Examen Final

Question 1

Main glucogenic substrate

Answer 1

Glycerol and alanine

Question 2

Works as a hydrogen career in Krebbs cycle as FAD

Answer 2

Riboflavin

Question 3

It’s deficiency causes sideroblastic anemia

Answer 3

Niacin

Question 4

It has an important role before and during pregnancy to prevent neural tube defect

Answer 4

Folic acid

Question 5

It’s a component of CoA as a acil transport

Answer 5

Panthotenic Acid

Question 6

Works as a hydrogen career in Krebbs Cycle as NAD

Answer 6

Niacin

Question 7

It’s a cofactor of carboxylase enzymes in the mitochondria

Answer 7

Biotin

Question 8

It’s deficiency causes Wernike Karsakoff encephalopathy

Answer 8

Thiamine

Question 9

If you have an elderly male patient with a HB of 11.3 mg/de and a VCM of 114; what deficiency do you suspect

Answer 9

Folic acid

Question 10

This mineral has an important role in insulin resistance

Answer 10

Chromium

Question 11

This vitamin has been used in neurological patients for its antioxidant properties

Answer 11

Vitamin E

Question 12

This vital has a crucial role in carboxylation and activation of coagulation factors

Answer 12

Vitamin K

Question 13

If I have a patient with anorexia Nervosa, who has been restricting her energy consumption for 2 months; her labs show glucose in upper limit, hyper triglyceride is and normal albumin, who’s is the main substrate that she is doing ?

Answer 13

Lipids form adipose tissue

Question 14

Regarding proteolysis during metabolic adaptation to simple starvation and stress starvation

Answer 14

Lower starvation than in stress

Question 15

Regarding gluconeogenesis during metabolic adaptation to simple starvation and stress starvation

Answer 15

Lower in starvation and high in stress

Question 16

Regarding ketogenesis during metabolic adaptation to simple starvation and stress starvation

Answer 16

Higher in starvation and in stress

Question 17

Nutritional Screening tool recommended by ASPEN for hospitalized patients

Answer 17

SGA

Question 18

Nutritional Screening tool recelmended by ESPEN for hospitalized patients

Answer 18

NRS

Question 19

Absolute GI contraindication for enteral nutrition

Answer 19

Intestinal obstruction and ileus

Question 20

You have a female patient with advance dementia, who suffered a stroke and consequent dysphagia; the neurology doesn’t expect a full recovery in the next 3 months, which would be the best option ?

Answer 20

Enteral nutrition with gastrostomy

Question 21

You have an obese patient who suffered a car accident and is in the ICU, he is tolerating the enteral nutrition, he is sedarte and with high values of PEEP on the mechanical ventilation; which would be the best option

Answer 21

Nasoyeyunal tube with continuous infusion

Question 22

Mention the parameter which we calculate gastric capacity for the bolus

Answer 22

5-7 ml/kg por bolus

Question 23

According to ASPEN and ESPEN how do we advance the infusion rate for continuous enteral nutrition

Answer 23

Start with 20 ml/gr and increase 20ml/gr every 6-8 hours according to tolerance until you achieve the infusion rate goal

Question 24

According to ESPEN, which is the make osmolaroty we can use with a peripheral catheter

Answer 24

850

Question 25

Best option for a central access

Answer 25

1. Subclavian catheter 2. Yugular catheter 3. Brachial Catheter 4. Axiliar catheter 5. Femoral catheter

Question 26

Tripulen catheters have a higher risk of infection

Answer 26

True

Question 27

Portacat catheters should be used in parenteral nutrition for a long period of time?

Answer 27

False

Question 28

PICCS are collected for peripheral acces

Answer 28

False

Question 29

Hickman catheter is an example of a tunneled central catheter

Answer 29

True

Question 30

PVI solutions are preferred and chlorhexidine for skin preperatiij for a CVC

Answer 30

False

Question 31

It's a way to control hipercatavolsim other than nutrition

Answer 31

All of the above : Analgesia, pain control ; temperature; prevention of infections

Question 32

Energy recommendation that you would use for a undernourished patient with a BMI is 15.5 to prevent refeeding syndrome

Answer 32

10

Question 33

I'm refeeding syndrome it is very important to supplement the following

Answer 33

Thiamine

Question 34

In the prevention of refeeding syndrome, thiamine supplement should be given :

Answer 34

Intravenously

Question 35

I'm the prevention of refeeding syndrome, thiamine should be administered

Answer 35

30 minutos before nutrition and administration starts

Question 36

Main electrolyte we need to monitor in a patient which refeeding risk

Answer 36

P

Question 37

I'm the management of anemia in a patient with refeeding syndrome, in which way iron supplementation should be administered

Answer 37

After 7 days we started nutritional therapy

Question 38

Dose in which we supplement omega 3 in critically I'll patients as immunotherapy

Answer 38

2000

Question 39

Dose in which most investigations report toxicity with omega 3 supplementation :

Answer 39

Over 6 gr a day

Question 40

Patients at risk which omega 3 supplementation should be carefully assessed and probably should not be used:

Answer 40

Thrombocytopenia

Question 41

You are siding glutamine supplementation to modulate inflammation in a critically I'll patient, which GI is perforated

Answer 41

Parenteral nutrition

Question 42

Dose in which we suppplement glutamin in a critically I'll patient

Answer 42

0.5 g/kg

Question 43

Main consideration to supplement a patient with glutamic

Answer 43

Patients liver function tests must be normal

Question 44

Due to the fact that arginine is predator of nitric oxide, it's supplementation is not recommended and/or should be carefully assessed in this type of pathologies

Answer 44

Sepsis

Question 45

Predominant features of liver disease in patients with HPN are

Answer 45

Cholestasis in children and steatosis in adults

Question 46

Mention the safest limit for HCO infusion in parenteral nutrition when treating liver disease associated to PN

Answer 46

Maximum 5 mg/kg//min