ASGE Adult and Pediatric Gastroenterology and Endoscopy Board Preparatory and Review Course | 2022-Khan_Pediatric Review Board Presentation

Khan_Pediatric Review Board Presentation_Nutrition

Pdf Summary

This document is a summary of a presentation on various topics related to gastroenterology and bariatric surgery. It includes several challenge questions with response options.<br /><br />Challenge Question 1 discusses the case of a 40-year-old male with symptoms of diarrhea, abdominal pain, and fatigue following gastric bypass surgery. The question asks for the most appropriate next step, with the correct response being to begin rifaximin therapy. This is because the patient's symptoms and laboratory results suggest small intestinal bacterial overgrowth (SIBO), which can be treated with antibiotics.<br /><br />Challenge Question 2 presents the case of a 50-year-old woman with high ostomy output following intestinal resections and pelvic radiation. The question asks for the most appropriate next step in managing her cholestatic liver disease. The correct response is to transition to a fish oil lipid formulation. Soy-based lipid emulsions commonly used in parenteral nutrition can promote cholestasis, while fish oil-based emulsions with minimal phytosterols are less likely to cause liver disease.<br /><br />Challenge Question 3 describes a 50-year-old female with a history of gastric bypass surgery presenting with symptoms of fatigue, palpitations, and anemia. The correct response is that she most likely has copper deficiency, given her symptoms and laboratory results.<br /><br />Challenge Question 4 involves a patient with severe acute pancreatitis and asks for the recommended nutritional management. The correct response is to initiate enteral feeding via a nasojejunal tube. Early initiation of oral or enteral feeding is recommended in acute pancreatitis to protect the gut-mucosal barrier and reduce complications.<br /><br />Challenge Question 5 discusses a 40-year-old woman with a rash and a history of fistulizing Crohn's disease. The question asks which treatment is most likely to improve her rash. The correct response is zinc supplementation, as patients with fistulizing Crohn's disease often have lower zinc levels and can benefit from supplementation.<br /><br />The document also provides helpful resources for further reading on the topics discussed.

Keywords

gastroenterology

bariatric surgery

SIBO

cholestatic liver disease

fish oil lipid formulation

copper deficiency

severe acute pancreatitis

enteral feeding

rash

zinc supplementation