Lecture 7 (Endocrine and GI) Flashcards
What disorder is due to a weak or incompetent LES?
GERD
What is steatorrhea found with?
fat malabsorption
What disorder is associated with vague epigastric discomfort and pain when eating?
Gastric Ulcer
What disorder has pain 2-5 hours after eating a meal and you get relief from pain after eating?
Duodenal ulcer
What general term for many disorders is due to eroded lesion in esophageal, gastric, or duodenal mucosa from the action of gastric acid?
Peptic Ulcer Disease
What are 5 common causes of PUD?
- H. Pylori
- Gastritis
- Use of aspirin and other NSAIDs
- Corticosteroids
- “stress ulcers”
What are the 2 goals of MNT for the treatment of PUD?
- Reduce and neutralize the secretion of gastric acid
2. Maintain the resistance of the GI epithelial tissue
Which of these is not a component of MNT therapy for PUD? A. Limit alcohol B. Eat more diary C. Avoid Skipping meals D. Increase Omega 3 and Omega 6
B. Eat more dairy
What disorder is associated with heartburn, increased belching, and painful spasm?
GERD
What are 4 behavior modifications for GERD?
- Don’t eat w/i 3 hours of retiring
- Don’t lay down after meals
- Avoid cigarette smoking
- Avoid tight fitting garments
What are 4 common vitamin deficiencies due to fat malabsorption?
A
D
E
K
Deficiency of what vitamin can lead to neuropathy and hemolytic anemia?
Vitamin E
Deficiency of what vitamin leads to prolongation of prothombin time and easy bruising?
Vitamin K
How many kcals/ kg shoudl those with compensated cirrhosis consume?
25-35 kcals/kg
How many kcals/kg should those with complicated cirrhosis consume?
35-40 kcals/kg
With stable cirrhosis, how many grams/kg/day of protein should a person consume?
1.0-1.2 grams/kg/day
How many gm/kg/day of protein should those with complicated cirrhosis and underlying malnutrition consume?
UP to 1.5 grams/kg/day
Should there be protein restriction for individuals during periods of episodic encephalopathy?
No
Individuals with ascites should consume how many grams of sodium per day?
2-3 grams (may need to be as low as 500 mg/day if extreme ascities)
What layers does Crohn’s Disease affect?
all layers of mucosa
Rectal bleeding is more common in ulcerative colitis or Crohn’s disease?
Ulcerative colitis
Fistulas are more common in ulcerative or Crohn’s disease?
Crohn’s Disease
Is Crohn’s Disease or ulcerative colitis segmented?
Crohn’s disease
What layers are affected in ulcerative colitis?
Mucosa and submucosa
What type diet is recommended for IBS?
low fat, low fiber, low lactose,
small frequent meals
How many grams of protein should someone with IBS consume?
1.0-1.5 gm/kg
A fasting plasma glucose of what is considered is considered criteria for diabetes?
> 126 mg/dL
A casual plasma glucose of what is considered diagnosis for DM?
> 200 mg/dL
What other symptoms with an elevated casual plasma glucose are considered criteria for DM?
Polyuria
Polydipsia
Unexplained weight loss
An A1c greater than what is considered criteria for DM?
> 6.5% on more than 1 occasion
What levels indicated impaired fasting glucose?
100-125 mg/dL
What glucose levels indicate impaired glucose tolerance (2 hour PP)
140-199 mg/dL
What adults should be tested for diabetes?
Overweight or obese + 1 risk factor
Over age 45
If results are normal, after how many years should DM take place?
3 years
In children, when should DM be tested?
10 years or older or at puberty with increased risk (family history in 1st/2nd relative, high risk ethinic population, signs of insulin resistance, maternal hx GDM)
What are 4 signs of insulin resistance?
acanthosis nigricans, HTN, dyslipidemia, PCOS
One servings of carbs is how many grams of sugar?
15 grams of sugar
How much physical activity is recommended for those with diabetes?
150 minutes/ week of moderate intensity aerobic activity
Resistance training 3x a week
What type insulin has the longest effective duration?
Long-acting (5.7-24 hours)
What type insulin has the shortest onset of action?
rapid-acting
What is the onset of action for intermediate acting insulin?
2-4 hours
What is the peak action time for intermediate acting insulin
4-10 hours
What is the effective duration of intermediate acting insulin?
10-16 hours
What is the peak action for rapid-acting insulin?
0.5-3 hours
What is the effective duration of rapid acting insulin?
2-5 hours
What is the peak action of short acting insulin?
2-4 hours
What is the effective duration of short acting insulin?
3-5 hours
What is considered low blood sugar?
<70 mg/dL
What are some signs of hypoglycermia?
Shakiness
Sweating
Fast heart beat
Dizziness
What is one symptoms seen in T2DM that isn’t seen in Type 1?
Polyphagia (excess hunger)
What is one symptom seen in T1DM that isn’t seen in type 2?
Electrolyte disturbances
Those with an A1C of _________ are at increased risk of diabetes.
5.7-6.4%
If pre-exercise glucose is ___________, a DM patient should eat CHO.
<100mg/dl
what vitamin deficiency can lead to hypocalcemia, osteomalacia, rickets?
vitamin D
What vitamin deficiency can lead to neuropathy or hemolytic anemia?
vitamin E
