Chapter 2 Workbook

LEARNER OBJECTIVES

At the completion of this chapter, the learner will be able to:

Section 2: Essential Physiologic Concepts
2.1 Describe the essential physiologic concepts in nutrition.
2.2 Identify hormonal regulation of nutrition metabolism by:

    a. Listing the regulatory hormones
    b. Describing each regulatory hormone's metabolic action

Section 3: Clinical and Lab Features of Protein-Energy Malnutrition
3.1 Identify the clinical and laboratory features of protein-energy
      malnutrition, including causes and clinical features.

Section 4: Effects of Malnutrition on GI Tract and Pancreas
4.1 Describe the effects of malnutrition, including both structural and
      functional changes, on the gastrointestinal tract and pancreas.

Section 5: Dietary Therapy in GI Disease
5.1 List the general principles of dietary therapy for:

    a. Celiac disease
    b. Inflammatory bowel disease

Section 6: Dietary Therapy in Liver Disease
6.1 Discuss appropriate dietary therapy for:

    a. Ascites
    b. Portal-systemic encephalopathy
    c. Cirrhosis

Section 7: Nutrition Intervention
7.1 Identify:

    a. Nitrogen requirements for well-nourished adults
    b. Energy requirements using the Harris-Benedict equation
7.2 Describe different types of nutrition intervention:
    a. Enteral nutrition, including formulas and complications
    b. Total parenteral, including solutions, routes of delivery,
        and complications

LEARNER WORKBOOK

EXERCISE 1
1.1 Short-term regulation between the fed state and interdigestive state
      is mediated by:

    a.
    b.
1.2 What are the four regulatory hormones in nutrient metabolism and
      their principal metabolic actions?
       Hormones            Metabolic Actions
    a.
    b.
    c.
    d.
1.3 Briefly describe carbohydrate, protein, and lipoprotein metabolism in
      the fed state and the interdigestive state.
Fed State Interdigestive State
Carbohydrate metabolism
Protein metabolism
Lipoprotein metabolism

EXERCISE 2
2.1 What are the causes of protein-energy malnutrition?

2.2 What are the effects of the following nutritional disorders on the liver?
    DisorderEffects
    Alcoholism
    Protein deficiency
    Uncontrolled diabetes
    Jejunoileal bypass
    Senecio alkaloids
    Kwashiorkor
    Gross dietary iron excess
    Obesity
2.3 Fill in the blanks:

Vitamin deficiency syndromes:

    Vitamins Name of Deficiency State Clinical Features
    1. Water-Soluble
    B1 (thiamine)
    Pernicious anemia
    Niacin
    2. Fat-Soluble
    A -
    D -
    E -
    K -

EXERCISE 3
3.1 Describe the effects of malnutrition on the GI tract and pancreas

    GI TractPancreas
    a. Structural
        changes
    b. Functional
        changes

EXERCISE 4
4.1 Describe appropriate dietary guidelines for patients with:

    a. Steatorrhea
    b. Celiac disease
    c. Inflammatory bowel disease
    d. Ascites
    e. Portal-systemic encephalopathy

EXERCISE 5
5.1 What does the term (zero) nitrogen balance mean?

5.2 What is enteral nutrition?
5.3 Briefly define the following enteral nutrition formulas:
    a. Polymeric
    b. Oligomeric
    c. Modular
5.4 List three complications of enteral feeding and briefly describe each.
5.5 What are the different components of TPN solutions?
5.6 TPN means:
6. Complications of TPN can be local or systemic. Briefly describe each
     type and its potential causes.
 

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