test

label the terms

lable the trems

Oropharyngeal dysphagia

Difficulty initiating swallowing; caused by neurological or structural issues (e.g., brainstem tumors, Parkinson’s, stroke).

Esophageal dysphagia

 Sensation of food getting stuck; caused by obstructions or motility disorders (e.g., tumors, reflux, spasms).

Describe dietary influences on GERD

Avoid high-fat meals (↓ LES pressure), Avoid spearmint/peppermint (↓ LES pressure) , Avoid caffeine and alcohol (↑ acid secretion), Eat small, frequent meals, Avoid lying down within 2 hours after meals, Avoid spicy/acidic foods when inflammation is present

 Describe dietary strategies to relieve constipation and diarrhea.-

C-Increase insoluble fiber (adds bulk to stool) ,Ensure adequate hydration ,Encourage physical activity

D-Use soluble fiber (forms gel, slows digestion), Consider BRAT diet (bananas, rice, applesauce, toast), Maintain fluid and electrolyte intake

Describe how FODMAPs are thought to promote IBS symptom

FODMAPs are poorly absorbed carbohydrates in the small intestine,They draw water into the intestine. In the colon, they are fermented by bacteria, producing gas,This causes distension, leading to pain and bloating,FODMAPs do not cause IBS but can exacerbate symptoms

 Describe potential health effects of low diversity in gut microbiota

Linked to: Obesity, Inflammatory bowel disease (IBD),Possibly: Type 2 diabetes, Alzheimer’s, Parkinson’s. Low diversity may lead to:Increased energy extraction/storage,Dysbiosis (microbial imbalance),

Differentiate between probiotics and prebiotics and their dietary sources

Probiotics:,Live microorganisms that support gut health,Sources: Yogurt, kefir, kimchi, sauerkraut -Prebiotic,Non-digestible fibers that feed probiotics,Sources: Fruits, vegetables, nuts, seeds, whole grains

 Identify dietary sources of gluten

Sources of gluten:Wheat,Rye,Barley,Contaminated oats

Common foods: bread, bran flakes, fried foods with breading, dinner rolls, some dressings and processed snacks

Define hepatitis and cirrhosis

Hepatitis: Inflammation of the liver, often caused by viral infections. Cirrhosis: Scarring of liver tissue, usually from chronic hepatitis or alcohol use, leading to impaired liver function

Describe basic MNT for liver disease

Energy: 35 kcal/kg, Protein: 1.2–1.6 g/kg (restriction not typically recommended for encephalopathy) , Sodium restriction (e.g., 2,000 mg/day) if ascites present, Small, frequent meals  ,Oral nutrition supplements may help due to low appetite

Write a PES statement for a mini case study-

Example (Mandy – Celiac Disease):

 PES Statement:- Gluten-induced gastrointestinal inflammation related to ongoing gluten intake (e.g., bran flakes, breaded foods, dinner rolls) as evidenced by a diagnosis of celiac disease and symptoms of diarrhea and abdominal pain.

 Define isocaloric balance, negative caloric balance, and positive caloric balance-Isocaloric balance:

 Calories consumed = calories expended → weight maintenance.,Negative caloric balance: Calories consumed < calories expended → weight loss.,Positive caloric balance: Calories consumed > calories expended → weight gain.

Describe potential dietary behaviors that may result from adverse childhood events

Hoarding food, binge eating, or compulsive overeating,High-fat, sugar, and/or salt diets,Reliance on convenience foods,Eating disorders or food addiction,Short-term food decisions over long-term planning,Lack of planning and budgeting around food

 Differentiate between a weight-centric and a weight-inclusive approach to healthcare.-   

Weight-centric: Focuses on weight loss as the primary health outcome.
Weight-inclusive: Focuses on overall health and well-being, regardless of weight; avoids shame, stigma, and blame.

 Define hypertrophy and hyperplasia of adipocytes-

Hypertrophy: Increase in size of fat cells (common in all obesity). Hyperplasia: Increase in number of fat cells (only in some types of obesity).

 Describe the effect of pro-inflammatory cytokines derived from adipose tissue-

Adipocytes secrete IL-6, TNF → cause low-grade chronic inflammation

It can affect blood pressure, blood clotting, and overall metabolic function.

Describe the effects of leptin and ghrelin on appetite/satiety and energy expenditure-

• Leptin (from fat cells):↑ Energy expenditure,↑ Satiety,↓ Food intake
  
  

• Ghrelin (from stomach):↑ Appetite,Promotes energy storage,↓ Energy expenditure

 List the health consequences of weight cycling-

Physical/psychological effects: Body hatred, Lowered self-esteem, Disordered eating/eating disorders, Decreased HDL, Frequent regain of lost weight

List the 3 components for successful obesity management

t-Diet Exercise  and ,Behavior modification

 Identify an appropriate amount of weekly weight loss

-Up to 2 pounds per week Or about 3–5% total body weight (produces health benefits)

 Describe differences between low fat and low carb diets in achieving and maintaining weight

loss (short term and long term)-

-Short term (6 months): Low-carb diets result in more weight loss. Long term (12 months): No significant difference—success depends more on calorie restriction than macronutrient ratio.

Identify whether Roux-En-Y Gastric Bypass, Laparascopic Gastric Banding, and Sleeve

Gastrectomies induce weight loss through restriction, malabsorption, or both-1 Roux-En-Y Gastric Bypass (RYGB):

Restriction + Malabsorption,Laparoscopic Adjustable Gastric Banding (LAGB): Restriction only,Sleeve Gastrectomy (LSG): Restriction only

 Describe factors that affect amount of food eaten

-Distractions (e.g., TV = ↑ calorie intake) Portion size,Palatabilit,Eating with others and Availability of food

 Describe potential consequences of dieting failures

95% regain lost weight, Development of eating disorders, Lower self-esteem, Psychological distress and , Physical health changes (e.g., decreased HDL)

 Describe potential benefits and disadvantages of using intuitive eating/HAES approach-

Benefits:Improved relationship with food,Prevents weight cycling,Promotes body acceptance,Improves health behaviors without focus on weight-Disadvantages:-May not result in weight loss (if that’s a goal)-Can be misunderstood or misapplied without proper guidance

 Describe which pancreatic cells produce glucagon and which produce insulin

Glucagon: Produced by alpha (α) cells of the Islets of Langerhans in the pancreas.Insulin: Produced by beta (β) cells of the Islets of Langerhans

 Describe how insulin resistance contributes to hyperglycemia

In insulin resistance, body cells (especially muscle, fat, and liver) don’t respond properly to insulin. Glucose can’t enter the cells efficiently, so it builds up in the bloodstream → hyperglycemia. The pancreas may produce more insulin to compensate, but over time this can lead to β-cell exhaustion.

 Differentiate between pathophysiology of Type 1 vs. Type 2 DM

Feature	Type 1 DM	Type 2 DM
Cause	Autoimmune β-cell destruction	Insulin resistance ± insulin deficiency
Insulin Production	Little to none	Varies (often high at first)
Onset	Often childhood/adolescence	Often adulthood (but rising in youth)
Body Type	Usually lean	Often overweight or obese
Ketoacidosis Risk	High	Rare

 List an autoimmune marker used in the diagnosis of Type 1 DM

• GADA (Glutamic Acid Decarboxylase Autoantibodies)

 Utilize carbohydrate counting to assess the adequacy of carbohydrate intake

1 carbohydrate exchange = ~15g carbs
Meals: typically aim for 3–4 exchanges (45–60g)
Snacks: 1 exchange (15g)
Adjust based on:Individual needs,Medications and Blood sugar response

 List long-term complications of poor glycemic control

-Macrovascular: Coronary artery disease, stroke, peripheral artery disease. Microvascular: Retinopathy, nephropathy, Neuropathy: Peripheral neuropathy, autonomic neuropathy (e.g., gastroparesis)

 Identify the biochemical indicator used to assess long-term glycemic control

-Hemoglobin A1c (HgbA1c) Reflects average blood glucose over ~3 months Goal: <7%

 Calculate the number of carb exchanges when presented with a Nutrition Facts label

Total Carbohydrates: 30g Dietary Fiber: 6g
Subtract half of fiber (>5g): 30g – 3g = 27g net carbs
27 ÷ 15 = 1.8 exchanges ≈ 2 exchanges

 List dietary protective factors and promoters of cancer

Protective:Fruits, Non-starchy vegetables,Whole grain.s Promoters: High fat,High calories,Red meat, Processed meat ,Alcohol

Nausea/Vomiting/Anorexia

• Cold foods → less odor
  
  

• Use microwave → less odor
  
  

• Drink through straw
  
  

• Small meals
  
  

• Avoid greasy, fried, spicy food
  
  

• Ginger
  
  

• ONS may be appropriate
  
  

Dysphagia

Altered consistency diets

• Thickened liquids
  
  

Enteral nutrition if unsafe for PO intake

Thrush

• Cold foods
  
  

• Avoid acidic, spicy, crunchy foods

Mucositis

Ice cold foods, ice pops

• Avoid spicy, crunchy, or acidic foods
  
  

• Protein
  
  

ONS

Malabsorption

• Elemental enteral nutrition
  
  

• TPN
  
  

• Nutrient supplements as needed
  
  

• May need ↑ fluid