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mercy cls 5: chemistry > 24) Nutrition & vitamins > Flashcards

24) Nutrition & vitamins Flashcards

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1
Q

Major components of energy output

A

Resting Energy Expenditure (REE)
physical activity

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2
Q

Average energy intake

A

American women is approximately 1800 kcal/d
American males is approximately 2600 kcal/d

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3
Q

Recommended dietary allowance (RDA) for protein

A

approximately 0.6 g/kg body mass per day

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4
Q

Dietary requirements for a healthy diet are ——% of calories from protein.

A

10-15

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5
Q

Contribution of carbohydrates to total caloric intake should be at least ——–%.

A

45-55

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6
Q

Brain requires approximately —– g/dL carbohydrate in order to function properly.

A

100

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7
Q

Benchmark recommendations for nutrient intakes developed to guide clinicians.

Replaced RDA

A

Dietary Reference Intakes (DRI)

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8
Q

DRI includes ———— for protein, fat, and carbohydrates

A

acceptable macronutrient distribution ranges (AMDRs)

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9
Q

Science of measuring the human body

A

Anthropometry

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10
Q

Anthropometry includes…

A

Craniometry
Osteometry
Skin-fold evaluation for subcutaneous fat estimation
Height and weight measurements
BMI

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11
Q

Body mass index < ——– and/or recent loss of ≥ ——- of usual body mass puts pt at risk for nutritional deficiency

A

18.5
10%

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12
Q

Hypermetabolic states

A

sepsis, protracted fever, extensive trauma or burns

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13
Q

serum albumin RR

A

3.5-5.0 g/dL

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14
Q

Serum prealbumin (transthyretin) RR

A

20-40 mg/dL

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15
Q

TIBC RR

A

240-450 ug/dL

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16
Q

Prolonged shows Vitamin K deficiency

A

PT
>15.5 sec

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17
Q

—– mg/dL serum creatinine reflects muscle wasting

A

< 0.6

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18
Q

24hr urine creatinine RR

A

500-1200 mg/d

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19
Q

reflects catabolism
Levels of >15 g/d severe catabolism

A

24 hr urinary urea nitrogen (UUN)

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20
Q

Protein Balance = Protein Intake - Protein Loss, where protein loss (protein catabolic rate) =

A

[24h UUN (g) + 4] x 6.25

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21
Q

——- mg/dL BUN = inadequate protein intake

A

< 6 mg/dL

adequate intake: 12-20 mg/dL

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22
Q

2 reasons for providing specialized nutrition support (SNS)

A
  1. Provide appropriate nutritional substances to maintain or replenish the nutritional status of patients unable to voluntarily ingest or absorb sufficient amounts of food
  2. Maintain the nutritional and metabolic status of sufficiently nourished patients who may have a health issue such as severe inflammation, injury, or infection
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23
Q

TPN

A

Direct infusion of complete mixtures of crystalline amino acids, dextrose, triglyceride emulsions, and micronutrients into the circulatory system through a central venous catheter.

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24
Q

TPN should be considered if…

A

energy intake has been or is anticipated to be inadequate for more than 10 days and enteral feeding is not feasible

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25
Q

3 techniques for functional/indirect vitamin assays

A
  • Increased or decreased activity of reactions
  • Cell response to inhibitors
  • Activators that will reflect alteration in vitamin concentrations
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26
Q

direct vitamin assays

A

Immunoassays, colorimetric, fluorescent, separation techniques, spectrophotometers, fluorometers, gas and liquid chromatographs, and mass spec.

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27
Q

Erythrocyte transketolase activation

A

B1/thiamine

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28
Q

Thiamine concentration in blood as thiamine pyrophosphate

A

B1/thiamine

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29
Q

Measure F A D-dependent glutathione reductase activity in freshly lysed erythrocytes

A

B2/riboflavin

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30
Q

(1) Measure two urine metabolites, Nmethyl nicotinamide and ‘N-methyl-2-pyridone-5’carboxyamide

(2) Determine ratio of
N A D/N A D P in erythrocyte and plasma tryptophan

A

B3/niacin

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31
Q

Measure activity of erythrocytes

A

B6/pyridoxine

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32
Q

Measure plasma levels of pyridoxal-5-phosphate

A

B6/pyridoxine

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33
Q

(1) Urine and serum concentration of methylmalonic acid

(2) Plasma homocysteine

(3) Deoxyuridine suppression test

(4) Vitamin absorption test

A

B12

34
Q

(1) Plasma vitamin level

(2) Retinol binding protein using radial immunodiffusion or nephelometry

A

vitamin A

35
Q

(1) Protection of erythrocyte hemolysis on addition of peroxides

(2) Inhibition of lipid peroxidation products

A

vitamin E

36
Q

(1) Serum alpha-tocopherol

(2) In tissue (lymphocytes, platelets, or red blood cells)

A

vitamin E

37
Q

(1) Prothrombin clotting time

(2) Immunoassay of γ-carboxy prothrombin or undercarboxylated prothrombin

(3) Plasma undercarboxylated osteocalcin

A

vitamin K

38
Q

Plasma phylloquinone

A

vitamin K

39
Q

Urine samples are not useful in some conditions because most vitamins are not…

A

under homeostatic control

40
Q

Coenzyme for cleaving carbon-carbon bonds

A

B1/thiamine

41
Q

Beriberi

A

B1/thiamine

42
Q

Cofactor for oxidation, reduction reactions

A

B2/riboflavin
B3/niacin

43
Q

Seborrhea, magenta tongue

A

B2/riboflavin

44
Q

Pellagra: pigmented rash of sun-exposed areas, reddish tongue

A

B3/niacin

45
Q

Component of Acetyl CoA

A

B5/pantothenic acid

46
Q

Cofactor for enzymes of amino acid metabolism

A

B6/pyridoxone

47
Q

Hypophosphatasia, glossitis, seborrhea, neuropathy, microcytic anemia

A

B6/pyridoxone

48
Q

Coenzyme for several carboxylases

A

B7/biotin

49
Q

Scaly dermatitis, glossitis, hair loss, anorexia, depression, and hypercholesterolemia

A

B7/biotin

50
Q

Coenzyme for methionine synthase and l-methylmalonyl CoA mutase

A

B12

51
Q

Megaloblastic anemia, dementia, increased homocysteine and methylmalonic acid

A

B12
folate

52
Q

Coenzyme for one carbon transfer in nucleic acid and amino acid metabolism

A

folate

53
Q

Participation as a redox ion in several biological oxidation and hydrogen transfer reactions

A

vitamin C

54
Q

petechiae, ecchymosis, inflamed and bleeding gums

A

vitamin C
scurvy

55
Q

Formation of rhodopsin and glycoproteins

A

vitamin A

56
Q

Nightblindness, follicular hyperkeratosis, xerophthalmia

A

vitamin A

57
Q

Hormone that controls calcium and phosphorus metabolism

A

vitamin D

58
Q

Antioxidants

A

vitamin E

59
Q

Peripheral neuropathy, skeletal muscle atrophy, retinopathy

A

vitamin E

60
Q

Cofactor for posttranslational carboxylation of many proteins and clotting factors

A

vitamin K

61
Q

Mostly found in yellow to orange pigmented fruits and veggies

A

carotene/previtamin A

62
Q

Most active form of carotenoid found in plants

A

B-carotene

63
Q

Nyctalopia

A

night blindness
vitamin A deficiency

64
Q

Bitot’s spots

A

small gray plaques with foamy surfaces
vitamin A deficiency

65
Q

rickets

A

vitamin D

66
Q

A peroxyl radical scavenger that protects LDL and polyunsaturated fats in membranes from oxidation

A

vitamin E

67
Q
  • Enhancing immune function
  • Blocking formation of nitrosamine (known carcinogen)
  • Delaying the development of coronary artery disease
A

Vitamin E
(controverial, not proven)

68
Q

causes of vitamin E deficiency

A
  • Premature birth
  • Malabsorption of dietary fat
  • Rare disorders of fat metabolism
69
Q

may reduce platelet aggregation and thus interfere with Vitamin K metabolism

patient on ——— should not over-supplement

A

vitamin E
warfarin

70
Q

Green vegetables, plant oils, margarines, cheese, eggs, and other milk products

A

vitamin K

71
Q

causes of vitamin K deficiency

A

May develop from taking anticoagulants and antibiotics

72
Q

Early deficiency: Anorexia and nonspecific symptoms

A

B1/thiamine

73
Q

Wet beriberi:
Dry beriberi:

A

Cardiovascular symptoms
Peripheral neuropathy

74
Q

Wernicke-Korsakoff Syndrome

A

Central nervous system complication that develops in alcoholics with thiamine deficiency

75
Q

lesions of the mucocutaneous surface of the mouth and skin

A

B2/riboflavin

76
Q

Occurs in individuals whose diets consist mainly of corn-based foods in China, Africa, and India

In the United States, occurs in alcoholics and in patients with carcinoid tumors

A

pellagra (niacin def)

77
Q

Bright red tongue, Casal’s necklace (skin rash), loss of appetite, generalized weakness and irritability

A

pellagra (niacin def)

78
Q

Tetrapyrrole ring surrounding cobalt atoms.

A

B12

79
Q

Progressive swelling of myelinated neurons, demyelization, and neuronal cell death in the spinal column and cerebral cortex

A

B12 def

80
Q

Kidney stones made of oxalic acid

A

vitamin C overdose

mercy cls 5: chemistry (24 decks)

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