NBCD - MNT: Nutritional Anemia, Neurologic disorders, Adverse Reactions to Foods (copy)

Anemia

Anemia

A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.

Nutritional Anemia

anemia caused by dietary deficiency of nutrients that are essential to red blood cell formation

microcytic hypochromic anemia

anemia characterized by small, pale red blood cells that lack adequate hemoglobin to carry oxygen; can be caused by deficiency of iron

megaloblastic anemia

a blood disorder characterized by anemia in which the red blood cells are larger than normal, immature, and nucleated caused by folate deficiency

Pernicious anemia

lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream

Sideroblastic anemia

Anemia - microcytic, hypochrmocic but with normal hemoglobin level - due to defective protoporphyrin synthesis maybe caused by vitamin B6 deficiency

Hemolytic anemia

Anemia caused by the destruction of red blood cells

Hemorrhagic anemia

anemia caused by excessive bleeding or pooor blood clotting

Vitamin E

Vitamin important for hemolytic anemia management

Calcium, Vitamin k

Vitamin important for hemorrhagic anemia management

Copper-deficiency anemia

Anemia where iron cannot be released due to low ceruloplasmin levels needed for iron mobilization

Alzheimer's disease

Progressive degeneration of the brain that ultimately results in dementia

Dementia

A general time for memory loss and other cognitive loss

Normal diet; consistency may be adjusted according to tolerance

Diet order for alzheimer's

Amyotrophic lateral sclerosis (ALS)

Neurodegenerative disorder of motor neurons in the spinal cord and brainstem causing muscle weakness and atrophy; aka Lou Gehrig Disease

4 and below

Severity scale rating for ALS in which nutrition support as EN or PN is warranted

6-5

Severity scale of ALS when diet consistency changes

4-3

Severity scale of ALS when TF is done to prevent or lessen wt loss; enhance QoL

2-1

Severity scale of ALS when px can no longer eat orally nor manage their own oral secretion; absent swallowing mechanism so NPO/permanent tube feeding is done

Cerebral palsy

A neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child's brain is under development

Epilepsy

Excessive discharge of electrical impulses, which may cause convulsions and loss of conciousness

Ketogenic diet using MCT oil, modified atkins diet, LGIT (low glycemic Index treatment

Dietary mgt of epilepsy

LGIT (low glycemic index treatment)

The LGIT allows more carbohydrate than the classic, medium-chain triglyceride (MCT) or modified Atkins ketogenic diet therapies. Children can eat 40 grams (g) to 60 g of carbohydrates per day

Modified Atkins Diet

The diet is a "modified" Atkins diet as it allows for less carbohydrates than the traditional Atkins diet (15 to 20 g/day) and more strongly encourages fat intake.

-For Epileptic patients

Seizure

Sudden, transient disturbances in brain function resulting from an abnormal firing of nerve impulses; may or may not be associated with convulsion

Ketogenic diet

Diet that aids in the production of ketones in the body which prevents seizures

3:1

K:AK ratio for adolescents and infants

4:1

K:AK ratio for children

Parkinson's disease (PD)

a chronic, degenerative central nervous disorder in which there is a progressive loss of control over movement, resulting in tremors and a shuffling gait. Decreased dopamine transmission observed.

Dietary protein

Macronutrient avoided at lunch or dinner for PD patients with dyskinesia (tics, involuntary muscle movement) because it can interfere absorption of levodopa

Foods containing l-dopa like fava, broad beans

Food to avoid for px with PD

L-dopa

A drug for Parkinson's disease that contains the precursors to dopamine so that once it is in the brain, it will be converted to dopamine.

myasthenia gravis (MG)

An automimmune disorder of the neuromuscular junction in which the immune system of the body raise a response to acetylcholine receptors. Characterized by excessive weakness and fatigability of the muscle and difficulty in speech

multiple sclerosis

a progressive disease of the nervous system that involves a degeneration of the myelin that surrounds nerve fibers in the brain and spinal cord's nerve fibers

Wernicke-Korsakoff syndrome

Organic brain syndrome resulting from prolonged heavy alcohol use, involving confusion, unintelligible speech, and loss of motor coordination. It may be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers.

Wernicke's Syndrome

Characterized by opthalmoplegia (loss of extraocular movement), ataxia (loss of full control of the bodily movements/drunk gait), and mental confusion

Korsakoff's syndrome

Characterized by disturbance in memor and inability to learn new things

Guillain-Barre Syndrome

autoimmune condition that causes acute inflammation of the peripheral nerves in which myelin sheaths on the axons are destroyed, resulting in decreased nerve impulses, loss of reflex response, and sudden muscle weakness

High kcal, high protein tube feeding

Dietary management for Guillan-Barre syndrome to promote positive nitrogen balance and lessen muscle wasting

Food allergy

an abnormal response to a food that is triggered by the immune system

Food intolerance

a negative reaction to a food or part of food caused by a metabolic problem, such as the inability to digest parts of certain foods or food components

Antigen

A protein that, when introduced in the blood, triggers the production of an antibody

Allergen

a substance that produces an allergic reaction in an individual

Milk, eggs, fish, shellfish, wheat, soy, peanuts, tree nuts

Common food allergens

G6PD deficiency

Enzyme deficiency which leads fo Low NADPH leading to hemolytic anemia (free radicals) with bite cells and heinz bodies

Phenylethylamine (PEA)

Amine found in trace amounts in the brain, peaks during orgasm, floods pleasure center of the brain with dopamine (also found in chocolate, wine, and aged cheese)

Tyramine

Adrenergic Agonist - Indirect

Releasing agent

Cause norepinephrine release from presynaptic terminals, potentiating effects. Found in fermented food, such as ripe cheese and Chianti. Oxidized by MAO.

Adverse - If patient taking MAOI, can precipitate serious vasopressor episodes.

Histamine

A chemical that is responsible for the symptoms of an allergy

Sulfites

-A food preservative, dough conditioner, antioxidant, antimicrobial and color stabilizer

-Found in wines, dried fruits, vinegars, instant potatoes and dried veggies

Oral food challenge

Diagnostic test used to screen for suspected allergenic foods involvin provision of food (after elmination of allergen) followed by tracking of symptoms

Double-blind, placebo-controlled food challenge

Gold standard for confirming diagnosis of food allergen testing. Patient and physician are blinded and food is disguised in gelatin capsule or powder mixed with tolerated food such as apple sauce

Single-blind food challenge

Food challenge where only patient is blinded.

Open food challenge

Food challenge where patient is knowingly provided with suspected food and observed

Elimination diet

A restrictive diet that systematically tests foods that may cause an allergic response by first eliminating them for 1 to 2 weeks and then adding them back, one at a time.

Desensitization therapy

Repeated exposure to stimulus which gradually reduces intense reaction. Provision of small quantities of allergen to reduce allergic response