Diseas Flashcards
Two sources of ammonia that can result in hepatic coma are ___________ and _______?
deamination of amino acids - intestinal bacteria from the gastrointestinal tract.
The consequences of cirrhosis are primarily due to?
Liver cell damage and altered hepatic blood flow
Pathological changes in the liver caused by cirrhosis are?
Fatty infiltration
Fibrous tissue formation
❛ When blood circulation through the liver is impaired by fibrous tissue?
a) Ammonia remains in the systemic circulation
b) Portal hypertension develops
c) Esophageal varices develop
d) All of the above
All of the above
Which of the following factors is associated with the development of cirrhosis?
a) Chronic malnutrition
b) Biliary obstruction
c) Chronic alcohol abuse
d) All of the above
d) All of the above
Uncontrolled phenylketonuria (PKU) in children causes?
Mental retardation
Sodium is often restricted in cirrhosis to control ?
❛Fluid retention
Which metabolic disease is characterized by the accumulation of ammonia and glutamine in the body?
Urea cycle disorder (HIGH AMMONIA)
Major changes in a cirrhosis patient that lead to the development of ascites are?
decreased albumin, portal hypertension, hyperaldosteronism.
Positive nitrogen balance occurs in?
Pregnant women
Negative nitrogen balance is seen during?
Infection
In healthy adults, dietary deficiency of one of the following leads to negative nitrogen balance?
a) glycine.
b) serine.
c) cysteine.
d) leucine.
d) leucine.
Which of the following typically shows improvement more quickly?
a) Iron levels/anemia
b) Body composition
c) Liver enzymes
Iron levels/anemia
which of the following are contributing to malnutrition in cirrhotic patients?
a. Hypermetabolism
b. Malabsorption
c. Altered nutrient metabolism
d. Anorexia
e. all of the above
e. all of the above
In a surgical patient’s severe stress is described as?
Tissue damage and hypermetabolism
Ascites is defined as an accumulation of fluid in the?
Abdomen
The major nutritional problem related to the development of ascites is?
Protein deficiency
The condition(s) in liver disease most likely to lead to ascites is?
Portal hypertension
Adequate carbohydrates are important in hepatic encephalopathy because it?
Prevents catabolism of body protein and a rise in ammonia levels
In liver patients, when is lactulose typically prescribed?
High ammonia levels
patient with cirrhosis due to hepatitis C and encephalopathy and other Forget to take 2 doses of lactulose What is best statement for his condition ?
cirrhosis due to hepatitis C related to Hepatitis C infection
is the nervous system disorder brought on by severe liver disease (Ammonia accumulation )
Hepatic encephalopathy
Clinical symptoms of hepatic encephalopathy include?
Confusion and impaired motor function
statements about hepatitis is true?
Chronic hepatitis can progress to cirrhosis
Protein is especially needed in the postoperative recovery period because?
a) It is needed for tissue synthesis
b) It helps to control edema
c) It provides resistance to infection
d) All of the above
d) All of the above
Which of the following statements is TRUE regarding hepatitis A?
a) Hepatitis A is caused by contaminated food
b) Hepatitis A is caused by unsterilized syringe
Hepatitis A is caused by contaminated food
Which form of hepatitis do infect food service workers transmit?y
Hepatitis A
The occurrence of hepatic encephalopathy could be due to?
a) Decrease serum ammonia level with an increase in the ratio of branched chain amino acids to aromatic amino acids
b) Decrease serum urea level with an increase in the ratio of branched chain amino acids to aromatic amino acids
c) Increase serum ammonia level with a decrease in the ratio of aromatic amino acids to branched chain amino acids
d) Increase serum ammonia level with an increase in the ratio of aromatic amino acids to
branched chain amino acids
d) Increase serum ammonia level with an increase in the ratio of aromatic amino acids to branched chain amino acids
liver cirrhosis is caused by which of the following?
a) High carbohydrate diet
b) High fat ingestion
c) Chloroform ingestion
c) Chloroform ingestion
A liver patient with ascites who missed medication for two days and experienced poor intake. What is the likely cause of poor intake? neww A) Increased Fluid Retention
B) Mental Confusion
C) Reduced Appetite
D) Gastrointestinal Distress
B) Mental Confusion
High urea levels in blood are commonly associated with which of the following conditions?
A) Acute Kidney Injury
B) Glomerulonephritis
C) Nephritic Syndrome
D) Chronic Kidney Disease
D) Chronic Kidney Disease
Osteodystrophy is a result of?
Kidney disease
The bone disease osteodystrophy develops because of the kidney’s inability to?
a) Excrete calcium
b) Absorb vitamin D
c) Excrete urea
d) Activate vitamin D
d) Activate vitamin D
Older adults may voluntarily restrict their fluid intake to cope with?
Urinary incontinence
Which of the following complications of chemotherapy involves pain during swallowing?
Odynophagia
In jejunostomy enteral feeding, one of the enteral nutrition access, which is true?
Cannot be used for intermittent or bolus feeding
Enteral nutrition is preferred over parenteral nutrition for all of the following reasons EXCEPT? a) Lower risk of electrolyte abnormalities
b) Lower risk of refeeding
c) Lower risk of liver disease
d) Improved glycemic control
b) Lower risk of refeeding
Which of the following statements regarding enteral nutrition formulas is TRUE?
b) For acute pancreatitis within 48 hours of hospital admission, jejunal delivery of semielemental formulas is the preferred form of nutrition support.
c) Enteral formulas are formulated to provide adequate micronutrients if caloric requirements are
being met
c) Enteral formulas are formulated to provide adequate micronutrients if caloric requirements are
being met
A 59-year-old female who successfully undergoes a lung transplant is prescribed long-term prednisone treatment. Which of the following is a common complication of prednisone therapy that may require nutritional intervention?
Hyperglycemia
Which of the following are metabolic functions of the normal, healthy liver?
Synthesis of bile salts and urea formation
A 30-year-old female with severe Crohn’s disease recently required an intestinal resection of her ileum. Which of the following is the most likely cause of fat malabsorption in patients with Crohn’s disease?
Inability to reabsorb bile salts
The important function of the gall bladder is to?
Concentrate and store bile
Polypeptide and gastrin-releasing polypeptide (bombesin)?
send signals to decrease hunger and increase satiety
factor that can lower esophageal sphincter pressure includes ?
A. Hiatal hernia
B. Smoking
C. Caffeine
Part of the stomach protrudes through the diaphragm into the thoracic cavity is?
Hiatal hernia
Hiatal hernia is characterized by?
a) possibly being caused by aging and obesity
b) MNT is a bland diet and small, frequent feedings & no food being eaten 3 - 4 hours before bedtime.
c) complaints of heartburn, reflux, and difficulty in swallowing
Appetite of food is little and varied among?
Children
Esophageal varices are a dangerous complication primarily because they?
Can lead to massive bleeding
**A patient on long-term TPN develops cardiomegaly. What is the most likely reason?
Excessive Lipid Emulsions
There was something about a patient who has cardiomegaly after long-term bed rest and TPN, due to deficiency in? (nutrition and diagnosis 656 & Krause 87)
Thiamine (B1) or– Selenium
Magnesium &selenium deficiency cause: cardiac for long tpn patien
All the following are characteristics of Ebb Phase except?
A. Hypovolemia
B. Tissue hypoxia
C. ↓ Cardiac output
D. ↑ Cardiac output
D. ↑ Cardiac output
immediately after injury, is associated with hypovolemia (decreased blood volume circulating in the body), shock, and tissue hypoxia. decreased cardiac output, oxygen consumption, and body temperature
The ebb phase,
Increased cardiac output, oxygen consumption, body temperature, energy expenditure, and total body protein catabolism characterize the
flow phase
What type of kidney stones is common among people with inflammatory bowel disease?
Oxalate stone
**A patient has a urinary pH of 9. What type of kidney stone is most likely to form in this environment?
Struvite OR calcium phosphate
Most kidney stones are made primarily from?
Calcium oxalate
Hyperoxaluria:
more than 40 mg of oxalate in urine per day) should reduction of dietary oxalate
and herb
In which of the following clinical situations should >1.0g protein per kg body weight be provided in nutrition support?
Patients with renal failure on hemodialysis
Which organ controls blood pressure?
Kidneys
The kidney plays an essential role in the metabolism of which of the following metabolic conversions?
25(OH) D3 to 125 (OH2)D3
The most common cause of Chronic Kidney Disease (CKD) is?
Diabetes mellitus
Complications commonly associated with chronic renal failure may include?
a) Growth failure and renal colic
b) Nausea, vomiting, and reflux esophagitis
c) Anemia, edema, and potassium deficiency
d) Anemia, bone disease, cardiovascular disease, and malnutrition
d) Anemia, bone disease, cardiovascular disease, and malnutrition
An inflammation of the esophagus caused by the backflow of acidic gastric juices from the stomach.
Reflux esophagitis
What are common complications associated with peritoneal dialysis (PD)?
Peritonitis ,Challenges in controlling blood sugar , Weight gain
a common post-operative complication following a kidney transplant?
a) Hypertension
b) Hyperglycemia (DIABETES from the tests)
c) Chronic rejection
In kidney transplant patients, which are common dietary considerations and complications?
Increased protein needs, risk of infections, and hypertension
The three common complications of diabetes affect the cells of the?
Kidney, eye, and nerve tissue
A patient with diabetes mellitus for 25 years presents with problems in food digestion. Which condition is most likely related to this symptom?
Gastroparesis or (neuropathy)
How is GERD (Gastroesophageal Reflux Disease) related to the risk of aspiration pneumonia?
GERD increases the risk of aspiration pneumonia by causing acid reflux that can be
inhaled into the lungs
(Small, frequent meals with low-fat, non-spicy foods)
For a patient in the ICU with diabetes who requires TPN, what is the specification?
Low glycemic
Sudden hyperglycemia in a person who has consistently maintained good blood glucose control can be precipitated by?
a) Infections or illnesses
Xerostomia
Dry mouth
Dysgeusia
altered taste
Hyposmia
decreased sense of smell
Ptyalism Gravidarm
excess saliva
symptoms of hyperosmolar hyperglycemic state HHS?
Blood sugar level of 600 mg/dl or 33.3 mmol/L or higher
Excessive thirst, dry mouth, increased urination, warm dry skin, fever, drowsiness, confusion,
hallucinations
All are true regarding hyperosmolar hyperglycemic state EXCEPT? A) Occurs due to infection
B) Due to DM 1
C) Plasma glucose level is <30 mmol/L
D) Extreme dehydration
E) Patient has ketonuria
B) Due to DM 1
A child with diabetes mellitus type I will/is?
ketoacidosis
What are potential complications of esophageal resection?
Gastroesophageal reflux disease (GERD) or Esophageal stricture
or dumping syndrome
After undergoing esophageal surgery, such as resection, what condition might the patient expect to develop?
Gastroesophageal reflux disease (GERD)
Which type of
cancer is characterized by symptoms of a decreased sense of taste
(hypogeusia)?
Head and Neck Cancer or oral cancer
What helps in muscle contraction?
A) Muscles
B) Nerve
C) Bile
Respiratory quotient (RQ) is the ratio of CO2 produced to oxygen consumed. Excess CO2 production and increased RQ can lead to which of the following adverse effects?
a) Heart failure
b) Difficult weaning of the ventilator
b) Difficult weaning of the ventilator
A 71-year-old male with COPD. Lab data reveal an elevated hemoglobin and hematocrit. What is the most likely etiology of these laboratory abnormalities?
a) Chronic hypoxia
Ulcerative colitis
Process that starts in the rectum and progresses to involve varying lengths of the colon
Ulcerative colitis is characterized by?
Use of anti-inflammatory medications and corticosteroid
Anemia incidence is frequent , Anemia due to bloody diarrhea
