Midterm 1 Details Flashcards
Supplementes in BS?
- B1
- B12
- Folate
- ADEK
- Iron
- Copper
- Zinc
- Calcium
Supplements which increase in RYBG compared to sleeve?
Zinc, Copper
Supplements which increases in BPD-DS compared to RYGB?
- Vitamin A,K
- Calcium, Zinc, Copper
Where does the common limb meet for Roux-en-Y? Nutritional concerns?
Distal Jejunum
-Iron Calcium, Folate, Vitamin D and B12 (Supplemented)
Where does the common limb meet fo BDP-DS? Nutritional Concerns?
Terminal Ileum
-Calcium, Iron, Folate, ADEK and B12 (Supplemented)
BN/BED dietary patterns (FF-BAR-CD)
- Forbidden Foods
- Fasting
- Binging
- Avoidance of high-kcal foods
- Removal of foods
- CHO restriction
- Diet Hx
AN dietary patterns (1/2) (GG-RR-L)
- Gradual reduction in food intake
- Gradual reduction in portion size
- Removal of high kcal food
- Rigid Schedule of eating
- Low nutrient, bulky foods
AN dietary patterns (2/2) (L-FFF-V)
- Limited choices.
- Fluid avoidance or overload
- Fat avoidance
- Food avoidance avoidance due to “digestion”
- Vegan/Vegetarian
BN Key characteristics? (BILE-CIAO)
- Body weight fluctuations
- Inability to express thoughts/feelings
- Labile food
- Excessive focus on weight/shape
- Chaotic relationships
- Impulsivity
- Anxiety
- Obsessiveness
AN Key characteristics? (3E/3S/A)
- Excessive concerns about weight, shape and health
- Excessive perfectionism
- Extreme focus on school/job
- Social withdrawal
- Social rigidity
- Self-denial
- Anxiety
ARFID Key characteristics (FAM)
- Food refusal
- Anxiety
- Maladaptive coping strategies
BED Key characteristics? (LONE)
- Long-term weight gain
- Obsessive thoughts about binging/restricting
- No weight-loss with abstinence
- Excessive thoughts about weight and shape
ARFID Diagnosis (1/2)?
1) Sub-optimal nutrient and kcal intake, which includes e4 factors
2) Not due to food insecurity or culturally-sanctioned practice
3) Not rooted in AN and BN, patient does not have a distorted perception of weight, body image and shape
4) Exceeds expected behaviour of any associated mental/physical disorders, or no other mental/physical disorder is indicated
ARFID diagnosis (2/2)
Sub-optimal nutrient/kcal intake leading to:
- Significant weight loss
- Significant nutrient deficiency
- Reliance on ONS or EN
- Psychosocial disturbances
What is a Binge?
Excessive amount of food, consumed within a discrete amount of time, with a lack of control and sense of shame, occurring >1x/week for >3months
BED Diagnosis? (1/2)
1) Binge
2) No compensatory behaviours
3) Includes 3/5 FEEEN factors
FEEN factors in BED diagnosis? (2/2)
- Feeling of shame/guilt
- Eating rapidly
- Eating alone
- Eating until uncomfortably full
- Not feeling physiologically hungry
AN Diagnosis?
1) Reduced intake resulting in significant weight loss
2) Intense fear of being fat or gaining weight
3) Distorted perception of body shape, image, weight, health and food
BN Diagnosis?
1) Binge
2) Compensatory behaviours
3) Distorted perception of body shape, image, weight, health and food
GFR slotting?
1: >90
2: 60-89
3A: 45-59
3B: 30-44
4: 15-29
5: <15
Hypercalcuria nutrition intervention?
- Reduce acid load
- Reduce NaCL and sodium
- Reduce refined CHO’s
- Increase dietary fibre
Hyperoxaluria nutrition intervention?
- Increase calcium and magnesium intake
- Reduce high-oxalate foods
- Discontinue vitamin D supplements
- Address fat malabsorption
- Probiotic therapy
Hyperuricosuria nutritional intervention?
- Decrease purine load from meats
- Reduce renal acid load
Hypernatriuria nutritional intervention?
-Decrease NaCl and sodium intake as low as possible
Hyperphosphaturia nutritional intervention?
-Normalize dietary intake of phosphorous if excessive
Hypercitraturia nutritional intervention?
- Reduce potential renal acid load
- Encourage dietary citric acid
- Address mg deficiency
What are precursors to bicarbonate?
Fruits and vegetables, may decrease renal acid load
Hypomagnesiuria nutritional intervention?
-Encourage mg rich foods, consider supplement
Low urine ph?
- Reduce renal acid load
- Address bicarb wasting
- Address overweight/obesity/diabetes
5 examples of low potassium food
- Apples
- Celery
- Mushrooms
- Carrot
- Cauliflower
What are the Renal requirements?
Know it
Which lab values are NOT liberalized in dialysis?
Calcium and sodium remain the same
Stage 1 AKI?
1) Sr. Cr 1.5-.1.9 x baseline or >0.3 mg/dl increase
2) <0.5 ml/kg/3hr for 6-12 hrs u/o
Stage 2 AKI?
1) Sr. Cr 2.0-2.9 x baseline
2) <0.5 ml/kg/3hr for >12 hours
Stage 3 AKI Sr. Cr?
1)3.0 times baseline
OR
2) Increase in serum creatinine to >/= 4.0 mg/dl
OR
3)Initiation of renal replacement therapy
OR,
3) In patients <18 years, decrease in eGFR to <35
Stage 3 AKI u/o?
< 0.3 ml/kg3h for 24 hours
OR
anuria for > 12 hours
