Nutrition & Vitamins

Question 1

What are the fat soluble vitamins?

Answer 1

A
D
E
K

Question 2

Fat soluble vitamins are stored whereas water soluble vitamins are excreted. True or false?

Answer 2

True

Question 3

Vitamins and minerals have key roles in processes such as?

Answer 3

Metabolism, cell production, tissue repair

Question 4

What affects absorption of minerals?

Answer 4

Presence of other minerals/vitamins, components found in the blood, amount of mineral already in blood

Question 5

Which groups of people are at higher risk of vitamin D deficiency?

Answer 5

Those with limited sun exposure and those with dark skin

Question 6

What is fortification?

Answer 6

Addition of nutrients to appropriate food vehicles

Question 7

What are some problems with supplements?

Answer 7

Toxicity & accumulation, expensive, cause complacency, legal status means there’s practically no control, interactions

Question 8

Which 2 vitamins can be made by the body from non-dietary sources?

Answer 8

D & K

Question 9

Where are fat soluble vitamins absorbed?

Answer 9

Absorbed by bile in large intestine

Question 10

Where are water soluble vitamins absorbed?

Answer 10

Upper SI - Duodenum

Question 11

Where is vitamin B12 absorbed?

Answer 11

Absorbed by intrinsic factor in ileum

Question 12

Vitamins are sources of energy. True or false?

Answer 12

False

Question 13

Vitamins have an antioxidant role. True or false?

Answer 13

True

Question 14

What does deficiency in vitamin A result in?

Answer 14

Poor night vision

Question 15

What does deficiency in vitamin B1 result in?

Answer 15

Wernicke’s encephalopathy

Question 16

What does deficiency in vitamin B7 result in?

Answer 16

Hair loss and anaemia

Question 17

What does deficiency in vitamin B12 lead to?

Answer 17

Megaloblastic anaemia - neural tube defects

Question 18

What does vitamin D deficiency lead to?

Answer 18

Rickets and osteoporosis

Question 19

What does vitamin C deficiency lead to?

Answer 19

Scurvy

Question 20

What does vitamin K deficiency lead to?

Answer 20

Abnormal clotting

Question 21

In pregnancy, why is vitamin B9 (folic acid) supplemented?

Answer 21

To prevent neural tube defects including spina bifida

Question 22

Trace elements are required in small quantities whereas minerals are required in large amounts. True or false?

Answer 22

True

Question 23

What can a deficiency in magnesium and potassium lead to?

Answer 23

cardiac arrhythmias

Question 24

What can a deficiency in calcium and magnesium lead to?

Answer 24

Osteoporosis, muscle cramps and tetany

Question 25

What can a deficiency in zinc lead to?

Answer 25

Hair loss and poor wound healing

Question 26

A deficiency in which trace element can lead to Wilson's disease?

Answer 26

Copper

Question 27

Methotrexate can interact with which vitamin?

Answer 27

Vitamin B9 (folic acid)

Question 28

What is meant by enteral nutrition?

Answer 28

Nutrition administered via the GI tract

Question 29

Who needs enteral nutrition?

Answer 29

Patients with eating and swallowing difficulties - e.g. facial injury or surgery, Severe intestinal malabsorption - Crohn's disease, Eating disorders, Self-neglect - intentional or non-intentional

Question 30

What are the different routes of administration for enteral nutrition?

Answer 30

Naso-gastric tubes (NG), NJ, PEG tubes, PEJ tubes

Question 31

What are some problems that can occur as a result of enteral nutrition?

Answer 31

Diarrhoea, regurgitation, dislocation of tube, especially NG

Question 32

What are some drugs that interact with enteral feeds?

Answer 32

Ciprofloxacin, Theophylline, Phenytoin

Question 33

When should total parenteral nutrition be used?

Answer 33

Only when EN is not an option when patient cannot take anything by mouth or via GIT. In "gut failure" - patient unable to digest and absorb food. If GIT is non-functional, inaccessible, or perforated

Question 34

How can short-term TPN be given?

Answer 34

Via Venflon

Question 35

How can long-term TPN be given?

Answer 35

peripherally inserted catheter - Hickman line | Via central line - intrajugular, subclavian, femoral

Question 36

How is re-feeding syndrome characterised?

Answer 36

Abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypokalaemia

Question 37

What are some consequences of malnutrition?

Answer 37

weakness and loss of muscle mass, apathy and depression, reduced immune response, poor wound healing, increased morbidity and mortality

Question 38

When should artificial nutritional support be given?

Answer 38

When patients can’t meet their requirements by eating and drinking normally

Question 39

What types of nutritional support is available?

Answer 39

normal diet, softened diet, IV fluids, oral nutrition support (fortified food, additional snacks, sip feeds), enteral tube feeding, total parenteral nutrition

Question 40

What are some benefits of enteral nutrition?

Answer 40

less risk of infection, closely mimics normal feeding, maintains GIT, cheaper, easier for home patients, calorie control

Question 41

What advise would you give regarding the administration of drugs via enteral feeding tubes?

Answer 41

Use liquid preps if possible, give each drug separately, flush with >20ml of water before and after each drug, crushed tablets may block tube, don’t give modified release or cytotoxic drugs

Question 42

What are some complications of TPN?

Answer 42

Air embolism/insertion problems, catheter blockage, line infections, metabolic problems, bone disease, re-feeding syndrome

Question 43

What monitoring should be done for those on TPN?

Answer 43

clinical history, fluid balance, weight, nutritional intake, GI function, temperature. Bloods: U&Es, renal function, glucose, LFTs, FBC, magnesium, phosphate calcium, selenium, zinc, other vitamin levels