M104 T1 L10

Question 1

What diseases are affiliated with maldigestion?

Answer 1

Chronic pancreatitis, pancreatic carcinoma

CF

Question 2

What diseases are affiliated with having an inadequate absorptive surface?

Answer 2

Intestinal resection
gastro colic fistula
jejuno-ileal bypass

Question 3

What diseases are affiliated with having a bile salt deficiency?

Answer 3

Cirrhosis, cholestasis, bacterial overgrowth, impaired ileal reabsorption, bile salt binders

Question 4

What diseases are affiliated with lymphatic obstruction?

Answer 4

Lymphoma, intestinal lymphangiectasia

Whipple’s disease

Question 5

What diseases are affiliated with vascular disease?

Answer 5

Constructive pericarditis, right sided HF, mesenteric arterial or venous insufficiency

Question 6

What infections are affiliated with mucosal disease?

Answer 6

giardia, Whipple’s disease, tropical sprue, Inflammatory diseases, radiation enteritis, eosinophilic enteritis, ulcerative jejunitis

Question 7

What causes Bile acid diarrhea?

Answer 7

too much bile acid in your colon, caused by bile acid malabsorption

Question 8

What are the effects of Whipple disease?

Answer 8

it interferes with normal digestion by impairing the breakdown of foods
it damages the body’s ability to absorb nutrients
it affects the joints

Question 9

What are the key signs of tropical sprue?

Answer 9

abnormal flattening of the villi

inflammation of the SI lining

Question 10

When does refeeding syndrome occur?

Answer 10

when food is introduced too quickly after a period of malnourishment

Question 11

What is the pathology behind refeeding syndrome?

Answer 11

shifts in electrolyte levels

Question 12

What complications can be caused by refeeding syndrome?

Answer 12

seizures, HF, and comas

can be fatal

Question 13

What are the risk factors for refeeding syndrome? (ONE or more of the following)

Answer 13

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

Question 14

What are the risk factors for refeeding syndrome? (TWO or more of the following)

Answer 14

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

Question 15

What drug abuse could contribute to refeeding syndrome? (CIDA)

Answer 15

chemotherapy, insulin, diuretics, antacids

Question 16

What should be done before feeding nil by mouth patients?

Answer 16

check urea and electrolytes levels on a daily basis prior to feeding

Question 17

What electrolytes should be checked before feeding nil by mouth patients?

Answer 17

K and Mg

Question 18

How might a diet be administered for a patient with chronic illness?

Answer 18

long term enteral feeding

Question 19

What are the features of a diet for a patient with a chronic illness?

Answer 19

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

Question 20

How might a diet be administered for a patient with acute illness?

Answer 20

enteral / parenteral

Question 21

What is the role of a stoma?

Answer 21

it helps solid waste and gas exit the body without passing through the colon or the rectum

Question 22

What are the features of a diet for a patient with an acute illnss?

Answer 22

must meet E demand and reduce catabolism

must support recovery – micro & macro nutrients

Question 23

What is the medical term for Vit B12 injections?

Answer 23

hydroxocobalamin

Question 24

How are stomas made?

Answer 24

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.

Question 25

What are the two main types of ileostomy?

Answer 25

loop ileostomy

end ileostomy

Question 26

What does a loop ileostomy involve?

Answer 26

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

Question 27

What does an end ileostomy involve?

Answer 27

the ileum is separated from the colon and is brought out through the abdomen to form a stoma

Question 28

Why might a clinician be concerned about the health of patients in care or in hospital?

Answer 28

Malnourished due to age, long term ill health
Being housebound
Disease related malnutrition (eg COPD won’t be eating as much)
Food poverty

Question 29

What cytokines are involved in disease inflammatory response?

Answer 29

TNFa insulin resistance, glycoylsis
IL2 glucose metabolism
IL4 lipid and glucose metabolism
Lipolysis acivitiy and appeptite reduecd