Fuel for colonocytes

Q) Primary fuel for colonocytes is 

a) Glucose

b) Lactate

c) Butyrate

d) Fats

Ans c ) Butyrate

Butyrate For the fermentable complex carbohydrates available, colonic flora produce short-chain fatty acids (SCFAs).

Butyrate, an SCFA, is the principal source of nutrition for the colonocyte.
Mammalian cells do not produce butyrate, the colonic epithelium and luminal bacteria form an essential and elegant symbiotic relationship.

Antibiotics disrupt this cohabitation—decreased bacteria leads to less butyrate, which, in turn, negatively affects colonocyte function leading to diarrhea.

Immunonutrition

Q) What is not included in Immunonutrition.

a) Arginine

b) Alanine

c) Omega 3

d) Glutamine

#Aiims 2022,

Ans B

The potential to modulate the activity of the immune system by interventions with specific nutrients is termed immunonutrition.

Major surgery is followed by a period of immunosuppression that increases the risk of morbidity and mortality due to infection. Improving immune function during this period may reduce complications due to infection

The nutrients most often studied for immunonutrition are arginine, glutamine, branched chain amino acids, n-3 fatty acids, and nucleotides

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Nutrition – refeeding Syndrome

Q) What should be done to prevent refeeding syndrome in a 70yr old on TPN?

#Aiims 2022, # General Surgery, Nutrition

a) Infuse amino acids  and lipids separately
b) Slowly increase calorie
c) Avoid lipid TPN
d) Slow infusion of TPN

Ans b 

Refeeding syndrome - results  in hypophosphataemia, hypocalcaemia and hypomagnesaemia.

Patients at risk include those with alcohol dependency, those suffering severe malnutrition,
anorexics and those who have undergone prolonged periods of fasting.

Treatment involves matching intakes with requirements and assiduously avoiding overfeeding.

Calorie delivery should be increased slowly and vitamins administered
regularly.

Hypophosphataemia and hypomagnesaemia require treatment.

Ref Bailey page 288

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Claudication pain

Q) 70 year old male has pain in right buttock on standing and gets relieved on sitting. What will be the next relevant  test to be ordered in him?

a) Doppler B/l lower limbs

b) MRI spine

c) Echo cardiography

d) Ankle Brachial Index

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