Final Exam Random Things to Know

Question 1

MIVF fluids per day range

Answer 1

30-40 mL/kg/day

Question 2

protein per day range if NOT in ICU

Answer 2

1-1.5 g/kg/day

Question 3

protein per day range if pt is in the ICU/surgery

Answer 3

1.5-2 g/kg/day

Question 4

one gram protein = ___ kcal

Answer 4

4

Question 5

kcal per day range for surgery/ICU pt

Answer 5

25-30 kcal/kg/day

Question 6

IBW male equation

Answer 6

50 kg + (2.3 * inches over 60”)

Question 7

IBW female equation

Answer 7

45.5 kg + (2.3 * inches over 60”)

Question 8

nutritional body weight formula

Answer 8

NBW = IBW + 0.25(wt - IBW)

Question 9

CRP is used to assess accuracy of ________

Answer 9

prealbumin

Question 10

prealbumin decreases as CRP increases -> _______

a. inflammation
b. malnutrition

Answer 10

a. inflammation

Question 11

prealbumin decreases as CRP normal -> _______

a. inflammation
b. malnutrition

Answer 11

b. malnutrition

Question 12

nitrogen balance formula

Answer 12

(N in) - (N out)

N in = 24-hr protein intake/6.25
N out = UUN + 4

Question 13

REE = 1950; RQ 0.74
calculate TEE

Answer 13

1950 * 1.2 = 2340 kcal/day

Question 14

standard distribution on non-protein calories

Answer 14

70/30 (70% carbs, 30% fat)

Question 15

3 central venous catheter insertion sites

Answer 15

subclavian (SC)
internal jugular (IJ)
femoral

Question 16

one gram dextrose = ____ kcal

Answer 16

3.4

Question 17

one gram lipids = ____ kcal

Answer 17

~10

Question 18

SMOF lipid components

Answer 18

-soybean oil 30%
-medium-chained TGs 30%
-olive oil 25%
-fish oil 15% (allergies)

Question 19

intralipid 10% components

Answer 19

soybean oil 10%
glycerin 2.25% (allergies)
egg yolk phospholipid 1.2% (allergies)
water for injection

Question 20

which is avoided if you have an egg allergy?

a. intralipid
b. SMOFlipid

Answer 20

a. intralipid

Question 21

which should be avoided with a fish allergy?

a. intralipid
b. SMOFlipid

Answer 21

b. SMOFlipid

Question 22

___ micron filter can be used for all total nutrient admixtures (TNAs) or 3-in-1 (w/lipids)

a. 0.22
b. 1.2
c. 2.0

Answer 22

b. 1.2

Question 23

___ micron filter is only used for 2-in-1 formulations (no lipids)

a. 0.22
b. 1.2
c. 2.0

Answer 23

a. 0.22

Question 24

CrCl < 50

a. Clinimix no electrolytes
b. Clinimix with electrolytes

Answer 24

a. Clinimix no electrolytes

Question 25

CrCl > 50 a. Clinimix no electrolytes b. Clinimix with electrolytes

Answer 25

b. Clinimix with electrolytes

Question 26

trace element adjustments in liver dysfunction (2 things)

Answer 26

-d/c trace elements -supplement individually zinc 5 mg (1 mL), selenium 60 mcg (1 mL)

Question 27

Which of the following is TRUE about trace element adjustments in renal disease? a. consider checking serum levels if use expected beyond 7 days b. use selenium and chromium with caution c. same rules apply for CRRT

Answer 27

b. use selenium and chromium with caution

Question 28

T or F: iron is recommended to be added to PNs

Answer 28

F

Question 29

TPN calcium and magnesium starting levels if normal

Answer 29

Ca 10 mEq/day Mg 8 mEq/day

Question 30

3 main electrolyte issues in refeeding syndrome

Answer 30

hypophosphatemia hypomagnesemia hypokalemia

Question 31

prevention of refeeding syndrome: -limit carbs to ___-___ gm -limit fluids to ___ mL/day -provide adequate amounts of ________ -provide approx ___% of total caloric needs

Answer 31

100-150 800 electrolytes 50%

Question 32

PEG location of the distal end of feeding tube

Answer 32

stomach

Question 33

PEJ location of distal end of feeding tube

Answer 33

small intestine (jejunum)

Question 34

T or F: it is ok to crush sustained-release or enteric coated formulations via enteral feeding tubes

Answer 34

F (can crush other tablets tho)

Question 35

Hodgkin's Lymphoma is characterized by which cells?

Answer 35

Reed-Sternberg cells

Question 36

what are the 3 B symptoms?

Answer 36

fever > 38 C drenching night sweats weight loss greater than 10% in 6 months

Question 37

which of the following describes Hodgkin Lymphoma? a. more frequent involvement of multiple peripheral nodes b. noncontiguous spread c. waldeyer ring and mesenteric nodes rarely involved d. extranodal presentation common

Answer 37

c. waldeyer ring and mesenteric nodes rarely involved

Question 38

Hodgkin's lymphoma 2 chemo regimens

Answer 38

ABVD AAVD

Question 39

which one drug is different between the ABVD and AAVD regimen for HL?

Answer 39

ABVD has bleomycin, AAVD has brentuximab vedotin

Question 40

maintenance tx for relapsed HL

Answer 40

brentuximab vedotin

Question 41

tx for relapsed HL

Answer 41

high dose chemo with autologous stem cell transplant

Question 42

T or F: follicular lymphoma can transform into an aggressive NHL (non-Hodgkin lymphoma)

Answer 42

T

Question 43

NHL chemo regimen

Answer 43

R-CHOP

Question 44

what drugs are in R-CHOP?

Answer 44

-rituximab -cyclophosphamide -doxorubicin -vincristine -prednisone

Question 45

which virus can be reactivated in pts with NHL and rituximab?

Answer 45

Hep B

Question 46

two third line BiTEs for NHL

Answer 46

epcoritamab glofitamab

Question 47

BiTEs 2 unique toxicities

Answer 47

-cytokine release syndrome (CRS) -immune effector cell-associated neurotoxicity syndrome (ICANS)

Question 48

Multiple Myeloma CRAB criteria

Answer 48

-hypercalcemia (Ca > 11.5) -renal dysfunction (SCr > 2 or CrCl < 40) -anemia (Hgb < 10 or 2 below normal) -bone lesions (one or more lesions or fractures)

Question 49

which drug class is indicated for all pts receiving primary myeloma therapy?

Answer 49

bisphosphonates

Question 50

multiple myeloma: there is an inc risk of infection with what 2 drug classes?

Answer 50

proteasome inhibitor monoclonal antibodies

Question 51

cornerstone of Multiple Myeloma therapy

Answer 51

autologous stem cell rescue

Question 52

first line drug class for tx of CML

Answer 52

TKI inhibitors (imatinib)

Question 53

3 2nd gen TKIs

Answer 53

dasatinib nilotinib bosutinib

Question 54

for TKI discontinuation, which value is a deep molecular response? a. BCR-ABL < 0.01 b. BCR-ABL < 0.05 c. BCR-ABL < 0.10 d. BCR-ABL < 0.5

Answer 54

a. BCR-ABL < 0.01

Question 55

CLL: transient lymphocytosis may occur with which inhibitors?

Answer 55

BTK inhibitors

Question 56

first line tx for CLL

Answer 56

BTK inhibitor +/- venetoclax

Question 57

which drug is NOT used 2nd line for FLT3 mutations in pts with AML? a. imatinib b. midostaurin c. quizartinib d. gilteritinib

Answer 57

a. imatinib

Question 58

the 7+3 intensive chemo regimen is for which disease state? a. CML b. CLL c. AML d. ALL

Answer 58

c. AML

Question 59

what is the 7+3 regimen for AML?

Answer 59

7 days cytarabine, 3 days of anthracycline

Question 60

important mutation for AML

Answer 60

t(15;17) = PML:RARA

Question 61

two drugs to treat APL

Answer 61

ATRA (all trans retinoic acid) ATO (arsenic trioxide)

Question 62

SE of all trans retinoic acid (ATRA) a. QT prolongation b. diarrhea c. differentiation syndrome d. neurotoxicity

Answer 62

c. differentiation syndrome

Question 63

SE of arsenic trioxide (ATO) a. QT prolongation b. diarrhea c. differentiation syndrome d. neurotoxicity

Answer 63

a. QT prolongation

Question 64

main chemo regimen for ALL a. CRAB b. HyperCVAD c. R-CHOP d. AAVD

Answer 64

b. HyperCVAD

Question 65

what is the importance of pegaspargase in ALL?

Answer 65

pegaspargase breaks down asparagine, which cancer cells cannot make their own, so will undergo cellular death

Question 66

for ALL, if a pt is Philadelphia Chromosome positive, what drug class can we add?

Answer 66

tyrosine kinase inhibitor