Medical Nutrition Therapy 
                       How to use this study guide 
                       Note to reader: Many RD2Be’s want to start studying for the RD exam with MNT. However, MNT makes up a very 
                       small portion of the RD exam. If you have already studied for the exam, I encourage you to focus instead on 
                       Management Concepts, Research Concepts, and Food Service, while using practice questions for clinical scenarios. 
                       As you review MNT considerations for each of the following states, think about how and why energy and nutrient 
                       needs change from standard pediatric or adult recommendations to the recommendations for each nutrition-related 
                       disorder. I recommend having a stack of blank paper or a blank notebook to use as you work through this study 
                       guide. There are study guide questions throughout that have you critically assess the information you’ve read. You 
                       can also use the MNT worksheet template available in the RD Exam Toolkit (https://www.allaccessdietetics.com/rd-
                       exam-toolkit/) to organize the information in this section. Be sure to read the recommended readings, many of 
                       which are position and practice papers. CDR considers these resources fair game for the exam. 
                       To help you organize the information, always come back to big picture questions. For example, if protein and calorie 
                       needs are elevated for a disease, know WHY. HOW does the underlying pathophysiology of the disease manifest in 
                       signs and symptoms, including lab test results? HOW might you expect the planned nutrition intervention to influence 
                       those signs and symptoms? Turn information that you read into questions you can answer, so that you aren’t 
                       overwhelmed by details so that you learn the information in the same way you’ll be asked on the test – in question 
                       form. You need to be able to connect details together into a bigger picture rather than trying to simply memorize the 
                       details. The study guide questions throughout are “big picture questions” and after a few sections you may be able to 
                       think of your own study guide questions. 
                       You’ll notice that most conditions have a nutrition therapy and MNT table at the beginning of the section. The format 
                       of this table varies from acute to chronic conditions. For example, some conditions, such as burns, may have specific 
                       energy, protein, and fluid recommendations. For other conditions, such as celiac disease, where the estimated needs 
                       are the same for someone without celiac disease, there is minimal change. I recommend keeping a table of the DRIs 
                       handy as you go through this document so that you can reinforce what the typical energy and macronutrient needs 
                       are with attention to changes that should be made for patients of certain conditions, such as a gluten-free nutrition 
                       prescription for patient with celiac disease. While this study guide mentions aspects of the Nutrition Care Process, it 
                       is not intended to replace review of the Nutrition Care Process. You can learn about the NCP in the Nutrition Care 
                       study guide or online for free at https://www.ncpro.org/nutrition-care-process.  
                       If you like the format of this study guide, you will like the other Study Smarter Method study guides. The other study 
                       guides also include more extensive lists of study guide questions (open-ended questions throughout this document in 
                       italics) as well as multiple-choice practice questions. A full list of study guides available is below. You can get these 
                       10 study guides in Pass the Exam Prep (powered by the Study Smarter Method) at 
                       www.allaccessdietetics.com/Pass-the-exam-prep  
                        •     Calculations and Formulas                                                     •    Food Science 
                        •     Normal Nutrition, Digestion, and Absorption                                   •    Food Safety 
                        •     Enteral and Parenteral Nutrition Support                                      •    Nutrition Care 
                        •     Kidney Function, Electrolytes, and Dehydration                                •    Research Concepts 
                        •     Food Service Logistics                                                        •    Management Concepts  
                        
                       Terms of use 
                       Bailey DeBarmore is the creator and sole owner of the exclusive copyright to this study resource. This resource is 
                       provided for free but rather than distribute it to others, please refer them to All Access Dietetics or to 
                       www.studysmartermethod.com to download their own copy. This publication may not be manipulated, copied, 
                       reprinted and/or sold, altered, or reproduced in any form or by any means without requesting further permission from 
                       the owner, Bailey DeBarmore. This study guide is for personal use only by a single individual. If you would like to 
                       distribute this resource to a dietetic internship class or otherwise use for academic purposes, please contact Bailey 
                       DeBarmore via www.studysmartermethod.com first to discuss terms of use. By downloading this item, you agree to 
                       the Terms of Use outlined herein.  
                       Suggested Citation: TOPIC NAME. Medical Nutrition Therapy Study Guide. Study Smarter Method. Bailey DeBarmore. Published 
                       2021. PAGE NUMBER. Accessed at www.studysmartermethod.com. DAY MONTH YEAR. 
                                                                     
                                                   Copyright 2021 / Version: 1JUNE2021 
           
                             
                                  WRITTEN BY 
                  Bailey DeBarmore, MHS RDN LDN 
                     creator of the Study Smarter Method 
                               Version: June 1, 2021 
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                                                   Copyright 2021 / Version: 1JUNE2021 
          Table of Contents 
          Critical Care & Hypermetabolic States .......................................................................................................... 5 
           Burns ......................................................................................................................................................... 6 
           Surgery ..................................................................................................................................................... 7 
           Pressure Ulcers ........................................................................................................................................ 8 
           Chronic Wounds ..................................................................................................................................... 10 
          Eating Disorders .......................................................................................................................................... 11 
          Food Allergies, Sensitivities & Intolerances ................................................................................................ 15 
          HIV Infection and AIDS ............................................................................................................................... 18 
          Malnutrition .................................................................................................................................................. 19 
           Protein-Calorie Malnutrition .................................................................................................................... 22 
           Failure-to-thrive ....................................................................................................................................... 23 
          Inborn Errors of Metabolism ........................................................................................................................ 23 
          Cancer ......................................................................................................................................................... 28 
           Cancer Treatment ................................................................................................................................... 28 
           Palliative Care and Hospice .................................................................................................................... 30 
           Nutrition-Related Adverse Effects........................................................................................................... 30 
          Anemias ...................................................................................................................................................... 33 
           Nutritional Anemias ................................................................................................................................. 34 
             Iron Deficiency Anemia ...................................................................................................................... 34 
             Megaloblastic Anemia ........................................................................................................................ 36 
             Other Nutritional Anemias .................................................................................................................. 39 
           Non-Nutritional Anemias ......................................................................................................................... 40 
             Hemolytic Anemia............................................................................................................................... 40 
             Anemia of Chronic and Inflammatory Disease (ACD) ........................................................................ 41 
          Gastrointestinal Disorders ........................................................................................................................... 41 
           GERD ...................................................................................................................................................... 41 
           Inflammatory Bowel Disease .................................................................................................................. 43 
           Irritable Bowel Syndrome ........................................................................................................................ 45 
             FODMAPs .......................................................................................................................................... 46 
           Chronic Peptic Ulcer Disease ................................................................................................................. 47 
           Gastric Surgery ....................................................................................................................................... 48 
             Dumping Syndrome ............................................................................................................................ 49 
           Celiac Disease ........................................................................................................................................ 50 
           Ostomies ................................................................................................................................................. 51 
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             Colostomy ........................................................................................................................................... 51 
             Ileostomy ............................................................................................................................................ 52 
          Cardiovascular Disease .............................................................................................................................. 53 
           Hyperlipidemia ........................................................................................................................................ 55 
           Hypertension ........................................................................................................................................... 55 
           Heart Failure ........................................................................................................................................... 57 
           Coronary Heart Disease ......................................................................................................................... 58 
          Respiratory Disease .................................................................................................................................... 59 
           COPD ...................................................................................................................................................... 59 
           ARDS ...................................................................................................................................................... 60 
           Cystic Fibrosis......................................................................................................................................... 61 
           Pneumonia .............................................................................................................................................. 62 
          Liver Disease .............................................................................................................................................. 63 
          Pancreatitis.................................................................................................................................................. 64 
          Kidney Disease ........................................................................................................................................... 66 
           Acute Kidney Injury ................................................................................................................................. 66 
           Chronic Kidney Disease ......................................................................................................................... 66 
             Renal Replacement Therapy .............................................................................................................. 68 
           Kidney Stones ......................................................................................................................................... 69 
          Neurological and Cerebrovascular Disease ................................................................................................ 70 
           Epilepsy .................................................................................................................................................. 70 
           Stroke and TIA ........................................................................................................................................ 72 
           Alzheimer’s Disease and Dementia ........................................................................................................ 72 
          Metabolic and Endocrine Disorders ............................................................................................................ 73 
           Obesity .................................................................................................................................................... 73 
             Bariatric Surgery ................................................................................................................................. 75 
           Diabetes Mellitus .................................................................................................................................... 77 
             Type 1 Diabetes ................................................................................................................................. 77 
             Type 2 Diabetes ................................................................................................................................. 83 
           Gestational Diabetes .............................................................................................................................. 86 
           Metabolic Syndrome ............................................................................................................................... 88 
           Gout ........................................................................................................................................................ 89 
           PCOS ...................................................................................................................................................... 90 
          References .................................................................................................................................................. 91 
           
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