- NO BROW (gluten, rye, oats, wheat) - OK foods = rice, potatoes, eggs, cheese - first sign of allergy = rash - other signs: flatulence, fogginess, GI distress, joint pain

- PPIs (-prazole) = take Vit. D and Ca supplements + DEXA bone scan + wt-bearing exercises - H2 blockers (-tidine) - LOW fat + small frequent emals - NO eating at bedtime + NO laying down after meals (must wait 2 hrs after) - NO alcohol/tobacco, chocolate, coffee, peppermint

- black, tarry stools - HIGH HR + LOW BP - long-term alcohol abuse = ALCOHOLICS - keep NPO!

- gastric pH = ≤ 5.5 - GRV (gastric residual volume) = ≤ 500 mL

- cause: trigger (spicy foods, dairy, stress, alcohol, coffee) - constipation, diarrhea, frequent BM, flatulence

GI + Nutrition Flashcards by Angelica Dela Rosa

intussusception

intestines telescope into itself
- currant jelly-like stool
- bloody mucus stools
- bilious vomit + nausea
- sausage-shaped mass = enlarged abdomen
- Tx: air / pneumatic enema

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pyloric stenosis

narrowed pyloric stenosis
- projectile vomiting
- non-bilious vomit (metabolic alkalosis)
- love-shaped mass
- dehydrated!

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Hirschsprung’s Disease

closed anus caused by inflamed large intestine
- MEGA-COLON!
- bilious vomit
- NO bowel movement for first 48 hrs!
- Tx: surgery + pull-through method!

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Celiac’s Disease

NO BROW (gluten, rye, oats, wheat)
OK foods = rice, potatoes, eggs, cheese
first sign of allergy = rash
other signs: flatulence, fogginess, GI distress, joint pain

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cystic fibrosis (CF)

genetic disorder that cannot keep NaCl in body
- dehydrated
- mucus plugs = thick and sticy
- NO pancreatic enzymes
- malabsorption + malnutrition
- Diet: HIGH fat, calories, protein + digestive enzymes (Pancreaslipase) during or with every meal with multivitamins
- can sprinkle pancreatic enzymes on top of acidic foods (applecauce)
- Tx: NaCl + IVF + Pancrealipase!

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acid reflux

Antiacids = Aluminum hydroxide, Magnesium cabonate, Hydroxide calcium, Bismuth salicylate

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GERD

PPIs (-prazole) = take Vit. D and Ca supplements + DEXA bone scan + wt-bearing exercises
H2 blockers (-tidine)
LOW fat + small frequent emals
NO eating at bedtime + NO laying down after meals (must wait 2 hrs after)
NO alcohol/tobacco, chocolate, coffee, peppermint

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gastritis

Misoprostol

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PUD

gastric + duodenal
- H. pylori
- Tx: triple therapy

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cirrhosis

fibrosing of liver
- causes: alcohol, hepatitis
- NO albumin
- LOW blood clotting factors = Hemophilia A & B = Tx: -xaban
- HIGH ammonia, bilirubin, bile, INR/PT, bleeding
- Hepatic Encephalopathy = Tx: Lactulose + Neomycin!
- Pathological Jaundice = Abnormal (first 24 hrs)
- Physiological Jaundice = Normal (after 24 hrs = 2-3 days after birth)
- bile = pruritis = itchy!

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esophageal varices

weak/distended varices!
- Tx: Octreotide, Balloon Angioplasty, Band Ligation, TIPS procedure

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upper GI bleed

black, tarry stools
HIGH HR + LOW BP
long-term alcohol abuse = ALCOHOLICS
keep NPO!

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cholelithiasis

6 F’s = female, fat, fertile, fourty, fair skin, family hx
- very PAINFUL!

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cholecystitis

inflammation of gallbladder
- RUQ pain
- radiating to R shoulder
** NPO!

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pancreatitis

inflammation of pancreas
- LUQ pain
- radiating to back
- cause: gallstones, alcohol, trauma
- monitor: pancreatic enzymes!
- can cause ARDS + psudeocyst!

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appendicitis

inflammation of appendix
- periumbilical/midepigastric pain
- radiating to RLQ
- if NO pain = RUPTURED!
- McBurney’s Point = rebound tenderness = RLQ

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diverticulitis

inflammation of small pouches in GI
- LLQ pain
- if radiating to LUQ = PERFORATION!
- Tx: NPO, IVF, PPIs, Metronidazole, high fiber/residue, no red meats/nuts

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GI lab values

gastric pH = ≤ 5.5
GRV (gastric residual volume) = ≤ 500 mL

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IBS

cause: trigger (spicy foods, dairy, stress, alcohol, coffee)
constipation, diarrhea, frequent BM, flatulence

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Ulcerative colitis (UC)

IBD only in colon (large intestine)
- bloody diarrhea consistently
- colonoscopy with biopsy
- Diet: HIGH protein + LOW fiber/residue
- small frequent meals
- Tx: Sulfasalazine –> SE: photosensitivity!

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Crohn’s Disease

IBD anywhere in GI tract (mouth to anus)
- watery diarrhea consistently
- colonoscopy with biopsy + endoscopy
- Diet: HIGH protein + LOW fiber/residue
- Tx: Sulfasalazine –> SE: photosensitivity!

pyelonephritis

FLANK pain + a fever

nephrolithiasis

FLANK pain radiating to GROIN

vitamin B1 (Thiamine)

Wernicke’s Encephalopathy + ALCOHOL

vitamin B3 (Niacin)

lowers bad cholesterol + increases good cholesterol - normal SE: flushing sensation + HTN! - monitor LFTs - peanuts, meats, wole grains

vitamin B6 (Pyridoxone)

treats TB! - prevents peripheral neuropathy - given with ISONIAZID - meats, salmon, bananas

vitmin B9 (Folic Acid/Folate)

prevents NTDs! - standard = 400-800 mcg - dark gree leafy veggies, meat,legumes, nuts/eggs

vitamin B12 (Cobalamin)

meat, poultry, fish, shellfish - at risk for Vitamin B12 deficiency = VEGANS + Pernicious anemia!

take Ca with?

Vitamin D "CAll Daddy"

take Fe with?

Vitamin C "IRON the Creases"

PPIs

(-prazole) - GERD + PUD - stress ulcers - may need Mg supplements! - SE: C. Diff + osteoporosis! - weight-bearing exercises, DEXA bone scan, Ca/Vit. D supplements!

H2 Blockers

(-tidine) - GERD + GI ulcers - SE: decreased libido + gynecomastia

antacids

- instant GI relief - NEVER take with other meds (wait 2 hrs AFTER) - long-term antacids = metabolic alkalosis!

Octreotide

- for esophageal varices - SE: N/V/D

Sulfasalazine

- for UC + Crohn's disease - SE: photosensitivity!

Ondansetron (Zofran)

- anti-emetic/nausea - SE: QT prolongation = V. Fib!

Metoclopramide (Reglan)

- anti-emetic/nausea - for gastroparesis, nausea, paralytic ileus - SE: EPS!

Misoprostol

- increases prostaglandins - for ulcers + ripens cervix for labor! - SE: diarrhea (long-term use) - NEVER in pregnancy!

Lactulose

- hepatic encephalopathy - weight loss

Orlistat

- weight loss med - normal SE: fatty stools, flatulence - ONLY take when eating! - take with Vitamins ADEK 2 hrs after

bananas, avocados, tomatos, potatoes, spinach

salt, bacon, canned foods, processed foods, soy sauce

dairy (milk, cheese), greens, broccoli, kale, canned fish

Vitamin D

oily fish, cod liver oil, tuna, sun, foritfied milk

"FONG" = fish, organ meats, nuts, grains

"MAGNET" = milk/meat, avocado/potatoes, greens (spinach, broccoli, legumes), nuts/peas, etc (raisins, yogurt), tuna/tofu

Iron (Fe)

iron-fortified cereals, red meats, lentils, fish, eggs, leafy greens (spniach), dried fruits

Vitamin C

Citrus = oranges, juice, strawberries, tomatos, peppers

Vitamin K

green leafy veggies (Kale) - vitamin K deficiency = bleeding! - antidote: Warfarin

new ileostomy

opening in abdominal wall made during surgery when colon/rectum are not working properly - NO broccoli, multigrains, popcorn - OK foods = easily digested foods (canned fruits, rice) - Diet = same as UC diet! = LOW fiber/residue+ HIGH protein/calories - small frequent meals

tube feedings

continuous @ 20-30 mL/hr