W9 CF, COPD, Depression, Kidneys Flashcards
CF: What is it?
Cystic fibrosis (CF) is a systemic disease of the exocrine glands characterized by a progressive obstructive lung disease (bronchiectasis), exocrine pancreatic insufficiency, and gastrointestinal secretory defects. The sweat glands, vas deferens, and other organs are also affected to varying degrees.
Key take-aways:
CF is also the most common cause of pancreatic insufficiency in children. Because normal absorption and digestion of nutrients, especially fat, are altered by pancreatic insufficiency, failure to thrive, malnutrition, diabetes, and growth problems are common clinical features in the absence of treatment. Altered fatty acid metabolism produces excess arachidonic acid and leads to inflammatory complications in multiple systems. The median age of survival is approximately 39 years.
Nutritional considerations:
Patients with CF are susceptible to weight loss for several reasons, including ongoing steatorrhea and azotorrhea (despite enzyme therapy); a 10-30% increase in elevated resting energy expenditure (REE), particularly during pulmonary exacerbations
Treatment goals for cystic fibrosis include:
a. Pancreatic enzyme replacement
b. Increased energy, protein, and fat intakes
c. Sodium restriction
d. A & B
Answer: D - Treatment goals for cystic fibrosis include pancreatic enzyme replacement and increased intakes of energy, protein, and fat. Cystic fibrosis is a wasting disease characterized by increased need for all nutrients, including sodium, which is lost through excessive sweating. Because the pancreatic duct may be blocked by mucous, supplementation with pancreatic enzymes is usually part of treatment.
True/False: Those with CF should have a higher energy intake…
With proper nutrition therapy, including an energy intake of 110-200% of the requirements for a general healthy population, patients with CF may have better pulmonary function and survival
True/False:
Biochemical evidence of deficiency of both the essential omega-6 fatty acid linoleic acid and docosahexanoic acid, a derivative of the essential omega-3 fatty acid alpha-linolenic acid, is common in patients with CF
True!
The following vitamin deficiencies are common in those with CF:
A. Vitamin C & A
B. Vitamin D & K
C. B Vitamins
D. Those with CF are not at risk for vitamin deficiencies
B. Vitamin D and K
These should potentially be supplemented in those with CF
Provision of a diet high in \_\_\_\_\_\_\_\_\_\_ helps with weight maintenance and prevention of deficiency symptoms A. EFA's B. carbohydrates C. protein D. none of the above
A. Essential Fatty Acids
COPD: Metabolism of carbohydrates produces the most carbon dioxide for the amount of oxygen used; metabolism of fat produces the least.
For some people with COPD, eating a diet with fewer carbohydrates and more fat helps them breathe easier.
People with COPD take steroids. Long-term use of steroids may increase your need for calcium. True/False: it is recommended that those with COPD consider a calcium supplement?
True!
Breathing requires more energy for people with chronic obstructive pulmonary disease (COPD). The muscles used in breathing might require \_\_\_\_ times more calories than those of a person without COPD. A. 2 times B. 5 times C. 10 times D. 15 times
C. 10 times
Those with COPD should stay hydrated - why?
Helps keep mucus thin
Fish oil supplements for treating depression are most effective with a composition of \_\_\_\_\_ % EPA and \_\_\_\_\_% DHA. A. 70/30 B. 60/40 C. 40/60 D. 50/50
B. 60/40
Kraus pg 857
True/False: B Vitamins and Magnesium deficiencies have been linked to depression
True
_____ serum zinc levels predispose people to treatment resistance in depression.
A. High
B. Low
B. Low
Zinc reduces depressive symptoms by: decreases dopamine reuptake, increasing the conversion of T4 to T3 and the promotion of excitatory neurotransmitter function
