Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical Nutritional Therapy > STUDY YAAAAAS > Flashcards

STUDY YAAAAAS Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q 
Predialysis
Energy: 30-35 kcal/kg dry weight
PRO: 0.6-0.8 g/kg dry wt. 
FAT: 30% of kcal and 10% or less saturated
Fluid: 500 mL/day + urine output
A

Dietary recommendations for Predialysis, Dialysis, Polycystic Kidney Disease (PKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • K: 4000 mg stages 2-3 and 2400 mg stages 4-5
  • Vitamins: no vitamin A b/c @ toxicity risk
  • Avoid high K foods like noni-juice and star fruit
A

Dietary recommendations for Predialysis, Dialysis, Polycystic Kidney Disease (PKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Dialysis
PRO: 1.0-1.5 g PRO/kg dry wt.
FAT: 30% of kcal and 10% or less saturated
Fluid: 1000 mL/day + urine output
*Prealbumin is always false high*
A

Dietary recommendations for Predialysis, Dialysis, Polycystic Kidney Disease (PKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hereditary: Grape-like cysts and as cysts obstruct/occlude

Lost salt w/ high urine output — increase salt intake

A

Dietary recommendations for Predialysis, Dialysis, Polycystic Kidney Disease (PKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment for Hypercalciuria

A

K+ wasting diuretic (thiazide diuretic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phos: restricted to 800-1600 mg/day
K: restrict to 1500-3000 mg/day (39 mg = 1 mEq)
Na: 2000 mg/day

A

Dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1 mEq K =

A

39 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

1 mEq Na =

A

23 mg of Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Norvasc

Ca Channel blocker for high BP – NO ____________!

A

Norvasc and Rocaltrol: functions, etc.

NO GRAPEFRUIT!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rocaltrol (calcitriol)
Active vitamin D (1,25 – Dihydroxycholecalciferol)
Binds to Ca and inc. absorption – hypercalcemia risk
Treats elevated iPTH in CKD pt.

A

Norvasc and Rocaltrol: functions, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Wt. gain between dialysis treatments should NOT exceed 1-2 lbs/day

Common to see 2-4 lb gains from Mon-Wed and 3-5 lb gains over the weekend

A

Look at pre and post dialysis weight and interpret fluid status: good or bad?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hectoral, Zemplar –> derivatives of Vit. D
High blood phosphorus and low blood Ca can stimulate body to produce iPTH

Sensipar – helps control hyperparathyroidism
More effective @ lowering iPTH than vit. D

A

Meds. used to treat elevated iPTH in CKD pt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BUN and Creatinine – always high
Retinol Binding Protein (RBP) – carries vitamin A in blood, generally false high and not ideal marker
Look at albumin and changes overtime

A

Look at renal pt. lab value and make assessment of PRO status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Calcium channel blocker for high BP

No Grapefruit or Seville oranges

A

Pt. on Norvasc: if any food med. interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management: maintain normal serum phosphorus, calcium, and parathyroid hormone levels

Parameter Target Range
Corrected total serum Ca = 8.4-9.5 mg/dl
Serum Phosphorus = 3.5-5.5 mg/dl
Ca x P = 22 mEq/L

A

Pt. on HD is @ risk for renal bone disorder (osteodystrophy): what tx plan to decrease risk?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperphosphatemia Mgmt: severe = serum ___—___ mg/dL

If serum P is less than 7 mg/dL then Ca supp. may be used to bind P
avoid Ca supp. as long as possible b/c @ risk for soft tissue calcification

A

Pt. on HD is @ risk for renal bone disorder (osteodystrophy): what tx plan to decrease risk?

7-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Decrease or avoid vit. D andCa

A

Hypercalcemia Mgmt:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

________– Calcium-sensing Receptor (CaR) modulator , help control hyperparathyroidism
help control hyperparathyroidism

A

*Sensipar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vitamin D Therapy – will help suppress iPTH and help normalize serum Ca

1,25 dihydroxy D3
Hectoral oral or IV (doxercalciferol) and Zemplar: vitamin D2

A

Pt. on HD is @ risk for renal bone disorder (osteodystrophy): what tx plan to decrease risk?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Parathyroidectomy – if all else fails to dec. iPTH, remove parathyroid

Calcific Uremic Arteriolopathy (calciphalaxis) – keep iPTH and Ca levels normal to prevent this

A

Pt. on HD is @ risk for renal bone disorder (osteodystrophy): what tx plan to decrease risk?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cardiac problems like arrhythmias, weakness, GI problems, death

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypoguesia, Hyposmia, poor appetite, rash, poor wound healing, immune and sexual dysfunction, poor growth in kids
Avoid laxatives w/ magnesium: Milk of Magnesia and Mineral Oil

A

Zinc deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Muscular weakness, cardiac arrhythmias (irregular heart beat), high plasma TG

A

Carnitine deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

inc. iron absorption and serum ferritin is > **300mg/dL

Hereditary disorder where iron stores may reach 20-40 grams (N= 1-3 grams)

A

Hemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S and S: cirrhosis, liver cancer, diabetes, bronze skin, cardiomyopathy, arrhythmias, heart failure, abdominal pain, arthritis

A

Hemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Antioxidant –> anticancer, anti-diabetic, anti-atherosclerotic
Promotes muscle development, decrease fat deposition
May lower plasma TC, TG, and; improve utilization of FA by heart
Found in beef, lamb, turkey, and dairy fats

A

What is CLA? – Conjugate Linoleic Acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Stanol ester –> blocks cholesterol absorption

2-3 g/day will lower LDL by 6-15%

A

What is Benecol? — Stanol Ester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Need 5-50 mg/day B6 supp.

Management of Wilson’s disease and Rheumatoid Arthritis

A

Penicillamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Lose weight if obese, low fat diet

Limit alcohol and high glycemic index CHO

A

Dietary recommendations for pt. w/ Familiar Dislipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

combines 3 or more HIV drugs to dec. viral load

Take a multi-vitamin mineral supplement daily and avoid food borne illnesses

A

AIDS pt w/ different disorders of large or small bowel: what recommendations to make

“Highly Anti-Retroviral Therapy” (HAART) -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Due to hyperlipidemia:
Maintain IBW, 30% kcal from FAT, lower saturated, trans fats, and TG (simple sugars)
Increase physical activity

A

AIDS pt w/ different disorders of large or small bowel: what recommendations to make

“Highly Anti-Retroviral Therapy” (HAART) -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q
  • Diarrhea*
  • Severe small bowel disease – often parenteral nutrition required
  • Partial small bowel disease – fat >20% kcals, low fiber/residue, lactose free, avoid caffeine; but rarely parenteral nutrition is required
  • Large bowel problems – same as above
A

AIDS pt w/ different disorders of large or small bowel: what recommendations to make

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q 
Exercise and lose weight if obese
Avoid elevated or low plasma TG
Intake smaller amounts of alcohol
Statins and Niacin
Stop smoking
Avoid androgenic and anabolic steroids
Avoid beta andrengenic blocking agents
A

Ways to help elevate HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Statins lower CRP

Decreased by stop smoking, omega 3 FA, exercise, avoid android obesity, more sleep, reduce stress

A

Therapies to lower CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ex. RA, lupus**, cancer, chronic infections, inflammatory bowel disease (IBD)

A

Diseases associated w/ being a cause of Anemia of Chronic Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Salt substitutes – Morton lite and cardia

Squash, noni juice and star fruit

A

Foods high in potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Retinol Binding Protein – carries vit. A and always elevated, causing a false high pre-albumin

Albumin – physiological stress and PRO malnutrition causes low albumin

A

Trying to assess hemodialysis pt. PRO status: pro and cons w/ looking at RBP vs. albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Cyclosporine
Hypomagnesmia, hyperkalemia, hyperlipidemia, increase BG, and hyperuricemia
Don’t take with grapefruit

A

Side effects of Cyclosporine, Mineral Oil, Cholestyramine, and Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Mineral Oil

May reduce absorption of vitamin A,D,E,K, calcium, carotenoids, and phosphate

A

Side effects of Cyclosporine, Mineral Oil, Cholestyramine, and Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cholestyramine
Always mix the powder into liquid
Long term therapy – depletion of fat soluble vitamins so vit. A, D, E, K supp. recommended
Folic acid deficiency may occur and 5 mg supp. recommended

A

Side effects of Cyclosporine, Mineral Oil, Cholestyramine, and Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Methotrexate
If chemotherapy agent – avoid folate
If taken for other disorders, folate supplement may be taken prophylactically

A

Side effects of Cyclosporine, Mineral Oil, Cholestyramine, and Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

This leads to exudative diarrhea - Inflammation of gut, excretion of blood, mucus, plasma proteins, and electrolytes

A

Pt. has Radiation Enteritis, and Ulcerative Colitis (UC): what kind of diarrhea would they have

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which antacid is most likely to cause diarrhea

A

Milk of Magnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Serum or plasma folate 100 mg FIGLU excretion*

A

Folate (B9) and Cobalamin (B12) anemia: lab test and abnormalities in complete blood count

Folate (B9)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q
  • High Methamalonic Acid (MMA) > 3.5 mg*

* Schilling Test (B12 absorption) – deficient if less urine excretion*

A

Folate (B9) and Cobalamin (B12) anemia: lab test and abnormalities in complete blood count

Cobalamin (B12)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Levadopa
High PRO – decrease drug’s effectiveness, eat less PRO at night
B6 can convert L-dopa to dopamine outside the brain → lessening the effect

A

Possible interactions and things to avoid: LDOPA, Tetracycline, Nardil, and Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Avoid high fortified foods (ex. cereal) and; supplements of B6 – don’t completely eliminate though
Don’t take with iron – absorption is decreased

A

Levadopa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Tetracycline
Calcium, iron, magnesium – form a chelate, reducing absorption of both the med and mineral
Should not be taken 3 hours before or 2 hrs. after – divalent or trivalent cations or Na bicarb.

A

Possible interactions and things to avoid: LDOPA, Tetracycline, Nardil, and Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Can alter activity of folate, K, B6, B12, vit. C and K if longer than 2 weeks (may need supplement)
Taking 500 mg vit. C w/ drug may increase blood levels of med

A

Tetracycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

INH (Isoniazid)
Avoid Swiss/Cheshire cheese, tuna, skipjack, sardinella – histamine and tyramine containing foods
Interferes w/ B6 metabolism – interferes w/ PLP and excretion of both is increased

A

Possible interactionsand things to avoid: LDOPA, Tetracycline, Nardil, and Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

PLP is needed to convert tryptophan to Niacin**, so 200-400 mg/day of niacin – with pellegra

A

INH (Isoniazid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

MAOI’s Nardil
Avoid consumption of high tyramine*** foods
Cheese, smoked/pickled fish, non-fresh meat and liver, chianti and vermouth wine, broad beans, banana peels, meat extracts, yeast extract, dry sausage, sauerkraut, beer and ale

A

Possible interactions and things to avoid: LDOPA, Tetracycline, Nardil, and Isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Chron’s disease and ulcerative colitis; inflammation* of the bowel

A

Inflammatory Bowel Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Possible cause - bacterial overgrowth in the SI, hypermotility or abdominal brain gut connection exacerbated by stress

A

Irritable Bowel Syndrome (Spastic Colon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Signs and Symptoms: gas, bloating, abdominal pain, cramps, spastic contractions, constipation and/or diarrhea, fecal incontinence, anxiety, back pain, mucous in stool

A

Irritable Bowel Syndrome (Spastic Colon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

For Hypertension:

2-3 servings/day of low fat dairy products - on the test it says 5 servings/day so it won’t be the answer

7-8 servings per day of whole grain
8-10 servings/day of fruit and vegetables

A

DASH diet: what it’s high and low in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Polyuria, polydipsia, or oliguria

Low plasma albumin – due to loss of PRO in urine

A

Look at pt. lab values, S and S: determine whether they have Nephrotic Syndrome, Carnitine deficiency, Polycystic kidney disease, and Acute Glomerulonephritis

Nephrotic Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Most common in kids 3-21 yrs. who have had beta hemolytic group A strep infection
Hematuria, albuminuria, azotemia, HTN, and edema

A

Look at pt. lab values, S and S: determine whether they have Nephrotic Syndrome, Carnitine deficiency, Polycystic kidney disease, and Acute Glomerulonephritis

Acute Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Hematuria, proteinuria, infection, and flank pain

A

Look at pt. lab values, S and S: determine whether they have Nephrotic Syndrome, Carnitine deficiency, Polycystic kidney disease, and Acute Glomerulonephritis

Polycystic Kidney Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Muscular weakness
Cardiac arrhythmias (irregular heart beat)
High plasma TG

A

Look at pt. lab values, S and S: determine whether they have Nephrotic Syndrome, Carnitine deficiency, Polycystic kidney disease, and Acute Glomerulonephritis

Carnitine Deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Absorbed in the bloodstream and provides quick energy for body and not as likely to be stores as fat
Acts as a CHO not FAT and goes to liver to be used as an immediate energy source

A

MCT oil: how it’s absorbed and possible side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Side Effects:

Ketone build up in DM, cause severe problems in liver disease, and upset stomach

A

MCT oil: how it’s absorbed and possible side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Ulcerative Colitis (UC) – DON’T go on TPN
Crohn’s - may help pt. go into remission
Severe vomiting and Diarrhea
Any disease of the SI causing malabsorption

A

Look at pt.’s condition and determine whether they need to be on TPN or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

High output (over 500) fistula
Short bowel/ major surgical resection
Severe gastritis or bleeding ulcers

A

Look at pt.’s condition and determine whether they need to be on TPN or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Acute bowel ischemia, severe total ileus, and severe acute pancreatitis
Complete mechanical bowel obstruction
Severe damage to a large part of the SI

A

Look at pt.’s condition and determine whether they need to be on TPN or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Name of formula for Chron’s Disease pts.

A

MODULEN IBD by Nestle’s – contains TGF-B2 which inhibits IFN-g, lowering MHC Class II PRO
Low in Omega 6 and decreases inflammation of SI

Peptamen – Peptide-based elemental diet for GI-impaired children ages 1-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Methotrexate: no folate supp. if for chemo and Dilatin: give minimum amt
{refer to #72}

A

Look at blood values, meds, S and S, and make dx of what is causing their anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Macrocytic Anemias
Effect B12:
Pernicious anemia, GI problems, and elderly
Meds: nitrous oxide, cholestyramine, INH, metformin, H2 receptor blockers, PPIs (prolisec and prevacid), Nexium, Dilantin

A

Look at blood values, meds, S and S, and make dx of what is causing their anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q 
MACROCYTIC
 large RBC’s, high MCV
NORMOCYTIC
 normal size RBC’s, normal MCV
MICROCYTIC
Small RBC’s, low MCV
A

CLASSES OF ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

COPD → chronic obstructive lung disease

A

Pt. w/ COPD taking Mylanta, Ldopa, Nardil and Warfarin: know side effects, nut. Interactions of these meds, know foods to restrict, or supplements to take

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Mylanta – antacid (contains Mg)
Phosphate deficiency risk w/ chronic use – inc. risk w/ low phosphorus and PRO intake
Deficiency risk: vitamin A, folate, thiamin, fluoride, and iron

A

Pt. w/ COPD taking Mylanta, Ldopa, Nardil and Warfarin: know side effects, nut. Interactions of these meds, know foods to restrict, or supplements to take

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

not common in CRF pts., heart problems, respiratory problems

A

Hypophosphatemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

anorexia, hyperreflexia, high heart rate, bone problems, calcification of soft tissues if Ca is also high

A

Hyperphosphatemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

confusion, GI disturbances, weakness

A

Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Anticoagulant
Keep steady vit. K intake – large inc. in dose may decrease anticoagulant effects; abrupt decrease may increase effect and result in bleeding

A

Warfarin: side effects and nutrient interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Don’t take CoQ10 – may interact adversely

Don’t take iron, mg, or zinc within 2 hours as absorption may be decreased

A

Warfarin: side effects and nutrient interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

CHO = 1.0
FAT = 0.71 (using fat for energy)
PRO = 0.83
RQ mixed diet = @ 0.85

A

Estimate RQ value of pt. and what is a good value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Ethanol = 0.67; 1.3 = invalid (error in calculation)

RQ of 0.85-0.95 is desirable for pt. on vent

A

Estimate RQ value of pt. and what is a good value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Jejunal and Ileal resection →Increased risk of hyperoxaluria** and Oxalate Kidney Stones

A

Make recommendations pt. w/ Short Bowel Syndrome to decrease risk of kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Avoid high oxalate foods and increase calcium and fluid intake
Avoid: beets, chocolate, coffee, cola, nuts, rhubarb, spinach, strawberries, tea, wheat bran

A

Make recommendations pt. w/ Short Bowel Syndrome to decrease risk of kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

OXEPA
Low CHO, calorically dense enteral formula
Minimize CO2 production. High CO2 levels can complicate weaning in vent.-dependent patients

A

OXEPA formula and ingredients that make it unique

82
Q

OXEPA
EPA (sardine oil), GLA (borage oil), and 25% fat as MCT
Meets 100% RDI for 24 key vitamins in 1420 kcals
Fortified with antioxidants, natural vit. E, beta-carotene, and vit. C

A

OXEPA formula and ingredients that make it unique

83
Q

Low CHO and high FAT – so less CO2 generated which dec. RQ

A

Usual balance of CHO, FAT in formula for pulmonary patient

84
Q

Foods with Gluten/Gliadin:
All wheat (gliadin), rye (secalin), malt, barley (hordein), and maybe oats
Spelt, triticale, kamut
Millet, sorghum, buckwheat, quinona, amaranth,

A

Identify foods w/ gluten

85
Q

distilled alcohol, white vinegar (contaminated?)- so I guess it is better to avoid them
There’s a question about this… Which food could someone with gluten sensitivity not eat? gravy

A

Identify foods w/ gluten

86
Q

Vitamin E
Synthetic Vit. E – “acetate,” all-rac, dL (“don’t like”)
Natural – RRR, d
Lowers/interferes Tamoxifen effects

A

Breast cancer pt. taking Tamoxifen: possible interactions

87
Q

Avoid Soy
Genistein, most prevalent isoflavone in soy, can stimulate estrogen receptor-positive (ER+) breast cancer growth and interferes w/ antitumor activity of Tamoxifen at low levels

A

Breast cancer pt. taking Tamoxifen: possible interactions

88
Q

Carcinoma in situ: non-invasive
Early stage of cancer when it’s confined to layer of cells where it began
“in situ” – means cancer cells stay confined to ducts (ductal carcinoma in situ, DCIS) or lobules (lobular carcinoma in situ, LCIS)

A

Definitions: ductal, lobular, in situ, invasive (breast cancer)

89
Q

Invasive (Infiltrating) Carcinoma:
Cancer has invaded into deeper tissues in the breast or spread to other organs in the body and no longer confined to ducts (IDC)/lobules (ILC) where it began

A

Definitions: ductal, lobular, in situ, invasive (breast cancer)

90
Q

Genisten – the most prevalent isoflavin in SOY

Avoid Phytoestrogen
Isoflavinoids, lignans

A

Foods to avoid by women w/ ER+ breast cancer

91
Q

Hypolipoprotenemia – Abetalipoteinemia: causes poor absorption
RBC hemolysis retinopathy, peripheral neuropathy w/ hyporeflexia and ataxia (no coordination)

A

S and S Tocopherol (vit. E) deficiency: what lipidemia puts you at risk for deficiency

92
Q 
Kidney Stones (Nephrolithiasis)
High fluid intake @ 2000-3000 mL/day
A

Recommendations for Primary Hyperoxaluria, Calcium Oxalate, and Uric Acid Kidney Stones

93
Q

Primary/Idiopathic
Restrict oxalate if it is in stones
High oxalate foods – beets, chocolate, coffee, cola, nuts, rhubard, spinach, strawberries, tea, wheat bran
Try restriction of Na and animal PRO and restrict dietary Ca to DRI

A

Recommendations for Primary Hyperoxaluria, Calcium Oxalate, and Uric Acid Kidney Stones

94
Q 
Primary Hyperoxaluria (PH) 
Type 2 – stones are often calcium oxalate and may lead to CKD 
400-600 mg/day B6 (pyridoxal phosphate)
A

Recommendations for Primary Hyperoxaluria, Calcium Oxalate, and Uric Acid Kidney Stones

95
Q

Uric Acid Stones

**Low PRO/purine diet and/or Citrate or bicarb supp. to make urine more alkaline*

A

Recommendations for Primary Hyperoxaluria, Calcium Oxalate, and Uric Acid Kidney Stones

96
Q

Saturated – because it inhibits clearing

A

Kind of fat is most likely to influence LDL levels and how

97
Q

Increase plasma HDL, TG accumulation and VLDL production

Decrease LDL oxidation

A

What lipids can be effected by alcohol consumption

98
Q

K+ sparing diuretics: Aldactone, Dyrenium, and Midamor
ACE Inhibitors – Benazepril and Ramipril
Beta Blocker – Lopressor
Cyclosporine

A

Cardiac Meds and diuretics: which frequently cause hyperkalemia

99
Q

800-1000 mg/day folic acid (B9) supp.

Avoid PABA or iron – both lessen med. effect

A

Pt. on Sulfasalazine (Mesalamine): know supps. they should take and any restrictions

100
Q

Histamine receptor blockers → Axid, Pepcid, Tagamet, and Zantac

A

Different antacids and acids suppressing meds in GERD: which are PPIs and H2 blockers

101
Q

Antacids
Mylanta, Maalox, Tums, or Rolaids etc
Gaviscon → foams and ↓ acid reflux into esophagus

A

Different antacids and acids suppressing meds in GERD: which are PPIs and H2 blockers

102
Q

Proton Pump Inhibitors (PPI’s) → Nexium, Prevacid, and Prilosec
Work best to ↓ acid production

A

Different antacids and acids suppressing meds in GERD: which are PPIs and H2 blockers

103
Q

Ex. Antacids may ↓ absorption of iron, thiamin, phosphorus, and vitamin A
Ex. PPI’s and Hist blockers may cause a ↓ in vitamin B-12 absorption
Ex. Lower stomach acid may ↓ calcium, magnesium, and iron absorption

A

Different antacids and acids suppressing meds in GERD: which are PPIs and H2 blockers

104
Q

High PRO intake and Metoclopramide (Reglan) - speed gastric emptying

A

Different antacids and acids suppressing meds in GERD: which are PPIs and H2 blockers

105
Q

Zinc – high dose may induce copper deficiency, so monitor
500-1000 µg/day Folate (B9) and Cobalamin (B12)
Retinol (vit. A), RBP, riboflavin, vit. E and C

A

Sickle Cell Anemia

106
Q

Homozygote who may have intermediate or major disorder
IRON OVERLOAD
Same deficiencies as Sickle Cell

A

Thalassemia Major = “Cooley’s Anemia”

107
Q

Genetic defect in the LDL receptor so LDL is not cleared out of the blood effectively
High total cholesterol (TC) and LDL

A

Abnormality causing Type A hyperproteinliponemia: what is elevated in plasma

108
Q

For after BMT – low bacterial diet to lower infection risk
Raw and undercooked brewer’s yeast, meats, fish

NO CHEESE! – Cottage cheese was an example on the test

A

Neutopenic diet: what it is and identify foods that wouldn’t be allowed

109
Q

K+ sparing: Aldactone, Dyrenium, and Midamor

K+ wasting: Diuril, Lasix, Thiazide

A

K sparing vs. K wasting diuretics

110
Q

Aldactone, Dyrenium, and Midamor

A

K+ sparing

111
Q

Diuril, Lasix, Thiazide

A

K+ wasting

112
Q

Predialysis Protein: 0.6-0.8 g/kg body wt (dry weight)

A

Given descriptions of renal pt: know grams of PRO/day recommended {calc. g per body wt}

113
Q

Hemodialysis → Dietary Protein Intake (DPI): ~1.0-1.5 g/kg dry body wt. (½ should be HBV)

A

Given descriptions of renal pt: know grams of PRO/day recommended {calc. g per body wt}

114
Q

Peritoneal Protein: 1.2-1.5 g/kg dry wt/day

A

Given descriptions of renal pt: know grams of PRO/day recommended {calc. g per body wt}

115
Q

↑ output or cause discomfort – nuts, corn, chocolate, lettuce, oranges, milk, alcohol, tomatoes

A

Food that causes intolerance w/ Ileoanal Reservoir

116
Q

Avoid insoluble fiber in foods: like fruit peels, mushrooms, corn, celery, lettuce, bean sprouts, coleslaw, coconut, pineapple, nuts, seeds, tough meat shrimp or lobster

A

Food that causes intolerance w/ Ileoanal Reservoir

117
Q

Foods that may cause gas and odor:
Asparagus, dried beans/peas, mustard, cabbage family, onions, carbonated beverages, eggs, strong flavored cheeses, melons, spiced foods, fatty foods (pastries/deep fried), whips and meringues

A

Food that causes intolerance w/ Ileoanal Reservoir

118
Q

Foods that contribute to anal irritation:
Certain raw fruits and vegetables (e.g., oranges, apples, coleslaw, celery and corn)
popcorn, nuts, coconut, dried fruit (ex. Raisins, figs), seeds, spicy, and oriental veggies

A

Food that causes intolerance w/ Ileoanal Reservoir

119
Q

High PRO – decrease drug’s effectiveness, eat less PRO at night
B6 can convert L-dopa to dopamine outside the brain →lessening the effect
Avoid high fortified foods (ex. cereal) and supplements of B6 – don’t completely eliminate though

A

Levadopa

120
Q

Don’t take with iron – absorption is decreased

A

Levadopa

121
Q

Anticonvulsant osteomalacia may occur – need vitamin D2 (ergocalciferol)
Calcium supp. may decrease absorption

A

Dilantin

122
Q

Take minimum folate to treat deficiency — dec. anti-convulsant effect
Whole formulas like Complete – slightly dec. levels
Whole blenderized TF and standard TF= increase therapeutic levels

A

Dilantin

123
Q

Monitor water, Na, Cl, K, Mg
Hypokalemia Risk and risk increases med. toxicity
Increase Thiamin excretion and cause depletion which may worsen heart failure

A

Lasix – K wasting diuretic

124
Q

Keep steady vit. K intake – large inc. in dose may decrease anticoagulant effects; abrupt decrease may increase effect and result in bleeding
Don’t take CoQ10 – may interact adversely

A

Warfarin (Coumadin) – anticoagulant

125
Q
  • Alcohol tends to increase plasma HDL, decreasing CVD risk*
  • Alcohol increases levels of clot dissolving enzyme*
  • Inhibits FA oxidation in liver → TG accumulation (fatty liver) and increased production of VLDL*
A

What happens if a person has 4 alcohol drinks a day: what would go up in their blood?

126
Q

PAD → blocking or narrowing of arteries in extremities (legs are most common)
Blood flow decreases in arteriosclerosis – buildup of fatty substances in wall of artery

A

Peripheral Vascular Disease : what it is and S and S

127
Q

Signs and Symptoms:
Intermittent claudication (tissues don’t received enough oxygen especially when walking)
Pain when walking or w/ activity

A

Peripheral Vascular Disease : what it is and S and S

128
Q

Phosphate, Magnesium, Potassium, Calcium… Thiamin

A

Minerals commonly low in Refeeding Syndrome

129
Q

Bile Acid Binding Resins to lower cholesterol
Always mix the powder into liquid
Long term therapy – depletion of fat soluble vitamins so vit. A, D, E, K supp. recommended
Folic acid deficiency may occur and 5 mg supp. recommended

A

Questran (Cholestyramine)

130
Q

IBS, RA, and anti-inflammatory
800-1000 mg/day folic acid (B9) supp
Don’t take PABA or Iron – decreases effect

A

Sulfasalazine (Mesalamine)

131
Q

Uses: Anti-arrythmia, inotropic agent, CHF
Monitor serum K, Na, Ca, Mg, and avoid hypo/hyper – may affect heart rhythm

Avoid licorice – has glycyrrhizic acid

A

Digitalis (Digitoxin)

132
Q

AST, ALT, — Jaundice

Gamma-glutamyl transpeptidase (GGTP, GTP, GGT) rise

A

Lab value high in Hepatitis

133
Q

EPA, DHA in salmon and other fatty fish

A

Omega 3 PUFA

134
Q

linoleic and arachidonic
safflower,
evening primrose seed oil

A

Omega 6 PUFA

135
Q

oleic and palmitoleic

olive, canola, peanut

A

Omega 9 MUFA

136
Q

no double bonds

Coconut, palm

A

Saturated FA

137
Q

1 cup = 8 oz = 240 mL = 240 cc

1 fl. ounce = about 30 mL

A

Gives pt. menu: calculate how many cc of fluid

138
Q

Test Diet for Phenocytomachroma → over-secretion of the adrenal medulla gland

Vanillylmandelic acid (VMA) and homovanillic acid (HVA) are elevated in urine

A

VMA test: what is it

139
Q

lower total cholesterol (NO GRAPEFRUIT)
Lipitor and Crestor – most effective in lowering TG
Inhibit HMG-CoA reductase
Need CoQ10 supp.

A

Statins

140
Q

binds bile to lower cholesterol

Colestid, Questran, Welchol, and Zetia

A

Bile Binding Resins

141
Q

lowers TG lipolysis and production of TG carrier PRO

Fenofibric acid and Fenofibrate

A

Fibric Acid Derivative

142
Q

VITAMIN, 1000-3000 mg QD (once a day)
Dec. VLDL, LDL, and IDL → lowers TG
Nicotinamide has no lipid lowering effect

A

Niacin (Nicotinic Acid)

143
Q

Defected LDL receptors
Omega 3, Saturated fat, trans FA
Some are cholesterol responders and dietary cholesterol intake causes their TC and LDL-C to rise

A

Causes of elevated LDL

144
Q

Polygenic hypercholesterolemia →hyperresponsive to sat fat and high chol. absorption and poor LDL clearance due to defective apo B-100 and/or apo E 4

Familial defective apo B-100 → LDL not recognized by receptor

A

Causes of elevated LDL

145
Q

graft or tissue from someone other than pt. who is non-identical (matching sibling)

A

Allogeneic

146
Q

produces right sides weakness or paralysis, cautious behaviors, aphasia** (speech and communication problems), and dysphagia**

A

CVA in the LEFT side of brain

147
Q

produces left side weakness or paralysis, impatience, impulsiveness, lack of inside and problems w/ spatial relationships

A

CVA in the RIGHT side of brain

148
Q

clot stops blood supply to an area of brain (more common in elderly)
anticoagulants (Heparin, Coumadin), anti-platelets (Aspirin), Plavix

A

Ischemic Stroke

149
Q

blood leaks into brain tissue (more common in younger people)
Do NOT take anti-coagulants, anti-platelets, Plavix, etc.

A

Hemorrhagic Stroke

150
Q

Ex. Young female with heavy periods – iron deficiency (microcytic anemia)
Ex. dialysis patients – need EPO shot, normocytic anemia
Ex. children have higher risk of lead poisoning (microcytic anemia)

A

Groups are at high risk for different anemias

151
Q

large RBC, high MCV (>100 fl), high LDL, iron, and bilirubin

A

Macrocytic Anemia

152
Q

Pernicious anemia –diminishes IF synthesis in parietal cells
Low IF due to gastric problems
Poor absorption due to ileal problems – NEED IV!
Elderly have difficulty freeing B12 from food b/c low stomach acid – high need

A

B12 (cobalamin) deficiency

153
Q

Pregnancy, malabsorption syndromes, hyperthyroidism, cirrhosis, and alcohol problems

A

B9 (folate) deficiency

154
Q

small RBC, low MCV (

A

Microcytic Anemias

155
Q

Thalassemia – Mediterranean, Middle Eastern, and South East Asia
Sideroblastic – enzyme defect

A

Iron Deficiency

156
Q

anemia due to low erythropoietin (EPO) – DIALYSIS PATIENT!
Aplastic Anemia
Myelopathic Disorders – disorder of spinal cord or bone marrow

A

Normocytic Anemia

157
Q

Sickle-Cell Anemia –African-Americans, but some from Italy, Greece, Arab countries, or Asia
Hemolytic Anemia – ex. G6P dehydrogenase deficiency only in men (x-linked)

A

Normocytic Anemia

158
Q

an esophageal motility disorder where LES doesn’t relax and no peristalsis
Causes a bag-like* distension of esophagus and caused by defective nerves or maybe a virus

A

Achalasia

159
Q

Signs and Symptoms:
Dysphagia for solids and liquids; Wt. loss/ malnutrition; Sub-sternal chest pain
Fullness in chest; Nausea and vomiting; Regurgitation and burning

A

Achalasia

160
Q

Ca channel blockers (Nifedipine (Adalat) or Nitrates (isordil) to relax LES
Intrasphincteric injection of botulinum toxin** {relaxes muscles}

Dietary fat may help relax LES

A

Achalasia

161
Q

Ca channel blockers (Nifedipine (Adalat) or Nitrates (isordil) to relax LES
Intrasphincteric injection of botulinum toxin** {relaxes muscles}

Dietary fat may help relax LES

A

Nutrients that may be helpful to lower elevated homocysteine

162
Q

Supplements of B6 (pyridoxine), B12 (cobalamin), and folate (B9)
*Deficiency of vit. B6, B9, B12 – can elevate plasma homocysteine

A

Nutrients that may be helpful to lower elevated homocysteine

163
Q

Renal multi-vit. w/o vitamin A like diatx, renax, dialyvite, nephrocaps, nephrovit
Diatx = more effective in lowering plasma homocysteine b/c has more folate, B12, and B6*

BAD = High (3g/day) niacin intake may cause tHcy to rise in some people

A

Nutrients that may be helpful to lower elevated homocysteine

164
Q

Hypokalemia – increase K or take supp.

A

Continuous Ambulatory Peritoneal Dialysis (CAPD)

165
Q

Hyperkalemia risk

A

Hemodialysis

166
Q

Hypermagnesia risk, don’t take vitamin A, elevated homocysteine and creatinine
Prealbumin is always false high

A

Both
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Hemodialysis

167
Q

Age- increases w/ age
Race – African Americans
Male and post-menopausal females
HTN, smoking, DM, Obesity, physical inactivity
Hereditary – inherited hyperlipidemia, history of CAD, blood clotting abnormality

A

Risk factors of CVD - lipid abnormalities and things in plasma

168
Q

Elevated total cholesterol (TC) = TC > 200 mg/dL
Elevated low density lipoprotein cholesterol (LDL) = LDL > 100 mg/dL
Elevated TG = > 150 mg/dL
Low high density lipoprotein cholesterol (HDL) = should be > 50 mg/dL

A

Risk factors of CVD - lipid abnormalities and things in plasma

169
Q

marker for assessing cholesterol clearing capacity of the blood
Low = high risk of CVD

A

Apolipoprotein A1

170
Q

marker for assessing cholesterol depositing capacity of the blood

A

Apolipoprotein B:

171
Q

Helps with blood clot formation

A

Lipoprotein (a)

172
Q

People w/ elevated CRP have 3-7 fold increase in risk of heart attack and stroke
Marker for inflammation of blood vessel

A

Risk factors of CVD - lipid abnormalities and things in plasma

173
Q 
Infection w/ organisms such as Chlamydia pneumonia, Helicobacter pylori, herpes simplex virus, hepatitis A and cytomegalovirus may be associated w/ inflammation and CVD risk
Gum disease (gingivitis) – also possible risk factor of CVD
A

Risk factors of CVD - lipid abnormalities and things in plasma

174
Q

If 2/3 or more of the SI is removed, TPN may be needed to sustain normal nutritional status
Oxalate Kidney Stones {see below}
Fatty acids in bowel bind to Ca, leaving less Ca to bind to oxalate, so more oxalate is absorbed. Also FFA may make gut more permeable which ↑ oxalate absorption

A

Understand why pt. w/ small bowel resection is @ risk for B12 deficiency. Understand why pt. w/ small bowel resection is @ risk for B12 deficiency, kidney stones, bile salt diarrhea, etc: how to treat them allency, kidney stones, bile salt diarrhea, etc: how to treat them all

175
Q

Ileal Resection
Terminal ileum – ONLY site where cobalamin (B-12)/gastric intrinsic factor complex is absorbed. IM B-12 injections needed to prevent megaloblastic anemia and neuropathy

A

Understand why pt. w/ small bowel resection is @ risk for B12 deficiency. Understand why pt. w/ small bowel resection is @ risk for B12 deficiency, kidney stones, bile salt diarrhea, etc: how to treat them allency, kidney stones, bile salt diarrhea, etc: how to treat them all

176
Q

treats bile salt diarrhea and oxalate kidney stones

A

Cholestyramine

177
Q

aka Bassen-Koenzweig Syndrome
Failure to thrive, Fat malabsorption (vomiting, diarrhea, steatorrhea)
Acanthrocytosis (spiked RBC)
Deficiencies in vitamin A (night blindness), D (osteodystrophy), K (easy bruising), E (neuropathy due to poor absorption)

A

Abetalipoproteinemia (Hypolipoproteinemia)

178
Q 
(3 or more risk factors = syndrome)
Abdominal obesity, waist circumference: males > 102 cm (40 in), females > 88 cm (35 in)
TG: 1.7 mmol/L or 150 mg/dL
HDL: males  130/ 85 mm Hg
Fasting BG: > 110 mg/dL
A

Metabolic X Syndrome

179
Q

Elevated Troponin I and T
S and S: chest pain, GERD, palpitations, diaphoresis, pallor, nausea, vomiting, confusion, anxiety, tachycardia or bradycardia, abnormal BP, fever, weak, SOB

A

Myocardial Infarction (MI)

180
Q

commonly causes by a hereditary lack of xanthine dehydrogenase
S and S: kidney stones, CKD, joint pains, myopathy, acidic urine

A

Xanthiuria

181
Q

Insoluble fiber may cause distress and ↑ risk of obstruction in pts. w/intestinal lumen narrowing or partial obstruction. – popcorn, seeds, nuts, fruit peels, broccoli, and dried beans

A

Pt. w/ Chron’s Disease: know dietary recommendations

182
Q

Most pts. w/ steatorrhea can be managed on 50-70 g fat/day and can use MCT oil
Gluten or wheat may not be tolerated by some patients
Use of elemental formulas may↓ stool frequency and provide nutrients for the gut such as glutamine

A

Pt. w/ Chron’s Disease: know dietary recommendations

183
Q

Calc. PRO/Kcal needs based on normal wt. for ht. and not current wt.
May need to add extra for malabsorption

A

Pt. w/ Chron’s Disease: know dietary recommendations

184
Q

Formulas: MODULEN IBD by Nestle’s and Peptamen

During remission or non-acute periods:
Maintain norm. nutrition status: (+300-500kcal to gain wt, 1.5 g pro/kg/day)

A

Pt. w/ Chron’s Disease: know dietary recommendations

185
Q

{ damage to lining of intestines (bowels) due to radiation therapy}
Exudative diarrhea

A

Radiation enteritis

Short Bowel Syndrome (SBS) – or Disease {malabsorption}

186
Q

30-50% resection: cause some S and S like diarrhea, steatorrhea, bloating, fatigue, and malnutrition

Steatorrhea doesn’t usually dev. unless > 100 cm (~ 3.3 feet) of terminal ileum has been removed

A

Short Bowel Syndrome (SBS) – or Disease {malabsorption}

187
Q

Ileum will generally adapt and take over IN TIME
No major malabsorption, but may have lactose intolerance
Most nutrient absorption takes place in the proximal jejunum

A

Jejunal Resection

188
Q

May have problems until remaining gut, primarily ileum adjust→hypertrophy and hyperplasia
Avoid lactose and may not tolerate hyperosmotic liquids- gas, bloating, diarrhea

A

Jejunal Resection MNT

189
Q

At some risk for hyperoxaluria which may lead to kidney stones due to:
Fatty acids in bowel bind to Ca, leaving less Ca to bind to oxalate, so more oxalate is absorbed. Also FFA may make gut more permeable which ↑ oxalate absorption
May need to↓ intake of high oxalate foods (100-300 mg/day) and ↑ calcium and fluid intake

A

Jejunal Resection MNT

190
Q

Site of absorption of cobalamin (B12), chloride, sodium, potassium

Hard for body to make enough and bile salts that are not reabsorbed may cause diarrhea

A

Ileal Resection

191
Q

Also this causes poor fat absorption and unabsorbed fats and fatty acids ↑ diarrhea

Risk for hyperoxaluria and oxalate kidney stones is HIGH!!
Loss of ileocecal valves ↑ problems w/malabsorption and diarrhea, and bacterial overgrowth

A

Ileal Resection

192
Q

ONLY site where cobalamin (B-12)/gastric intrinsic factor complex is absorbed. IM B-12 injections needed to prevent megaloblastic anemia and neuropathy from developing*

A

*Terminal ileum

193
Q

Initially after surgery TPN needed – Wean to elemental or semi-elemental high N formula that is low in fat (may have MCT oil).

A

Ileal Resection MNT

194
Q

Usually in SI, especially terminal ileum (ileitis), but may occur in any area of GI tract
Transmural (throughout bowel wall) inflammation w/granulomatous areas – scarring, obstruction, and fistula

A

Crohn’s Disease - IBD

195
Q

Usual onset age 15-35 yrs {about ¼ of pts. need surgery}

A

Crohn’s Disease - IBD

196
Q

Sulfasalazine – Mesalamine (Asacol)
Supplemental folate {B9} of 800-1000 µg/day is recommended

Cyclosporine and Cholestyramine (binds bile) – fat soluble vit. and folate supps. needed

A

Treatment/Mgmt of Crohn’s Disease

197
Q

Inflammation in the colonic mucosa w/sores - Usually in COLON but may be in terminal ileum

A

Ulcerative Colitis (UC)

198
Q

Taking 20 grams of psyllium (Plantago ovata) seeds together w/ Mesalamine for 12 months may improve the maintaining of remission in ulcerative colitis

A

Management of Ulcerative Colitis (UC)

199
Q

During Remission → no specific diet, avoid diarrhea/discomfort foods, and sm. frequent meals

A

Ulcerative Colitis MNT

200
Q

During acute exacerbations → may have 20 + stools per day w/mucous, blood (iron loss), pus and loss of PRO, iron, water , electrolytes, and trace minerals stool

A

Ulcerative Colitis MNT

201
Q

During acute exacerbations

TPN or elemental TF may↓ symptoms but generally not found to induce remission – no TPN!

A

Ulcerative Colitis MNT

202
Q

To cure UC- a colectomy (surgical removal of colon) followed by an ileostomy (sm. intestine is brought to surface of abdomen to form a stoma) and often creation of an ileoanal reservoir so waste can again be excreted via anus

A

Ulcerative Colitis MNT

Medical Nutritional Therapy (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions