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Clinical nutrition Final > Final > Flashcards

Final Flashcards

1
Q

What is NF-kB

A

(osteoarthritis) associated with inflammation (direct relationship)
Transcription factor. when activated increases the risk of Cancer, MI, diabetes, alzheimers, crohns, allergy/asthma, and atherosclerosis

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2
Q

What supplements are recommended for OA patients and how do they work

A

omega-3 synergistic with glucosamine sulfate

adequate vit-D

glucosamine sulfate and chodroitin sulfate-will inhibit the expression of iNOS, COX-2, mPGEs, and NF-kB

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3
Q

Would you reccommend anti oxidants for a patient with OA or would you reccommend Vit-D

A

Anti-oxidants No there is no evidence that they will help

Vit-D has been shown to be beneficial for younger patients

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4
Q

What is the anti-inflammatory diet low in

A

Low

sat/trans fat, n-6 fatty acids, refined carbs, red meat butter processed foods and alcohol

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5
Q

what is the anti-inflammatory diet high in

A

fruits/veggies, n-3 fatty foods (fish walnut, or grapeseed oil)

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6
Q

What is the anti-inflammatory diet moderate in

A

EVOO, low fat dairy, whole grains, spices, lean meat, tea, dark choc, unsalted nuts

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7
Q

OA resistance training

A

30 mins 3 days per week Isometric contraindicated for elderly

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8
Q

OA aerobic

A

30 mins 3 days per week moderate intensity

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9
Q

Tai Chi OA

A

Yang Style 20-60 mins 1-5 days per week

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10
Q

water therapy OA

A

60 min 1 day per week

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11
Q

yoga therapy OA

A

90 min 1 day per week

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12
Q

What impact does supplementation with glucosamine and chondroitin have on inflammatory compounds

A

inhibits expression of iNOS, COX-2,mPGEs, and NFkB

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13
Q

What are the most common nutritional deficiencies in RA patients

A

B vitamins, Calcium, VIt-D and E, zinc and selinium

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14
Q

what nutritional malabsorption can you have with RA

A

Ca and Vit-D

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15
Q

what nutritional depletions can you have with RA drugs

A

folate, B6, Ca and Vit-D

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16
Q

What daily intake of protein should a patient with RA be consuming

A

increase protein to 1.5-2 g/kg

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17
Q

what probiotics may be beneficial for RA

A

bacillus coagulans or lactobacillus GG

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18
Q

What dose of fish oil may be helpful for RA

A

3 g/day

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19
Q

What diet should RA patients follow

A

Anti-inflammatory

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20
Q

What are some recommended treatments for Gout

A

NSAID, anti-gout meds, low PURINE DIET, limit animal protein, alcohol, and fructose

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21
Q

What should a patient with gout increase with their nutrition

A

dairy, eggs, cherries, coffee, and vegetable protein

increase fluid intake and maintain healthy BW

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22
Q

What food should be eliminated in patients with gout

A

Purine containing foods

sardines, anchovies, gravy, kidney, liver, sweetbreads, yeast, broth, scallops, mackerel, and mussles

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23
Q

What are risk factors associated with stroke

A

age, htn, smoking, obesity, diabetes and physical activity

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24
Q

What are some nutritional factors that may increase the risk of stroke

A

high sodium intake, meat intake, processed meat, western diet

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25
Q

What are some nutritional factors that may decrease the risk of stroke

A

high potassium diet, n-3 intake, 5+ servings of fruits and veggies, low fat dairy, chocolate, tea, coffee, whole grains

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26
Q

what diets can decrease the risk of stroke

A

DASH and Mediterranean diets

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27
Q

What are the protein and energy requirements for Traumatic Brain injury

A

2g/kg for protein
hypermetabolism form inflammation 100-140% REE
sedatives reduce metabolism 100-120% REE

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28
Q

With traumatic brain injury what nutrient may be helpful

A

N-3

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29
Q

What are some risk factors for alzhiemers

A

age, HTN, obesiety, dyslipidemia, insulin resistance, inflammation, down syndrome, TBI, and genetics (Apo-E4)

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30
Q

What nutritional factors are important for prevention of Alzheimers

A

AOX Vit-E and C, essential fatty acids (EPA and DHA from fish) decrease omega-6, B vitamins, medium chain triglycerides, caloric restriction

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31
Q

What diet may be helpful for Alzheimers prevention

A

Mediterranean

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32
Q

What supplements may benefit a patient with alzhiemers

A

Resveratrol (skin of grapes, raspberries, and mulberries) and curcumin (turmeric

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33
Q

what supplements should be avoided by patients with alzhiemers

A

MV containing iron and copper

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34
Q

What are some feeding strategies that may improve quality of life with Alzheimer’s

A

offer 1 food at a time simple place setting, plate different color, add condiments, finger foods, minimize noise, and eat a big lunch

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35
Q

what nutritional therapy is recommended for epilepsy

A

fasting (trigger foods) ethically Keto diet

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36
Q

what macro ratios do you recommend for a keto diet

A

4:1 fat to carbs and protein 4 grams fat for every 1 gram protein and carb approx 10-20 carbs per day

37
Q

how do you monitor adherence to the keto diet

A

seizure frequency, monitor vitamin and mineral deficiencies and proper growth and ketone in blood

38
Q

What are the energy and protein requirements in a person with acute Spinal cord injury

A

90% energy intake and 2g/kg protein

39
Q

what are the protein req for rehab spinal cord injury

A

.8-1 g/kg

40
Q

What is the fluid intake recommendation for a patient with rehab spinal cord inury

A

40ml/kg + 500 ml

41
Q

what nutritional interventions may be helpful for MS

A

limit sat fat to <20 g/day, increase PUFA, Vit D (1000-2000 iu/d) acetyl-l-carnitine (fatigue) and L-theronine (spasticity)

42
Q

What drug-nutrient interactions may occur in patients with Parkinsons disease

A

L-dopa (levodopa)- limit protein intake to .5-1g/kg bw

supplement with B-6 to convert L-dopa to dopamine before it reaches the brain.

43
Q

how do you treat gastroparesis, GERD, and constipation in patients with parkinsons

A

smaller more frequent meals. low in fat and fiber. increase fluid, maintain vit-D and n-3 intake along with a diet high in AOX

44
Q

what factors increase the likelyhood of migraine

A

obesity, low blood sugar, inflammatory disorders, and gut dysbiosis

45
Q

what are some food sensitivities that are migraine triggers

A

alcohol, high tyramine foods, nitrates, sulfites, and histamines
low blood sugar is a trigger in 60% of migraine patients

46
Q

what diet may be helpful for patients suffering from migraines

A

ketogenic diet

47
Q

how can lipid intake be modified to decrease the number of headache days

A

low fat diets DEC intensity and duration

increasing omega-3 must be combined with decreasing omega-6 to decrease headache days

48
Q

which micronutrient disturbances are most common in migraine patients

A

low folate, low magnesium, and HIGH IRON

49
Q

is dehydration an issue with migraine patient

A

yes dehydration significantly increases headache days er month

50
Q

what is the fluid intake recommendation for migraine patients

A

8-10 8oz glasses per day

51
Q

what supplements may be beneficial for patients with migraines

A

MG (women with menstrual migraine)
Riboflavin and CoQ10 (mitochondrial dysfxn) CoQ10 peds
buterbur

52
Q

What are the protein requirements for thyroid fxn

A

min .8g/kg

53
Q

what micro and macro nutrients are imp for thyroid fxn

A

iodine, iron, selenium (less than 500mcg/day), zinc, Vit-A and D,

54
Q

If a patient has hypothyroidism what should they avoid

A

ALA (alpha-lipoic acid) decreases conversion of T4-T3

55
Q

What macro and micro nutrients are imp for bone synthesis

A

Protein calcium, phosphate, Vit A, D, C, K, Mg and potassium

also co enzyme Q10

56
Q

What are some etiologies involved in cancer

A

Genetics, excess energy, viruses (HPV and Hep) chemical carcinogens, limitied fruits and veggie, sedentary lifestyle, radiation, and tobacco

57
Q

what are some dietary strategies that increase risk of cancer

A

red meat, salt, sat fat, trans fat, alcohol, high temp cooking, and obesity

58
Q

what are some dietary strategies that decrease the risk of cancer

A

fruits/veggies, whole grains, fish fiber, Vit-D coffee and tea

59
Q

ACA guidelines for cancer prevention in terms of exercise and weight

A

be as lean as possible
limit high cal foods and beverages
exercise 150 min/week moderate 75 mins/week vigorous
kids 60 mins/day moderate or vigorous

60
Q

ACA guidelines for cancer prevention in terms of Diet

A

limit red meat, choose plants, watch portions, limit alcohol, 2.5 cups fruits/veggies daily, whole grains

61
Q

what nutritional assessment could you do in practice for a patient with cancer.

A

use patient generated subjective global assessment for malnutrition (SGA)

62
Q

how do you monitor for malnutrition in cancer patient

A

anthropometric data with every visit. mid arm muscle circumference

63
Q

what types of cancer usually present with malnutrition

A

head/neck, esophageal gastric, pancreatic, lung

64
Q

which types of cancer are usually found in patients with over nutrition

A

breast prostate colon (all others)

65
Q

What diets can help in cancer patients

A

Ketogenic diet- glucose deprivation increases oxidative stress in cancer cells
Calorie restriction- decrease tumor initiation promotion and progression

66
Q

What are the energy requirements for an obese cancer patient

A

21-25 cal/kg bw

67
Q

what are the energy requirements to maintain weight in cancer patient

A

25-35 cal/kg bw

68
Q

what are the energy requirements to gain weight in cancer patients

A

30-40 cal/kg

69
Q

What are the protein requirements in cancer patients. Stressed vs non stressed

A

Stressed 1.5-2.5 g/kg

non-stressed 1-1.5 g/kg

70
Q

do you reccommend multi vitamins in cancer patients

A

no get nutrients from food, not supplements. only if supplemental deficiency is biochemically or clinically demonstrated or if intake is consistently

71
Q

When should supplementation be considered with cancer patients

A

with cachexia

72
Q

how is cancer cachexia diagnosed

A

weight loss >10%
caloric intake <1500 cal/day
CRP >10ml/L

73
Q

What are some strategies used to increase energy intake in your cachectic patient

A

high fat, high protein diet. Drink fluids with calories, phytochemicals

74
Q

what dietary strategies can be helpful to patients with nausea/vomiting

A

small low fat meal morning of treatment. clear liquid diet for days after. avoid high fat, spicy or sweet foods. Eat bland, soft easy to digest

75
Q

what dietary strategies can be helpful to patients with constipation

A

increase fiber and fluid. eat and snack throughout the day. increase physical activity

76
Q

what dietary strategies can be helpful to patients with diarrhea

A

small amounts of electrolyte containing fluid. avoid fruit juices, sugar alcohol. CRAM (cereal rice applesauce milk)
probiotic (Lacto and bifido), glutamine, and decrease high soluble fiber foods

77
Q

what dietary strategies can be helpful to patients with sore throat

A

eat soft moist foods, avoid dry coarse foods. avoid alcohol, citrus caffeine, tomatoes, vinegar, and hot pepers

78
Q

what dietary strategies can be helpful to patients with mucositis (inflammation of epithelial cells lining GI)

A

maintain oral hygeine, maintain minimum protein levels (1.5 g/kg) eat soft non fibrous non-acidic foods. avoid fizzy drinks
honey (20 ml swish and swallow)
supplement with zn, glutamine, epicatechin, and DGL (heals ulcers)

79
Q

what dietary strategies can be helpful to patients with dysguisia (alt taste)

A

avoid metal utensils, pour into glass first, high protein foods, cooler foods, marinades or spices,
supplement with zn and Vit-D

80
Q

what dietary strategies can be helpful to patients with xerostomia (extreme dry mouth)

A

avoid coffee, tea, soda, and alcohol containing mouth wash.

sip on liquids use sugar free gum. suck on frozen fruits. use good oral hygiene, mouth moisturizers, and accupuncture

81
Q

What is the fluid intake recommendation for cancer patients

A

1 ml/calorie

82
Q

is exercise recommended during cancer treatment

A

150 min mod per week or 75 vigorous per week.
can be in 10 min intervals
resistance training 2 days per week

83
Q

what are some etiologies associated with breast cancer

A

age, history, ovarian cancer, personal history, BRCA 1/ BRCA 2, early menarche, late menopause, later pregnancy

84
Q

what are some etiologies associate with prostate cancer

A

older than 50, genetics, obesity, sedentary lifestyle, prostate infection, not circumcised, precessed carbs, dairy

85
Q

what are some etiologies associated with colon cancer

A

over 50, genetics, obesity, sedentary lifestyle, tobacco, alcohol, height (short), and red meat

86
Q

what are some etiologies associated with lung cancer

A

smoking, radon, air pollution, asbestosis, race, radiation, high dose beta carotene/ Vit A, red meat

87
Q

what are some dietary strategies that may decrease the risk of the above cancers

A

maintain healthy weight, exercise, dont smoke, limit red meat and processed meat, limit alcohol, eat plants and fish, drink green tea, grill responsibly

88
Q

what are some nutritional strategies for breast cancer survivors

A

3-5 cups green tea daily, avoid alcohol, MVM with no more than 100% RDA except Vit D, get nutrients from food not supp, avoid soy supp, and ER/PR cancers limit fat to 15-20% of energy

Clinical nutrition Final (1 decks)

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