RD Exam - Domain II, MNT Questions And Answers Verified Update

RD Exam - Domain II, MNT Questions And Answers Verified Update How do H₂ Blockers (Cimetidine, Rantidine) help w/ gastric ulcers? - ANSWER Prevents binding of histamine to receptor; decreases acid secretion Diverticulosis - ANSWER Presence of diverticula (mucosal sacs in intestinal wall) rx: High fiber diet Diverticulitis - ANSWER When diverticula become inflamed rx: Clear liquids (Low residue diet or elemental), gradual return to high fiber Describe how to tell if someone has lactose intolerance using the lactose tolerance test - ANSWER If lactose intolerant - blood glucose will not rise past 25 mg/dl above fasting (flat curve) If tolerant - glucose will rise above 25 mg/dL (normal curve) What should be avoided w/ lactose intolerance? What might be tolerated? - ANSWER Avoid - animal milk/milk products May tolerate - yogurt & small amounts of aged cheese What should be restricted in children up to age 6 in order to prevent chronic, nonspecific infantile diarrhea - ANSWER No more that 4 oz or apple/grape juice 2' high osmolar loads What type of small bowel resection is more dangerous? What are some consequences? - ANSWER ileal resection - ileum normally absorbs B₁₂, Intrinsic factor, bile salts, and major portion of fluid -If bile salts are recycled, lipids can't be emulsified --> malabsoprtion of fat-soluble vitamins Nutritional Care for ileal resection - ANSWER limit fat - use MCT oil (because it doesn't need bile salts for digestion) Parental B₁₂ initially followed by monthly injections What are the 4 liver enzymes and what is indicated if they are elevated? - ANSWER ALP - Alkaline phosphatase LDH - lactic acid dehydrogenase AST - aspartate aminotransferase ALT - alanine aminotransferase Elevated liver enzymes indicates tissue damage Nutrition care for hepititis - ANSWER Small, frequent feedings 2' anorexia High protein can help prevent fatty liver Describe how ascites occurs w/ liver disease - ANSWER Connective tissue overgrowth blocks blood flow out of liver in to vena cava Fluid/blood builds up in liver, eventually leaking into peritoneal cavity High osmolar load pulls more fluid, leading to sodium & water retention What causes esophageal varicies? - ANSWER Portal htn Wernicke-Korsakoff syndrome - ANSWER confusion/ams 2' thamine deficiency - typically seen in alcoholic cirrhosis Typical treatments for ESLD - ANSWER supplementing BCAAs - may not have benefit Lactulose - removes N Neomycin - destroys bacteria that produce ammonia Diet rx for HTN - ANSWER low sodium ( ≤ 2400 mg), DASH diet Therapeutic Lifestyle Change (TLC) - ANSWER AHA Diet for Hyperlipidimia -35% of kcals from fat (<7% saturated, 10% PUFA, 20% MUFA, <200 mg cholesterol) -25 to 30 g fiber (half soluble) - 2 to 3 g stanols/sterols to inhibit cholesterol absorption -Maintain IBW -30 minutes moderate activity on most days 3 Hormones involved in renal function - ANSWER Vsasopressin (ADH) Renin Erythropoietin Vasopression (location/fxn) - ANSWER Secreted from hypothalamus Elevates BP Renin (location/fxn) - ANSWER Secreted by glomerulus of kidneys Elevates BP Erythropoietin (location/fxn) - ANSWER Produced by kidney Stimulates bone marrow to produce RBCs Urine tests that detect kidney disease - ANSWER Decreased GFR & creatinine clearance Blood tests that detect kidney disease - ANSWER Increased serum creatinine & BUN