Final Exam - Exam 2

Question 1

Name two patient scenarios that would be automatic indications for using Parental Nutrition

Answer 1

1) short bowel syndrome
2) GI not functioning/obstruction/traume/EN cannot be bypassed

Question 2

Define/explain Refeeding Syndrome. Which patients are more likely to experience this? What should be monitored (be specific) to prevent Refeeding syndrome and why?

Answer 2

Refeeding syndrome is going from fat as the main enegy source to higher amounts of glucose. Glucose is taken up with electrolytes from the blood into the cells of the tissues, which can easily lead to death if not caught early
- patients that were previously not eatig are more suceptible
- monitor potassium, phosphorus, and magnesium

Question 3

T/F acute pancreatitis is an automatic inidcation for TPN initiation

Answer 3

False

Question 4

Name at least six MNT guidelines for GERD patients

Answer 4

1) avoid large high fat meals
2) eat 2-3 hours before going to bed
3) elevate Head of bed (HOB)
4) avoid drinking
5) avoid smoking
6) avoid acidic and spicy foods

Question 5

What does IDDSI stand for?

Answer 5

Internation Dyphagia Diet Standardization Initiative

Question 6

What is the most common cause of peptic ulcer disease?

Answer 6

H. Pylori

Question 7

Name two foods that inhibit H. Pylori?

Answer 7

Cranberries, ginger

Question 8

What is the name of the medication that is used to increase GI motility by increasing acetylcholing concentrations in the gut? Hint: many patients with gastroparesis try this medication

Answer 8

Reglan

Question 9

Which of the following is not included as MNT for dumping syndrome?
a. small, frequent meals
b. lay down after eating
c. limit simple sugars
d. consume ample fluids with meals
e. all of the above are appropriate MNT recs for Dumping syndome

Answer 9

d. consume ample fluids with meals

should actually limit fluids to 4 fl oz

Question 10

When trying to decrease gas, name five foods that patients should avoid.

Answer 10

Gum, beans, cruciferous vegetables, legumes, dairy

Question 11

What is the most effective therapy for a Clostridium Difficile infection?

Answer 11

Fecal Matter Transplantation (FMT)

Question 12

What specific MNT must be followed for life for celiac disease patients? Be specific on what must be avoided. (include which nutrient deficiencies you will check for and supplements that may be needed)?

Answer 12

Avoid gluten, wheat, barley, and rye
- check labels and make sure other foods such as quinoa, arrowroot, or buckwheat aren’t contaminated
- look for deficiencies in iron, and fat soluble vitamins (Vit A, K, D, E)

Question 13

what is an example of a good breakfast meal for a celiac patient?

Answer 13

Breakfast idea: oats with sliced bananas/bliueberries and chicken sausage on the side

Question 14

What does FODMAP stand for? What would be an example of a low FODMAP lunch? Which patients should try a low FODMAP diet?

Answer 14

Fermentable aligosaccharides, disaccharides, monosaccharides, and polyols
- Food ex: lactose free yogurt, banana, blueberries, oranges
- Good diet for patients with fructose malabsorption or IBS

Question 15

Which type of IBD is limited to the large intestine?
a. Crohn’s disease
b. ulceratve colitis

Answer 15

Ulcerative colitis

Question 16

Which type of IBD often has strictures and fistulas?
a. Crohn’s disease
b. ulcerative colitis

Answer 16

Crohn’s disease

Question 17

Which type of IBD shows positive benefits to probiotic supplementation?
a. Crohn’s disease
b. ulcerative colitis

Answer 17

ulcerative colitis

Question 18

T/F patients with diverticular disease must avoid nuts, seeds, berries, and popcorn for life

Answer 18

False

The foods have been proved to be safe and won’t get stuck in the pockets

Question 19

Which of the following in part of MNT recs for ostomies?
a. high fiber diet for first 4 weeks
b. at least 40% of calories from fat
c. low fiber diet for the first 6-8 weeks
d. limit fluid to 4-6 cups per day

Answer 19

c. low fiber diet for the first 6-8 weeks

Question 20

Explain how excess alcohol consumption can cause malnutrition. What vitamins are likely to be deficient? Be specific.

Answer 20

• people replace food with alcohol
• limited utilization of fat and carbs
• vitamin deficiencies: thiamin, folate, B6, iron

Question 21

T/F fatty liver is reversible

Answer 21

True

Question 22

What does MASLD stand for?

Answer 22

Metabolic Associated Stetotic Liver Disease

Question 23

What vitamin has been show to be effective for treatment of MASLD?

Answer 23

Vitamin E

Question 24

T/F patients with Hepatic Encephalopathy need to consume higher levels of BCAA (branch chain amino acids) to help alleviate symptoms

Answer 24

False

Question 25

T/F a plant-based diet has proven to be preventative against Gallbladder Disease

Answer 25

True

Question 26

Which of the following should be included in Chronic Cholelithiasis MNT?
a. low fat
b. weight reduction, if warranted
c. water soluble forms of fat-soluble vitamins
d. All of the above

Answer 26

d. All of the above

Question 27

Name four things included in MNT recs for pacreatitis

Answer 27

1) if patient is unable to eat for 5-7 days, may start EN
2) 25-35 kcals
3) 1.2-1.5 g/kg protein
4) restrict complex carbs, high fat
5) decrease fiber

Question 28

What is the name of the sedation medication that is suspended in lipid solution?

Answer 28

Propifol