medical nutrition therapy for individuals Flashcards
Ulcer: omit___ avoid ___
pepper/chili powder, avoid excess caffeine and alcohol
hiatal hernia: ___,___ feedings
small bland feedings
Gastrectomy (Billroth I, II) may cause
Dumping syndrome
Dumping syndrome happens when rapidly hydrolyzed carb enters ___
jejunum, water comes in, BP drop, 2 hrs, absorbed sugar rise, insulin rice, reactive alimentary hypoglycemia
Billroth II affect what nutrients
Ca, Fe
pernicious anemia dx is ___
schilling test
gastroparesis: delayed ___ ___ may cause ____
gastric emptying, hyperglycemia.
bezoar formation in ___ pts dt undigested food/ med
gastroparesis
diet for gastroparesis:
small frequent meals, pureed food, avoid high fiber high fat.
celiac dz also called
non tropical sprue
symptom of celiac dz:
malabsorption (loss of fat soluble v) anemia, wt loss, D, steatorrhea
celiac dz need to avoid:
bran. graham, malt, bulgur, ccouscous, durum, orzo, thickening agents
small mucosal sacs: dz? diet?
diverticular dz, high fiber diet
gastritis is ___ of stomach, symptoms, diet
inflammation, anorexia, NVD, clear liquids
IBD has two kinds: regional, chronic
chrohn’s dz, UC
tx for IBD
Limit fat if steatorrhea, frequent feedings Ca Mg Zn supplement if fatty stool.
Lactose intolerance need to supplement
ca and riboflavin
diarrhea diet:
40% calories as fat, balance with limited fluids, restrict fruit juices with high osmolar loads
steatorrhea _g is indicative of malabsorption
7
SBS short bowel syd involved with which part of SI
ileum
what happens if ileal resection
B12 bile salt resorption, fluid, increased need for Ca Zn Mg
what to watch for with ilead resection (fat, fluid)
limit fat, use MCT to bypass bile salt, supplement Ca, Zn, Mg 1 L more water
with liver disease, liver enzymes are ___
elevated because tissue damage cause them to leak into circulation
___happens when blood cannot leave liver, ___happens when blood cant enter the liver
ascites, esophageal varices (connective tissues)
diet for cirrhosis :
high protein, high cal, moderate to low fat, low fiber if varices, low sodium if edema, B complex V
Alcoholic liver disease explain how metabolism disturbed
alcohol-acetaldehyde, excess hydrogen, replace fat as fuel, fat accumulate
asterisix is
flapping, involuntary jerking motions sign on impending coma in ESLD
tx of asterisix:
high protein, high cal
gallbladder dz, pancreatitis
low fat diet, MCT in P
PERT IS
Pancreatic enzymes
chronic pancreatitis fat rec: need___for PERT to work
max fat tolerated for wt gain, antacids
Acute pancreatitis: fomula
elemental EN nto jejunum
Tx for cystic fibrosis
PERT, high prot, cal, fat, salt, all Vs
resveratrol is in __ may lower __ ___
red grapes, bp
metabolic syn how many risk factors what are those?
3/5 BP (130/85), TG 150, glu 110, waist 40 35, HDL40 50
LDL optima
100
total cholesterol desirable
200
HDL
40 50
___ ___ level is independent risk factor for CHD
high homocysteine
PUFA MUFA rec from TLC
5-10% pufa, 20% mufa
in HT failure pt, evaluate __ because __cannot be converted for energy if not
thiamin, pyruvate
hormones involved in renal fx
vasopressin ADH, renin, EPO
vasopressin is secreted from __ stored in __ controls ___ ___, increase __ ___
ADH hypothalamus pituitary BP water resorption
renin secreted by ___ when __ __ decreases, stimulates __ to increase __ absorption and increase ___ ___
vasoconstrictor, glomerulus, blood volume, aldosterone, sodium, bp
renal calculi/kidney stone diets
alkaline ash/acid diets alkaline ash: increase cations, acid ash: anions
high oxalate food
dark leafy green, choco, strawberries, nuts, beets tea
nephrosis is defect in membrane of ___ which permits ___ of ___ ___ of ___ into ___
glomerulus large amount protein escape filtrate
because protein escaped in nephrosis ___is not made, so ___ transport/absorption is interrupted and cause ___, so diet must restrict ___
VLDL, fat, hyperlipidemia, fat
CKD Stage 123 will have GFR > ___ NO ___symptoms
60 uremic
potassium generally not restricted unless serum level ___ and urine output is ____/day
elevated
risk factor for DM: acanthosis nigricans
gray-brown skin pigmentations in skin folds
mgt goal for DM preprandial post prandial
70-130 180
gestational diabetes increased risk of ___ ___
fetal macrosomia
