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Clin Med III > Nutrition > Flashcards

Nutrition Flashcards

1
Q

carb digestive end product and enzyme

A

monosaccharides

amylase

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2
Q

protein digestive end product and enzyme

A

amino acids

protease

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3
Q

fat end product and enzyme(s)

A

monoglycerides + fatty acids

lipase and bile

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4
Q

fat soluble vitamins

A

vitamin A

vitamin D

vitamin E

vitamin K

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5
Q

vision

what vitamin

A

vitamin A

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6
Q

Calcium absorption

what vitamin

A

Vit D

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7
Q

Clotting

what vitamin

A

K

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8
Q

binds to intrinsic factor

what vitamin

A

B12 (cobalamin)

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9
Q

aids in iron absorption

what vitamin

A

ascorbic acid (vit C)

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10
Q

6 major minerals

A

Na+

K+

Ca++

Cl-

Mg+

Phosporus

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11
Q

7 trade elements

A

Iron

Zinc

Copper

Iodine

Manganese

Chromium

Selenium

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12
Q

why is it important to get rainbow veggies?

A

all have different vitamins, micronutrients, etc.

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13
Q

where is vitamin B12 absorbed

A

distal ileum

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14
Q

B12 binds to intrinsic factor where

A

stomach

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15
Q

Beriberi is a deficiency in what what vitamin

A

thiamine

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16
Q

wenicke-korsakoff syndrome is a deficiency in what vitamin

A

thiamine

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17
Q

cheilitis - what vitamin def?

A

riboflavin, niacin, pyridoxine

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18
Q

angular stomatitis - what vitamin def?

A

riboflavin, niacin, pyridoxine

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19
Q

glossitis - what vitamin def?

A

riboflavin, niacin, pyridoxine

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20
Q

pellagra (3 Ds - diarrhea, dermatitis, and dementia)

what vit def?

A

niacin (b3)

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21
Q

macrocytic anemia only -what vit def

A

folate

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22
Q

macrocytic anemia + peripheral neuropathy - what vit def

A

b12 - cobalamin

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23
Q

rockets, osteomalacie - what vit def

A

D

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24
Q

night blindness, bitot spots, poor wound healing, dry skin - what vit def

A

A

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25
Q

tetany- what nutrient def

A

calcium

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26
Q

pallor, pale conjunctiva, koilonychia (spoon nails) - what nutrient def

A

iron

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27
Q

petechiae/purpura - what vit def

A

C and K

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28
Q

what is necessary to prevent neural tube defect in preg

A

folic acid

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29
Q

what foods should be avoided in preg due to safe food handling/consumption concerns

A

cured deli meats, unpasteurized products, fish

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30
Q

what should exclusively breastfed infants also receive

A

vit D supplementation

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31
Q

what is a crucial component to healthy infancy

A

chart and monitor growth patterns

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32
Q

healthy childhood suggestions

A

whole grains, fruit/veggies, dairy, lean meats

avoid sweetened foods and beverages

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33
Q

components of healthy adulthood

A

well-balanced nutrient rich diet - healthy food choices, portion control, food prep and meal planning, and mindful eating

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34
Q

Na+ recommendation

A

less than 2300 mg/day

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35
Q

what method should you promote with adult pts

A

MyPlate method

replace refined grains with whole grains

5+ servings of veggies/fruits

25-35 g fiber

protein rich foods

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36
Q

in the elderly population, what increases nutritional risk

A

just normal aging

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37
Q

what are some “normal aging” problems with the elderly that lead to increased nutritional risk

A

multiple medical problems

malignancy, dementia

polypharmacy

phys changes

decreased functional status

can’t prep food

social implications - poverty, fixed income, isolation, depression

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38
Q

how should you approach nutrition with the elderly

A

liberalize their diet

incorporate high calorie foods if needed

add oral nutrition and supplements as needed

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39
Q

who conducts nutrition assessment

A

dietitian

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40
Q

what does the nutrition-focused physical exam focus on

A

body weight

muscle wasting

fat stores

volume status

signs of nutrient deficiencies

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41
Q

edema and ascites are found on physical exam – what deficiency

A

protein

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42
Q

sunken dry appearance of orbital area - what deficiency

A

dehydration

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43
Q

temporal muscle wasting - what def

A

protein and calorie

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44
Q

poor wound healing, pressure ulcers - what def

A

protein

vit C/A

zinc

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45
Q

muscle wasting and decreased strength - what def

A

protein, calorie

46
Q

confusion - what def?

A

thiamine

47
Q

what labs should you order with elderly

A

hydration status

CBC - looking at iron, B12, folate (anemia)

Serum albumin and pre-albumin

CRP.ESR - inflammation

Glucose - DM

BMP/CMP - looking at Na+, K+, Ca+, PO4, Mg (kidney and liver function)

Vitamins, minerals, trace

Acid base assessment

48
Q

dietary adjustments - what might you need to do

A

provide specialized/modified/altered consistency diets as appropriate

49
Q

when you would you use clear or full liquid

A

post-op

50
Q

when would you use pureed or soft food diet

A

poor dentition, difficult to swallow

51
Q

use high fiber diet for what

A

constipation and diarrhea

52
Q

concentrated source of cals, protein, vit/minerals

A

oral nutrition

53
Q

when do you consider nutrition support - EN or PN

A

provision of nutrients to individuals who cannot meet their nutrition requirements by mouth

54
Q

what is preferred - EN or PN

A

EN

55
Q

nutrition delivered directly into GI tract bypassing oral cavity

A

EN

56
Q

appropriate for those with a functioning GI tract who are unable to meet adequate nutrient requirements by mouth

A

EN

57
Q

two routes for EN

A

gastric

small bowel

58
Q

when would you NOT use gastric route for EN

A

gastroporesis (slow emptying of stomach contents)

59
Q

options for short term EN

A

nasogastric

nasoduodenal

nasojejunal

60
Q

options for long term EN

A

gastrostomy (g tube)

jejunostomy (j tube)

G/J tube

61
Q

administration of EN into stomach

A

bolus

62
Q

administration of EN into small bowel

A

continuous small amount

63
Q

formulas for EN

A

standard

pre-digested

concentrated

lyte-restricted

64
Q

complications of EN

A

tube misplacement - use radiographic imaging to make sure it is okay

tube displacement - becomes dislodged

tube obstruction (displacement can lead to this)

65
Q

metabolic complications that can occur with EN

A

hyperglycemia

unstable fluid/lytes

66
Q

what does intolerance look like with EN

A

emesis

diarrhea

67
Q

nutrition delivered directly into veins

A

PN

68
Q

what do you administer with PN

A

admixture of dextrose, aa, lipid emulsion, fluid, lytes, vit/min

69
Q

what type of nutrition would you use with:

prolonged ileus

bowel obstruction

small bowel resection

short gut syndrome

A

PN

70
Q

what type of nutrition would you use

high output fistula

IBD

GI bleed

Ischemic bowel

Can’t tolerate EN

A

PN

71
Q

which is used more frequently for PN

PPN (peripheral)

or

TPN (total)

A

total

72
Q

TPN - short or long term

A

long term over 7 days

73
Q

two options for TPN

A

central venous catheter

PICC - peripherally inserted central cath

74
Q

refeeding syndrome

A

intracellular shift of lytes - Mg, PO4, K

75
Q

Name access routes appropriate for a pt expected to need enternal nutrition for less than 4-6 weeks

A

NG, ND, NJ

76
Q

Primary mode of nutrition support in a pt with non-functioning GI tract

A

PN

77
Q

Common complications of nutrition support include

A

mechanical, metabolic/electrolyte abnormalities

78
Q

individualized therapeutic dietary interventions used in mgmt of medical conditions

A

medical nutrition tx

79
Q

reflux of gastric contents into esophagus

A

GERD

80
Q

dietary interventions for GERD

A

small freq meals

elevate head of bed

no citrus, acidic, spicy food

no caffeine, cola

no choc

no alcohol

81
Q

gastroparesis - complication of what

A

DM - diabetic autonomic neuropathy

glycemic control should be optimized in diabetics

82
Q

dietary interventions for gastroparesis

A

small frequent low fat/low fiber meals

cooked, blenderized, pureed foods and liquids

EN if needed

83
Q

lactase def

A

lactose intolerance

84
Q

restrictive/malabsorptive bariatric surgery procedure

A

roux-en-y gastric bypass

85
Q

complication of bariatric surger

A

dumping syndrome - rapid emptying of food into small bowel

86
Q

what do you do about dumping syndrome

A

small frequent meals

separate solids from liquids by 30 min

avoid simple sugars

87
Q

immune disorder triggered by ingestion of gluten leading to mucosal inflammation and vilous atrophy

A

celiac

88
Q

surgical resection or disease of small bowel can disrupt digestive/absorption capacity and contribute to nutrient malabsorption.diarrhea, dehydration, lyte abnormalities

A

short bowel syndrome

89
Q

diverticula of the colonic wall

A

diverticular disease

90
Q

diff between diverticulosis and diverticulitis

A

osis - presence of sac-like protrustion/outpouching

itis - inflammation of diverticulum

91
Q

how to prevent diverticular disease

A

high fiber

92
Q

what kind of malabsorption occurs with chronic pancreatitis and pancreatic insufficiency

A

protein and fat malabsorption

93
Q

what things cause risk of iron def

A

blood loss

celiac

h. pylori

roux-en-y

PPI use

94
Q

what things cause risk of B12 def

A

vegan

roux en y

pernicious anemia

terminal ileum crohns disease

celiac

chronic pancreatitis

metformin

95
Q

diet for CVD

A

med/DASH

96
Q

diet for HTN

A

DASH

97
Q

diet for CHF

A

low Na+, fluid restriction

98
Q

renal disease leads to what

A

sodium and fluid retention, hyperkalemia, hyperphosphatemia

99
Q

what is important to remember with vit K and Coumadin

A

CONSISTENCY - must maintain vit K consistency

100
Q

avoid ___ with statins

A

grapefruit juice

101
Q

avoid _____ with MAOIs

A

tyramine containing foods

102
Q

avoid administration of ___ with thyroid meds

A

calcium

103
Q

what are foods that contain tyramine

A

choc, aged and mature cheeses, smoked meats, hot dogs

104
Q

ACE-I/ARBS combined can lead to what

A

hyperkalemia

105
Q

Diuretics can lead to what

A

hyponatremia

hypokalemia

hypomagnesemia

106
Q

Cholestyramine can lead to what

A

fat soluble vitamin def

107
Q

Sulfasalazine, methotrexate can lead to what

A

folic acid def

108
Q

isoniazid can lead to what

A

vit b6 def

109
Q

metformin can lead to what

A

vit b12 def

110
Q

coumadin needs what

A

vit K consistency

111
Q

statins and ___ should be avoided taken together

A

grapefruit

Clin Med III (6 decks)

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