Wintervention strategies for the management of patients with ith reference to current literature and guidelines, discuss the decompensated liver possible dietary

 

1          Jenny Brown Jones a 35 year old police constable, presented to her GP with                    lethargy, diarrhoea and abdominal bloating. Following extensive investigations she

has been diagnosed with coeliac disease and has been referred to you for dietary           advice.

The following information is available:

Weight: 67kg, Height: 1.74m, usual weight 68Kg.

Haemoglobin 11g/dl

Normally goes to the gym 3 times a week for spin cycle class , but not been managing this of late

Non smoker No other relevant PMH, Medications: Ovranette Lives with boyfriend, works shifts

24 hour recall Breakfast:

Medium bowl of cereal with semi skimmed milk, 2 x slices of toast with butter and jam, cup of tea with semi skimmed milk Midmorning:

Scone, low fat spread, jam. cup of tea with semi skimmed milk

Lunch: Sandwich (homemade- 2 slices of wholemeal bread) with various fillings (eg egg mayonnaise, ham salad, cheese and pickle), packet of crisps, can of juice and an apple.

Mid -afternoon: banana and carton of fruit juice

Evening: Usually homemade e.g. pasta with vegetables and bought sauce; spaghetti bolognaise, breaded haddock with oven chips and peas; chilli with rice, chicken stir fry and rice.

Glass of water with meal and generally cup of tea and chocolate biscuit in the evening before bed

Has takeaway usually about twice a week especially on late shift which varies between Thai, fish and chips, pizza

Drinks approximately 12-14 units alcohol/week, normally wine

 

 

Using an evidence based approach discuss and justify your approach to the dietetic

(100%)           management of this woman.

 

           Answer TWO from the following:

 

You have been asked to do the first of six fortnightly 75 minute group sessions to

individuals who have opted in, via their GP, to a 12 week, weight and lifestyle             management programme. There are a maximum of 10 individuals per group, the             group is generally of mixed gender, with an age range 45-55 years old, all have a             BMI>30 kg/m2 and the group is held in a deprived area of the city.

(100%)            Outline and justify both the content and delivery of your session

 

 

 

 

  1. Compare and contrast in paediatrics versus adults:
    1. The causes and consequences of disease related undernutrition (40%)
    2. The nutritional support strategies used to treat disease related

undernutrition.             (60%)

 

  1. Wintervention strategies for the management of patients with ith reference to current literature and guidelines, discuss thedecompensated liver possible dietary

disease secondary to alcohol intake. (100%)

5 Mark Daniels is a 52 year old man who lives with his wife husband and two teenage daughters. He presented to her GP three weeks ago with symptoms of polyuria,

nocturia and was subsequently diagnosed with type 2 diabetes. He has now been referred to the GP Practice Dietitian for advice.

The following information is available:

Weight 88kg

Height 1.68m

Waist Circumference: 103cm

PMH of hyperlipidaemia and hypertension , Medications: atorvastatin and captopril.

Recently stopped smoking.

His father died a few years ago secondary to a heart attack.

Works shifts in a call centre,

Doesn’t do any formal exercise

RBG: 18.1mmol/L

HbA1c 88 mmol/mol

Breakfast: large bowl of corn flakes with semi skimmed milk (fried breakfast on the weekends) and a glass of fruit juice

 

Mid–morning: 4 digestive biscuits, mug of tea with milk and one teaspoon of sugar

 

Lunch: If at work, two sandwiches (meat, egg or cheese filling). Fruit pie or crumble with custard from canteen.

mug of tea with milk and one sugar

Afternoon: 3 or 4 – digestives or rich tea, with a mug of tea with milk and one sugar

Dinner: chicken/chop/lamb/sausages/

casserole/chili with either spaghetti/potatoes/pasta/rice two vegetables if chicken/chop/lamb glass of squash

Before bed: tea with milk and one sugar, two slices of white toast with marmite

Take-away meal once a week,

3 evenings a week:2-3 pints of beer at the

pub

Using an evidence based approach discuss and justify your approach to the dietetic

management of this man.       (100%)

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