M104 T1 L10 Flashcards
What diseases are affiliated with maldigestion?
Chronic pancreatitis, pancreatic carcinoma
CF
What diseases are affiliated with having an inadequate absorptive surface?
Intestinal resection
gastro colic fistula
jejuno-ileal bypass
What diseases are affiliated with having a bile salt deficiency?
Cirrhosis, cholestasis, bacterial overgrowth, impaired ileal reabsorption, bile salt binders
What diseases are affiliated with lymphatic obstruction?
Lymphoma, intestinal lymphangiectasia
Whipple’s disease
What diseases are affiliated with vascular disease?
Constructive pericarditis, right sided HF, mesenteric arterial or venous insufficiency
What infections are affiliated with mucosal disease?
giardia, Whipple’s disease, tropical sprue, Inflammatory diseases, radiation enteritis, eosinophilic enteritis, ulcerative jejunitis
What causes Bile acid diarrhea?
too much bile acid in your colon, caused by bile acid malabsorption
What are the effects of Whipple disease?
it interferes with normal digestion by impairing the breakdown of foods
it damages the body’s ability to absorb nutrients
it affects the joints
What are the key signs of tropical sprue?
abnormal flattening of the villi
inflammation of the SI lining
When does refeeding syndrome occur?
when food is introduced too quickly after a period of malnourishment
What is the pathology behind refeeding syndrome?
shifts in electrolyte levels
What complications can be caused by refeeding syndrome?
seizures, HF, and comas
can be fatal
What are the risk factors for refeeding syndrome? (ONE or more of the following)
BMI < 16 kg/m2
unintentional weight loss greater than 15% within the last 3–6 months
little or no nutritional intake for more than 10 days
low levels of K, P or Mg prior to feeding
What are the risk factors for refeeding syndrome? (TWO or more of the following)
BMI < 16 kg/m2
unintentional weight loss greater than 10% within the last 3–6 months
little or no nutritional intake for more than 5 days
a history of alcohol abuse or drugs including
What drug abuse could contribute to refeeding syndrome? (CIDA)
chemotherapy, insulin, diuretics, antacids
What should be done before feeding nil by mouth patients?
check urea and electrolytes levels on a daily basis prior to feeding
What electrolytes should be checked before feeding nil by mouth patients?
K and Mg
How might a diet be administered for a patient with chronic illness?
long term enteral feeding
What are the features of a diet for a patient with a chronic illness?
must be a balanced diet increased E intake where blood glucose levels are managed where the kidney's workload is reduced where any inflammation is reduced must support any treatment
How might a diet be administered for a patient with acute illness?
enteral / parenteral
What is the role of a stoma?
it helps solid waste and gas exit the body without passing through the colon or the rectum
What are the features of a diet for a patient with an acute illnss?
must meet E demand and reduce catabolism
must support recovery – micro & macro nutrients
What is the medical term for Vit B12 injections?
hydroxocobalamin
How are stomas made?
In a loop colostomy, a loop of colon is pulled out through a cut in your tummy. The loop is opened up and stitched to your skin to form an opening called a stoma. The stoma has 2 openings that are close together. One is connected to the functioning part of your bowel, where waste leaves your body after the operation.
What are the two main types of ileostomy?
loop ileostomy
end ileostomy
What does a loop ileostomy involve?
a loop of SI is pulled out through an incision in the abdomen, before being opened up and stitched to the skin to form a stoma
What does an end ileostomy involve?
the ileum is separated from the colon and is brought out through the abdomen to form a stoma
Why might a clinician be concerned about the health of patients in care or in hospital?
Malnourished due to age, long term ill health
Being housebound
Disease related malnutrition (eg COPD won’t be eating as much)
Food poverty
What cytokines are involved in disease inflammatory response?
TNFa insulin resistance, glycoylsis
IL2 glucose metabolism
IL4 lipid and glucose metabolism
Lipolysis acivitiy and appeptite reduecd
