Nutrition

Question 0

Ileum

Answer 0

B12, fat absorbed

Question 1

Duodenum

Answer 1

Fe, Ca absorbed

Question 2

Steatorrhea

Answer 2

Pancreatitis
Cystic fibrosis
Crohn's
Celiac disease
Formation of oxalate kidney stones
Risk of bone loss

Question 3

Enhance intestinal adaptation after short bowel syndrome

Answer 3

Glutamine
Short chain fatty acids
Glu-peptide 2
Better if ileum and colon intact
Oral feed sooner the better

Question 4

Colon resection

Answer 4

Fluid electrolyte losses

Diarrhea

Question 5

Short bowel syndrome

Answer 5

Low fat
High complex carb
Small frequent feedings
short chain fatty acids - retain h2o
Medium chain triglyc
Low oxalate 
Avoid lactose

Question 6

Restrictive surgery

Answer 6

Vertical band
Sleeve gastrectomy
Gastric binding
Weight loss due to reduced food intake

Question 7

Gastric bypass surgery (most common)

Answer 7

Malabsorption and restrictive
Weight loss is from decreased intake and malabsorption
Change in GI hormones (GLP, PYY, Leptin) decrease ghrelin
Water, liquid, purée, soft foods
70g protein/day, multivitamins

Question 8

Malabsorptive (infrequent)

Answer 8

Bileopancreatic diversion
Jejunal-ileal bypass
Weight loss due to malabsorption

Question 9

Celiac disease

Answer 9

Lifelong Gluten free diet

Fresh fruit and vegetables, meat

Question 10

Crohn’s disease

Answer 10

Any part of GI tract
High calorie, high protein diet
Low fiber
Liquid supplements

Question 11

Ulcerative colitis

Answer 11

Only in the colon
Colectomy may be curative
Replace fluid and electrolyte losses
Low fiber

Question 12

Inflammatory bowel disease treatment

Answer 12

Antidiarrheal
Immunosuppressant
Anti inflammatory

Question 13

Pancreatitis acute

Answer 13

Nothing by mouth (NPO) until pain subsides
Fluids and electrolytes
Mild-low fat diet
Severe-J tube
High protein, high kcal

Question 14

Pancreatitis chronic

Answer 14

Steatorrhea treat w/ enteric coated pancreatic enzymes

Low fat diet, MCT oil

Question 15

Cystic fibrosis

Answer 15

High calorie, high fat
Frequent meals&snacks with
Pancreatic enzyme replacement
Multivitamins, fat sol vit
Liberal use if salt&salty foods

Question 16

Extensive bowel resection

Colon present

Answer 16

High carbs - colonic salvage
Low oxalate
Vit B12 injections
Calcium due to fat malabsorption 
Anti motility agents

Question 17

Extensive bowel resection

Colon absent

Answer 17

High salt
Vit B12
Multivitamins
Calcium
Oral rehydration solution
Antimotility agent

Question 18

Irritable bowel syndrome

Answer 18

High fiber
Low fat
Bulk agent psyllium
Low FODMAP

Question 19

Diverticular disease

Answer 19

High fiber
Bulk forming psyllium
Avoid nuts, seeds
Clear liquid diet

Question 20

Conditions that may require an ostomy

Answer 20

Inflamm bowel disease
Diverticulitis
Colorectal cancer
Clear liquid to low fiber diet
Carefully chew food

Question 21

Colostomy

Answer 21

High fiber diet

Question 22

Diarrhea

Answer 22

BRAT diet

Cheese, peanut butter

Question 23

Lactose intolerant

Answer 23

Most can tolerate 6g/day of milk products

Concern for Ca, vit D, riboflavin

Question 24

AREDs 1

Answer 24

Antioxidants and zinc good for intermediate/advanced AMD No effect of nutrients on cataracts

Question 25

AREDS 2

Answer 25

``` Lower risk with fish and green veg Lower risk in both with lutein and zeaxanthin (green veg) Helped AMD Supplements good Not helpful for cataracts ```

Question 26

Nephrotic syndrome

Answer 26

Plasma protein in urine Wasting Infection Rickets Edema Protein restriction Low sat fat, sodium

Question 27

Osteodystrophy

Answer 27

Decrease serum phosphate - binders Calcitriol supplement Calcium supplement

Question 28

Hepatitis

Answer 28

Adequate energy and protein | Eliminate alcohol

Question 29

Hepatic encephalopathy

Answer 29

Hyperammonemia Treat with lactulose, antibiotics Branched chain amino acids (veg, milk protein)

Question 30

Cirrhosis

Answer 30

20-75% above expenditure | Multivitamins

Question 31

Dialysis nutrition

Answer 31

Folate, riboflavin, vit B6 Calcium Restrict phosphorus

Question 32

Orlistat

Answer 32

Pancreatic Lipase inhibitor - fat is unabsorbed and excreted Use with low fat diet Approved for long term use

Question 33

Belviq

Answer 33

Increase brain serotonin levels

Question 34

Qysmia

Answer 34

Has phentermine appetite suppressant | & topiramate

Question 35

Soluble fiber

Answer 35

Slows transit | Good for diarrhea

Question 36

Insoluble fiber

Answer 36

Speeds transit | Good for constipation

Question 37

BMI

Answer 37

Weight/height^2

Question 38

Abdominal fat

Answer 38

Independent predictor of morbidity

Question 39

Recommended weight loss

Answer 39

``` 5-10% Reduce intake by 500kcal/day 1 pound/week Lose weight over 6 months Maintain weight after 6 months ``` Improved control of HTN, blood sugar, blood pressure

Question 40

Low fat diet

Answer 40

Increase TG | Decrease HDL

Question 41

Atkins diet

Answer 41

High protein - preserve LBM High fat Very low CHO Causes insulin levels to decrease Reduce B vitamins Goal ketosis/lipolysis

Question 42

Sleep deprivation

Answer 42

``` Increase ghrelin (increase appetite) Decrease Leptin (increase appetite) ``` BMI increase to decrease in sleep

Question 43

Weight loss drugs approved for

Answer 43

BMI > 30 | BMI =27+T2DM, HTN, or high cholesterol