Lecture 1 Flashcards

1
Q

What is a nutrition assessment?

A

Evaluation of patient’s nutritional status based on subjective and objective clinical information

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2
Q

How much do people usually underestimate on how much they eat?

A

Normal BMI: 20% underestimation
Overweight/obese BMI: 40% underestimation

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3
Q

What BMI is considered Obese?

A

> 30

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4
Q

What would we want a longer food diary?

A

It would have greater accuracy

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5
Q

What complications could occur with anemia?

A

Weakness
Dizziness
Fatigue
Palpitations

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6
Q

What complications could occur with gluten sensitivity/celiac?

A

Headaches
Fatigue
GI symptoms

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7
Q

What complications could occur with anorexia?

A

Amenorrhea
Palpitations
Weakness

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8
Q

What do you obtain in a physical exam?

A

Vital signs
Height
Weight
BMI
General appearance

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9
Q

How large does the waist circumference to be considered overweight/obese?

A

Men: ≥40 inches (102 cm)
Women: ≥35 inches (88 cm)

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10
Q

What does measuring the waist circumference help indicate?

A

Excess fat in abdominal area
(visceral adipose tissue)

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11
Q

What are the overweight/obese patients susceptible of?

A

Morbidity
DM
HLD
HTN
Cardiovascular disease

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12
Q

What are the macronutrients?

A

Proteins
Carbohydrates
Fats

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13
Q

What are the micronutrients?

A

Vitamins
Minerals
Essential amino acids
Essential fatty acids

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14
Q

What are the fat-soluble vitamins?

A

A, D, E, K

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15
Q

What are the water-soluble vitamins?

A

B complex and C

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16
Q

When do we usually see a deficiency in fat-soluble vitamins?

A

In fat malabsorption syndromes

Examples: bariatric surgery, GI illness

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17
Q

What are the vitamin-like substances?

A

Choline
Taurine
I-carnitine
Inositol
Bioflavonoids
Alpha-Lipoic Acid
Coenzyme Q (CoQ)

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18
Q

What is role for Thiamine (B1)?

A

Glucose metabolism
Antioxidant
Neuro metabolism

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19
Q

What disease is associated with a Thiamine deficiency?

A

Berberi

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20
Q

What are the two types of Beriberi?

A

Wet and dry beriberi

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21
Q

What symptoms are associated with wet beriberi?

A

Cardiovascular: heart failure, cardiomegaly, edema, increased HR, SOB

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22
Q

What symptoms are associated with dry beriberi?

A

Neurologic: symmetrical sensory and motor neuropathy

Includes Wernicke’s encephalopathy and Korsakoff syndrome

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23
Q

Who are usually thiamine deficient?

A

Alcoholics
Poor/restricted diet

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24
Q

What is the role for Niacin (B3)?

A

Create NAD and NADP coenzymes

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25
Q

Who are usually deficient in Niacin?

A

Alcoholics
Anorexics
HIV+
Malabsorption pts

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26
Q

What are symptoms of Niacin deficiency?

A

Pellagra (3 D’s)

Photosensitive dermatitis
Diarrhea
Dementia

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27
Q

Whats the difference between plant and meat-based niacin?

A

Plant-based niacin not easily used in body

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28
Q

What is the role of Pryidoxine (B6)?

A

Protein and neurotransmitter metabolism
Gluconeogenesis

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29
Q

Who are usually deficient in pyridoxine?

A

Patients with
CKD
GI disease(IBD, celiac)
Autoimmune pts

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30
Q

What medications can cause pyridoxine deficiency?

A

Oral contraceptives
Anti-TB
Theophylline
L-dopa

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31
Q

What are some symptoms of pyridoxine deficiency?

A

Anemia
Dermatitis (also stomatitis)
Depression
Seizures

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32
Q

What is the role of folate (B9)?

A

Amino acid and nucleic aid metabolism
Cell division

33
Q

Who are usually deficient in folate?

A

Alcoholics
Poor diet (low veggies)
Smokers
Malabsorption patients
MTHFR(Methylenetetrahydrofolate reductase) patients

34
Q

What medications can cause a folate deficiency?

A

Trimethoprim
Methotrexate
Phenytoin

35
Q

What are some symptoms of folate deficiency?

A

Anemia
Glossitis/stomatitis
GI upset
Fatigue

36
Q

What is the role of Cobalamin (B12)?

A

Nucleic acid metabolism
Conversion of folate to active form
Metabolic roles

37
Q

Where does cobalamin not naturally occur in?

A

Plant-based foods

38
Q

Who are usually deficient in cobalamin?

A

Vegan diet
GI illness causing malabsorption

Examples: Gastritis, gastric bypass, H. pylori, pernicious anemia

39
Q

What medications can cause cobalamin deficiency?

A

PPIs (usually for GERD)

40
Q

What are some symptoms of cobalamin deficiency?

A

Anemia
Peripheral neuropathy
Cognitive defects
Fatigue

41
Q

What is the function of Ascorbic acid (Vit C)?

A

Antioxidant
Gene expression
Production of proteins, collagen

42
Q

Who are usually deficient in ascorbic acid?

A

Alcoholics
Smokers
Poor/restricted diet
Dialysis

43
Q

What are symptoms of ascorbic acid deficiency?

A

Scurvy

Fatigue
Gingivitis
Poor wound healing

44
Q

What is the function of Retinoids (Vit A)?

A

Component of rods and cones in retina
Epithelial cell reproduction
Bone/teeth/reproductive/immune function

45
Q

Who are usually deficient in retinoids?

A

Those in underdeveloped countries
Poor diet
Fat malabsorption

46
Q

What are symptoms of retinoid deficiency?

A

Night blindness
Blurry vision
Xerosis
Keratomalacia

47
Q

What are signs of retinoid toxicity?

A

Altered mental status
Seizures
Headaches
Blurred vision

48
Q

What is the role of calciferol (Vit D)?

A

Aid in absorption of Calcium in gut
Receptors found throughout body

49
Q

Who are usually deficient in Calciferol?

A

Low sunlight exposure
Darker-skin
Poor diet
Renal or liver disease pts
Breastfed newborns

50
Q

What are some symptoms of calciferol deficiency?

A

Fatigue
Bone pain
Muscle weakness or cramps

51
Q

What are signs of calciferol toxicity?

A

Same as symptoms of deficiencies

52
Q

What is the role of alpha-tocopherol (VIt E)?

A

Antioxidant
Making cell membranes

53
Q

Who are usually deficient in alpha-tocopherol?

A

It is rare.
Malnourished pts
Fat malabsorption

54
Q

What are symptoms of alpha-tocopherol deficiency?

A

Ataxia
Muscle weakness
Impaired vision

55
Q

What are symptoms of alpha-tocopherol toxicity?

A

Bleeding
Muscle weakness
F/N/V

56
Q

What is the role of Vit K?

A

Blood clotting
Bone and kidney metabolism

57
Q

Who are usually deficient in Vit K?

A

Newborns
Fat malabsorption
Warfarin pts

58
Q

What are symptoms of Vit K deficiency?

A

Bleeding (hemorrhage)
Bone malformation

59
Q

What is the biggest difference between vitamins and minerals?

A

Vitamins are organic
Minerals are inorganic

60
Q

What is the difference between macro minerals and trace minerals?

A

Macrominerals are much more abundant in human tissues.

Think of all electrolyte disorders

61
Q

What is the role of iron?

A

Transport O2

62
Q

Who are usually deficient in iron?

A

Plant-based diet pts
Women
Pts who had chronic blood loss

63
Q

What are symptoms of iron deficiency?

A

Fatigue
Anemia
Cognitive difficulties
Impaired immunity

64
Q

What is the most common nutritional deficiency worldwide?

A

Iron

65
Q

What is the most common nutritional deficiency in the US?

A

Folate

66
Q

What is the role of Iodine?

A

Incorporated into thyroid hormone for metabolic function

67
Q

Who are usually at risk for iodine deficiency?

A

Countries with low iodine content in soil and have no fortification

68
Q

What are symptoms of iodine deficiency?

A

Thyroid goiter
Pregnancy loss
Infant psychomotor retardation
Cretinism

69
Q

What are the symptoms of calcium deficiency?

A

Neuro/MSK symptoms:
Weakness
AMS
Muscle spasm
Muscle weakness
Thinned bones

70
Q

Who are likely to be calcium deficient?

A

Restricted diet
Malabsorption/GI disease

71
Q

What are the symptoms of magnesium deficiency?

A

Same as calcium minus the thinned bones

72
Q

Who are likely to be magnesium deficient?

A

Restricted diet
Malabsorption/GI disease
Renal disease
Diuretics
PPIs

73
Q

How many essential amino acids are there?

A

9

74
Q

What are the essential fatty acids?

A

Linoleic acid
Alpha-linoleic acid

75
Q

What is synthesized from linoleum acid?

A

Arachidonic acid

76
Q

Who are usually deficient in essential fatty acids?

A

Patients on total parenteral nutrition

77
Q

Alcoholics are usually deficient in what?

A

Thiamine
Niacin
Folate
Ascorbic Acid

78
Q

What test do we prefer in measuring folate levels?

A

Serum folic acid