Neurologic Disorders Part 2

Question 1

Chronic condition characterized by recurring seizures

Answer 1

epilepsy

Question 2

epilepsy seizures are caused by abnormal ________ in the brain

Answer 2

electrical activity of a group of neurons

Question 3

drug given for epilepsy

Answer 3

phenytoin (dilantin)

Question 4

food drug interactions for phenytoin (dilantin)

Answer 4

decreases absorption of calcium
vit D supplementation is recommended with long term use

hypoalbuminemia - drug toxicity

continuous tube feeding inhibits the absorption of phenytoin
- hold TF for 1-2 hours before and after giving drug

Question 5

diet used as a last resort in children with intractable seizures

Answer 5

keto diet (KD)

Question 6

What is the classic version of keto diet
percentages ?
ratio?
grams of carbs per day?
benefit?

Answer 6

extremely low carbs (2-4%)
high at (90% kcal)
protein (6-8%)

4:1 of fat to protein +carbs combined

10-15 g/day

can be curative

Question 7

ketogenic diet has two version ____ vs. ____

Answer 7

LCT vs. MCT oil

Question 8

LCT version of diet is calculated to meet
____ of estimated energy needs
_____ for protein
______ of maintenance fluid needs or _______ mL of fluid per kcal

need to provide a _____________________

Answer 8

75%
DRI
75% or 0.75-1.0

MVI with minerals, calcium, and magnesium supplements

Question 9

LCT version calculation for Fat ?

LCT calculation for protein and carbs?

Answer 9

FAT:
kcal needs x 0.90
divide by 9 kcal to convert to grams of fat

PROTEIN & CARBS:
kcal needs x 0.10
divide by 4 kcal/gram to convert to grams of protein and carbs
provide DRI for pro and remaining provided as carbs

Question 10

possible side effects of the KD…

early??
late??

Answer 10

EARLY
- hypoglycemia
- stomach upset
- acidotic dehydration
- hypokalemia

LATE
- constipation
- GERD
- hyperlipidemia

Question 11

less restrictive KD options

Answer 11

modified Atkins diet
low glycemic index diet

Question 12

what is modified Atkins diet?

Answer 12

65% fat
30% pro
5% carb

Question 13

what is low glycemic index diet?

Answer 13

60% fat
30% protein
10% carb

Question 14

Multiple sclerosis (MS) is Destruction of the ________ which protect the nerves and facilitate the transmission of nerve impulses

Answer 14

myelin sheaths

Question 15

MS etiology ?
Cure ?

risk factors ?

Answer 15

not sure, maybe autoimmune
no cure

female
Northern European ancestry
smoking
geographic location with less sun

Question 16

manifestations of MS are similar or variable?
explain?

Answer 16

variable
- many patients have periods of remission and relapse and others have more rapid progression

Question 17

Early deficits of MS?

other manifestations?

Answer 17

diplopia
paresthesia
vertigo
dysarthria
ataxia
muscle weakness

neurogenic bladder
neurogenic bowel
some pts progress to cognitive impairment, inability to speak, blindness, and tetraplegia

Question 18

People with MS have what nutrition risks?

Answer 18

decreased ability to get and make food or feed self

dysphagia due to damaged cranial nerves and muscle weakness

Question 19

MNT for MS

1. Body wt?
2. Assess vitamin ___ status & provide ___ if needed
3. Some evidence that _________ diet may be beneficial
4. Dysphagia=> Provide proper food texture and consistency of liquids using _____ diets
5. _______ if necessary

Answer 19

1. Maintain desirable body weight & nutritional status
2. vitamin D : vitamin D3
3. an anti-inflammatory diet
4. IDDSI diets
5. Enteral nutrition

Question 20

MNT for neurogenic bladder?

Answer 20

BLADDER:
provide adequate fluid
distribute evenly throughout the day
limit before bed
increase intake of cranberry juice and blueberries to reduce UTI

Question 21

MNT for neurogenic bowel?

Answer 21

Provide adequate fiber
prunes
adequate fluid

Question 22

Parkinsons disease is progressive, disabling, _______ disease cause by loss of _______ in the brain

why is it bad to lose this?

Answer 22

neurodegenerative
dopaminergic neurons

dopamine is involved in voluntary motor control

Question 23

Parkinson’s disease most commonly occurs ages _____ yrs

cause?

cure?

Answer 23

40-70 yrs

unknown

no cure

Question 24

General Manifestations of PD

Answer 24

tremor at rest
muscular rigidity
bradykinesia
poor balance

GI dysmotility = costipation

Question 25

Later problems with PD

Answer 25

dysphagia and aspiration
dementia
malnutrition
become chair/bed bound

Question 26

MNT for Parkinson’s Disease:

1. Optimize ______ to maintain ______ for strength & mobility
2. Assess ability to _____
3. _______ evaluation
4. _________ for constipation
5. Educate on _________
6. Assess for _________
7. May need ______ (if consistent with patient’s wishes)

Answer 26

1. dietary intake : muscle mass
2. feed self
3. Dysphagia
4. Increase fiber & fluid
5. food-drug interactions
6. skin breakdown
7. enteral nutrition

Question 27

Medication for Parkinson’s Disease

Answer 27

Levodopa

Sinemet (levodopa + carbidopa)

Question 28

levodopa side effects

Answer 28

N/V
constipation
anorexia
dry mouth
ageusia or dysguesia

Question 29

sinemet side effects

Answer 29

same as levodopa but less GI side effects

Question 30

interactions for Levodopa

Answer 30

amino acids compete with med for absorption both in the intestine and blood brain barrier
- high protein foods decrease absorption of med

Question 31

MNT for levodopa

Answer 31

Provide most of daily protein needs in the evening

take med with meals to decrease GI effects

excessive vitamin B6 (≥5 mg) decreases effectiveness