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Pharm Y2S2 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Why are vitamins and minerals required in the body?

A

They play a key role as co-factors or co-enzymes in mot metabolic reactions

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2
Q

Give examples of water soluble vitamins

A 
Vit C - ascorbic acid
Vit B1 - Thiamine 
Vit B2 - Riboflavin 
Vit B3 - Niacin / Nicotinic acid
Vit B5 - Pantothenic acid 
Vit B6 - Pyridoxine 
Vit B7 - Biotin 
Vit B9 - Folic acid 
Vit B12 - Cyanocobalamin
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3
Q

Give examples of fat soluble vitamins

A

Vit A - retinol
Vit D - Cholecalciferol
Vit E - 𝜶 tocopherol
Vit K - Phytomendione

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4
Q

Where are water soluble vitamins absorbed?

A

In the duodenum

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5
Q

Where are fat soluble vitamins absorbed?

A

In the ileum

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6
Q

What absorbs Vit B12?

A

Intrisic factor in the ileum

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7
Q

Apart from the diet, what is another source of Vit D?

A

Sunlight

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8
Q

What does Vit A deficiency cause?

A

Poor night vision

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9
Q

What does Vit B1 deficiency cause?

A

Wernickes encephalopathy

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10
Q

What does Vit B7 deficiency cause?

A

Hair loss

Anaemia

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11
Q

What does Vit B9 deficiency cause?

A

Megaloblastic anaemia

Neural tube defects

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12
Q

What does Vit B12 deficiency cause?

A

Pernicious anaemia

Peripheral neuropathy

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13
Q

What does Vit C deficiency cause?

A

Painful joints

Scurvy

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14
Q

What does Vit D deficiency cause?

A

Rickets

Osteoporosis

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15
Q

What does Vit K deficiency cause?

A

Abnormal clotting

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16
Q

What do folic acid supplements do in pregnancy?

A

Prevent neural tube defects - spina bifida

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17
Q

What dose of folic acid should given to a woman with no previous history of neural tube defects?

A

400mcg OD until 12th week

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18
Q

When should a woman be given a dose of 5mg folic acid?

A
  • Previous history of neural tube defects

- Epilepsy / on anti-epileptics

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19
Q

What are minerals and trace elements required for?

A
  • Formations of bones and teeth
  • Body fluids and tissues
  • Enzyme systems
  • Nerve function
  • Blood constituents
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20
Q

Give examples of minerals

A
  • Calcium
  • Magnesium
  • Phosphorous
  • Sodium
  • Potassium
    Required in large amounts
21
Q

Give examples of trace elements

A 
Iron
Zinc
Iodine
Fluoride 
Selenium 
Copper
22
Q

What does potassium and magnesium deficiency cause?

A

Cardiac arrhythmias

23
Q

What does calcium and magnesium deficiency cause?

A

Osteoporosis
Muscle cramps
Tetany

24
Q

What does zinc deficiency cause?

A

Hair loss

Poor wound healing

25
Q

What does iron deficiency cause?

A

Anaemia

26
Q

What is Wilson’s disease?

A

Build up of copper and excessive copper deposits due to an enzyme deficiency

27
Q

What are the problems associated with supplements?

A 
Toxicity / accumulation 
Supplements are expensive 
Complacency 
No control because of legal status 
Difficult to offer advice as they are not medicines
28
Q

What does folic acid interact with?

A

Methotrexate

29
Q

What does vitamin C interact with?

A

Iron

30
Q

What are the consequences of malnutrition

A
  • Weakness and loss of muscle mass
  • Apathy and depression
  • Reduced immune system
  • Poor wound healing
  • Increased morbidity and mortality
31
Q

What are the normal feeding aims?

A

Energy: 25-35 kcal / kg / day
Protein: 0.8 - 1.5g / kg / day
Fluid: 30 - 35ml / kg / day

32
Q

What are the methods that can be used to feed patients?

A
  • Normla diet
  • Enteral nutrient
  • IV fluids
  • Parenteral nutrition
33
Q

How is enteral nutrition administered?

A

Via gastrointestinal tract

34
Q

What are the benefits of EN?

A
  • More physiological
  • Less risk of infection
  • Maintain GIT
  • Gut bacteria translocation
  • Lower cost
  • Easier for home patients
  • Patient ease
  • Calorie control
35
Q

Which patients would benefit from EN?

A
  • Patients with eating / swallowing difficulties
  • Severe intestinal malabsorption
  • Increased nutritional requirements
  • Eating disorders
  • Self neglecting patients
36
Q

What are the routes of EN administration?

A

Oral
Naso gastric tube
Percutaneous endoscopic gastronomy (tube passed through abdominal wall)
Percutaneous endoscopic jejunostomy

37
Q

What are the problems associated with EN?

A
  • diarrhoea
  • regurgitation
  • abdominal distention
  • blocked feeding tube
  • problems with the pump
  • taste/acceptability
  • dislocation
38
Q

How should drugs be administered in EN patients?

A
  • Use liquid preparation where possible
  • Give each drug separately
  • Flush with >20ml water before and after
  • Crushed tablets may block tube
  • Not MR or e/c
39
Q

Which drug directly interact with EN feed?

A 
Ciprofloxacin
Albumin antacids
Theophylline
Phenytoin 
Penicillamine
40
Q

When should TPN be used?

A
  • When EN is not an option
  • When patient can’t take food in orally
  • Digestion / absorption problems
  • Unavailable GIT
41
Q

What are short term indications for TPN?

A
  • waiting for feeding tubes
  • bowel obstruction
  • excisional surgery
  • ICU patients with multi-organ system failure
  • severe pancreatitis
  • pre-term neonates
  • acute intestinal failure
42
Q

What are long term indications for TPN?

A
  • radiation enteritis
  • Crohns disease
  • motility disorders
  • bowel infarction
  • cancer surgery
  • chronic intestinal failure
43
Q

How is short term TPN administered?

A

via cannula (Venflon)

44
Q

How is long term TPN administered?

A

Peripherally inserted central catheter (PICC)
Hickman line
Central line : intrajugular, subclavian, femoral

45
Q

What needs to be monitored when a patient is on TPN?

A 
Clinical history 
U&Es
Glucose
Vitamins
LFTs
FBS
Trace elements
Fluid balance 
Weight
46
Q

What are TPN complications?

A
  • air embolism / insertion problems
  • catheter blockage
  • line infections
  • metabolic problems
  • bone disease
  • re-feeding syndrome
47
Q

What is re-feeding syndrome?

A

It is characterised by abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypophosphatemia, hypermagnesaemia and hypokalaemia

48
Q

How is re-feeding syndrome prevented?

A

By introducing feed at no more than 50% of the normal requirements. Start at 10kcal / kg / day and increase slowly to meet full needs by 4-7 days

49
Q

What supplements should be given in re-feeding?

A

Oral thiamine 200-300mg daily
Vitamin B co-strong 1-2 three times daily
Multivitamin

Pharm Y2S2 (26 decks)

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