6 month old infant has large, foul-smelling stools

Discussion in 'MRCS Forum' started by Lona., Nov 3, 2007.

  1. Lona.

    Lona. Guest

    A 6 month old infant has large, foul-smelling stools and is not gaining weight. Cystic fibrosis has just been diagnosed. Appropriate nutritional recommendations include all the following EXCEPT -
    a- Supplementation with fat-soluble vitamins
    b- Pancreatic enzyme replacement
    c- Low fat diet
    d- High-caloric diet
    e- Tube feeding as necessary
  2. Lona.

    Lona. Guest

    The answer is C. (Rudolph 20/e, pp 1648-1649) The goal in treatment of patients with cystic fibrosis is to supply enough calories to maintain normal growth. Extra calories are needed to replace those lost as a result of gastrointestinal losses, to offset the catabolic and anorectic effects of respiratory infection, and for catch-up growth. Almost 90 percent of patients have poor digestion of fat and protein as a result of the deficiency of pancreatic function, which may be partially corrected by oral pancreatic enzyme replacement; protein an fat losses are reduced and patients are usually able to tolerate a reasonably normal diet. The high caloric density of fat is useful in meeting the patient’s caloric needs. Supplementation with fat-soluble vitamins (A, D, E, K) is necessary. With severe disease, feedings by nasogastric tube, percutaneous enterostomy, or intravenous nutrition may be necessary.

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