CHN - Nutrition Support Service

Nutrition Support Service Barnes-Jewish Hospital

PRE-TEST
Please print out and take the pre-test before the first attending rounds.

TRAINING FILES:

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Tier 1 (Medical Students):
1. Lecture: Nutrient absorption and malabsorption. (Davidson)
a. Reading and case studies: Course Handbook. Pp 61-71.
2. Vitamin and Mineral Metabolism. (Reeds)
a. Reading Pp345-378 Course handbook
b. Optional Reading: The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults. Ann Intern Med. 2006;145(5):372-85
3. Lecture: Introduction to nutritional therapy in hospitalized patients (Reeds)
a. Reading: A Primer of Nutritional Support for Gastroenterologists. Gastroenterology 2002; 122:1677-1687
b. Reading: Surrogate nutrition markers, malnutrition, and adequacy of nutrition support. Nutrition in Clinical Practice 20:308-313.
4. Protein-calorie malnutrition (Manary)
a. Reading: Management of the severely malnourished child: perspective from developing countries. BMJ 2003; 326(7381); 146–151
5. Lecture: Introduction to Obesity. (Sullivan)
a. Reading: Pharmacological and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2005;142:525-53
b. Reading: Bariatric surgery for morbid obesity. NEJM 356:2176-2183

Tier 2 (Residents)
1. Lecture: Nutritional support II: Feed a fever? Nutrition Support in the Critically Ill
a. Reading: Energy balance in critical illness. Proc. Nutrition Society 2003; 62, 545-522
b. Reading: The effect of postoperative intravenous feeding (TPN) on outcome following major surgery evaluated in a randomized study. Ann. Surg 271;2, 185-195
c. Nutrition support in the morbidly obese, critically ill patient. Nutr Clin Pract. 2004 Jun;19(3):290-6
2. Methods of assessing energy expenditure and body composition.
a. Reading: Methods of assessing energy expenditure in the intensive care unit. Nutrition in clinical practice. 17:21-28.
3. Lecture: Management of Malnutrition. (Reeds)
a. Reading: Management of severe malnutrition: A manual for physicians and other senior health workers. Pp 37-40
b. Anorexia nervosa. 2005 New England Journal of Medicine 353;14
4. Lecture: Case studies in nutrient deficiencies (Reeds)
a. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004 Sep;7(5):569-75.
b. Diets and Disease
5. Nutritional management of the patient with acute or chronic pancreatitis
a. ESPEN Guidelines on Enteral Nutrition: Pancreas. Clin Nutr. 2006 Apr;25(2):275-84
b. Nutrition support in severe acute pancreatitis. Gastroenterol Clin North Am. 2007 Jun;36(2):297-312
6. Nutrition support at the end of life (Loitman)
a. Ethics of nutrition support. 2005 New England Journal of Medicine 353;24

Tier 3 (GI fellows complete tiers 1-3)
1. Lecture: Management of nutrient requirements in patients with GI pathology: celiac disease, ileal resection, and gastric bypass.
a. Diarrhea
b. Nutrition in end-stage liver disease. Gastroenterology 2008;134:1729–1740
2. Evaluation and management of short-bowel syndrome: Understand the indications for isolated and combined liver and intestinal transplantation. Long and short term management of patients with short bowel syndrome.
a. Nutrition in short-bowel syndrome. Gastroenerology 2006;130:S60–S66
3. Nutrition support in immunosuppressed patients
4. Outpatient and inpatient nutritional management in patients with underlying disease-diabetes, dyslipidemia, wasting disease, renal disease, pregnant or lactating patients, patient with osteoporosis.
5. Management and complications of patients requiring long-term TPN. Gastroenterology 2003;124:1651–1661