Jean Inman Exam |342 Questions
with Solutions
NAFLD MNT - -lifestyle changes: steady weight loss, eating well, physical
activity
- ESLD - -liver cannot convert ammonia to urea, ammonia accumulates
- ESLD MNT - -mod-high protein levels 1-1.5 g/kg, MCTs as tolerated, add
BCAAs, low Na with ascites
- Alcoholic Liver Disease (ALD) - -ETOH interferes with thiamin, B12, C,
folate absorption. Increase B vitamins, Mg, folate, thiamin.
- Wernicke-Koraskoff - -thiamin deficiency, most seen in alcoholics
- cirrhosis MNT - -high protein, high cal, mod-low fat. Supplement B
complex, C, K, Zn, Mg
- acute viral hepatitis - -inflammation, necrosis, jaundice (when bile salts
are blocked)
- acute viral hepatitis MNT - -Supplement MVI, B complex, C, K, Zn. Increase
fluids, 50-55% CHO to replenish liver glycogen. Small frequent meals, mod-
liberal fat.
- liver fxn tests - -ALP, LDH, AST, SGOT, ALT, SGPT - all elevated with liver
disease. Indicates tissue damage.
- fxns of the liver - -1. stores/ releases blood
2. filters toxic elements
3. metabolizes and stores nutrients
4. regulates fluid and electrolyte balance
- SBS MNT - -1. parenteral initially to restore nutrition
2. enteral- stimulate growth, increase as tolerated, drip
- ileal resection MNT - -limit fat, use MCT supplement, fat soluble vitamins,
parenteral B12
- ileal resection - -interferes with absorption of B12, intrinsic factor, bile
salts, increase fluid intake
, - steatorrhea MNT - -consequence of malabsorption, >7 g stool fat =
malabsorption. Increase protein, complex CHO, fat as tolerated, supplement
fat soluble vitamins, minerals, MCT
- IBS (irritable bowel syndrome) - -altered intestinal motility
Goals: adequate intake, tailor treatment to GI issues.
Avoid: large meals, caffeine, ETOH, sugars.
- When IBD is in remission/ under control MNT - -high fiber to stimulate
peristalsis
- IBD (Crohn's Disease) - -inflammatory bowel disease.
Effects terminal ileum. B12 deficiency leads to megaloblastic anemia. Iron
deficiency anemia due to blood loss and decreased absorption.
- Ulcerative Colitis - -effects the colon, chronic diarrhea (electrolyte
imbalances) MNT: maintain fluids, energy requirements from current BMI,
frequent feedings, MCTs.
- Fiber needs: male and female - -M: 38 gm
F: 25 gm
- High fiber diet, increased need of: - -Ca, Mg, P, Cu, Se, Zn, Fe
- Gastritis MNT - -inflammation of stomach, clear liquids (advance as
tolerated), avoid gastric irritants
- Diverticulosis - -diverticula (small mucosal sacs that protrude through
intestinal walls), MNT: high fiber diet
- Diverticulitis - -inflamed diverticula, MNT: clear liquids, low residue/
elemental, gradual return to high fiber
- gastroparesis MNT - -delayed gastric emptying, mod-severe
hyperglycemia, detrimental effects to gastric nerves. MNT: small, frequent
meals, puree foods, avoid high fiber, avoid high fat, avoid fiber supplements.
- Billroth 1 - -gastroduodenostomy, attaches the remaining stomach to
duodenum
- Billroth 2 - -gastrojejunostomy, attaches stomach to jejunum
, - Billroth MNT - -small, frequent meals, restrict concentrated sweets,
complex CHO at each meal, mod. fat, B12 supplement may be needed.
- Dumping Syndrome - -follows gastrectomy (Billroth 1 or 2), rapid entrance
of sugars into jejunum. Causes cramps, rapid pulse, dizziness, sweating.
Alimentary hypoglycemia.
- Hiatal Hernia - -profusion of the stomach above the diaphragm into the
chest. MNT: small, bland feedings, avoid: late night snacks, caffeine, spice,
pepper.
- gastric ulcer MNT - -eradicate H. Pylori bacteria. MNT: diet as tolerated,
balanced, avoid: late night snacks, pepper, spice, excess caffeine, ETOH.
- Fe (Iron) - -ferric (food) to ferrous (digested)
needed for: oxygen transport
lab test: ferritin (measures iron status)
dairy inhibits absorption, deficiency: paleness, spoon shaped nails
- Ph (phosphorus) - -needed for: DNA, RNA, ATP, transports fat through
lymph
sources: diary, grains, beans
deficiency: RARE
- Ca (Calcium) - -most abundant mineral in body, controlled by parathyroid.
needed for: blood clotting, nerves
sources: leafy greens, legumes, dairy
deficiency: tetany (muscle spasms)
- Biotin - -synthesized by intestinal bacteria, coenzyme in fatty acid
synthesis
sources: liver, kidney, egg, yeast
deficiency: glossitis
- Vitamin C - -ascorbic acid, most easily destroyed
with Solutions
NAFLD MNT - -lifestyle changes: steady weight loss, eating well, physical
activity
- ESLD - -liver cannot convert ammonia to urea, ammonia accumulates
- ESLD MNT - -mod-high protein levels 1-1.5 g/kg, MCTs as tolerated, add
BCAAs, low Na with ascites
- Alcoholic Liver Disease (ALD) - -ETOH interferes with thiamin, B12, C,
folate absorption. Increase B vitamins, Mg, folate, thiamin.
- Wernicke-Koraskoff - -thiamin deficiency, most seen in alcoholics
- cirrhosis MNT - -high protein, high cal, mod-low fat. Supplement B
complex, C, K, Zn, Mg
- acute viral hepatitis - -inflammation, necrosis, jaundice (when bile salts
are blocked)
- acute viral hepatitis MNT - -Supplement MVI, B complex, C, K, Zn. Increase
fluids, 50-55% CHO to replenish liver glycogen. Small frequent meals, mod-
liberal fat.
- liver fxn tests - -ALP, LDH, AST, SGOT, ALT, SGPT - all elevated with liver
disease. Indicates tissue damage.
- fxns of the liver - -1. stores/ releases blood
2. filters toxic elements
3. metabolizes and stores nutrients
4. regulates fluid and electrolyte balance
- SBS MNT - -1. parenteral initially to restore nutrition
2. enteral- stimulate growth, increase as tolerated, drip
- ileal resection MNT - -limit fat, use MCT supplement, fat soluble vitamins,
parenteral B12
- ileal resection - -interferes with absorption of B12, intrinsic factor, bile
salts, increase fluid intake
, - steatorrhea MNT - -consequence of malabsorption, >7 g stool fat =
malabsorption. Increase protein, complex CHO, fat as tolerated, supplement
fat soluble vitamins, minerals, MCT
- IBS (irritable bowel syndrome) - -altered intestinal motility
Goals: adequate intake, tailor treatment to GI issues.
Avoid: large meals, caffeine, ETOH, sugars.
- When IBD is in remission/ under control MNT - -high fiber to stimulate
peristalsis
- IBD (Crohn's Disease) - -inflammatory bowel disease.
Effects terminal ileum. B12 deficiency leads to megaloblastic anemia. Iron
deficiency anemia due to blood loss and decreased absorption.
- Ulcerative Colitis - -effects the colon, chronic diarrhea (electrolyte
imbalances) MNT: maintain fluids, energy requirements from current BMI,
frequent feedings, MCTs.
- Fiber needs: male and female - -M: 38 gm
F: 25 gm
- High fiber diet, increased need of: - -Ca, Mg, P, Cu, Se, Zn, Fe
- Gastritis MNT - -inflammation of stomach, clear liquids (advance as
tolerated), avoid gastric irritants
- Diverticulosis - -diverticula (small mucosal sacs that protrude through
intestinal walls), MNT: high fiber diet
- Diverticulitis - -inflamed diverticula, MNT: clear liquids, low residue/
elemental, gradual return to high fiber
- gastroparesis MNT - -delayed gastric emptying, mod-severe
hyperglycemia, detrimental effects to gastric nerves. MNT: small, frequent
meals, puree foods, avoid high fiber, avoid high fat, avoid fiber supplements.
- Billroth 1 - -gastroduodenostomy, attaches the remaining stomach to
duodenum
- Billroth 2 - -gastrojejunostomy, attaches stomach to jejunum
, - Billroth MNT - -small, frequent meals, restrict concentrated sweets,
complex CHO at each meal, mod. fat, B12 supplement may be needed.
- Dumping Syndrome - -follows gastrectomy (Billroth 1 or 2), rapid entrance
of sugars into jejunum. Causes cramps, rapid pulse, dizziness, sweating.
Alimentary hypoglycemia.
- Hiatal Hernia - -profusion of the stomach above the diaphragm into the
chest. MNT: small, bland feedings, avoid: late night snacks, caffeine, spice,
pepper.
- gastric ulcer MNT - -eradicate H. Pylori bacteria. MNT: diet as tolerated,
balanced, avoid: late night snacks, pepper, spice, excess caffeine, ETOH.
- Fe (Iron) - -ferric (food) to ferrous (digested)
needed for: oxygen transport
lab test: ferritin (measures iron status)
dairy inhibits absorption, deficiency: paleness, spoon shaped nails
- Ph (phosphorus) - -needed for: DNA, RNA, ATP, transports fat through
lymph
sources: diary, grains, beans
deficiency: RARE
- Ca (Calcium) - -most abundant mineral in body, controlled by parathyroid.
needed for: blood clotting, nerves
sources: leafy greens, legumes, dairy
deficiency: tetany (muscle spasms)
- Biotin - -synthesized by intestinal bacteria, coenzyme in fatty acid
synthesis
sources: liver, kidney, egg, yeast
deficiency: glossitis
- Vitamin C - -ascorbic acid, most easily destroyed
