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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.

A

True

25
Q

Sxs of severe hypophos and who gets it?

A

Ppl with refeeding syndrome - sz and resp distress

26
Q

T/F: Anorexia, bulimina, and binge eating DO all typically go to remission in pregnancy.

A

False - anorexia and bulimia do, BEDO does not

27
Q

Pts with roux en Y and LUQ pain years after. What to consider?

A

Internal herniation - can be intermittent and cause pain, emesis

28
Q

What besides protein can be low in prot losing enteropathy?

A

Immunoglobs (except IgE), cholesterol, lymphocytes

29
Q

Best diet for PLE?

A

High protein, low fat with MCT for fat

30
Q

What is function of ghrelin?

A

Get Hongry

31
Q

What decreases ghrelin surgery wise?

A

Gastric bypass and sleeves

32
Q

Which hormones reduce hunger?

A

Leptin and CCK

33
Q

T/F: Leptin and CCK directly decrease ghrelin?

A

False, the hormones do not directly affect each other

34
Q

Cutoffs of SI for oral diet and TPN needs?

A

> 200 cm - usually oral diet

< 100 cm - usually TPN

35
Q

Bariatric surgery improvements %.

A 
DM2 80%
HTN 70%
HLD 70%
Fatty liver 90%
Fibrosis of liver 50%
OSA 85%
GERD 75%
Joint dz 88%
36
Q

T/F: Tube feed diarrhea - should attempt more caloric dense formula?

A

False, not thought to help with diarrhea from TF

37
Q

Thiamine def sxs

A

burning neuropathy, gait ataxia, nystagmus, confusion, CHF with edema (wet beriberi)

38
Q

Conditions that lead to thiamine def

A

Alcoholism
Hyperemesis gravidarum
Gastric bypass
Crohns

39
Q

T/F: More extensive resections of the ileum lead to bile acid diarrhea and should tx with bile acids. Why?

A

False - more extensive make fat malabs more likely, thus, bile acid resins lead to worsened fat absorption and worsened diarrhea

40
Q

Pts with allergy to what are more likely to have non-anaphylactoid food allergy?

A

Latex gloves

41
Q

Which foods MC to cause non-anaphylactoid food allergy?

A

Banana, kiwi, peaches, avocado

42
Q

What should be used to tx ciguatera poisoning

A

Supportive care

43
Q

What are sxs of manganese toxicity?

A

Parkinsons like syndrome with manganese accumulating in globus pallidus, seizures

44
Q

Who is at risk for manganese tox?

A

Chronic TPN with cholestatic liver dz

45
Q

List subjective global assessment grades.

A

A - well nourished
B - Mildly malnourished
C - Severely malnourished

46
Q

Sxs of niacin def?

A

Pellagra (4Ds) - diarrhea, dementia, dermatitis (sun exposed rash), death

47
Q

Deficiency of what can lead to hyperglycemia and insulin resistance?

A

Chromium

48
Q

Sxs of selenium def?

A

Cardiomyopathy (Keshan’s dz)

49
Q

HC and MMA in B12 and folate def.

A

B12 - MMA and HC elevated

Folate - HC elevated, MMA not

50
Q

Sxs of manganese toxicity and who gets it?

A

Chronic TPN, esp if liver dz also - HCN, EPS (tremor, etc)

51
Q

Copper def sxs

A

Micro anemia, hypopigmentation, leukopenia, hypopig hair, myelopathy with poor gait, numbness, tingling and can lead to paralysis

52
Q

What is the cutoff for ileal removal section for bile acid diarrhea vs deficiency?

A

<100cm removed - bile acid diarrea

>100cm removed - bile acid deficiency (steatorrhea)

53
Q

Caloric reqs to maintain wt?

A

25-30 kcal/kg/day

54
Q

What type of kidney stones in Crohns and why?

A

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
Q

T/F: Prealbumin is a good marker of nutrition status.

A

False - can be falsely elevated in inflammatory state

56
Q

Selenium def sxs

A

Myopathy, CMyopathy - SEe MYOPATHY

Gastro Review (15 decks)

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