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Gastro Review > Nutrition/Vitamins@ > Flashcards

Nutrition/Vitamins@ Flashcards

1
Q

Sxs of Cu def

A

muscle weakness, gait probs, micro anemia or neutropenia, may mimic MDS

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2
Q

Cu def MCC

A

gastric bypass

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3
Q

Micro anemia worsened by Fe is what and why?

A

Cu def - Fe reduced Cu abs even more

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4
Q

Sxs of riboflavin def (B2)

A

Photophobia, burning mouth, glossitis

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5
Q

Sxs of zinc def

A

Diarrhea, dysgeusia, night blindness, acroderatitis

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6
Q

Which tend to improve with pregnancy?

  1. Anorexia
  2. Bulemia
  3. Binge eating DO
A

Anorexia

Bulemia

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7
Q

Intestinal fx TP in which pts?

A 
Liver fx 2/2 TPN
2+ Cent Vn thrombus
2+ sepsis episodes/yr
1 episode of fungemia/shock
Frequent dehydration
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8
Q

Why A1AT good test for prot in stool and not other prot?

A

Others broken down by proteases

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9
Q

T/F: Need to be on PPI for accurate Stool A1AT?

A

True - ensure gut acidity not high enough to break down protein

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10
Q

WHat level of A1At in stool is positive for PLE?

A

> 24 ml/d in nl

> 56 ml/d in diarrhea

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11
Q

Ghrelin is increased with doing what?

A

Fasting

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12
Q

Ghrelin levels are significantly decreased after what?

A

Gastric bypass and sleeves

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13
Q

Bariatric surg decreases levels of the following dz by what?

  1. HTN
  2. DM2
  3. OSA
  4. Steatosis
  5. HLD
A 
DM2 - 82%
HTN - 70%
HLD - 62%
Steatosis - 50-80%
OSA - 85%
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14
Q

Which gastric wt loss surg is the only one shown to improve GERD?

A

RYGB

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15
Q

Describe subjective global assessment scores

A

A - well nourished
B - Mildly malnourished
C - severely malnourished (severe wt loss, muscle wasting, etc)

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16
Q

Which mineral def can lead to hyperglycemia?

A

Chromium

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17
Q

Which condition leads to chromium def?

A

Short gut 2/2 surgeries

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18
Q

Effects of selenium def?

A

Cardiomyopathy, myopathy

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19
Q

Who is at risk for selenium def?

A

chronic TPN, malabsorption, poor oral intake

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20
Q

Sxs of hypophos and who gets it?

A

Sz, respiratory distress - see it in refeeding syndrome

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21
Q

How long after PEG should you start feeds?

A

3 hours

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22
Q

Cu def seen in who?

A

Gastric bypass, chronic biliary tube, Crohns

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23
Q

Sxs of Cu def?

A

Similar to B12 (Gait probs, vibration sense abnl), but MICRO def worsened with Fe supp

24
Q

T/F: People with binge eating DO usually have a history of anorexia.

25
Sxs of severe hypophos and who gets it?
Ppl with refeeding syndrome - sz and resp distress
26
T/F: Anorexia, bulimina, and binge eating DO all typically go to remission in pregnancy.
False - anorexia and bulimia do, BEDO does not
27
Pts with roux en Y and LUQ pain years after. What to consider?
Internal herniation - can be intermittent and cause pain, emesis
28
What besides protein can be low in prot losing enteropathy?
Immunoglobs (except IgE), cholesterol, lymphocytes
29
Best diet for PLE?
High protein, low fat with MCT for fat
30
What is function of ghrelin?
Get Hongry
31
What decreases ghrelin surgery wise?
Gastric bypass and sleeves
32
Which hormones reduce hunger?
Leptin and CCK
33
T/F: Leptin and CCK directly decrease ghrelin?
False, the hormones do not directly affect each other
34
Cutoffs of SI for oral diet and TPN needs?
> 200 cm - usually oral diet | < 100 cm - usually TPN
35
Bariatric surgery improvements %.
``` DM2 80% HTN 70% HLD 70% Fatty liver 90% Fibrosis of liver 50% OSA 85% GERD 75% Joint dz 88% ```
36
T/F: Tube feed diarrhea - should attempt more caloric dense formula?
False, not thought to help with diarrhea from TF
37
Thiamine def sxs
burning neuropathy, gait ataxia, nystagmus, confusion, CHF with edema (wet beriberi)
38
Conditions that lead to thiamine def
Alcoholism Hyperemesis gravidarum Gastric bypass Crohns
39
T/F: More extensive resections of the ileum lead to bile acid diarrhea and should tx with bile acids. Why?
False - more extensive make fat malabs more likely, thus, bile acid resins lead to worsened fat absorption and worsened diarrhea
40
Pts with allergy to what are more likely to have non-anaphylactoid food allergy?
Latex gloves
41
Which foods MC to cause non-anaphylactoid food allergy?
Banana, kiwi, peaches, avocado
42
What should be used to tx ciguatera poisoning
Supportive care
43
What are sxs of manganese toxicity?
Parkinsons like syndrome with manganese accumulating in globus pallidus, seizures
44
Who is at risk for manganese tox?
Chronic TPN with cholestatic liver dz
45
List subjective global assessment grades.
A - well nourished B - Mildly malnourished C - Severely malnourished
46
Sxs of niacin def?
Pellagra (4Ds) - diarrhea, dementia, dermatitis (sun exposed rash), death
47
Deficiency of what can lead to hyperglycemia and insulin resistance?
Chromium
48
Sxs of selenium def?
Cardiomyopathy (Keshan's dz)
49
HC and MMA in B12 and folate def.
B12 - MMA and HC elevated | Folate - HC elevated, MMA not
50
Sxs of manganese toxicity and who gets it?
Chronic TPN, esp if liver dz also - HCN, EPS (tremor, etc)
51
Copper def sxs
Micro anemia, hypopigmentation, leukopenia, hypopig hair, myelopathy with poor gait, numbness, tingling and can lead to paralysis
52
What is the cutoff for ileal removal section for bile acid diarrhea vs deficiency?
<100cm removed - bile acid diarrea | >100cm removed - bile acid deficiency (steatorrhea)
53
Caloric reqs to maintain wt?
25-30 kcal/kg/day
54
What type of kidney stones in Crohns and why?
Calcium oxalate - bile acid def --> steatorrhea, fat binds Ca and so it cannot bind to oxalate --> inc abs of oxalate. Should go on low fat, high calcium diet
55
T/F: Prealbumin is a good marker of nutrition status.
False - can be falsely elevated in inflammatory state
56
Selenium def sxs
Myopathy, CMyopathy - SEe MYOPATHY

Gastro Review (15 decks)

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