Nutritional Disorders & Allergies

Question 1

brush border enzyme that hydrolyzes disaccharide lactose into glucose and galactose

Answer 1

lactase

Question 2

what occurs d/t a lactase deficiency?

Answer 2

undigested lactose moves into intestines, changing fluid osmosis and leads to excess gas

Question 3

a patient presents with abdominal cramps, bloated feeling, flatulence, and osmotic diarrhea. Dx?

Answer 3

lactase deficiency

Question 4

what are 2 diagnostics for lactase deficiency?

Answer 4

lactose-free diet x 2 weeks
hydrogen breath test

Question 5

what is a positive hydrogen breath test?

Answer 5

> 20 within 90 mins

Question 6

what is the management for lactase deficiency? (4)

Answer 6

stay below symptom threshold
have diary with lactase
lactase enzyme replacement
ensure adequate calcium

Question 7

a patient presents with bloating, upset stomach, and diarrhea after eating pasta. Dx? Tx?

Answer 7

gluten intolerance

stay below symptom threshold or avoid gluten

Question 8

what immunoglobulin is responsible for nut allergies?

Answer 8

IgE

Question 9

isolated to a single organ system, most commonly the skin

Answer 9

allergic reaction

Question 10

involves at least 2 organ systems

Answer 10

anaphylaxis

Question 11

what is the acute management for nut allergies if symptoms involve the respiratory system?

Answer 11

IM epinephrine

Question 12

what are 3 other treatments for nut allergy, besides epi?

Answer 12

diphenhydramine (H1)
methylprednisolone
famotidine (H2)

Question 13

caused by rapid initiation of refeeding after a period of undernutrition

Answer 13

refeeding syndrome

Question 14

what is considered prolonged fasting?

Answer 14

> 5 days

Question 15

what 4 conditions can contribute to refeeding syndrome?

Answer 15

IBD
celiac
cancer
recent surgery

Question 16

what is the dysfunction in refeeding syndrome due to?

Answer 16

hypophosphatemia

Question 17

why is phosphate important?

Answer 17

all cellular activities require phosphate to create ATP

Question 18

what should be checked before refeeding? (2)

Answer 18

electrolytes
trace mineral levels

Question 19

what should be administered to prevent refeeding syndrome? (3)

Answer 19

thiamine
vitamin B
daily multivitamin

Question 20

what is the management to prevent refeeding syndrome?

Answer 20

start feeding slowly at 10 calories/kg/day x 4-7 days
rehydrate + correct electrolytes/trace minerals x 2 weeks