Digestion & Metabolism 2: SA Therapeutic Nutrition Flashcards

1
Q

GOAL of dietary therapy? (1 overall, 2 subs)

MORE organ dysfunction = restriction of ____ nutrients

A

= to provide NUTRITIONALLY ADEQUATE DIET that…
1. MAXIMIZES NUTRIENT ABSORPTION
2. REDUCES INFLAMMATION

MORE organ dysfunction = restriction of ESSENTIAL nutrients

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2
Q

how can we feed a diet that is MAXIMALLY ABSORBED?

A

feed a diet that’s HIGHLY DIGESTIBLE!

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3
Q

3 benefits of INCREASING digestibility of diets?

A
  1. CHRONICALLY SICK patients have HIGHER LIKELIHOOD of absorbing ADEQUATE NUTRIENTS/CALORIES
  2. DECREASED chance of OSMOTIC D+ due to SEMI-DIGESTED contents sitting in lumen
  3. DECREASED chance of ANTIGENIC STIMULATION causing DIETARY HYPERSENSITIVITY
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4
Q

5 factors AFFECTING diet digestibility…

hints: SMALLER, PROTEINS, POSITIVE effect on DIGESTIBILITY

A
  1. PATIENT’S GI FUNCTION
  2. MEAL SIZE = SMALLER & FREQUENT IS BETTER
  3. SOURCE and QUALITY of nutrients, especially PROTEINS
  4. FIBER; INSOLUBLE fibers DECREASE DIGESTIBILITY
  5. PROCESSING = can have POSITIVE effects on DIGESTIBILITY
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5
Q

ANIMAL protein has ___ digestibility, while PLANT protein has ____ digestibility

A

VARIABLE, UNIFORM

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6
Q

in a HIGHLY digestible diet, the AMOUNT of FAT is ____-____

A

LOW- MODERATE

why?
–> DIGESTION & ABSORPTION of fat is VERY COMPLEX

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7
Q

if an animal CANNOT absorb fat properly, what 3 things are they missing out on?

A
  1. CALORIES
  2. FAT-SOLUBLE VITAMINS
  3. ESSENTIAL FATTY ACIDS
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8
Q

INSOLUBLE fiber…

main example in PET FOODS?

___-forming

____ GI TRANSIT TIME

has ____ fermentability

A

main example = CELLULOSE

BULK-FORMING

DECREASES GI TRANSIT TIME

has LOW fermentability

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9
Q

SOLUBLE FIBERS…

2 examples?

_____-forming

can ____ GASTRIC EMPTYING

___ fermentability

A

2 examples?
1. GUMS
2. PECTIN

GEL-forming

can SLOW GASTRIC EMPTYING

HIGH FERMENTABILITY

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10
Q

DIETARY HYPERSENSITIVITY….

can be involved in perpetuating WHAT disease?

what can this cause the GUT to become? why?

A

can be involved with IBD

can cause GUT to become INCREASINGLY PERMEABLE in MUCOSA due to INFLAMMATION

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11
Q

if an animal has IDIOPATHIC INFLAMMATORY BOWEL DZ, what 2 kinds of diets can we put them on?

which one tends to be more EFFECTIVE?

how SOON do we tend to see RESOLUTION of clinical signs if caused by DIETARY HYPERSENSITIVITY? (range)

A

2 diets?
1. HYDROLYZED –> MORE EFFECTIVE
2. NOVEL PROTEIN LIMITED-ANTIGEN

how SOON? = within 1-2 WEEKS if dietary hypersensitivity

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12
Q

5 traits in diet for animals with GI DZ?

A
  1. NUTRITIONALLY-BALANCED
  2. PALATABLE
  3. CONVENIENT
  4. HIGHLY DIGESTIBLE
  5. LOW-MODERATE FAT
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13
Q

CANINE PANCREATITIS…

chronicity?

2 clinical signs?

NPO until patient RESOLVES clinical signs?

what diet/when is best?

A

usually ACUTE

2 clinical signs?
1. V+
2. ABDOMINAL PAIN

NOT NECESSARY

should do EARLY ENTERAL NUTRITION

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14
Q

MEDIUM CHAIN TRIGLYCERIDES used mostly in ____ > ____

A

DOGS > CATS

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15
Q

FELINE PANCREATITIS…

present with WHAT 2 clinical signs?

associated with WHAT 2 diseases?

these patients require ____ SUPPORT

A

2 clinical signs?
1. ANOREXIA
2. WEIGHT LOSS

associated with…
1. IBD
2. HEPATIC DZ

these patients require NUTRITIONAL SUPPORT

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16
Q

3 roles of NUTRITION in managing LIVER DZ?

A
  1. MAINTENANCE of NORMAL METABOLISM
  2. avoid TOXIC BY-PRODUCT ACCUMULATION
  3. provides substances that HELP with HEPATOCELLULAR REPAIR & REGENERATION
17
Q

animals with HEPATIC dz often show WHAT clinical sign?

A

NAUSEA/VOMITING

18
Q

HEPATOBILIARY FUNCTIONS related to NUTRITION (5)

A
  1. METABOLISM of CARBS, FAT & PROTEIN
  2. PROTEIN SYNTHESIS
  3. BILE SYNTHESIS & SECRETION (fat assimilation)
  4. STORAGE of ENERGY, VITAMINS & MINERAL
  5. ENDOCRINE FUNCTION
19
Q

3 CLINICAL signs related to NUTRITION & HEPATIC DZ?

& where these signs ORIGINATE from

A
  1. HYPOREXIA (can be from FOOD AVERSION if forced)
  2. ENCEPHALOPATHY (can be from PORTOSYSTEMIC SHUNT)
  3. COAGULOPATHY (clotting factors not made in enough quantity)
20
Q

CBC/chem findings for LIVER DZ… (6)

A
  1. INCREASED PT/PTT
  2. INCREASED BLOOD AMMONIA
  3. INCREASED SERUM BILE ACIDS
  4. DECREASED BUN
  5. HYPOCHOLESTEROLEMIA
  6. HYPOALBUMINEMIA
21
Q

HEPATIC ENCEPHALOPATHY…

associated with either… (two)

what can CAUSE this?

A

associated with either…
1. HEPATIC INSUFFICIENCY (liver NOT synthesizing what it should)
2. PORTOSYSTEMIC SHUNT (substances from GUT that are NORMALLY CLEARED BY LIVER can ENTER SYSTEMIC like AMMONIA)

DIETARY EXCESS OF PROTEIN CAN CAUSE THIS!

22
Q

what should we DO for DIETS if evidence of HEPATIC DZ?

how can we do this in diets? (3)

A

REDUCE DIETARY PROTEIN as much as possible (safely)

in diets…
1. HIGH digestibility even for a SMALL AMOUNT OF PROTEIN
2. PROPER AMINO ACID balance
3. JUST MEETS PROTEIN REQUIREMENTS but NOT GREATLY IN EXCESS

23
Q

we should ONLY restrict protein if we see signs of…

what EXAMPLE of a diet has this?

A

INTOLERANCE

LIVER DIETS are RESTRICTED IN PROTEIN

24
Q

ADEQUATE ___ ___ is ESSENTIAL to provide ___ of ENDOGENOUS tissues

A

CALORIC INTAKE, CATABOLISM

25
Q

3 BENEFITS of INCREASING MEAL FREQUENCY?

A
  1. IMPROVED overall INTAKE (more likely to finish each meal)
  2. IMPROVED DIGESTIBILITY
  3. DECREASED manifestations of HEPATIC ENCEPHALOPATHY because of DECREASED PROTEIN EXPOSURE