiness,
confusion, coma (PSE - portal systemic encephalopathy)
,⩥ In ESLD what is a sign of impending coma. Answer: asterixis -
flapping, involuntary jerking motions
⩥ Nutrition Therapy for ESLD. Answer: -if not comatose: moderate to
high levels of pro, increased up to 1-1.5 g/kg as tolerated
-30-35% kcal from fat
-low sodium if ascites
⩥ -altered neurotransmitter theory. Answer: BCAA decrease (used by
muscles for energy)
AAA increase b/c damaged liver is unable to clear them
- adding BCAA - adds kcal and Pro => may not reduce symptoms but
used when std therapy does not work
⩥ With ESLD ADD.... Answer: BCAA !!!!!
⩥ What are the 2 standard treatments of ESLD?. Answer: Lactulose
(removes N) and Neomycin (antibiotic that destroys bacterial flora that
produces ammonia)
⩥ What is NAFLD. Answer: Non-alcoholic fatty liver disease
fat buildup in liver unrelated to alcohol consumption
,⩥ NAFLD is common in those with. Answer: BMI>35
T2DM
Metabolic syndrome
⩥ What is the treatment for NAFLD. Answer: lifestyle
wt loss (7-10% of starting weight GRADUALLY)
Mediterranean diet, low alcohol and avoid SSBs
150+ min aerobic + strength exercise per week
⩥ Cholecystitis: an infection causes.... Answer: excess water to be
absorbed causing cholesterol to precipitate out leading to gallstones -
cholelithiasis
⩥ MNT for gallbladder disease. Answer: low fat diet (30-45g if acute,
25-30% kcal if chronic)
must limit fat for several months after cholecystectomy
⩥ After a cholecystectomy, bile is now secreted from.... Answer: the
liver directly into the intestine (so you don't need a gallbladder!)
⩥ Pancreatitis: inflammation with.... Answer: edema, cellular exudate
(muscle accumulation) and fat necrosis
, ⩥ Pancreatitis may be due to..... Answer: blockage or reflux of the ductal
system; premature activation of enzymes which LEADS TO
AUTODIGESTION - pancreatic enzymes digest the pancreas - very
painful
⩥ Acute pancreatitis:. Answer: -put pancreas at rest, withhold all feeding
-progress as tolerated to easily digested foods WITH A LOW FAT
CONTENT (b/c pancreas secretes lipase)
-elemental (pre-digested) EN into jejunum may be tolerated - b/c don't
want to leave them NPO for too long
⩥ For chronic pancreatitis use.... Answer: PERT - pancreatic enzymes
orally with meals and snacks to minimize fat malabsorption from lack of
pancreatic lipase
antacids if pancreatic bicarb is defective
⩥ For chronic pancreatitis use what type of fat.... Answer: MCTs
because they don't require pancreatic lipase - add to mixed dishes, jams,
and jellies
⩥ In severe and prolonged cases of pancreatitis what might be
necessary?. Answer: PN
⩥ CF is a disease of.... Answer: exocrine glands - secretion of thick
mucus that obstructs gland and ducts
