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MNT2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

The two factors used to classify burns are

A
  1. Depth of Burn

2. Total Body Surface Area

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2
Q

Paralytic ileus, anorexia/nausea, and ______ aka curiling’s ulcers are the GI complications seen in burn patients

A

stress ulcers

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3
Q

Which solution is commonly given post-burn

A

Ringer’s Lactate solution

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4
Q

The goal weight of a burn pt, is to maintain at _______% of pre-burn weight

A

maintain 90-110% pre-burn weight

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5
Q
  1. Debridgement of dead skin (whirlpool)
  2. escharotomy (surgical incision to
    Lessen contraction)
  3. Antibiotics
  4. Skin grafts
A

Wound treatment techniques

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6
Q

What is the recommended Kcal:N ratio for burn pts and how to calculate it

A

80-100:1 or 100-150:1

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7
Q

Which micronutrients is particularly important in large burns and aids in immune response and wound healing with a recommendation of 5000 IU per 1000 calories?

A

Vitamin A

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8
Q

Which micronutrients is particularly important in large burns and is a coenzyme in collagen synthesis and immune fx and has a recommendation of 1g/day, given as 500 mg twice daily?

A

Vitamin C

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9
Q

Which micronutrients is particularly important in large burns and is a cofactor in energy metabolism and protein synthesis and has a recommendation of 220mg zinc sulfate/day?

A

Zinc

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10
Q

What is grafting with own skin from other part of body?

A

autograft

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11
Q

What is grafting with same species of cadaver or another person?

A

homograft?

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12
Q

What is a grafting of another species often pig

A

heterograft

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13
Q

What is a grafting of a silastic material?

A

artificial skin

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14
Q

What is a grafting of a silastic material?

A

artificial skin

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15
Q

What is the transient phase, lasting hours up to 3-5 days when everything in body function decreases?

A

Ebb Phase

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16
Q

What is the phase where acute and adaptive phase; length of phase depends on severity of injury

A

flow phase

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17
Q

what phase includes:

  1. hypovolemic shock
  2. ↓ tissue perfusion
  3. ↓ metabolic
  4. ↓ kcal
  5. ↓ oxygen consumption
  6. ↓ blood pressure
  7. ↓ body temp
A

Ebb phase response

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18
Q

What phase includes:

  1. Catabolism predominates
  2. ↑glucocorticoids
  3. ↑glucagon
  4. ↑catecholamines
  5. ↑excretion of nitrogen
  6. ↑metabolic rate
  7. ↑ oxygen consumption impaired use of fuels
A

Acute Phase response

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19
Q

Which micronutrients is particularly important in large burns?

A

Vitamin A, Vitamin C, Zinc

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20
Q

What phase includes:

  1. Catabolism predominates
  2. ↑glucocorticoids
  3. ↑glucagon
  4. ↑catecholamines
  5. ↑excretion of nitrogen
  6. ↑metabolic rate
  7. ↑ oxygen consumption impaired use of fuels
A

Acute Phase response

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21
Q

What are hormone-like proteins, secreted by many cell types, which regulate the intensity and duration of immune responses?

A

cytokines

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22
Q

Fever causes an increase in the metabolic rate by what amount?

A

13% per °C
&
7% per °F

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23
Q

What are the characteristics of SIRS?

A

Body temp >38°C / >100.4°F
or
90beats/min
Respiratory rate > 20 breaths/min (tachypnea)
Hyperventilation
WBC > 12,000 mm3 or 10% bands (immature neutrophils in the absence of chemotherapy)

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24
Q

MODS generally begins in what organ?

A

lungs

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25
Q

What is the effect of glucagon on hepatic glycogenolysis and glyconeogenesis?

A

Increases both at expense of protein synthesis

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26
Q

What is the effect of cortisol on skeletal amino acids?

A

mobilizes them

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27
Q

How do catecholamines affect the metabolic rate?

A

Increases it

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28
Q

There are changes in nutrient metabolisms with metabolic stress, and alteration in PRO affects branched-chain amino acids because it

A

accelerates oxidation of them from skeletal muscle

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29
Q

There are changes in nutrient metabolisms with metabolic stress, an alteration in CHO affects blood glucose how?

A

by increasing it

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30
Q

There are changes in nutrient metabolisms with metabolic stress, what is the max rate of glucose oxidation in stress?

A

7 or 15 mg/kg/min

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31
Q

epidermis, dermis, and subcutaneous tissue are the

A

three layers of the skin

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32
Q

What are limited to the epidermis and upper portions of the dermis and heal by regeneration, no scar tissue or loss of function?

A

partial thickness wounds

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33
Q

What are limited to the epidermis and upper portions of the dermis and heal by regeneration, no scar tissue or loss of function?

A

partial thickness wounds

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34
Q

What is total destruction or loss of epidermis, dermis and subcutaneous tissue and may involve destruction of muscle and bone, and heals by scar formation?

A

full thickness wounds

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35
Q

What are the three classical steps in the process of wound healing?

A
  1. Inflammatory Phase
  2. Proliferative Phase
  3. Collagen Remodeling Phase
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36
Q

Which AA helps in protein synthesis and collagen deposition?

A

Argenine

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37
Q

in healing, what vitamin is involved during the inflammatory phase by stimulating epithelializaton and increasing collagen deposition by fibroblasts?

A

Vitamin A

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38
Q

in healing, what vitamin is involved in synthesis of collagen connective tissue protein?

A

Vitamin C

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39
Q

In healing, what mineral is a cofactor for enzymes necessary for protein and collagen formation and tissue growth?

A

Magnesium

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40
Q

In healing, what mineral is essential for cross-linking and strengthening of the collagen framework?

A

Copper

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41
Q

in healing, what mineral is involved in the immune function, DNA synthesis, protein nd collagen synthesis, cellular proliferation, and wound healing?

A

Zinc

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42
Q

What are the two main hormones produced by the thyroid gland?

A

T3 ( tri-iodthyronine)
&
T4 ( thyroxine)

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43
Q

Which of the two main hormones is the most active form the body can use?

A

T3

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44
Q

What two items are needed to make T3 & T4?

A

Tyrosine and iodine

45
Q

What is an autoimmune disorder in which the immune system attacks and destroys thyroid gland tissue?

A

Hashimoto’s thyroiditis

46
Q

What are common foods that are goitrogens?

A 
cyanogenic plant foods:
cauliflower
broccoli
cabbage
brussel sprouts
mustard seed
turnips
radish
bamboo shoot
cassava
47
Q

When are soybeans considered goitrogenic?

A

when the iodine intake is limited

48
Q

what are the three things severe iodine deficiency can cause during pregnancy?

A
  1. Still-births
  2. Spontaneous abortions
  3. congenital abnormalities
49
Q

What autoimmune disease is when the thyroid is diffusely enlarged (goiter) and overactive, producing an excessive amount of thyroid hormones?

A

Graves disease

50
Q

What are the symptoms of graves disease?

A 
red, dry, swollen, puffy bulging eyes
heat intolerance
difficulty sleepping
anxiety
and the less common is goiter
51
Q

In Cushing’s Syndrom, what hormone remains in the blood stream in too high amounts and for too long?

A

cortisol

52
Q

What disease is characterized by being a primary adrenal insufficiency?

A

Addisons Disease

53
Q

What are the symptoms of Addison’s Disease?

A 
loss of appetite
fatigue
low BP
nausea
vomiting
darkening of skin on face and neck
54
Q

What % of water makes up males?

A

60%

55
Q

What % of water makes up females?

A

50%

56
Q

What are the two main compartments of boy water and how much fluid is held in them?

A

Intracelluar includes 1/3 of TBF

Extracellular includes 2/3 of TBF

57
Q

What are the fluid requirements based on energy for adults?

A

1 mL/kcal

58
Q

What are the fluid requirements based on energy for infants?

A

1.5mL/kcal

59
Q

What is the number of osmotic particles per kg of water or solvent?

A

osmolality

60
Q

What is the function of ADH (Antidiuretic Hormone)?

A

affects water reabsorption especially with those with diabetes insipidus

61
Q

What is the function of Aldosterone?

A

affects sodium reabsorption

62
Q

an increase in ADH decreases _____ _____

A

urine output

63
Q

a decrease in ADH increases ______ ______

A

urine output

64
Q

What are laboratory values to observe in hypovolemia?

A 
Na
K
Cl
BUN
CR
Glucose
65
Q

What is the retaining of water which causes swelling?

A

edema

66
Q

what is generalized massive edema?

A

anasarca

67
Q

what is fluid in the parataneal cavity

A

ascities

68
Q

in electrolytes, what is the main intracellular cation?

A

potassium

69
Q

in electrolytes, what is the main extracellular cation?

A

sodium

70
Q

in electrolytes, what is the main extracellular anions?

A

chloride

71
Q

in electrolytes, what is the main intracellular anions?

A

phosphate

72
Q

HTN, hyperglycemia, weight gain, osteoporosis and negative nitrogen balance are all side effects of

A

Corticosteroids

73
Q

IBW BMI range is :

A

18.5-24.9

74
Q

What is the brand name for a drug used to provide relief from pain and inflammation for rheumatic disease also known as Tylenol

A

Analgesics

75
Q

What are the two forms of Nonsteriodal anti-inflammatory drugs (NSAIDS) & their commonly known name?

A

Ibuprofen aka Advil/Motrin
&
Naproxen aka Aleve

76
Q

What drug that is used to treat rheumatic disease are known as COX-2 Inhibitors?

A

Celecoxib (Celebrex)

77
Q

Kineret, Humira, Enbrel, & Remicade make up what kind of drugs?

A

Biologic respone modifiers

78
Q

Cortone, Deltason, Medrol, Cortef make up what kind of drugs?

A

Corticosteriods

79
Q

What is a debilitating/crippling autoimmune disease with personal, social and economic effects. That also affects the interstitial tissues, blood vessels, cartilage, bone, tendons, and ligaments, as well as the synovial membranes that line joint surfaces?

A

Rheumatoid Arthritis (RA)

80
Q

What RA joints are most commonly affected?

A

Proximal interphalangeal joints of hands and feet

81
Q

Nutrition consequence of DMARD MTX treatment include:

A
  1. Disease-modifying antirhematic drugs methotrexate

2. Folate antagonism

82
Q

RA lipid recommendations include:

A
  1. Change type of fat, but don’t eliminate
  2. ↑ omega-3 fatty acids to reduce inflammatory activity, increase physical function & improve vitality
  3. Olive and evening prim rose oils have indirect anti-inflammatory actions
  4. Fish oils alleviates RA symptoms & reduces the us of NSAIDS
83
Q

What is a chronic autoimmune disease with lymphocytic infiltration of the exocrine glands, especially the salivary and lacrimal glands, leading to dryness of mouth and of the eyes?

A

Sjorgren’s Syndrome

84
Q

what is dryness of mouth

A

xerostomia

85
Q

what is xeropthalmia

A

dryness of eyes

86
Q

What is the major issue of Sjogren’s Syndrome?

A

malabsoption & symptoms decreasing appetite or causing eating to become difficult

87
Q

what is the inflammation of the tongue

A

glossitis

88
Q

what is the inflammation of the lips

A

cheilitis

89
Q

what is difficulties chewing and swallowing

A

dysphagia

90
Q

what is a disturbance in smell perception

A

dysosmia

91
Q

what is a disturbance in taste acuity

A

dysguesia

92
Q

What is the prescribed diet for individuals for TMD

A

mechanically soft diet

93
Q

What is a disorder of purine metabolism in which high levels of uric acid accumulate in the blood?

A

Gout

94
Q

Where does Gout usually begin?

A

big toe

95
Q

Who typically is at risk for gout?

A

those >35 you & males

96
Q

What is a chronic, systemic sclerosis, or hardening, of the skin and visceral organs characterized by deposition of fibrous connective tissue?

A

Scleroderma

97
Q

What are common symptoms of Systemic Lupus Erythematosus SLE?

A 
Extreme fatigue
painful/swollen joints
unexplained fever
skin rashes (butterfly mask)
mouth ulcers
kidney problems
98
Q

What are common symptoms of hypernatremia?

A 
Being thirsty
Dry mouth
Muscle weakness or muscle cramps
Decreased urination
Weight loss
Lightheadedness
Irritability
Confusion
Muscle twitching
99
Q

What are common symptoms of hypokalemia?

A

weakness, fatigue, constipation, and muscle cramping

100
Q

What are common symptoms of hyperkalemia

A

Abnormal heart rhythm – arrhythmia – that can be life-threatening
Slow heart rate
Weakness

101
Q

What is hyperkalemia

A

too much potassium in blood

102
Q

what is hypokalemia

A

too little potassium in blood

103
Q

What cation accounts for nearly all plasma osmotic activity?

A

sodium

104
Q

what is the most common cause of hypothyroidism

A

iodine deficiency

105
Q

what is the most prevalent form of arthritis?

A

OA, degenerative arthritis

106
Q

What is the most important nutrient compromised in critically ill patients

A

protein

107
Q

what is the most abundant amino acid in the plasma?

A

glutamine

108
Q

which is the most important mineral in wound healing?

A

zinc

MNT2 (3 decks)

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