MNT Guidelines

Question 1

Indications for Enteral Nutrition (EN)

Answer 1

Functional GI tract but unable to meet needs orally.

Examples: Dysphagia, head/neck cancer, altered mental status, high energy needs.

Question 2

Contraindications for Enteral Nutrition

Answer 2

Severe malabsorption, GI obstruction or ileus, intractable vomiting or diarrhea, hemodynamic instability.

Question 3

Types of Enteral Formulas

Answer 3

Standard: Intact proteins, needs normal digestion (e.g., Jevity); Semi-elemental: Partially hydrolyzed for easier absorption (e.g., Peptamen); Elemental: Free amino acids for severe malabsorption (e.g., Vital); Disease-specific: Renal, hepatic, diabetic formulas.

Question 4

Indications for Parenteral Nutrition (TPN)

Answer 4

Non-functional GI tract, severe malabsorption (e.g., short bowel syndrome), bowel obstruction, prolonged ileus.

Question 5

Complications of TPN

Answer 5

Refeeding syndrome, hyperglycemia or hypoglycemia, hepatic steatosis, cholestasis, catheter infections (sepsis).

Question 6

Cardiovascular Disease (CVD) MNT

Answer 6

Limit saturated fat (<7% kcal), trans fat, cholesterol; increase fiber (25-30g/day), omega-3s (fatty fish, flaxseed); DASH diet for hypertension.

Question 7

Pancreatitis MNT

Answer 7

Acute: NPO → low-fat, easily digestible diet; may need EN. Chronic: High-calorie, high-protein, low-fat diet; PERT (pancreatic enzyme replacement therapy) required.

Question 8

COPD MNT

Answer 8

High calorie, high protein (1.2-1.5 g/kg); small frequent meals, easy-to-chew foods; limit CHO if CO2 retention is an issue.

Question 9

Warfarin & Vitamin K

Answer 9

Keep vitamin K intake consistent; avoid large fluctuations in green leafy vegetable consumption.

Question 10

Metformin & B12 Deficiency

Answer 10

Long-term use may lead to B12 deficiency; monitor levels, supplement if needed.

Question 11

Phenytoin & Tube Feeds

Answer 11

Hold tube feeds 1-2 hours before and after; decreases folate, vitamin D, calcium absorption.

Question 12

Post-Bariatric Surgery Nutrition Stages

Answer 12

Stage 1: Clear liquids (24-48 hrs); Stage 2: Full liquids (high-protein shakes); Stage 3: Soft/puréed foods; Stage 4: Solid foods (small, high-protein meals).

Question 13

Common Deficiencies After Bariatric Surgery

Answer 13

Iron, calcium, vitamin D, B12; lifelong supplementation required.

Question 14

Failure to Thrive (FTT) – Signs & Causes

Answer 14

Poor weight gain, delayed milestones; causes: neglect, inadequate intake, metabolic disorders.

Question 15

PKU (Phenylketonuria) MNT

Answer 15

Restrict phenylalanine (found in protein foods); special formula required.

Question 16

Galactosemia MNT

Answer 16

Avoid dairy, lactose-containing foods; soy-based formulas used in infants.

Question 17

Sarcopenia – Nutrition Strategies

Answer 17

Higher protein intake (1.2-1.5 g/kg); resistance training, adequate calories.

Question 18

Pressure Ulcer Nutrition

Answer 18

Higher protein needs (1.2-1.5 g/kg, up to 2 g/kg for severe wounds); zinc, vitamin C supplementation if deficient.

Question 19

Dysphagia Management

Answer 19

Texture-modified diets (pureed, minced, thickened liquids); monitor aspiration risk.

Question 20

Muscle Wasting Signs

Answer 20

Temporalis (hollowing in temples), clavicle prominence, interosseous muscle loss (thumb/index finger area).

Question 21

Fat Loss Signs

Answer 21

Orbital hollowing, triceps skinfold thinning, ribs clearly visible without adipose coverage.