GI Nutrition Lecture Powerpoint

Question 1

Essential nutrients

Answer 1

Those that the body cannot make in sufficient quantities to meet physiologic needs

Question 2

Carb/protein/fat kcals per gram

Answer 2

4/4/9

Question 3

2 formulas for calculating kcals

Answer 3

• Harris benedict formula

- Mifflin St Jeor formula

Question 4

Nutrient transport in the GI system upon absorption

Answer 4

• Water soluble enter the blood stream

- fat soluble vitamins and other fats form chylomicrons and are released into the lymphatic system

Question 5

Secretin

Answer 5

Hormone in small intestine that is released upon chyme entering the duodenum which stimulates pancreatic release of bicarb juices into duodenum

Question 6

Cholecystokinin

Answer 6

Hormone triggered when fat enters small intestines that stiulates gallbladder to release bile for fat emulsification

Question 7

Subjective global assessment

Answer 7

A 5 criteria guide to assessing presence of malnutrition alongside other tools such as a good physical exam

Question 8

Clinical assessment of malnutrition (4)

Answer 8

• muscle wasting (temporalis muscle)
• fat wasting (hollow sunken in eyes)
• edema and ascites
• alopecia

Question 9

Marasmus

Answer 9

Protein and calorie deficiency resulting in wasting but NO edema

Question 10

Kwashiorkor

Answer 10

Protein deficiency but not caloric deficiency resulting in extreme edema

Question 11

Risks for malnutrition (4)

Answer 11

• critical illness
• impaired bowel function
• alcoholism
• obesity

Question 12

Thiamine B1 deficiency common groups and clinical manifestations and treatment

Answer 12

• alcoholism, poverty, crohns, GI surgery
• beriberi (wet cardiovascular heart failure, late stage dry beriberi neurologic wernicke and korsakoff syndrome)
• IV then oral thiamine

Question 13

Riboflavin B2 deficiency common groups and clinical manifestations and treatment

Answer 13

• Undeveloped countries, malabsorption or malnutrition
• cheilosis/angular stomatitis, glossitis (swollen shiny tongue), corneal vascularization
• IV then oral riboflavin

Question 14

Niacin B3 deficiency common groups and clnical manifestations and treatment

Answer 14

• alcoholism, poverty, PPD rxn
• pellagra (dermatitis, diarrhea, and dementia)
• oral supplementation

Question 15

Vit A deficiency common groups and clinical manifestations and treatment

Answer 15

• children, elderly, poor
• night blindness, bitot spot, xerosis (dry skin)
• oral supplementation and refer to opthalmology

Question 16

Vit C deficiency common groups and clinical manifestations and treatment

Answer 16

• those without access to fresh fruits and veggies
• scurvy (poor wound healing), petechiae (small red spots), splinter hemorrhage
• oral supplementation

Question 17

Vit D deficiency common groups and clinical manifestations and treatment

Answer 17

• inadequate sunlight, inadequate dietary intake
• rickets (kids) and osteomalacia (adults)
• sun exposure or oral supplementation

Question 18

Vit E deficiency common groups and clinical manifestations and treatment

Answer 18

• those on anticoagulants or malnutrition
• excess bleeding
• oral/im/subQ supplementation

Question 19

Clinical manifestations of lactose intolerance

Answer 19

30-2 hours after ingestion get bloating, abdominal cramps, flatulence, and in high amounts diarrhea, treated with lactaid or avoidance

Question 20

Phenylketonuria (PKU) and treatment

Answer 20

Autosomal recessive disorder where a pt is unable to metabolize phenylalanine tested at newborn screening as delay in diagnosis will lead to potential brain injury, treated with low phenylalanine diet and tyrosine supplementation, strict protein control for life

Question 21

Benefits of enteral nutrition (3)

Answer 21

• more physiologic with preservation of gut mucosa
• fewer complications
• cheaper

Question 22

Peripheral parenteral nutrition

Answer 22

Short term use of nutrition admission thru a peripheral vein that can supplement those with low intake despite being unable to meet caloric needs on own

Question 23

Total parenteral nutrition

Answer 23

Use for patients who require extended period of tie (>7 days) using the superior vena cava to meet high calorie requirements