Medical Nutrition Therapy
What to know
MNT is the clinical core: tailoring nutrition to disease. Know the nutrition therapy for diabetes (carbohydrate consistency/counting, glycemic index context), cardiovascular disease (saturated fat, soluble fiber, sodium), chronic kidney disease (protein, phosphorus, potassium, sodium by stage and dialysis status), liver disease, obesity, and enteral/parenteral nutrition. Understand refeeding syndrome (electrolyte shifts, especially phosphate), the indications and complications of enteral vs parenteral feeding, and the transition from one to the other. Be able to interpret lab values in context (albumin as an inflammation marker, not a pure nutrition indicator).
Traps
Questions often test when to use a therapy rather than what it is-e.g., enteral feeding is preferred when the gut works. Watch for over-restriction traps: overly aggressive protein or potassium restriction in CKD without stage context. Another common error is treating a single lab value as diagnostic; stems may include confounders like inflammation or hydration status.
Rule of thumb
For any MNT question, anchor on: disease stage, current intake/route, and the specific nutrient being modified. If the gut functions, prefer enteral over parenteral. If a patient is malnourished and starting feeding, anticipate refeeding syndrome and monitor phosphate, potassium, and magnesium.
Worked example
A patient with advanced CKD on hemodialysis needs higher protein than a pre-dialysis patient because dialysis removes amino acids. Answer: increase protein, not restrict it-stage and treatment modality drive the prescription.