RD Exam-Domain 2 (MNT) 125 Questions Correct Answers Graded A+

what happens after a gastrectomy? - dumping syndrome: -cramps, rapid pulses, weakness, perspiration, dizziness what is alimentary hypoglycemia? - when rapidly hydrolyzed CHO enters the jejunum, water is drawn in to achieve osmotic balance. This causes a rapid decrease in the vascular fluid compartment and a decrease in peripheral vascular resistance. Blood pressure drops and signs of cardiac infufficiency appear. About two hours later, the CHO is digested and absorbed rapidly. Blood sugar rises, stimulating an overproduction of insulin, causing a drop in blood sugar below fasting. feedings for post-gastrectomy - MOST IMPORTANT: frequent, small, ***DRY feedings, fluids before or after meals (to slow passage), restrict hypertonic concentrated sweets -also: give 50-60% complex CHO, protein at each meal, moderate fat **B12 injections may be needed. -lactose may be poorly tolerated due to rapid transport what does decreased pancreatic secretion lead to? - steatthorhea what is tropical sprue? - bacterial, viral, parasitic infection what is the treatment for tropical sprue? - antibiotics, *high kcal, high protein, intramuscular B12 and oral folate supplements* Non-tropical sprue, celiac disease, gluten-induced enteropathy - *reaction to GLIADIN-affects jejunum and ileum (proximal intestine) *need (gliadin-free) gluten-restricted diet: NO wheat, rye, oats (if harvested and milled with wheat), barley (buckwheat may be contaminated with WROB); no bran, graham, malt, bulgur, couscous, durum, orzo, thickening agents -OK: corn, potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flaxgastritis - diet: clear liquids, ADAT IBD - inflammatory bowel disease *Crohn's=regional enteritis *affects terminal ileum *B12 deficiency Chronic ulcerative colitis (also IBD) - disease of the COLON, begins in rectum *chronic bloody diarrhea, electryolyte (Na, K) disturbance -also negative nitrogen balance treatment of IBD - *limit fat ONLY if steatorrhea *High fat may improve energy balance Lactose tolerance test - (for lactose intolerance) *oral dose of lactose (up to 50 gm) after a fast. If intolerant of lactose, blood glucose will rise <25 mg/dL above fasting (flat curve). If tolerant to lactose, the rise would be above 25 (normal curve) Diarrhea in infants and children - acute: *immediate rehydration (Pedialyte) chronic: *give 40% kcals as fat, balanced with limited fluids; restrict or dilute fruit juices with high osmolar loads-apple, grape ileal resections - significant resections produce major complications *distal: absorption of B12, IF, bile salts *ileum normally absorbs major portion of fluid in GI tract *if ileum can't recycle bile salts: lipids are not emulsified, which leads to malabsorption of fat-sol vitamins (review this for details in notebook)loss of colon - water and electrolyte loss, loss of salvage absorption of CHO and other nutrients