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SP17- Special Needs > Diet and Nutrition in the patient with Special Needs > Flashcards

Diet and Nutrition in the patient with Special Needs Flashcards

1
Q

What is a “food dessert?”

A

an area with limited access to affordable nutritious foods

-typically low income neighborhoods

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2
Q

True or False: Patients with disabilities only have problems eating a healthy diet because they don’t understand what is healthy.

A 
False,
-abnormal muscle tone
-posture/breathing issues
-lack of development of motor patterns
-metabolic issues
-food aversions
-reflux
-vomiting
etc.
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3
Q

True or False: Special diets include those for weight gain, diabetics, kidney disease, allergies, ketones, and gluten free.

A

True

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4
Q

____ disease = true gluten allergy

A

Celiac

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5
Q

Many people believe that gluten worsens the symptoms of _____.

A

autism

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6
Q

Where is gluten found?

A

in wheat, barley, and rye

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7
Q

What is the etiology of Celiac Disease?

A

multifactorial

  • genetic predisposition is present
  • affected by environmental factors
  • CD4+ T Cell response to gliadin peptides
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8
Q

Which protein is toxic to patients with celiac disease?

A

alpha-gliadin

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9
Q

Alpha-Gliadin contains high amounts of which two amino acids?

A

proline and glutamine

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10
Q

________ is an enzyme that is found in the small intestine and is released when injured or inflammed.

A

Transglutaminase

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11
Q

How is transglutaminase involved with Celiac Disease?

A

Transglutaminase binds with gliadin protein to form a complex which is immunogenic

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12
Q

Does celiac disease affect men or women more commonly?

A

2 to 1
or
3 to 1
Female to male

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13
Q

What is the prevalence of Celiac Disease?

A

0.5 to 1%

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14
Q

Among first degree relatives with celiac disease, the prevalence is _____?

A

10 to 12%

compared to 0.5 to 1% in the general public

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15
Q

True or False: There is an increased prevalence of Celiac Disease in some disorders, such as Down Syndrome and Turner Syndrome.

A

True

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16
Q

True or False: Patients with Celiac Disease have an increased risk for cancer.

A

True (TWICE that of the general population)

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17
Q

What is the clinical presentation of Celiac Disease?

A

diarrhea
abdominal pain
abdominal swelling

18
Q

Patients with Celiac Disease have an increased risk of __________ which can occur in the intestines or other areas.

A

B-Cell or T-Cell non-Hodgkin lymphoma

19
Q

______ diets are often used in an attempt to control epilepsy, primarily in children.

A

Ketogenic (high-protein low carb diets)

20
Q

What is the difference between ketosis and ketoacidosis?

A

Ketosis: a NORMAL physiologic response that occurs when the dietary carb levels are inadequate to meet the metabolic demand for proteins
Ketoacidosis: a PATHOLOGIC condition that can occur in insulin-dependent diabetes or alcoholism; it is potentially life-threatening

21
Q

True or False: A ketogenic diet is as effective as antiepileptic medications on the short to medium-term seizure control.

A

True, but subjects are unable to follow the diet long-term

22
Q

True or False: Failure to Thrive is a diagnosis.

A

False, its a term to describe malnutrition associated with child weight loss or failure to gain enough weight

23
Q

What is the cause of FTT?

A

malnutrition

24
Q

FTT is often the manifestation of an underlying disease such as ______, ______, ______, etc.

A 
cerebral palsy
celiac disease
cystic fibrosis
Crohn's disease
Munchausen Syndrome
GERD
allergies/defects
anorexia
25
Q

FTT could be a symptom of ______.

A

neglect

26
Q

In the developed world, FTT affects as much as _____% of individuals in the inpatient setting.

A

24%

27
Q

What are 5 methods that are employed to nutritionally combat FTT if it’s not caused by an underlying disease?

A
  1. Increase food intake
  2. Enrichment of food (leads to poor macronutrient ratios)
  3. Frequent consumption of energy-rich foods
  4. Drinks and Tube feeding
  5. Parenteral feeding (temp. tx for severe malnutrition)
28
Q

Approximately _____% of dental erosion cases have been associated with GERD.

A

20-30%

29
Q

True or False: Patients can have “silent reflux.”

A

True, unknown problem until dental erosion leads to diagnosis of GERD

30
Q

What is the pH of gastric acid? At what pH does enamel demineralize?

A

gastric acid: 1.2

enamel demin: 5.5

31
Q

Where does dental erosion from GERD appear most frequently? Least frequently?

A

most: maxillary anteriors and mandibular molars
least: mandibular anteriors (protected by tongue)

32
Q

What are the two medications typically used to treat GERD?

A

histamine-2 receptor antagonist
or
proton pump inhibitors

33
Q

What type of surgical intervention can be used to treat GERD?

A

Nissen fundoplication (fundus is wrapped around the esophagus)

34
Q

Describe a diet used to manage Chronic Kidney Disease.

A

high carb
low protein
limited fluids
limited electrolytes

35
Q

Food allergies affect ____ % of individuals under 4 years old and ___% of individuals over 10 years old.

A

6 to 8 % under 4yrs

4% over 10yrs

36
Q

What are the most common food allergens?

A 
cows milk
egg
wheat
soy
peanut
tree nut
fish
shellfish
37
Q

Which allergy is considered to be among the most severe? How common is it?

A

Peanut
(fatal reactions are IgE mediated and can occur even to trace amounts of peanuts)
1% of the population by age 5

38
Q

What percentage of patients with a peanut allergy will “grow out of it?”

A

20%

39
Q

There are ___ allergens in peanuts and more than ___% of patients have allergies to at least 2 of the proteins.

A

8 allergens

90%

40
Q

What are the steps in treatment of peanut allergy symptoms (wheezing, coughing, rash, etc).?

A
  1. Administer IM epinephrine
  2. call the squad (airway management and oxygen)
  3. administer benadryl (1mg per kg body weight)
  4. IV fluids and medications
  5. Discharge instructions (meds for 3 days)
  6. follow up

SP17- Special Needs (9 decks)

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