MNT part 2 & Dialysis

Question 1

Thyroid disease

1. Hyperthyroidism
2. Hypothyroidism

Answer 1

1. Increase BMR

2. Decrease in BMR: weight gain

Question 2

Why diet for arthritis?

Answer 2

anti-inflammatory

*omega 3

Question 3

5 high phosphorus foods

Answer 3

Dairy, cheese, yogurt, soda, processed meats

* high phos pulls out calcium from bones

Question 4

Ketogenic diet

Answer 4

• designed for kids w/ epilepsy
• 90% fat
• Mcts (rapid metabolism)
• 4g Fat to 1g of non-fat

Question 5

6 high potassium foods

Answer 5

Banana, tomato, avocado, potato, spinach, oranges

Question 6

what does each lead to:

1. neuropathy
2. retinopathy
3. Nephropathy

Answer 6

1. neuropathy: peripheral and autonomic; gastroparesis
2. retinopathy: leads to blindness
3. Nephropathy: decreased kidney function

Question 7

Prader-willi syndrome

Answer 7

High Ghrelin levels (hunger!)

Question 8

Obesity BMI

1. Class 1:
2. Class 2:
3. Class 3:

Answer 8

1. Class 1: 30 - 34.9
2. Class 2: 35 - 39.9
3. Class 3: >40
   * 3500 = 1lb

Question 9

Gastric bypass requirement

Answer 9

• needs to try to lose weight w/ diet
  1. BMI of 40 or greater
  2. BMI of 35 w/ co-morbidities
• multi vitamins are needed after surgery

Question 10

ADHD (diet)

Answer 10

B/c meds will cause to lose weight

* needs to understand ^ to provide adequate kcals

Question 11

Goiter (diet)

Answer 11

Enlargement of thyroid

1. needs iodine (fish)
2. Free of goitrogens

Question 12

Burns/Trauma

Answer 12

*low albumin, C-RP and high inflammation
so
- increase vita C, Zinc
- adequate kcal & protein

Question 13

CKD stage 3 pro and level

Answer 13

GFR: 30-59
pro: .6-.8g/kg

Question 14

CKD stage 4 pro and level

Answer 14

GFR: 15-29
pro: .6-.8g/kg

Question 15

Consequences of high potassium

Answer 15

Cardiac complications

Question 16

Cerebral palsy diet

1. spastic
2. non-spastic

Answer 16

1. Difficult to move
   - low kcal, high fluid, high fiber
2. Can move better
   - more kcal, more protein, finger foods

Question 17

Alzheimers disease

Answer 17

• make sure they can chew and swallow
• make sure they are hydrated
• not distracted
• same meal times

Question 18

EBB and flow response

Answer 18

Catabolic response following trauma

Question 19

Latrogenic malnutrition

Answer 19

Caused by the hospital (treatment and meds)

Question 20

Autism spectrum disorders

Answer 20

Very pricey eaters!

- communicate to keep offering foods

Question 21

AIDS pt diet

Answer 21

“the least amount of food disease exposure possible”

• fruits w/ thick peels
• cook all foods throughly

Question 22

Anorexia Nervosa

Answer 22

*distorted body image
“nervosa” is because it is mental-like
Anorexia is starving

Question 23

Bulimia

Answer 23

*damage to teeth and throat (this is the focus as an RD)

Question 24

Where does vita D get activated and what is it called

Answer 24

1. Kidney

2. Calcitriol

Question 25

Maple syrup urine disease

Answer 25

Inborn error metabolism (infant) - restrict BCAA - Provide adequate energy from CHO & Fat - small feedings

Question 26

Stage 1 CKD protein and level

Answer 26

GFR >90 | Pro: .8-1.4g/kg

Question 27

CKD Stage 2 protein and level

Answer 27

GFR 60-89 | Protein: .8-1.4g/kg

Question 28

Marasmus

Answer 28

Protein and kcal starvation (causes muscle wasting)

Question 29

Paralysis (diet)

Answer 29

* could be from stroke | Highly likely to get pressure ulcers

Question 30

Pressure ulcers needs (3)

Answer 30

Zinc, VIta C and Protein

Question 31

Consequences for high phosphorus

Answer 31

- bone fractures - Darkening of skin - Itching

Question 32

Who is more likely for osteoporotic fracture

Answer 32

White women and asian women

Question 33

NND (meanning)

Answer 33

National dysphagia diet

Question 34

NND1

Answer 34

Pureed, pudding like (ice cream)

Question 35

Chemotherapy (treatment)

Answer 35

Radiation can cause loss of B2 vitamin, will cause mouth "injuries." (like dry mouth)

Question 36

Healthy Kidneys will (6)

Answer 36

- Remove waste products - remove excess fluid (urine) - Control BP - Regulate K/Na - Make RBC - Activate Vita D

Question 37

Acute Hypoglucose 1. what to do (3) 2. Treatment (2)

Answer 37

1. What to do: - If <70mg/dL, begin w/ 15g CHO - Wait 15min, is still under 70mg/dL give another 15g CHO - Repeat until normal 2. Treatment - Insulin - Rehydration

Question 38

Homocystinurias | *what is needed

Answer 38

* excessive excretion of homocystine in urine | - Need supplement of Folate and B12

Question 39

Galactosemia

Answer 39

* Don't breastfeed inf if they have this This is the only disease that diet is the cure and stay away from galactose and lactose * Soy is good

Question 40

NDD3

Answer 40

Transition to regular foods (avoid crunchy and hard foods)

Question 41

Renal diet (5)

Answer 41

1. low phosphorus 2. Low potassium 3. Low Na 4. Adequate protein 5. 48oz fluid/day

Question 42

NND2

Answer 42

Moist, soft-texture foods, (soft pancakes)

Question 43

COPD pt diet

Answer 43

High frequent meals w/ high fats

Question 44

ESRD: HD level and Pro

Answer 44

GFR <15 | Pro: 1.2g/kg

Question 45

Peritoneal (4)

Answer 45

- Everyday - More protein and K allowed - Catheter is implanted - done at home

Question 46

Function of Dialysis

Answer 46

- Remove unwanted toxins/waste - Remove excess fluid - Prevent salts and electrolytes from accumulating

Question 47

Hemodialysis(4)

Answer 47

- 3-4 times week - Less protein and potassium - Use of demodialyzer - Done at dialysis center

Question 48

National Cholesterol Education program (5 things to do)

Answer 48

- up to 35% cals from fat - 25-30g Fiber - Stanols and sterols inhibit cholesterol - Maintain DBW - Increase PA to 30 mins most days

Question 49

Diet for Addison's disease

Answer 49

Adrenal cortex insufficiency | - high protein, frequeng feedings and high salt

Question 50

ESRD: PD GFT and Pro

Answer 50

GFR <15 | Pro: 1.2-1.3g/kg

Question 51

Phosphorous binding meds

Answer 51

"binds" phos out of the stomach bisphosphonate (can cause fractures)

Question 52

Heart Failure (diet 3)

Answer 52

``` * heart not able to pump Treatment - meds - dash diet (low Na) - high protein! 1.1-1.4g/kg -B12 and multivitamin ```

Question 53

W/ Fever and Infection

Answer 53

BMR will increase 7% w/ each degree after 98.6F

Question 54

Hemodialysis Side Effects

Answer 54

- High K levels - low BP - Anemia

Question 55

Peritoneal side effects

Answer 55

- High blood - Weight gain - Fever and abdominal pain

Question 56

Glycogen storage disease (and diet)

Answer 56

Liver can't covert glycogen to glucose | * so need high carb, low fat diet

Question 57

Urea cycle defects (diet)

Answer 57

* ammonia accumlates in teh body | - low protein needed

Question 58

Gout (diet)

Answer 58

1. low purines (no fish) 2. No alcohol 3. Moderate protein

Question 59

Metabolic syndrome 5 categories

Answer 59

1. Elevate blood pressure 2. Elevate TG 3. Fasting Serum Glucose >100 mg 4. Waist measurement 5. Low HDL * 3 or more is metabolic syndrome

Question 60

PKU (diet)

Answer 60

- low carb diet (b/c high carb can cause cavities) | - Low protein

Question 61

Neoplastic disease (avoid?)

Answer 61

1. Protein kcal malnutrition 2. Fluid and electrolytes imbalances * avoid red meat