Nutrition

Question 1

What are the electrolyte disturbances seen in refeeding syndrome?
What %total calories should be give to avoid this?

Answer 1

In refeeding syndrome, there are low serum levels of phosphate, potassium, and magnesium.

give 75% of total daily caloric needs

Question 2

What are pharmacological options for weight loss?

Answer 2

Phentermine -adrenergic agonist that acts to suppress appetite.

Liraglutide GLP-1 analogue that induces satiety, slows gastric emptying, and enhances pancreatic insulin production.

Bupropion/naltrexone is a combined opioid receptor antagonist and dopamine and noradrenergic reuptake inhibitor that reduces hunger and cravings.

Orlistat is a lipase inhibitor that inhibits fat digestion.- Don’t give in malabsorption disorders such as primary intestinal lymphangiectasia, which

Question 3

metabolic derrangements in hyperemesis

Answer 3

Hypochloremic hypokalemic metabolic alkalosis with paradoxical aciduria

Question 4

What is sucrase-isomaltase (SI) deficiency?

Answer 4

hese dissacharidases are produced in the brush border of the small intestine responsible for the cleaving of disaccharides into monosaccharides to facilitate absorption. The end result is carbohydrate malabsorption and production of increased intestinal gas and flatus, as well as an osmotic effect leading to diarrhea.

Question 5

Crohns disease s/p ileocectomy

Answer 5

linoleic acid - needs to be consumed, cannot be synthesized

Question 6

what types of anemia are associated with loss of proprioception/ vibration with preserved pain, and temperature sensation

Answer 6

vitamin b12- macrocytic anemia
copper deficiency- microcytic anemia often with iron deficiency