Answer:
Type 2 diabetes mellitus, coronary artery disease, hypertension, deep venous thrombosis, pulmonary embolus, lymphedema thrombophlebitis, weight-bearing osteoarthritis (involving the hip, knees, ankles, and feet), low back syndrome, herniated disk, lower extremity edema, gallbladder disease, gastroesophageal reflux disease (GERD), asthma, sleep apnea, pseudotumor cerebri, cirrhosis, varicosities, intertriginous dermatitis, breast cancer, uterine cancer, prostrate cancer, and Pickwickian [...]
Archive for the 'Nutrition (Gastroenterology)' Category
Question: What comorbid diseases are directly attributable to obesity?
Wednesday, February 27th, 2008Posted in Nutrition (Gastroenterology) | No Comments »
Question: Which vitamin deficiencies might develop in a patient maintained on long-term TPN (> 6 mo) containing only Na+, K+, Cl-, HCO3-, glucose, and amino acids?
Wednesday, February 27th, 2008Answer:
This TPN solution clearly is lacking in vitamins and trace minerals. In a matter of weeks, the patient would be expected to develop deficiencies in magnesium, zinc, essential fatty acids, and water-soluble vitamins (with the exception of B12). Over several months, vitamin K and copper deficiencies would develop. Over a period of years, deficiencies in [...]
Posted in Nutrition (Gastroenterology) | No Comments »
Question: What are the most common complications of TPN?
Wednesday, February 27th, 2008Answer:
The most common complications are related to catheter placement and management. Examples include infections, thrombosis, nonthrombotic occlusion, and other mechanical complications during line placement. Catheter-related complications can be minimized by maintaining strict and reproducible technique as well as meticulous line care.
Reference: Rustgi AK (ed): The Requisites in Gastroenterology: Vol 1: Esophagus and Stomach. St. Louis, [...]
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Question: After avoiding dairy products, the patient’s symptoms have disappeared. Does this confirm the diagnosis of lactose deficiency?
Wednesday, February 27th, 2008Answer:
No. The diagnosis cannot be made simply by advising the patient to avoid dairy products for 2 weeks to determine if the altered bowel habits revert to normal because many patients who respond to these manipulations are actually not lactase deficient. The diagnostic test to be used is the lactose hydrogen breath test.
Reference: Sleisenger MH, [...]
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Question: What is the most common disorder of carbohydrate digestion in humans?
Friday, February 15th, 2008Answer:
Lactase deficiency. Lactase-deficient adults retain 10-30% of intestinal lactose activity and develop symptoms (diarrhea, bloating, and gas) only when they ingest sufficient lactose. Symptoms result from the colonic bacteria metabolizing lactose to methane, CO2, and short-chain fatty acid.
Reference: Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th ed. Philadelphia, W.B. Saunders, 2003.
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Question: With what is severe folate deficiency most often associated?
Friday, February 15th, 2008Answer:
Severe folate deficiency occurs most often in association with chronic alcoholism, celiac sprue, tropical sprue, and blind loop syndrome. Minor deficiencies can be found in Crohn’s disease and following partial gastrectomy. Since folate absorption is largely completed in the upper small intestine, malabsorption is worse in disorders that affect the upper gut. However, any intestinal [...]
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Question: What are the six common vitamins and trace minerals and the clinical manifestations of their respective deficiency states?
Friday, February 15th, 2008Answer:
Thiamine: beriberi, muscle weakness, tachycardia, heart failure
Niacin: pellagra, glossitis
Vitamin A: xerophthalmia, hyperkeratosis of skin
Vitamin E: cerebellar ataxia, areflexia
Zinc: hypogeusia, acrodermatitis
Chromium: glucose intolerance
Reference: Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th ed. Philadelphia, W.B. Saunders, 2003
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