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2016 CSO Exam Study Group > Chapter 20: MNT for GI Cancers > Flashcards

Chapter 20: MNT for GI Cancers Flashcards

1
Q

What nutrients are absorbed in the stomach?

A 
water
alcohol
copper
iodide
fluoride
molybdenum
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2
Q

What nutrients are absorbed in the Duodenum?

A 
Ca
Phos
Mg
Fe
Copper
Selenium
Thiamin
Riboflavin
Niacin
Biotin
Folate
Vit A
Vit D
Vit E
Vit K
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3
Q

What nutrients are absorbed in the Ileum?

A 
Vit C
Folate
B12
Vit D
Vit K
Mg

bile salts/acids

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4
Q

What nutrients are absorbed in the Large Intestine?

A 
water
Vit K
Biotin
Sodium
Chloride
K+
SCFAs
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5
Q

What nutrients are absorbed in the Jejunum?

A 
Thiamin
Riboflavin
Niacin
Pantothenate
Biotin
Folate
Vit B6
Vit C
Vit A
Vit D
Vit E
Vit K
Ca
Phos
Mg
Fe
Zinc
Chromium
Manganese
Molybdenum

Lipids
Monsaccharides
AAs
Small peptides

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6
Q

Name the two sections of the stomach

A

Upper - proximal (contains cardia [closest to esophagus], fundus and body)
lower - distal (antrum and pylorus)

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7
Q

What is believed to be the leading cause of gastric CA?

A

H pylori infections, particularly with distal stomach CA

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8
Q

Where do gastric CAs most frequently metastasize to?

A

liver, lung and bone

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9
Q

What are risk factors for gastric CA?

A 
GERD
Obesity
Etoh/smoking
lack of physical activity
chronic H pylori infections
hx of gastric surgeries
salted/smoked foods
high heme iron intake from meats
high intake of grilled/processed meats
low intake F/V, particularly betacarotene ones and Vit C
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10
Q

Name the common chemos for GI CA?

A 
Xeloda
Paraplatin (Carbo)
Cisplatin
Taxotere (Docetaxel)
Adriamycin
Epirubicin (Ellence)
5-FU
Gemzar (Gemcitabine)
Camptosar (Irinotecan)
Mitomycin
Oxaliplatin (Eloxatin)
Taxol
Zaltrap
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11
Q

What are common side effects from XRT to the abd (stomach/liver/gallbladder)?

A 
abd pain/discomfort
N/V
Urinary/bladder changes
D
decreased appetite
anorexia
fatigue
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12
Q

What are common side effects from XRT to the pelvis (Sm Intestine, colon, rectum)?

A 
D
bowel gas (and anus) bloating
urinary/bladder changes
proctitis
decreased appetite
anorexia
fatigue
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13
Q

What are the common biotherapies used for GI CA?

A 
Avastin
Erbitux
Vectibix
Nexavar
Stivarga
Herceptin
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14
Q

What are some sign/symptoms of gastric CA?

A 
early satiety (full/bloating)
heartburn/indigestion
abd pain
N/V (with or wout blood)
anorexia and unintended wt loss

Also unexplained anemia (from GERD)

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15
Q

Name the possible nutrition related complications from Gastric CA surgery?

A

Surgery itself - partial/total gastrectomy
GERD
Dumping Syndrome
Osteoporosis risk
Vit/Min malabsorption - Fe, B12, folic acid

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16
Q

MNT for Gastrectomy

A

Pre-op - small/freq meals, soft/easy-to-digest foods and fluids

post-op - small/freq meals, soft/easy-to-digest foods and fluids
initially limit refined CHO and lactose
avoid greasy/fried foods and initially limit total fat foods
include protein at east meal
seperate solids from fluids, wait 30-60 min before/after eating solids to consume liquids

17
Q

What are the risk factors for colon CA?

A 
over 50
presence of adenoma polyps in colon
inherited syndromes
race/ethnicity - AAs, Ashkenazi jews
DM II
obesity, particularly abd obesity
smoking/etoh
physical inactivity
UC or Crohn's
diet high in red/processed meats/grilled meats
low serum Vit D and low Ca intake
18
Q

What are signs/symptoms of Colon CA?

A 
change in bowel habits (having D or C, narrowing of stool)
also, heme+ stools or unexplained anemia
abd pain/bloating
N/V
blood in stool
unintended wt loss
fatigue
19
Q

Name the common surgeries for colon CA?

A

left colectomy - portion of colon taken (transverse or desending colon)

right colectomy - portion of colon taken closest to small intestine (cecum or ascending colon)

sigmoid colectomy - portion of colon taken at the end of colon/near rectum (sigmoid)

Low anterior resection - sigmoid colon/rectum removed, reconnected right to anus

abd perineal resection - portion of desending, all of sigmoid/rectum/anus taken - stoma created (permanent)

segmental resection - transverse colon taken

20
Q

What is the diet recommendation for Colon CA survivors?

A 
reduce red/processed meats
limit etoh
increase F/V/fiber
maintain healthy wt
add physical activity
adequate Vit D levels
21
Q

MNT for bowel resections/ostomies

A

small/frequent meals

fluids/electrolytes in small/frequent amounts as well - recommended to consume 1 L more than ostomy output

May need sports drinks to help with losses of electrolytes

Initially a low fiber, low fat, soft diet needed for 6-8 weeks, after that gradual introduction to other foods as able. most can eat majority of foods further out from surgery

ostomies have foods to watch for blockage/odor/consistency concerns

22
Q

Risk factors for HCC?

A 
Male
Hep B or C
Etoh
Aflatoxin
Hemochromatosis
inherited metabolic diseases
cirrhosis
obesity
DM II
anabolic steroids
23
Q

What are the most common causes for HCC in the US specifically?

A

Cirrhosis from chronic Hep C
Etoh abuse
NAFLD

24
Q

What are the common treatment options for HCC?

A

Surgery - resection, or partial/total transplant (rare-most don’t qualify due to underlying risk factors)

Ablation - directly into the tumor, usually

25
Q

What are signs/symptoms of HCC?

A

Usually not until later stages of disease

N/V
Enlarged Liver
pain in abd/swollen abd
itching
yellow skin/eyes
loss of appetite
early satiety
fatigue
unintended wt loss

some tumors secrete hormones, causing hypercalcemia, hypoglycemia, and erythrocytosis

26
Q

What are the risk factors for gallbladder CA?

A 
Gallstones
obesity
female
ethnicity/race - highest in mexican americans and native americans
DM
Biliary abnormalities
parasitic infections (salmonella)
industrial/environmental chemicals
27
Q

What are the surgical options for gallbladder CA?

A

Potentially curative - resect the CA

Palliative - to relieve plain and/or prolong life

28
Q

How common is Anal CA in the US?

A

uncommon - only 4% of all CAs of the lower GI tract

29
Q

What are risk factors for Anal CA?

A 
HPV
HIV
Multiple sex partners
smoking
post-transplant/compromised immune systems
race - AAs
Gender - women
History of other CAs or cervical dysplasia (cervix/vagina/vulva thats also linked to HPV)
30
Q

What are the common chemos for Anal CA?

A

Mitomycin and 5-FU in combo
5-FU
Cisplatin

2016 CSO Exam Study Group (27 decks)

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