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Nutrition
Exam 3
29
Other
Graduate
09/03/2012

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Term
what is DM?
Definition
group of chronic diseases when the body does not produce or respond to insulin thus affecting carbohydrate, protein and fat metabolism
Term
name 6 possible sx of type 1 DM at dx
Definition
lean
polydipsia
polyuria
hyperglycemia
electrolyte disturbances
ketoacidosis
Term
what are 4 other causes of glucose intolerance
Definition
-other dz/steroid use (CF, pancreatitis/CA)
-malnutrition
-impaired glucose intolerance
-gestation DM
Term
what is a normal fasting plasma glucose? what is the criteria for DM dx?
Definition
-<115 mg/dL
->126 mg/dL
Term
what are 2 other tests that can be used to dx DM besides fasting plasma glucose?
Definition
-plasma glucose >200 mg/dL with sx
-oral glucose tolerance test
Term
What are 5 organ systems affected by DM?
Definition
vascular
renal
GI
retinopathy
CVD
Term
what are hgb A1C goals?
Definition
Goal of A1c for non diabetic is 4-6
Goal for diabetic is <7
With A1c is 6, your avg blood sugar is about 126
Fore every 27-28 increase in the glucose level causes A1c to go up a percent
Term
in CHO counting, how many grams of CHO=1 CHO choice?
Definition
15 grams
Term
what are 5 strategies for DM type 1 management?
Definition
-consistent intake
-timing of meals (shouldnt vary meal times any more than 30m-1hr in-between days)
-insulin adjustments
-monitor bg levels
multiple injections (4-6/day depending on insulin type)
Term
what are 7 management strategies for type 2 DM?
Definition
-normal BG levels
-normal lipid leves
-weight loss/maintenance
-exercise
-behavior mod
-fat intake
-meds
Term
what are the PRO, fat, CHO, and fiber recommendations for DM pt
Definition
-pRO 0.8 g/kg/day
-FAT: sf <30% of total cals, increase MUFA
-CHO: complex, less simple
-Fiber: 35 g/day
Term
what is the somogyi effect? dawn phenomenon?
Definition
-when you have a reactive hyperglycemia from a drop in blood sugar and then trying to compensate too fast
-type 2 DM: high blood sugars in AM
Term
whipple's triad?
Definition
low plasma glucose level and have sx and then sx resolve with administration of CHO
Term
which part of the intestines is the work horse of the GI tract?
Definition
small intestine
Term
what is the primary purpose of the large intestine?
Definition
absorb water
Term
where does dietary fiber do all its work?
Definition
large intestine
Term
what causes stomatitis?
Definition
chemotherapy and B deficiencies
Term
glossitis, what causes it?
Definition
b vitamin deficiencies
Term
what is the tx for chronic esophagitis?
Definition
same as for GERD
Term
what is celiac dz
Definition
Permanent intestinal intolerance to dietary wheat gluten & related proteins
that produces mucosal lesions in genetically susceptible individuals
Term
celiac sx? dx?
Definition
Symptoms
Diarrhea (Bulky, loose & watery)
Weight Loss (failure to thrive)
Abdominal swelling & bloating w/ excess gas and abdominal pain
Diagnosed with antibody detection and intestinal biopsy
Term
tx for celiac? supplements?
Definition
Gluten free diet
Eliminates foods containing wheat, barley, rye, and oats
Supplementation
Calcium
Zinc
VitaminD
Magnesium
?Vitamin B 12
Term
what is short bowel syndrome? sx? nutritional management?
Definition
jejunal + ileal length of 100-200 cm
-fat malabsorption, diarrhea
-TPN, 3 adaptive stages, dietary strategies
Term
how do you treat diverticulosis? -itis?
Definition
-high fiber (20-35 g /day), increased H20 intake
-clear liquids, low residue, surg
Term
hepatitis patients should get more of what and less of what?
Definition
-pro and CHO
-fat
Term
3 things to do dietary wise for hepatic steatosis
Definition
-weight loss
-avoid alcohol
-mediterranean diet
Term
what the biggest thing to increase in cirrhosis pts?
Definition
protein
Term
what is the protein requirements for pt with hepatic encephalopathy? what is lactulose?
Definition
-start low and increase to what they need
-pts with high ammonia levels are given thie by mouth (or down feeidng tube) makes them malabsorb and gives them diarrhea to lower their ammonia levels when they are extremely encephalopathic
Term
how are pts with acute pancreatitis fed?
Definition
enterally- feeding tube into ligament of trietiz (transpyloric)
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