Midterm II Labs and Medications

Question 1

HMG-CoA reductors?

Answer 1

-STATIN

Question 2

Diet with-STATIN?

Answer 2

-Low fat, low chol, avoid grapefruit relate citrus , take 6h before fibre

Question 3

Blood serum with STATIN?

Answer 3

-Decrease chol, TGs, LDL, VLDL, increase ALT, AST an ALP Phos

Question 4

Loop diuretics?

Answer 4

• IDE

- K+ depleting

Question 5

Diet with -IDE?

Answer 5

-Increase K+, Mg, decrease Na, avoid natural liquorice

Question 6

Side effects with -IDE?

Answer 6

• Anorexia, increased thirst

- Cramps, N/V

Question 7

Blood serum w/ -IDE?

Answer 7

-Decrease K, Mg, Na, Cl, Ca, increase glucose, BUN

Question 8

(T/F) Cilastatin is a antibiotic

Answer 8

-T

Question 9

Imipenem, Cilastatin, Primaxin?

Answer 9

-Antibiotics

Question 10

Imipenem GI SE?

Answer 10

-N/V, cramps, colitis

Question 11

Imipenem Blood serum?

Answer 11

Increased alk-phos, AST, ALT,BUN, Creat, K, Cl, decrease NA

Question 12

Demerol?

Answer 12

-Analgesic

Question 13

Demerol Nutr?

Answer 13

Anorexia

-Avoid alcohol

Question 14

Demerol Oral/GI?

Answer 14

-Dry mouth, N/V, GI pin, constipation

Question 15

Demerol blood serum?

Answer 15

-Increase amylase and lipase

Question 16

Methotrexate or -RINE? **

Answer 16

• Immunosuppression
• Folic acid antagonist
• Heptoxicity

Question 17

Prednisone? **

Answer 17

-Corticosteroids
-Increase glucose, weight gan, increase appetite, may mask infections
-BMD, impair calcium and vitamin D
-Increase Ca, PROTEIN, Vit D, and decrease Na
DO NOT IMPACT FOLATE

Question 18

Sulfasalazine? **

Answer 18

• Competes with intestinal folate absorption

- Other aminosalicylate do not

Question 19

Furosimides? **

Answer 19

• K+ losing
• increase K, Ca, Mg in diet
• Avoid grapefruit

Question 20

Spironolactone?

Answer 20

• K+ sparing diuretic

- Avoid salt subs, potassium chloride, potassium phosphate

Question 21

CyclospoRINE? **

Answer 21

• Immunosuppressant common to IBD
• Avoid K/Salt subs, avoid grapefruit
• Vit E increases absorption
• Increase Bun, Creatinine , LFTS

Question 22

-AZIDE,-AMINE, -AZINE **

Answer 22

• Aminosalicylate used in IBD
• Anti-inflammatory
• Anorexia, decrease weigh
• Increase LFTS, Bun and Creatinine

Question 23

-SONIDE, -SOLONE? **

Answer 23

• Glucorticoids

- See prednisone

Question 24

Infliximab? **

Answer 24

• Indicated in IBD
• PN only
• TNF-alpha inhibitor
• Mouth ulcer, dyspepsia, vomiting, abdo pain

Question 25

Metronidazole **?

Answer 25

Nitroimidazole antibiotic in IBD - Take with meals to decrease GI stress, drug decrease availability - Consider decrease Na in diet - Metallic taste, N/V, epigastric distress, diarrhea - Decrease AST/ALT, increased LDH and TG

Question 26

Ciprofloxacin? *

Answer 26

- Fluoroquinolone antibiotic - Avoid taking with Ca or dairy products - Bad taste, N/V - Increase LFTs, BUN Creat, Increase bilirubin, chol, TG

Question 27

-PRINE PURINE?

Answer 27

-Immunosuppressive

Question 28

Albumin?

Answer 28

35-52 g/L

Question 29

Pre-albumin?

Answer 29

0.2-0.4 g/L

Question 30

Sodium?

Answer 30

136-147 mmol/L

Question 31

Potassium?

Answer 31

3.5-5.2 mmol/L

Question 32

HgB?

Answer 32

Males: 140-180 g/L Females: 120-160 g/L

Question 33

Hct?

Answer 33

Males: 0.42-0.52 Females: 0.37-0.47

Question 34

Glucose?

Answer 34

3.3-6.4 mmol/L

Question 35

T-Chol?

Answer 35

<5.2 mmol/L

Question 36

TG?

Answer 36

0.4-2.29 mmol/L

Question 37

LDL?

Answer 37

<2.59 mmol/L

Question 38

HDL?

Answer 38

>1.55 mmol/L

Question 39

T. Protein?

Answer 39

60-79 g/L

Question 40

BP?

Answer 40

120/80

Question 41

Heart rate?

Answer 41

60-100 BPM

Question 42

Resp rate?

Answer 42

12-20/minute

Question 43

Temp?

Answer 43

Greater than 37.5 C considered fever

Question 44

Thiamin IV replenishment?

Answer 44

- 50-220 mg oral | - 100-300 mg IV x 7 days

Question 45

Phosphate replenishment?

Answer 45

-Potassium phosphate unless K+ >/= 4mmol/L

Question 46

Folate replenishment?

Answer 46

-5 mg/day if deficiency

Question 47

Magnesium replenishment?

Answer 47

- Max infusion rate of 8mmol/hr and up to 100 mmol/hr over 12 hours if asymptomatic - Up to 32 mmol/L over 4-5 mins for severe, symptomatic hypomg.

Question 48

Motilin?

Answer 48

Motilin participates in controlling the pattern of smooth muscle contractions in the upper gastrointestinal tract, NOT gastric motility.

Question 49

What is secretory diarrhea?

Answer 49

Secretory diarrhea occurs when your body secretes electrolytes into your intestine.

Question 50

(T/F) Excessive amount of bile salts in the colon cause osmotic diarrhea

Answer 50

F | Cause watery diarrhea, Bile salts are not osmotic

Question 51

A low oxalate diet is appropriate for which patients?

Answer 51

A patient with short bowel syndrome with persistent fat malabsorption --> Not with steatorrhea

Question 52

What does the ileum control?

Answer 52

-Hormones controlling gastric hypersecretion

Question 53

Key consequences if the ileum is resected?

Answer 53

- Depletion of bile salt pool - Gastric hypersecretion - B12 deficiency - Bacterial overgrowth (loss of ileocecal valve)

Question 54

ERAS is a multimodal pathway based on evidence-based best practices to reduce the surgical stress response that includes

Answer 54

Early ingestion of normal food (within 2-3 days) augmented by the use of oral nutritional supplements and early mobilization

Question 55

If you had a patient with acute pancreatitis that you recommended EN, according to ASPEN when can you use a standard EN product and why?

Answer 55

Standard products may be used in acute pancreatitis if delivered below the LOT and delivered slowly at first with attention to pain and tolerance as the rate is advanced

Question 56

You are consulted on a patient with acute pancreatitis on the 2nd day of hospitalization. The patient is on mechanical ventilation and has evidence of necrosis of the pancreatic gland, about 30% and a small pseudocyst in the tail. What would be your recommendation?

Answer 56

Place a NJ tube and begin feeds slowly advancing to the goal of 48-72 h

Question 57

4 most common micronutrient deficiencies in IBD due to drug-nutrient interactions?

Answer 57

- vit D, calcium - folate - potassium, phosphorus - vit A or C

Question 58

2 vitamins produced endogenously in the colon?

Answer 58

- Vitamin K | - Biotin