Liver Disorders

Question 1

what is increased with liver damage?

Answer 1

(hepatic serum enzymes) ALT, AST

Question 2

nutritional requirement for liver disease?

Answer 2

protein 1.2-1.3g/kg/d
vit ADEK (if steatorrhea present)
B vitamins (if an alcoholic, specifically thaimin)
iron (with chronic bleeding)
magnesium and zinc (if alcoholic)

Question 3

what is the most commonly recommended supplement for the liver?

Answer 3

milk thistle

Question 4

gallstones are caused by?

Answer 4

low fiber, high fat diets

high animal protein

Question 5

what should you do for acute cholecystitis?

Answer 5

rest bowels

low fat diet (30-45g/d)

Question 6

what should you do for chronic cholecystitis?

Answer 6

long term low fat diet

25-30% cal from diet

Question 7

secretin stimulation test

Answer 7

measures pancreatic secretion, especially bicarbonate in response to secretin

Question 8

gluose tolerance test

Answer 8

assess endocrine function of the pancreas

Question 9

72 hr fecal fat test

Answer 9

assess exocrine function of the pancreas

Question 10

fecal elastase test

Answer 10

most common enzyme to determine pancreatic function

Question 11

recommendations for acute pancreatitis

Answer 11

rest bowels

easily digestible carbs, low fat, 6 small meals, adequate protein

Question 12

recommendations for chronic pancreatitis

Answer 12

at risk for protein enetgy malnutriotn
same as diet as acute
supplement pancreatic enzymes
supplement ADEK and B12
alcohol is prohibited

Question 13

kidney stone prevention

Answer 13

fluid- at least 1 cup per meal, between meals, bed time and when up at night
cranberry juice, black currant
limit animal proteins
reduce oxalate

Question 14

prevension of kidney stones

Answer 14

Na:K needs to be <1
decrease intake of citrate, fructose, vitamin C supplements, ridiculously high doses of vitaminD
incrase intake of vitamin B6, EPA (omega 3)

Question 15

what are the most common type of kidney stones?

Answer 15

calcium stones

Question 16

what helps decrease calcium stones

Answer 16

dietary calcium

Question 17

oxalate stones are due to?

Answer 17

fatty malabsorption (MC)
low vitamin B6
limit oxalate containing foods
ecessive vitamin C
lack of oxalobacter formigenes

Question 18

high oxalate foods to limit

Answer 18

rhubarb
spinach
straberries
chocolate
wheat bran and whole grainwheat
nuts (almonds and pecans)
peanuts
beets tea
high dose tumeric

Question 19

what are the stones that can dissolve?

Answer 19

uric acid stones

Question 20

what are uric acid stones due to?

Answer 20

low urine pH
too much acidic foods
too little alkaline foods
limit meat, fish, poultry
avoid organ meats, anchovies, sardines, broth and gravy