Nutrition Case study of Maple Syrup Urine Disease GB is the second born child of a Lebanese family. He has an older sister who is normal. He was born after an uncomplicated pregnancy and labor. His birth weight is 3.2kg. He seemed normal and had no immediate neonatal complications. He fed well and was alert. At 7 days of age, GB stopped sucking and became lethargic. He was readmitted to the hospital. He was afebrile but had 3 episodes of apnea. The mother noticed that there was a sweet odor of the urine. Blood test and urine AA chromatography on 24-h urine collection were done. Normal plasma (mg/100mL) Plasma (mg/100ml) Patient urine (mg/24h) Leucine 1.5-3.0 57.49 Too high to read Isoleucine 0.8-1.5 14.10 41.1 Valine 2.0-3.0 14.76 77.28 Thus, GB was diagnosed with Maple Syrup Urine Disease. Thiamin responsiveness was evaluated: 510mg/kg/d of oral thiamin were prescribed for a period of 3 weeks. No improvement was noticed. GB was put from first day on BCAA-free diet. Part 1 1-Assess the patient. 2-Calculate energy, protein and BCAA needs. 3-Translate the prescription into diet with Similac and MSUD Analog (composition shown in Table below).

Nutrition Case study of Maple Syrup Urine Disease GB is the second born child of a Lebanese family. He has an older sister who is normal. He was born after an uncomplicated pregnancy and labor. His birth weight is 3.2kg. He seemed normal and had no immediate neonatal complications. He fed well and was alert. At 7 days of age, GB stopped sucking and became lethargic. He was readmitted to the hospital. He was afebrile but had 3 episodes of apnea. The mother noticed that there was a sweet odor of the urine. Blood test and urine AA chromatography on 24-h urine collection were done. Normal plasma (mg/100mL) Plasma (mg/100ml) Patient urine (mg/24h) Leucine 1.5-3.0 57.49 Too high to read Isoleucine 0.8-1.5 14.10 41.1 Valine 2.0-3.0 14.76 77.28 Thus, GB was diagnosed with Maple Syrup Urine Disease. Thiamin responsiveness was evaluated: 510mg/kg/d of oral thiamin were prescribed for a period of 3 weeks. No improvement was noticed. GB was put from first day on BCAA-free diet. Part 1 1-Assess the patient. 2-Calculate energy, protein and BCAA needs. 3-Translate the prescription into diet with Similac and MSUD Analog (composition shown in Table below).

Surgical Tech For Surgical Tech Pos Care

5th Edition

ISBN:9781337648868

Author:Association

Publisher:Association

Chapter14: General Surgery

Section: Chapter Questions

Problem 1CS

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Case study 1 A 28 year –old Asian woman is referred by her general practitioner (GP) with persistant vomiting at 7 weeks gestation. She is in her second pregnancy having had a normal vaginal delivery 3 years ago . She is now vomiting up to 10 times in 24 hours and has not managed to tolerate any food for 3 days. She can only drink small amounts of water. She saw her GP a week ago who prescribed prochlorperazine suppositories but these only help for a few. She feels very weak and is unable to care for her son now. On direct questioning, she has upper abdominal pain that is constant, sharp and burning. She has not opened her bowels for 5 days. She is passing small amounts of dark urine infrequently but there is no dysuria or haematuria. There has been no vaginal bleeding. There is no other medical or gynaecological history of note except that she suffered persistent vomiting in her pregnancy requiring two overnight admissions. EXAMINATION She is pyrexia. Lying blood pressure is…
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