Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUTR 442 > Lecture 11 > Flashcards

Lecture 11 Flashcards

1
Q

common nutr diagnoses with PUD

A

inadequate oral intake, inadequate energy intake, altered GI fxn, unintended wt loss, food and nutrition related knowledge deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

management of PUD pharmacotherapy:

A

antacids, PPI, prostaglandin analogs, mucosal barrier fortifiers, H2 receptor agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

this med causes black stool

A

peptobismal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is h pylori triple therapy?

A

7-14 day course 2 antibiotics + PPI (cause nausea, vomiting, ab pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

management of PUD nutrition:

A

prevent wt loss and restore nutrient interactions, support med therapies and v symptoms, trial restriction of foods increasing acid secretion, avoid foods not tolerated, avoid lying down after eating, avoid larger meals close to bedtime, small/frequent meals, omega 3 and 6 f.a.?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

historical diet treatment of PUD:

A

milk and cream (but now know that they increase gastrin and pepsin secretion so don’t recommend)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

one of major diffs between GERD and PUD nutrition management:

A

don’t restrict acid foods/juices for PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

acute symptomology of PUD:

A

sharp, sudden, persistent, severe pain; melena (bloody/black stools), hematemesis (vomiting blood, coffee ground emesis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

acute symptomology of PUD indicative of serious complications like:

A

acute/chronic GI bleed, perforation, obstruction (big drops in Hb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when use surgery for PUD?

A

when severe, refractory to treatment, complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

types of surgery for PUD:

A

vagotomy, gastroenterostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is vagotomy?

A

interruption of impulses carried by vagus nerve to parietal cells (v acid production, v response to gastrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

preferred vagotomy for treating PUD

A

highly selective vagotomy (preserves antral motility)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is truncal vagotomy with pyloroplasty?

A

vagus nerve cut at distal esophagus to decrease antral contraction, delay emptying of solids, v pylorus relaxation; pyloroplasty is surgical revision to widen pyloric canal that creates leaky pylorus to enhance emptying (can cause dumping, less control of food flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a gastrectomy?

A

resection of stomach (partial or total) –>used in gastric CA, more aggressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

alternative to pyloroplasty:

A

gastric remnant of partial gastrectomy anastomosed to small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

primary gastric surgeries for PUD:

A

gastroduodenostomy (billroth 1), gastrojejunostomy (Billroth 2) , roux-en-Y anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is billroth 1?

A

removal of pylorus and/or antrum of stomach, anastomosis of proximal end of duodenum to distal end of remnant stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is billroth 2?

A

removal of antrum, anastomosis of remnant stomach to side of jejunum, blind duodenal loop (stapled) to allow for bile and pancreatic secretions to flow into intestine (aid in digest and absorb) –>it is more distal and lower down than billroth 1

20
Q

what is roux-en-Y

A

close to total gastrectomy, jejunum pulled up and anastamosed at distal end of esophagus or gastric remant, duodenum then connected to small bowel to allow bile and pancreatic secretions to flow into intestine

21
Q

potential complications of vagotomy:

A

impaired motor fxn of stomach

22
Q

potential complications of total gastric and truncal vagotomy

A

gastric stasis and poor emptying

23
Q

potential complications of subtotal gastrectomy with vagotomy

A

early satiety, delayed gastric emptying, rapid emptying of hypertonic fluids

24
Q

potential complications of total gastrectomy

A

early satiety, nausea, vomiting, wt loss, poor availability bile acids and pancreatic enzymes cuz anastomotic changes, malabsorption, PEM, anemia, dumping, B12 deficiency

25
Q

what is dumping syndrome?

A

physio response to presence of larger than normal amts of food/liquid in small intestine

26
Q

healthy individual digestion:

A

food partially digests in 1-3 hr, enters duodenum slowly via pyloric sphincter, acidic chyme is neutralized by pancreatic bicarbonate

27
Q

why are refined/simple sugars particularly problematic for dumping syndrome?

A

highly osmotic so rapidly absorb water from body

28
Q

post-gastrectomy nutr goals of care

A

Adequate cals and nutr (promote healing, attenuate wt loss, correct micronutrient deficiencies), symptom management (reflux, early satiety, dumping syndrome)

29
Q

nutr interventions post-gastrectomy:

A

dependent on goals of care, reason for surgery (PUD with acute complication, gastric carcinoma, neoadjuvant treatment pre-op, bariatric surgery), post op considerations (anastomosis, EN, PN

30
Q

98% of digestion and absorption occurs in ___

A

lower GIT

31
Q

3 parts of small intestine:

A

duodenum, jejunum, ileum

32
Q

autoimmune disease caused by immunological rxn to gluten

A

celiac disease

33
Q

peptide fractions (storage proteins) found in wheat, barley, rye to give shape and elasticity

A

gluten

34
Q

this type of gluten appears to be particularly problematic

A

gliadin

35
Q

exposure to gliadin cause:

A

inappropriate T cell mediated inflamm response

36
Q

etiology of celiac?

A

unknown, but strong gene component, several other disorders associated with it

37
Q

pathophysio of celiac?

A

absorptive surface of small intestine damaged by inflamm response/rxn to gluten proteins–>damage to enterocytes (less absorptive SA, loss of digestive enzymes), villi have ht reduced and are flattened

38
Q

GI symptoms of celiac

A

diarrhea, ab pain, cramping, bloating , gas production

39
Q

extraintestinal symptoms of celiac:

A

bone and joint pain, muscle cramping, fatigue, peripheral neuropathy, seizures, skin rash, mouth ulcers, depression, infertility

40
Q

other clincal features encountered in celiac?

A

vit and min deficiencies (iron, B12, fat sol vits, Zn, Mg, Folate), secondary lactase deficiency, metabolic bone disease

41
Q

treatment of celiac:

A

lifelong elimination of gluten (improve symptoms after 2 wks in most pt, histological improvement not seen for years)

42
Q

considerations for gluten free diets:

A

beware cross contamination (ie. oats)

43
Q

what does CELIAC stand for?

A

consultation with dietitian skilled in celiac, education, lifelong adherence to GED, identification and treatment of nutr deficiencies, access to advocacy group, continuous long term follow up by multidisciplinary team

44
Q

what is non-celiac gluten sensitivity

A

clinical state in which pt develop symptoms related to celiac disease when consume gluten and feel better on GFD but do NOT have celiac (no biomarkers, autoantibodies absent, no villous atrophy)

45
Q

packaged GF foods are higher in __ and lower in __

A

fat, CHO; protein, Fe, folate

NUTR 442 (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions