MNT liver

Question 1

How much blood is circulated in the liver per min

Answer 1

1500 ml

Question 2

how does blood exit the liver

Answer 2

via the hepatic veins into the interior vena cava

Question 3

what makes poop brown

Answer 3

bile

Question 4

where is bile made

Answer 4

liver

Question 5

where is bile stored and concentrated

Answer 5

gallbladder

Question 6

steatoreaha

Answer 6

fatty greasy diharea

Question 7

how much liver function is needed to sustain life

Answer 7

10-20% cannot survive totally wihtout it

Question 8

functions of the liver

Answer 8

activation/storage of vits and minerals
converts vit D to active form
formation/excreation of bile
metabolism of steriods
conversion of amonia to urea (affects MNT)
synthesis of clotting factors(bleeding affects MNT)

Question 9

thorugh all liver diseases what can happen

Answer 9

10-20% liver function

Question 10

Viral Hepitis

Answer 10

won’t impact us unless it gets to ESLD

Question 11

Steatosis

Answer 11

fat in the liver or fatty liver

Question 12

How much wt loss can improve steatosis

Answer 12

3-5% wt loss

Question 13

how much wt loss is needed to reverse NASH

Answer 13

10%

Question 14

meds for NAFLD

Answer 14

Vit e if no TD2
coffee unsweetend =protective

Question 15

ALD

Answer 15

most common liver disease
40% of deaths from cirrhosis atributed to ETOH

Question 16

ALD charaterized by

Answer 16

fatty liver hepatitis or cirrhosis

Question 17

Alchoholic cirrhosis may lead to

Answer 17

GI bleed hepatic encephalopathy, portal HT ascites

Question 18

Necrosis

Answer 18

death of cells

Question 19

Alcoholic liver micronutrient deficiency

Answer 19

thiamin is most common

Question 20

Bottom line for Hepatitis

Answer 20

liver disease is a spectrum of severity
MNT is for complications

Question 21

Cirrhosis

Answer 21

irreversible fibrotic changes ( scarring) of the liver with inflamtion blood wont flow thorugh as well

Question 22

Portal HTN

Answer 22

increased pressure in portal vein

Question 23

varices

Answer 23

englarged blood vessels in esophagus
we care if feeding tube has to be placed and nick can cause bleed due to lack of cltting factors being made

Question 24

increased prothrimbin time

Answer 24

increased clotting time

Question 25

MNT for Portal HTN and Esoph Varices

Answer 25

if acute GI bleed no EN
PN if NPO 5-7 days
No PEG either dt the acites

Question 26

Ascites

Answer 26

accumulation of fluid in the abdominal cavity

Question 27

Medical treatment for ascites

Answer 27

paracentesis
diuretics

Question 28

MNT for ascites

Answer 28

NA restriction 2 g ( not lower to avoid decrease oral intake)
adequate protein

Question 29

MOnitor for ascites

Answer 29

wt to know energy needs
electrolytes (NA and pottasium)
abdominal girth know where the wt is

Question 30

Paracentesis

Answer 30

remove 5 liters of fluid , does pull off electrolytes and protein
need to get the dry wt after the fluid is removed for energy calulations

Question 31

Hyponatremia

Answer 31

low sodium
dt decreased water excretion
sodium losses with paracentesis

Question 32

Hyponatremia MNT

Answer 32

fluid restriction 1-1.5 l day
low sodium 2 g /d

Question 33

Hepatic Encephalopathy

Answer 33

impaired mentiaiton or thinking neuromuscualr diturbances and altered conciousness

Question 34

Hepatic encephalopathy possible mechanism

Answer 34

high ammonia impaired urea synthesis

Question 35

Sources of ammonia

Answer 35

GI tract protein metabolism blood from GI bleed

Question 36

HE MEds

Answer 36

lactulose and antibiotics both cause diharea to get rid of the ammonia in the body

Question 37

MNT encephalopathy

Answer 37

avoid unnecessary protein restriction
fiber increases aids in excretion of N compunds
intake of .25 g/kg of oral BCAA

Question 38

DIseased liver isn’t able to

Answer 38

maintain blood glucose levels or keep bs from tanking in periods of fasting

Question 39

MNT for ESLD

Answer 39

recomend carb consistent intake
consitent meal intake (3-6) day including bedtime snack conating carb and protein
nocturnal EN for malnurished pts

Question 40

milk thistle

Answer 40

may help liver butn ot in liver disease

Question 41

VIt def in ESLD

Answer 41

vit A D E K

Question 42

Liver transplant

Answer 42

established treatment for ESLD
malnutrion is common at time of transplant