nutritional malabsorption Flashcards
1
Q
what diseases are associated with Mal-digestion?
A
- chronic pancreatitis
- cystic fibrosis
- pancreatic carcinoma
2
Q
what diseases are associated with inadequate absorptive surface?
A
- intestinal resection
- gasto colic fistula
- jejunoileal bypass
3
Q
what diseases are associated with bile salt deficiency?
A
- cirrhosis
- cholestasis
- bacterial overgrowth
- impaired ileal reabsorption
- bile salt binders
4
Q
what diseases are associated with lymphatic obstruction?
A
- lymphoma
- Whipple’s disease
- intestinal lymphagiectasia
5
Q
what diseases are associated with vascular disease?
A
- constructive pericarditis
- right sided heart failure
- mesenteric arterial/venous insufficiency
6
Q
what diseases are associated with mucosal disease?
A
- infection (giardia, whiles disease, tropical sprue, inflammatory diseases, radiation enteritis, eosinophilic enteritis, ulcerative jejunitis)
7
Q
how is energy balanced during disease?
A
in absence of food, glucose is maintained through mobilisation of stores of glycogen and if prolonged gluconeogenesis, lipolysis
8
Q
what happens when energy is balanced during disease?
A
- cytokines
- TNF alpha insulin resistance, glycolysis
- IL2 glucose metabolism
- IL4 lipid and glucose metabolism
- IL6 lipolysis
- activity and appetite reduced
9
Q
what are the risk factors for refeeding syndrome?
A
- BMI less than 16 kg/m^2
- unintentional weight loss greater than 15% within the last 3-6 months
- little or no nutritional intake for more than 10 days
- low levels of potassium, phosphate or magnesium prior to feeding
10
Q
what are the key characteristics of the chronic illnesses?
A
- start with food
- may have long term internal feeding
- focus on balanced diet
- diet to increase energy intake
- diet to manage blood glucose
- diet to reduce workload of kidney
- diet to reduce inflammation
- diet to support treatment
11
Q
what are the key characteristics of acute illnesses?
A
- start with food
- consider other routes such as enteral/parenteral
- diet to meet energy demand and reduce catabolism
- diet to support recovery - micronutrients and macronutrients
