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Clinical Cases in Dietetics
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The introduction 1 The cases (and contexts) 15 Case 1 Gillian Mercer 17 Diabetes Case 2 The Odessa fi le 18 Renal disease, haemodialysis Case 3 Darshan 19 Renal disease, peritoneal dialysis Case 4 Professor Plum 20 Renal disease, pre-dialysis Case 5 Annie 21 Renal disease, pre-dialysis Case 6 Jon 23 Obesity Case 7 Mr Smart 24 Obesity, renal calculi Case 8 Susan Ritzio 25 Ulcerative colitis Case 9 Mr Rodger 26 Irritable bowel syndrome Case 10 Pauline Trotter 27 Obesity, pharmacological management Case 11 Harriet Baker 28 Obesity, metabolic issues Case 12 Mr Cunningham 29 Functional dyspepsia, weight loss Case 13 Mrs Rose Petroni 30 Obesity, infection, wound healing Case 14 Linda Middlemiss 31 Arthralgia, food intolerance Case 15 Josh Herriot 32 Coeliac disease, new diagnosis Case 16 Carly Carpenter 33 Disordered eating in adulthood Case 17 Mr Tony Marshall 34 Obesity, renal calculi Case 18 Carrie West 35 Bulimia nervosa Case 19 Holly Shakespeare 36 Obesity, polycystic ovarian syndrome Case 20 Barry Morgan 37 Post-surgical weight loss, appetite failure Case 21 Rayan Hussein 39 Iron-deficiency anaemia, ethnic diet Case 22 Peggy 40 Dementia Case 23 Cain 41 Cerebral palsy Case 24 Abel 42 Down's syndrome Case 25 Lucinda Smythe 45 Reactive hypoglycaemia Case 26 Mrs Jolly 46 Type 2 diabetes Case 27 Cordelia 47 Irritable bowel syndrome Case 28 Josh 48 Human immunodefi ciency virus (HIV) Case 29 Murdo MacKenzie 49 Cardiovascular and colorectal cancer risk Case 30 Anna Walker 50 Bone health Case 31 Shirley Stringfellow 51 Angioedema, salicylate exposure Case 32 Family tree 52 Diet and lifestyle change over time Case 33 RMS Titanic 53 Dietary judgement of menus Case 34 Maria von Twigg 56 Anorexia nervosa Case 35 Alan Wanderlust 57 Colorectal cancer Case 36 George and Dragon 58 Dementia, weight loss Case 37 Mandy Morton 59 Ventilated patient, enteral feeding Case 38 Betty Meldrew 60 Breast cancer, weight loss Case 39 Sheila Borrowman 61 Chronic pancreatitis, diabetes Case 40 Miss Taylor 62 Cancer of lung, cachexia Case 41 Mary Glover 63 Coeliac disease, lymphoma Case 42 Pamela Nightingale 64 Chronic fatigue syndrome Case 43 Jenny Friel 65 Crohn's disease Case 44 Alan Lehman 66 Type 1 diabetes Case 45 Mark 67 Attention deficit hyperactivity disorder Case 46 Mary Montgomery and Mary Hamilton 68 Oral pathology, nutritional issues Case 47 Sara Bloomfield 69 Chronic obstructive airways disease Case 48 Jonny Morgan 70 Thinness, faulty diet and health risk Case 49 Patrick Foley 71 Burn injury Case 50 Doris Blessing 72 Type 2 diabetes, pressure sore Case 51 Rupert St. John Stevens 74 Alcoholic liver disease Case 52 Mrs Morningside 75 Chronic peptic ulceration Case 53 Mandy Goodenough 76 Gestational diabetes Case 54 Mrs Jessie Banks 77 Renal disease, type 2 diabetes Case 55 Toby Harris 80 Fractured mandible Case 56 John Thomson 81 Motor neurone disease Case 57 Daisy Marsden 82 Alcoholic liver disease Case 58 Freda Ingram 84 Obesity, cognitive behavioural therapy Case 59 Susan O'Connel 85 Crohn's disease, anorexia Case 60 Dominic Pruz 87 Ulcerative colitis, loop ileostomy Case 61 Rudi Jordache 88 Obesity, behaviour modifi cation Case 62 Glenda Henderson 90 Gestational diabetes, obesity Case 63 Daniel Borden 91 Head injury, nutritional support Case 64 Shaun Gascoine 92 Oesophageal carcinoma Case 65 Frank Calder 94 Type 1 diabetes, overweight Case 66 Stanislaw Roza 95 Hypertension, ethnic diet, health risk Case 67 Peter Donnelly 96 Overweight, hypertension Case 68 John Mortimer 98 Stroke Case 69 Maude Ashby 99 Stroke, clinical chemistry Case 70 Christopher Smith 100 Terminal cancer, palliative care The diaries (and contexts) 103 Diary 1 Weight loss, diet patterns 105 Diary 2 Migraine, diet exclusion 106 Diary 3 Type 2 diabetes, diverticulitis 108 Diary 4 Irritable bowel syndrome 109 Diary 5 Coronary artery disease, health risk 110 Diary 6 Hypertension, renal calculi 111 Diary 7 Reactive hypoglycaemia 113 Diary 8 Bowel habit, dietary influences 114 Diary 9 Constipation, hunger 116 Diary 10 Obesity 117 The referrals (and contexts) 119 Referral 1 Letter 121 Mrs Brown (managing serum cholesterol levels) Referral 2 Letter 122 Ms Philpott (irritable bowel syndrome) Referral 3 Letter 123 Mrs Young (obesity, confl ict with medications) Referral 4 Letter 124 Mrs Leadbetter (coeliac disease, iron-defi ciency anaemia) Referral 5 Letter 125 Mr Grant (obesity, hypothyroidism) Referral 6 Letter 126 Ms Horvig (abdominal pain, elimination diet) Referral 7 Nutritional screening 127 Mr Al-Khatim, Room 221 (prostatic cancer, chemotherapy) Referral 8 Nutritional screening 129 Mrs Collins, Room 401 (anterior resection of bowel) Referral 9 Nutritional screening 131 Mr Roundman, Room 613 (type 1 diabetes, infection) Referral 10 Handwritten note 133 Mrs Lundquist, Room 408 (gestational diabetes) The mini-cases (and contexts) 135 Mini-case 1 Multiple sclerosis, obesity 137 Mini-case 2 Anterior resection of bowel 137 Mini-case 3 Obesity, weight control 137 Mini-case 4 Obesity, nutritional screening 137 Mini-case 5 Coeliac disease, peer-reviewed information 138 Mini-case 6 Type 2 diabetes, dietary compliance 138 Mini-case 7 Obesity, aggressive weight loss 138 Mini-case 8 Hip replacement, nutritional status 138 Mini-case 9 Unconscious patient, feeding issues 139 Mini-case 10 Weight loss, older client 139 The commentaries 141 The commentaries: the cases 143 Case 1 Gillian Mercer 143 Diabetes Case 2 The Odessa fi le 144 Renal disease, haemodialysis Case 3 Darshan 145 Renal disease, peritoneal dialysis Case 4 Professor Plum 145 Renal disease, pre-dialysis Case 5 Annie 146 Renal disease, pre-dialysis Case 6 Jon 148 Obesity Case 7 Mr Smart 149 Obesity, renal calculi Case 8 Susan Ritzio 150 Ulcerative colitis Case 9 Mr Rodger 150 Irritable bowel syndrome Case 10 Pauline Trotter 151 Obesity, pharmacological management Case 11 Harriet Baker 152 Obesity, metabolic issues Case 12 Mr Cunningham 153 Functional dyspepsia, weight loss Case 13 Mrs Rose Petroni 153 Obesity, infection, wound healing Case 14 Linda Middlemiss 154 Arthralgia, food intolerance Case 15 Josh Herriot 155 Coeliac disease, new diagnosis Case 16 Carly Carpenter 156 Disordered eating in adulthood Case 17 Mr Tony Marshall 158 Obesity, renal calculi Case 18 Carrie West 159 Bulimia nervosa Case 19 Holly Shakespeare 160 Obesity, polycystic ovarian syndrome Case 20 Barry Morgan 161 Post-surgical weight loss, appetite failure Case 21 Rayan Hussein 161 Iron-defi ciency anaemia, ethnic diet Case 22 Peggy 162 Dementia Case 23 Cain 163 Cerebral palsy Case 24 Abel 164 Down's syndrome Case 25 Lucinda Smythe 165 Reactive hypoglycaemia Case 26 Mrs Jolly 166 Type 2 diabetes Case 27 Cordelia 167 Irritable bowel syndrome Case 28 Josh 168 Human immunodefi ciency virus (HIV) Case 29 Murdo MacKenzie 169 Cardiovascular and colorectal cancer risk Case 30 Anna Walker 170 Bone health Case 31 Shirley Stringfellow 171 Angioedema, salicylate exposure Case 32 Family tree 172 Diet and lifestyle change over time Case 33 RMS Titanic 172 Dietary judgement of menus Case 34 Maria von Twigg 173 Anorexia nervosa Case 35 Alan Wanderlust 174 Colorectal cancer Case 36 George and Dragon 174 Dementia, weight loss Case 37 Mandy Morton 175 Ventilated patient, enteral feeding Case 38 Betty Meldrew 176 Breast cancer, weight loss Case 39 Sheila Borrowman 177 Chronic pancreatitis, diabetes Case 40 Miss Taylor 178 Cancer of lung, cachexia Case 41 Mary Glover 179 Coeliac disease, lymphoma Case 42 Pamela Nightingale 179 Chronic fatigue syndrome Case 43 Jenny Friel 180 Crohn's disease Case 44 Alan Lehman 181 Type 1 diabetes Case 45 Mark 181 Attention deficit hyperactivity disorder Case 46 Mary Montgomery and Mary Hamilton 182 Oral pathology, nutritional issues Case 47 Sara Bloomfi eld 183 Chronic obstructive airways disease Case 48 Jonny Morgan 184 Thinness, faulty diet and health risk Case 49 Patrick Foley 185 Burn injury Case 50 Doris Blessing 186 Type 2 diabetes, pressure sore Case 51 Rupert St. John Stevens 187 Alcoholic liver disease Case 52 Mrs Morningside 188 Chronic peptic ulceration Case 53 Mandy Goodenough 189 Gestational diabetes Case 54 Mrs Jessie Banks 190 Renal disease, type 2 diabetes Case 55 Toby Harris 191 Fractured mandible Case 56 John Thomson 192 Motor neurone disease Case 57 Daisy Marsden 193 Alcoholic liver disease Case 58 Freda Ingram 194 Obesity, cognitive behavioural therapy Case 59 Susan O'Connel 195 Crohn's disease, anorexia Case 60 Dominic Pruz 195 Ulcerative colitis, loop ileostomy Case 61 Rudi Jordache 196 Obesity, behaviour modifi cation Case 62 Glenda Henderson 197 Gestational diabetes, obesity Case 63 Daniel Borden 198 Head injury, nutritional support Case 64 Shaun Gascoine 199 Oesophageal carcinoma Case 65 Frank Calder 200 Type 1 diabetes, overweight Case 66 Stanislaw Roza 201 Hypertension, ethnic diet, health risk Case 67 Peter Donnelly 202 Overweight, hypertension Case 68 John Mortimer 204 Stroke Case 69 Maude Ashby 205 Stroke, clinical chemistry Case 70 Christopher Smith 206 Terminal cancer, palliative care The commentaries: the diaries 209 Diary 1 Weight loss, diet patterns 209 Diary 2 Migraine, diet exclusion 209 Diary 3 Type 2 diabetes, diverticulitis 210 Diary 4 Irritable bowel syndrome 210 Diary 5 Coronary artery disease, health risk 211 Diary 6 Hypertension, renal calculi 211 Diary 7 Reactive hypoglycaemia 212 Diary 8 Bowel habit, dietary infl uences 213 Diary 9 Constipation, hunger 213 Diary 10 Obesity 214 The commentaries: the referrals 215 Referral 1 Letter 215 Mrs Brown (managing serum cholesterol levels) Referral 2 Letter 216 Ms Philpott (irritable bowel syndrome) Referral 3 Letter 216 Mrs Young (obesity, confl ict with medications) Referral 4 Letter 217 Mrs Leadbetter (coeliac disease, iron-defi ciency anaemia) Referral 5 Letter 218 Mr Grant (obesity, hypothyroidism) Referral 6 Letter 219 Ms Horvig (abdominal pain, elimination diet) Referral 7 Nutritional screening 220 Mr Al-Khatim, Room 221 (prostatic cancer, chemotherapy) Referral 8 Nutritional screening 220 Mrs Collins, Room 401 (anterior resection of bowel) Referral 9 Nutritional screening 221 Mr Roundman, Room 613 (type 1 diabetes, infection) Referral 10 Handwritten note 222 Mrs Lundquist, Room 408 (gestational diabetes) The commentaries: the mini-cases 223 Mini-case 1 Multiple sclerosis, obesity 223 Mini-case 2 Anterior resection of bowel 223 Mini-case 3 Obesity, weight control 224 Mini-case 4 Obesity, nutritional screening 224 Mini-case 5 Coeliac disease, peer-reviewed information 225 Mini-case 6 Type 2 diabetes, dietary compliance 225 Mini-case 7 Obesity, aggressive weight loss 226 Mini-case 8 Hip replacement, nutritional status 226 Mini-case 9 Unconscious patient, feeding issues 227 Mini-case 10 Weight loss, older client 228 The appendices: clinical information and reference data 231 The appendices: tools 265 Index 275

About the Author

Dr Fred Pender BSc, PhD, RD is Director of Dietetics at University College, Chester

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