24) Nutrition & vitamins

Question 1

Major components of energy output

Answer 1

Resting Energy Expenditure (REE)
physical activity

Question 2

Average energy intake

Answer 2

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

Question 3

Recommended dietary allowance (RDA) for protein

Answer 3

approximately 0.6 g/kg body mass per day

Question 4

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

Answer 4

10-15

Question 5

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

Answer 5

45-55

Question 6

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

Answer 6

100

Question 7

Benchmark recommendations for nutrient intakes developed to guide clinicians.

Replaced RDA

Answer 7

Dietary Reference Intakes (DRI)

Question 8

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

Answer 8

acceptable macronutrient distribution ranges (AMDRs)

Question 9

Science of measuring the human body

Answer 9

Anthropometry

Question 10

Anthropometry includes…

Answer 10

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

Question 11

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

Answer 11

18.5
10%

Question 12

Hypermetabolic states

Answer 12

sepsis, protracted fever, extensive trauma or burns

Question 13

serum albumin RR

Answer 13

3.5-5.0 g/dL

Question 14

Serum prealbumin (transthyretin) RR

Answer 14

20-40 mg/dL

Question 15

TIBC RR

Answer 15

240-450 ug/dL

Question 16

Prolonged shows Vitamin K deficiency

Answer 16

PT
>15.5 sec

Question 17

—– mg/dL serum creatinine reflects muscle wasting

Answer 17

< 0.6

Question 18

24hr urine creatinine RR

Answer 18

500-1200 mg/d

Question 19

reflects catabolism
Levels of >15 g/d severe catabolism

Answer 19

24 hr urinary urea nitrogen (UUN)

Question 20

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

Answer 20

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

Question 21

——- mg/dL BUN = inadequate protein intake

Answer 21

< 6 mg/dL

adequate intake: 12-20 mg/dL

Question 22

2 reasons for providing specialized nutrition support (SNS)

Answer 22

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

Question 23

TPN

Answer 23

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

Question 24

TPN should be considered if…

Answer 24

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

Question 25

3 techniques for functional/indirect vitamin assays

Answer 25

* Increased or decreased activity of reactions * Cell response to inhibitors * Activators that will reflect alteration in vitamin concentrations

Question 26

direct vitamin assays

Answer 26

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

Question 27

Erythrocyte transketolase activation

Answer 27

B1/thiamine

Question 28

Thiamine concentration in blood as thiamine pyrophosphate

Answer 28

B1/thiamine

Question 29

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

Answer 29

B2/riboflavin

Question 30

(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

Answer 30

B3/niacin

Question 31

Measure activity of erythrocytes

Answer 31

B6/pyridoxine

Question 32

Measure plasma levels of pyridoxal-5-phosphate

Answer 32

B6/pyridoxine

Question 33

(1) Urine and serum concentration of methylmalonic acid (2) Plasma homocysteine (3) Deoxyuridine suppression test (4) Vitamin absorption test

Answer 33

B12

Question 34

(1) Plasma vitamin level (2) Retinol binding protein using radial immunodiffusion or nephelometry

Answer 34

vitamin A

Question 35

(1) Protection of erythrocyte hemolysis on addition of peroxides (2) Inhibition of lipid peroxidation products

Answer 35

vitamin E

Question 36

(1) Serum alpha-tocopherol (2) In tissue (lymphocytes, platelets, or red blood cells)

Answer 36

vitamin E

Question 37

(1) Prothrombin clotting time (2) Immunoassay of γ-carboxy prothrombin or undercarboxylated prothrombin (3) Plasma undercarboxylated osteocalcin

Answer 37

vitamin K

Question 38

Plasma phylloquinone

Answer 38

vitamin K

Question 39

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

Answer 39

under homeostatic control

Question 40

Coenzyme for cleaving carbon-carbon bonds

Answer 40

B1/thiamine

Question 41

Beriberi

Answer 41

B1/thiamine

Question 42

Cofactor for oxidation, reduction reactions

Answer 42

B2/riboflavin B3/niacin

Question 43

Seborrhea, magenta tongue

Answer 43

B2/riboflavin

Question 44

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

Answer 44

B3/niacin

Question 45

Component of Acetyl CoA

Answer 45

B5/pantothenic acid

Question 46

Cofactor for enzymes of amino acid metabolism

Answer 46

B6/pyridoxone

Question 47

Hypophosphatasia, glossitis, seborrhea, neuropathy, microcytic anemia

Answer 47

B6/pyridoxone

Question 48

Coenzyme for several carboxylases

Answer 48

B7/biotin

Question 49

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

Answer 49

B7/biotin

Question 50

Coenzyme for methionine synthase and l-methylmalonyl CoA mutase

Answer 50

B12

Question 51

Megaloblastic anemia, dementia, increased homocysteine and methylmalonic acid

Answer 51

B12 folate

Question 52

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

Answer 52

folate

Question 53

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

Answer 53

vitamin C

Question 54

petechiae, ecchymosis, inflamed and bleeding gums

Answer 54

vitamin C scurvy

Question 55

Formation of rhodopsin and glycoproteins

Answer 55

vitamin A

Question 56

Nightblindness, follicular hyperkeratosis, xerophthalmia

Answer 56

vitamin A

Question 57

Hormone that controls calcium and phosphorus metabolism

Answer 57

vitamin D

Question 58

Antioxidants

Answer 58

vitamin E

Question 59

Peripheral neuropathy, skeletal muscle atrophy, retinopathy

Answer 59

vitamin E

Question 60

Cofactor for posttranslational carboxylation of many proteins and clotting factors

Answer 60

vitamin K

Question 61

Mostly found in yellow to orange pigmented fruits and veggies

Answer 61

carotene/previtamin A

Question 62

Most active form of carotenoid found in plants

Answer 62

B-carotene

Question 63

Nyctalopia

Answer 63

night blindness vitamin A deficiency

Question 64

Bitot's spots

Answer 64

small gray plaques with foamy surfaces vitamin A deficiency

Question 65

rickets

Answer 65

vitamin D

Question 66

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

Answer 66

vitamin E

Question 67

* Enhancing immune function * Blocking formation of nitrosamine (known carcinogen) * Delaying the development of coronary artery disease

Answer 67

Vitamin E (controverial, not proven)

Question 68

causes of vitamin E deficiency

Answer 68

* Premature birth * Malabsorption of dietary fat * Rare disorders of fat metabolism

Question 69

may reduce platelet aggregation and thus interfere with Vitamin K metabolism patient on --------- should not over-supplement

Answer 69

vitamin E warfarin

Question 70

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

Answer 70

vitamin K

Question 71

causes of vitamin K deficiency

Answer 71

May develop from taking anticoagulants and antibiotics

Question 72

Early deficiency: Anorexia and nonspecific symptoms

Answer 72

B1/thiamine

Question 73

Wet beriberi: Dry beriberi:

Answer 73

Cardiovascular symptoms Peripheral neuropathy

Question 74

Wernicke-Korsakoff Syndrome

Answer 74

Central nervous system complication that develops in **alcoholics** with **thiamine** deficiency

Question 75

lesions of the mucocutaneous surface of the mouth and skin

Answer 75

B2/riboflavin

Question 76

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

Answer 76

pellagra (niacin def)

Question 77

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

Answer 77

pellagra (niacin def)

Question 78

Tetrapyrrole ring surrounding cobalt atoms.

Answer 78

B12

Question 79

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

Answer 79

B12 def

Question 80

Kidney stones made of oxalic acid

Answer 80

vitamin C overdose