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Gyn Onc > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What is the most sensitive test for malnutrition?

A

Albumin

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2
Q

Anergy secondary to malnutrition is mediated through what cells?

A

T-cells

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3
Q

What elements are increased in tumor lysis syndrome?

A

Potassium
Phosphorus
Uric acid

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4
Q

Which element is DECREASED in tumor lysis syndrome?

A

Calcium

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5
Q

Which electrolyte abnormality is LEAST consistent with tumor lysis syndrome?

A

Hypercalcemia, calcium is DECREASED with tumor lysis

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6
Q

Which element is most INCREASED with massive transfusion?

A

Potassium

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7
Q

Which element is most DECREASED with massive transfusion?

A

Calcium

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8
Q

What are the benefits of enteral feeds compared to TPN?

A

Trophic to small gut, decreased risk of infection compared to TPN

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9
Q

What non-essential amino acid is essential in patients with critical illness?

A

Glutamine

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10
Q

What is an essential fatty acid in critical illness?

A

Linolenic acid

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11
Q

What causes cholestasis associated with TPN?

A

Excessive carbohydrate calories

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12
Q

What is the most common METABOLIC abnormality with TPN?

A

Hyperglycemia

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13
Q

What is the equation used to calculate basal energy expenditure?

A

Harris-Benedict
666+(9.6kg)+(1.7cm)-(4.7*yrs)

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14
Q

Which factor is Basal energy expenditure most dependent on?

A

Weight

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15
Q

What is the most common ELECTROLYTE abnormality with TPN?

A

HYPOphosphatemia

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16
Q

Where is iron absorbed?

A

Duodenum

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17
Q

What cofactor is required for iron absorption?

A

Vitamin C

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18
Q

Night blindness, weakened immunity, diarrhea, and alopecia are common when deficient in what nutrient?

A

Zinc

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19
Q

Where is folate absorbed?

A

Duodenum

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20
Q

What trace element is needed for the creation of red blood cells?

A

Copper

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21
Q

Postoperative hyponatremia is secondary to what physiologic changes?

A

Increased ADH and free water retention

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22
Q

What is the most common cause of HYPERkalemia?

A

Renal failure, lab error

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23
Q

What are EKG manifestations of HYPERkalemia?

A

Peaked T-waves, flat p waves, prolonged QRS

24
Q

What is the best ACUTE treatment for HYPERkalemia with EKG changes?

A

Glucose, insulin, calcium (stabilize cardiac myocytes)

25
Q

What is the best continued treatment for hyperkalemia to deplete stores?

A

Kayexalate, saline diuresis, dialysis

26
Q

How do you calculate FeNa?

A

[(urine Na x Plasma Cr)/(Plasma Na x Urine Cr)] x 100

27
Q

What electrolyte abnormality is common with malignant hyperthermia?

A

HYPERkalemia

28
Q

A patient with stage IIIB SCCC presents with ureteral obstruction, K>7, cr: 9.0, and peaked t-waves. What is the best INITIAL step?

A

Glucose/insulin

(calcium gluconate if an answer choice is more appropriate to stabilize cardiac myocytes

29
Q

What is the most common cause of HYPOkalemia?

A

Vomiting, diarrhea, malnutrition, alkalosis

30
Q

Which vitamin is required for magnesium absorption?

A

Vitamin D

31
Q

Which patients are prone to become hypermagnesemic?

A

Patients with renal failure or acidosis

32
Q

What EKG changes are present in patients who are hypermagnesemic?

A

Widened PR and QRS

33
Q

What is the treatment for hypermagnesemia?

A

IV calcium

34
Q

Which patients are prone to become hypomagnesemic?

A

Patients who have received cisplatin, on diuretics, or radiation enteritis

35
Q

Radiation enteritis can result in bradycardia secondary to loss of what electrolyte?

A

Magnesium

36
Q

What are some symptoms of low magnesium?

A

Similar to hypocalcemia: weakness, tetany, QT prolongation

37
Q

What is the most reversible cisplatin toxicity?

A

Hypomagnesemia

38
Q

Where is calcium absorbed?

A

Duodenum

39
Q

What forms does calcium circulate in?

A

45% ionized, 40% protein bound, 15% bound tightly to other ions

40
Q

What are common causes of hypercalcemia in cancer patients?

A

Lytic bone lesions, secretion of PTH-like peptides, thiazide diuretics

41
Q

What are symptoms of hypercalcemia?

A

Short QT, weakness, confusion, nausea/vomiting

42
Q

What are options for treatment of hypercalcemia?

A

Hydration, lasix, calcitonin (rapid onset 48 hrs duration of action), zolendronic acid

43
Q

What is the most common EKG finding of hypercalcemia?

A

Shortened QT internal

44
Q

What are causes of hypocalcemia in cancer patients?

A

Malnutrition, hypomagenesemia, tumor lysis syndrome

45
Q

What are clinical signs of hypocalcemia?

A

Chvosteks sign, prolonged QT and ST

46
Q

What is the most common electrolyte abnormality with TPN?

A

Hypophosphatemia

47
Q

What are the symptoms of hypophosphatemia?

A

Weakness, mental status changes

48
Q

What hormone mediates the release of phosphate?

A

PTH

49
Q

Where is phosphorous stored?

A

Bone

50
Q

What are common causes of metabolic acidosis?

A

GI loss, ketoacidosis, lactic acidosis, ASA, Tylenol or methanol ingestion, renal tubular acidosis

51
Q

Which causes of metabolic acidosis cause an anion gap?

A

Lactic, ASA, Tylenol, DKA

52
Q

What is the expected change in PH associated with a change of 10 pCO2?

A

0.08

53
Q

What are causes of high anion gap?

A

Lactic acidosis (sepsis), DKA, ASA, ESRD

54
Q

Which patient will likely have a non-gap acidosis?

A

Renal tubular acidosis and a patient with a transverse colon conduit

55
Q

What is the LEAST likely to produce acidosis?

A

Vomiting

Gyn Onc (4 decks)

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