Exam #1: Proteins and Malnutrition

Question 1

What is the difference between an essential and non-essential amino acid? Conditionally essential?

Answer 1

Essential= need to get from diet

**Conditional= need more of in certain disease states

Question 2

What is the mnemonic for the essential amino acids?

Answer 2

PVT TIM HLL

Phenylalanine
Valine
Threonine

Tryptophan
Isoleucine
Methionine

Histidine
Arginine
Leucine
Lysine

Question 3

What are the five stages of protein synthesis?

Answer 3

1) Amino acid activation
2) Initiation of polypeptide chain
3) Elongation
4) Termination and release
5) Folding and processing

Question 4

What is cystinuria?

Answer 4

See picmonic.

Question 5

What is hartnup disease?

Answer 5

See picmonic.

Question 6

What is the free amino acid pool?

Answer 6

Amino acids that are available for oxidation

Question 7

What is nitrogen balance in normal conditions?

Answer 7

Protein in= protein out i.e. nitrogen in = nitrogen out

Question 8

What is unique about the metabolism of protein compared to fat and carbohydrates?

Answer 8

Minimal breakdown in the mouth

Question 9

Where does the majority of digestion and absorption of protein occur?

Answer 9

Small intestine

Question 10

What enzyme do infants possess that beings protein breakdown in the mouth?

Answer 10

Rennin

Question 11

What is the role of protein in the eight common food allergies?

Answer 11

Intact proteins absorbed through leaks in cell junctions–>allergy development

Question 12

What organ regulates the flow of amino acids?

Answer 12

Liver

Question 13

What amino acids help to remove nitrogenous waste from skeletal muscle following exercise?

Answer 13

Alanine & glutamine

Question 14

What amino acid is completely oxidized for energy in skeletal muscle?

Answer 14

Leucine

Question 15

What two organs can participate in gluconeogenesis?

Answer 15

Liver & kidney

Question 16

What is the major function of the kidney in relation to proteins?

Answer 16

Removal of nitrogenous wastes

Question 17

How do essential amino acids get into neurons for neurotransmitter and neuropeptide production?

Answer 17

Active transport

Question 18

What is the PDCAA?

Answer 18

Protein Digestibility Corrected Amino Acid Score

***** Evaluating the protein quality based on both the amino acid requirements of humans and their ability to digest it.

Question 19

What vitamin is ONLY found in animal products and must be supplemented by vegans?

Answer 19

B12

Question 20

What do vegetarian athletes need to remember in regards to protein intake?

Answer 20

• Plant protein is less digestible

- Need more protein than non-veg athlete

Question 21

How does the protein requirement change for the critically ill and major trauma victims?

Answer 21

Hypermetabolic state=

• Increased for critically ill
• Further increased for burns/ multiple trauma

**Healthy =0.8 g/Kg, Critically Ill= 1.5 g/Kg, & Burn= 2.0 g/Kg

Question 22

What are the risks of overshooting protein intake?

Answer 22

• Pre-renal azotemia (nitrogen/ urea in blood)
• Increased kidney burden
• Kidney stones
• Osteoporosis
• Gout

*****Ca++ used to buffer pH changes with increased N in blood–>Osteoporosis

Question 23

How does the net acid change in a high protein diet?

Answer 23

Acidic state

Question 24

What is the primary substrate for gluconeogenesis?

Answer 24

Protein

Question 25

How many days of starvation does it take for the body to switch from glucose to ketones as an energy source?

Answer 25

~2 days

Question 26

What amino acid is vital for rapidly dividing cells?

Answer 26

Glutamine

*****E.g. trauma

Question 27

What amino acid is vital for immunomodulation?

Answer 27

Arginine

Question 28

What amino acid may have anti-inflammatory properties?

Answer 28

Cysteine

Question 29

What percentage of inpatients are malnourished upon arrival?

Answer 29

30-50%

Question 30

What are six indications of malnutrition?

Answer 30

1) Decreased energy intake
2) Weight loss
3) Decreased body fat
4) Decreased muscle mass
5) Fluid accumulation
6) Decreased grip strength

Question 31

What is a nutrition focused physical assessment?

Answer 31

Examination of the body to determine clinical criteria for malnutrition