Dz Specific Nutrition

Question 1

Counter regulatory hormones responsible for hypercatabilism

Answer 1

Glucagon
Epinephrine
Cortisol

They are responsible for 
glycogenolysis
Gluconeogenesis ( generates glucose from non carb sources)
Proteolysis
Free fatty acid release

Question 2

Lipogenesis ( making fat from glucose) due to over feeding

Answer 2

Makes 6 to 8 times more CO2 than oxidative energy production.

Can also cause Resp. Acidosis

Question 3

In HD what vitamins have increased needs?

Answer 3

Folic acid thought to help normalize homocysteine.

FYI: vitamin A is usually elevated

Question 4

Protein needs for CRRT?

Answer 4

1.5 to 2 gram/kg per day

Question 5

Peritoneal dialysis protein needs?

Answer 5

1.2 to 1.3 grams/kg

Question 6

Liver disease causes of malnutrition

Answer 6

Anorexia
Early satiety
Fat malabsorption due to altered bile acid circulation 
Increased protein and fat oxidation
Increased energy expenditure

Question 7

Tumor lysis syndrome causes the acute release of intracellular contents is cells to extra cellular compartments…..

Answer 7

Hyperkalemia
Hyperphosphatemia
Hyperuricemia

Question 8

Crohn’s disease in distal ileum affects absorption of

Answer 8

Fat soluble vitamins
B12
Magnesium

Question 9

Absorption of manganese and folic acid is in the

Answer 9

Jejunum

Question 10

What can be contributing factors in Metabolic bone disease?

Answer 10

Corticosteroids
Aluminum toxicity in PN patients
Hypercalciuria in PN patients

Question 11

Short bowel with bacterial overgrowth can lead to her

Answer 11

D lactic acidosis

Question 12

Refractory diarrhea in short bowel can be controlled with

Answer 12

Octreotide a synthetic form of somatostatin. It decreases intestinal secretions in patients with no colons. Used when standard antidiarrheals don’t work

Question 13

Diet for short bowel with part orcall of colon?

Answer 13

High complex carb diet as they can be converted to short chain fatty acids

Question 14

Short bowel with colon may need to avoid

Answer 14

Oxalate. When fat is malabsorbed, dietary calcium binds with free fatty acids leaving oxalate to be absorbed in colon. Then filtered by kidney that binds it and forms stones. Calcium supplementation can prevent this by binding with dietary oxalate.

Question 15

Cyclosporine can cause what in transplant patients?

Answer 15

Hyperkalemia
Hypomagnesemia
Hyperglycemia
Hyper cholesterolemia

Question 16

Dialysis needs

Answer 16

Over 65: 30 to 35 cal/kg

Less than 65 years: 35 cal/kg

Question 17

Water Insensible loss from skin, lungs and feces is

Answer 17

10 mL/kg/day

Question 18

Encephalopathy do what first?

Answer 18

Lactulose snd neomycin

Question 19

Wilson’s dz

Answer 19

Copper accumulation in the liver and other organs- rare as usually the body will secrete copper in the bile

Question 20

Hepatic steatosis May be treated with

Answer 20

Choline

Question 21

Catabolic phase can last

Answer 21

7 days

Question 22

Most of fat digestion occurs in the

Answer 22

Duodenum

Question 23

Glutamine is the primary fuel for

Answer 23

Intestinal cells

Question 24

Most of fat digestion occurs

Answer 24

In duodenum

Question 25

Gluconeogenesis occurs in

Answer 25

Kinda deny and liver

Question 26

Diarrhea causes metabolic

Answer 26

Acidosis ( loss of bicarbonate)

Question 27

Vomiting causes

Answer 27

Metabolic alkalosis