Brainscape's Knowledge GenomeTM

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


See full index

Domain 2: Nutrition Care for Individuals and Groups > Medical Nutrition Therapy - A. GI Disorders (p. 1-5) > Flashcards

Medical Nutrition Therapy - A. GI Disorders (p. 1-5) Flashcards

1
Q

An eroded mucosal lesion. The cause of many ____ is the H. pylori bacteria.** Diet: As tolerated (whatever does not aggravate the patients condition). May wish to omit gastric irritants (black pepper, caffeine, alcohol)

A

Ulcer

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

Gastric surgery connecting the remaining stomach to the duodenum.

A

Billroth 1

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

Gastric surgery connecting the remaining stomach to the jejunum. Jejunum further along SI than duodenum, making this a more serious procedure.

A

Billroth 2

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

Protrusion of a portion of the stomach above the diaphragm into the chest. Main symptom is heart burn.

A

Hiatal hernia

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

Hiatal hernia diet therapy: _____, _____ feedings. Avoid late night snacks and gastric irritants.

A

Hiatal hernie diet therapy: *SMALL, BLAND feedings.

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

Dumping syndrome follows a ____________. Types include Billroth 1 and Billroth 2.

A

**Dumping syndrome follows a GASTRECTOMY.

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

In dumping syndrome, the holding capacity of the stomach is _______, so the food is literally dumped into the ______.

A

Decreased, intestine

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

When rapidly hydrolyzed (simple) CHO enter the jejunum, _________ is drawn from the blood into the SI to achieve osmotic balance. This causes a rapid _______ in the vascular fluid compartment, or rapid drop in _______ ______, and signs of cardiac insufficiency.

A

When rapidly hydrolyzed (simple) CHO enter the jejunum, WATER is drawn from the blood into the SI to achieve osmotic balance. This causes a rapid DROP in the vascular fluid compartment, or rapid drop in BLOOD PRESSURE, and signs of cardiac insufficiency.

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

~__ hours later, this CHO is rapidly digested and absorbed, causing a sharp ______ in blood sugar, _______ of insulin, followed by a sharp _____, or REACTIVE HYPOGLYCEMIA.

A

~2 hours later, this CHO is rapidly digested and absorbed, causing a sharp RISE in blood sugar, OVERPRODUCTION of insulin, followed by a sharp DROP in blood sugar, or REACTIVE HYPOGLYCEMIA.

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

Following Billroth 2, where the ________ is being bypassed, secretion of SECRETIN and CCK is ______, also _______ pancreatic secretion. This adversely effects absorption of _______, whose absorption is most rapid in the _____, and ______, whose absorption requires acidity. Iron, B12 (lack of intrinsic factor), and Folate (lack of B12 and iron) may arise.

A

Following Billroth 2, where the DUODENUM is being bypassed, secretion of SECRETIN and CCK is DECREASED, also DECREASING pancreatic secretion. This adversely effects absorption of CALCIUM, whose absorption is most rapid in the DUODENUM, and IRON, whose absorption requires acidity. Iron, B12 (lack of intrinsic factor), and Folate (lack of B12 and iron) may arise.

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

*______ Diet: -Small, frequent meals -Limit fluids during meals (drink before and after) -Restrict simple sugars (CHO) -Protein at each meal -Moderate fat (lactose may be poorly tolerated due to rapid transport)

A

DUMPING DIET* -Small, frequent meals -Limit fluids during meals (drink before and after) -Restrict simple sugars (CHO) -Protein at each meal -Moderate fat (lactose may be poorly tolerated due to rapid transport)

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

Delayed gastric emptying. Due to surgery, diabetes, obstructions.

A

Gastroparesis

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

_________ can ________ gastric emptying. This may lead to long-term, detrimental effects on GASTRIC NERVES and motility.

A

Hyperglycemia can slow gastric emptying.

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

__________, medications that control acid reflux, INCREASE stomach contractility, also INCREASING gastric emptying time.

A

Prokinetics

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

A _____ is a disease of the small intestine.

A

Sprue

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

There are 2 types of sprue: ________ and ______.

A

Tropical sprue and Non-tropical sprue

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

A chronic GI disease characterized by intestinal lesions related to bacterial, viral or parasitic infection. Symptoms include deficiencies in vitamin B12 and folate (due to decreased HCl and IF). Associated with diarrhea and malnutrition.

A

Tropical Sprue

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

Gluten-induced enteropathy (CELIAC DISEASE)

A

Non-tropical sprue

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

Diet therapy in Gastroparesis: Small, frequent meals, _______ foods (liquid better tolerated), AVOID high fiber.

A

Gastroparesis: Small, frequent meals Pureed foods Avoid High Fiber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diet therapy for Tropical Sprue: Antibiotics High Cal High ______ Supplementation of deficient nutrients: _____ and ____

A

Tropical Sprue: Hi Cal Hi Pro B12, Folate supps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

______ refers to STORAGE PROTEINS. (Prolamins: protein found in grains. Ex. gliadin in wheat)

A

Gluten refers to STORAGE PROTEINS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In ____ disease, there is damage to the VILLI –> MALABSORPTION (leads to loss of fat soluble vitamins, diarrhea, steatorrhea, iron-deficiency, ANEMIA)

A

Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diet therapy for ______: Gliadin-free, Gluten-restricted diet (NO wheat, rye, oats, barley)

A

Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diet therapy for _____ includes high fluid, high fiber diet and exercise.

A

Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The presence of small mucosal sacs that protrude through the wall of the intestine due to structural weakness.

A

Diverticulosis (sacs=diverticula)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Diet therapy for Diverticulosis: *_____ fiber diet

A

Diet therapy for Diverticulosis: *HIGH fiber diet (provides rapid transit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Once diverticula become inflamed as a result of food and residue accumulation and bacteria.

A

Diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diet therapy for Diverticulitis: *Begin with clear liquids. Advance as tolerated to ______ fiber, low-residue and advance back to ____ fiber gradually.

A

Diet therapy for Diverticulitis: *Begin with clear liquids. Advance as tolerated to LOW fiber, low-residue and advance back to HIGH fiber gradually.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

_____ provides indigestible bulk and promotes intestinal function. Nondigestible CHO and lignin.

A

Fiber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Oat bran and SOLUBLE FIBERS decrease serum ______ by binding bile acids and converting cholesterol–>bile, lowering the serum level.

A

Cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pectins and gums are examples of ____ fibers.

A

Soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

AI ____: 38 g/d (MALE) 25 g/d (FEMALE)

A

AI FIBER: 38 g/d (MALE) 25 g/d (FEMALE)

33
Q

_____ fiber absorbs water forming a gel and delaying gastric emptying, providing feelings of fullness. Inhibits absorption of glucose and cholesterol.

A

Soluble

34
Q

______ fiber does not dissolve in water and pass through the GI tract relatively intact, speeding up gastric emptying. Laxative effect, adds bulk to the diet, preventing constipation.

A

Insoluble

35
Q

Inflammation of the stomach. Diet therapy includes clear liquids, advancing as tolerated, and avoiding gastric irritations.

A

Gastritis

36
Q

Two types of Irritable Bowel DISEASE: ______ and _____.

A

Crohn’s Disease and Ulcerative Colitis

37
Q

Inflammatory conditions primarily effecting the terminal ileum. Symptoms include weight loss, anorexia, diarrhea.

A

Crohn’s disease

38
Q

Since the terminal ileum is effected, there may be a _________ deficiency in Crohn’s disease, leading to megaloblastic anemia.

A

Vitamin B12

39
Q

An ulcerative disease of the COLON.

A

Ulcerative colitis

40
Q

The main function of the colon is reabsorption of _______ and ________. **Chronic bloody diarrhea and electrolyte (Na/K) disturbances are major symptoms of UC.

A

Reabsorption of water and electrolytes

41
Q

Treatment of IBD includes: Frequent feedings. Maintain ____ and ____ balances. Use of an anti-______ agent. Limit fat only if steatorrhea. Supplement nutrients lost in malabsorption (iron, folate, B12, assess Ca, Mg, Zn) Watch lactose. High fiber when in remission/under control.

A

Frequent feedings. Maintain fluid and electrolyte balances. Use of an anti-diarrheal agent. Limit fat if steatorrhea. Supplement nutrients lost in malabsorption. Watch lactose. High fiber when in remission/under control.

42
Q

Chronic abdominal discomfort and altered intestinal motility.

A

Irritable bowel syndrome

43
Q

Goals for ___: Adequate nutrient intake Tailor diet to specific GI issues (pt should track intake and associated symptoms) Avoid large meals and gastric irritants

A

IBS

44
Q

Lactose intolerance is due to a ________ deficiency.

A

LACTASE

45
Q

Lactase breaks down lactose into _______ and _____.

A

Glucose and galactose

46
Q

Absence of _______ causes ______ to remain intact in the intestine, exerting hyperosmolar pressure, causing water to be drawn in to dilute the load.

A

Lactase, lactose

47
Q

In lactose intolerance, water is drawn into the intestine, causing abdominal distension, cramping, and diarrhea. In addition, bacteria _____ the undigested lactose, releasing CO2 (gas).

A

Ferment

48
Q

Lactose intolerance is detected with the breath ______ test (____ is produced by colonic bacteria on lactose, absorbed into blood, then exhaled) or the _____ tolerance test (breakdown to glucose and galactose–>glucose raises blood sugar).

A

Breath hydrogen test, Hydrogen or Lactose tolerance test

49
Q

Lactose intolerance diet: No ______ or ______ products, No _____

A

*NO ANIMAL MILK OR MILK PRODUCTS, NO WHEY

50
Q

*In the lactose tolerance test, if _______, blood glucose will rise

A

INTOLERANT, TOLERANT

51
Q

The treatment for acute infant diarrhea is aggressive and immediate ___________.

A

Rehydration

52
Q

Chronic, nonspecific infant diarrhea may be due to improper ratio of ____:____ calories. Provide __% fat cal, balanced with limited fluids.

A

Fat:CHO calories 40%

53
Q

*Up to age 6, RESTRICT OR DILUTE fruit juices with high _____ _____ (4 oz/d).

A

Osmolar load

54
Q

Treatment for adult diarrhea is _______ and replacement of _________. Prebioitcs or probiotics (sources of bacteria used to reestablish bacterial gut flora) may help.

A

Treatment for adult diarrhea is bowel rest and replacement of electrolytes. Prebiotics and probiotics may help.

55
Q

A consequence of malabsorption (> 7g stool fat)

A

Steatorrhea

56
Q

Consequences associated with significant resections of the small intestine. Severity depends on length and location of resection and health of remaining tract. Loss of the _____ ____, _____ ____ and ____ are of particular concern.

A

Short bowel syndrome

57
Q

If the ________ has been resected, the ______, over time, can take over its function. It is when the ____ is resected that the patient experiences significant complications.

A

If the JEJUNUM has been resected, the ILEUM, over time, can take over its function!! It is when the ileum is resected that the pt experiences significant complications.

58
Q

The _____ _____ is where vitamin B12, intrinsic factor, and bile salts are absorbed.

A

The DISTAL ILEUM is where vitamin B12, intrinsic factor, and bile salts are absorbed.

59
Q

The ileum absorbs major part of ____ in GI tract. With resection, major losses in stool and increased needs for WATER to compensate.

A

Fluid

60
Q

The ileum reabsorbs ____ ____. If _____ ____ are not reabsorbed, the liver cannot produce enough to adequately absorb lipids–>Fat and Fat-soluble vitamin malabsorption.

A

The ileum reabsorbs BILE SALTS. If BILE SALTS are not reabsorbed, the liver cannot produce enough to adequately absorb lipids–>fat malabsorption.

61
Q

Resection of the ____ is associated with water and electrolyte loss, loss of salvage of absorption of CHO and some nutrients.

A

Colon

62
Q

Following an ileal resection, limit _____ intake. Without the ileum, _____ ____ are not recycled, so are not available to emulsify ______.

A

Following an ileal resection, limit FAT intake. Without the ileum, bile salts are not recycled, so are not available to emulsify fats. Provide some fat as MCTs (do not require bile salts)

63
Q

Functions of the _____ include: storing and releasing blood, filtering toxic elements, metabolizes and storing nutrients, and regulating fluid and electrolyte balance.

A

Liver

64
Q

_____ levels in the blood are elevated when tissue damage causes them to leak into circulation. Elevated _____ levels indicate tissue damage.*

A

Enzyme *Elevated enzyme levels indicate tissue damage.

65
Q

**In liver disease, enzyme levels are ALL _____. AST is decreased in uncontrolled diabetes.

A

In liver disease, enzyme levels are ALL ELEVATED.

66
Q

Condition characterized by inflammation and partial necrosis of the liver.

A

Acute viral hepatitis

67
Q

*ANOREXIA is a major symptom of _____.

A

*ANOREXIA is a major symptom of HEPATITIS.

68
Q

Diet therapy for hepatitis: Care varies by symptoms and pt nutritional status. Increase fluids to prevent ______. Increase _____ (to 50-55% cal) to REPLENISH LIVER GYLCOGEN, AND SPARE PROTEIN. Increase protein (1-1.2 g/kg) to provide for cell regeneration, and to PROVIDE LIPOTROPIC AGENTS to covert FAT–>Lipoproteins for transport out of the liver (PREVENT FATTY LIVER) Limit fat if steatorrhea *SMALL, FREQUENT FEEDINGS DUE TO ANOREXIA

A

Diet therapy for hepatitis: Care varies by symptoms and pt nutritional status. Increase fluids to prevent dehydration. Increase CHO (to 50-55% cal) to REPLENISH LIVER GYLCOGEN, AND SPARE PROTEIN. Increase protein (1-1.2 g/kg) to provide for cell regeneration, and to PROVIDE LIPOTROPIC AGENTS to covert FAT–>Lipoproteins for transport out of the liver (PREVENT FATTY LIVER) Limit fat if steatorrhea *SMALL, FREQUENT FEEDINGS DUE TO ANOREXIA

69
Q

The difficulty in providing nutritional support is that hepatitis patients are often ______. Small, frequent feedings are advised.

A

The difficulty in providing nutritional support is that hepatitis patients are often ANOREXIC. Small, frequent feedings are advised.

70
Q

In ______, the liver attempts to repair its damaged cells by replacing them with bands of connective tissue, which is NON-FUNCTIONAL. The connective tissue divides the liver into clumps, rerouting many veins and capillaries. BLOOD FLOW IN THE LIVER IS DISRUPTED. Poor food intake leads to deficiencies.

A

Cirrhosis

71
Q

In cirrhosis, _____ deficiencies lead to ascites, fatty liver, and impaired blood clotting.

A

Protein

72
Q

** ______ occurs when blood can’t LEAVE the liver.

A

Ascites

73
Q

In cirrhosis, connective tissue blocks blood from leaving the liver, so it accumulates. Once the liver has reached capacity, fluid (plasma) leaks into peritoneal cavity. Plasma is high osmolar load, causing additional fluid to be pulled into peritoneal cavity to dilute the load. This leads to sodium and water retention. **This accumulation of fluid and the sodium that carries it IS _____.

A

Ascites

74
Q

________ ______ occur when blood can’t ENTER the liver.

A

Esophageal varices

75
Q

In esophageal varies, _______ _______ overgrowth disrupts blood flow, causing blood to back up into the portal vein. This increased pressure is PORTAL HYPERTENSION, which causes the varices (dilated blood vessels).

A

Connective tissue

76
Q

Varices are FRAGILE and can burst on their own, or be torn open with a diet ____ in roughage (fiber).

A

High

77
Q

**Diet for Cirrhosis is _____ protein _____ calorie _____ fat

A

Diet for cirrhosis is HIGH protein (0.8 - 1.0 g/kg) (at least 1.5 in stress) HIGH calorie (25-35 kcal/kg) MODERATE fat (25-40%) Low FIBER if varices present. Low SODIUM if edema/ascites. Fluid restriction if hyponatremia.

78
Q

_______ _______ ______ has 3 stages. 1.Hepatic steatosis (fat build up) 2. Alcoholic hepatitis (inflammation) 3. Cirrhosis

A

Alcoholic liver disease

79
Q

Alcoholic liver disease is due to the constant presence of alcohol and the metabolic changes it causes. Alcohol–>Acetaldehyde conversion forms excess production of HYDROGEN, which disrupts liver metabolism. _______ steps into TCA cycle in place of _____, causing fat to accumulate in liver.

A

Hydrogen in place of fat.

Domain 2: Nutrition Care for Individuals and Groups (16 decks)

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