1- Nutrition Flashcards
1
Q
What function to provide energy, promote muscle growth/ repair, and support cell function?
A
Macronutrients
2
Q
What is the primary fuel source?
A
Carbohydrates
3
Q
What is the primary digestive enzyme of carbohydrates?
A
Amylase
4
Q
What is the primary digestive enzyme for protein?
A
Protease
5
Q
What is the primary digestive enzyme of fat?
A
Lipase
6
Q
What function to support cellular metabolic processes, biochemical reactions, hormone function, nerve impulse propagation, and muscle function?
A
Micronutrients
7
Q
What are the water-soluble vitamines?
A
B1-3, B5-6, B12, biotin, folate, vit C
8
Q
What are the fat-soluble vitamines?
A
Vit A, D, E, K
9
Q
What water-soluble vitamin binds to intrinsic factor?
A
B12
10
Q
What water-soluble vitamin aids in iron absorption?
A
Vit C
11
Q
What fat-soluble vitamin contributes to vision?
A
Vit A
12
Q
What fat-soluble vitamin contributes to Ca absorption?
A
Vit D
13
Q
What fat-soluble vitamin contributes to clotting?
A
Vit K
14
Q
What are the components of micronutrients?
A
Water-soluble vitamins, fat-soluble vitamins, major minerals, trace elements
15
Q
What are the macronutrients?
A
Carbohydrates, fats, proteins
16
Q
Where are minerals absorbed?
A
Stomach
17
Q
Where does vit B12 bind to intrinsic factor? Where is the complex absorbed?
A
Binds in stomach, absorbed in ileum
18
Q
What are the manifestations of a thiamine deficiency?
A
- Beriberi (peripheral neuropathy, edema)
- Wernicke-Korsakoff syndrome (neurologic sequela)
19
Q
What are the manifestations of a B2, B3, or B6 deficiency?
A
Cheilitis, angular stomatitis, glossitis
20
Q
What are the manifestations of a B3 deficiency?
A
Pellagra (diarrhea, dermatitis, dementia)
21
Q
What are the manifestations of a folate deficiency?
A
Macrocytic anemia
22
Q
What are the manifestations of a B12 deficiency?
A
Macrocytic anemia, peripheral neuropathy
23
Q
What are the manifestations of a vit D deficiency?
A
Rickets, osteomalacia
24
Q
What are the manifestations of a vit A deficiency?
A
Night blindness, bitot’s spots, poor wound healing, dry skin
(bitot’s spots = hyperkeratinization on cornea)
25
What are the manifestations of a sodium deficiency?
Confusion, hypotension, tachycardia
26
What are the manifestations of a zinc deficiency?
Taste disturbance, impaired wound healing
27
What are the manifestations of an iodine deficiency?
Goiter
28
What are the manifestations of a calcium deficiency?
Fractures, tetany
29
What are the manifestations of a potassium deficiency?
Muscle cramping, fatigue, EKG w/ U-waves
30
What are the manifestations of an iron deficiency?
Fatigue, pallor, pale conjunctiva, pica, koilonychia
31
What are the manifestations of a vit C and K deficiency?
Bleeding gums, easy bruising, poor healing wounds, petechiae/ purpura
32
What are the manifestations of a vit E deficiency?
Sensory and motor neuropathy
33
What are the manifestations of a fluoride deficiency?
Tooth decay
34
What are the manifestations of sodium toxicity?
Edema
35
What are the manifestations of potassium toxicity?
Weakness, vomiting, EKG w/ peaked T-waves
36
What are the manifestations of niacin toxicity?
Flushing
37
What are the manifestations of fluoride toxicity?
Tooth discoloration
38
What are the manifestations of copper toxicity?
Golden-brown discoloration or iris
39
Folic acid is necessary during pregnancy to decrease the risk of what?
Neural tube defects
40
The following are nutrition recommendations for what population?
* Diet rich in fruits/ vegetables, whole grains, low-fat dairy, variety of protein
* Folic acid
* Safe food handling/ consumption
* Safe pet care
* Avoid EtOH/ tobacco
Pregnant women
41
What should an infant solely be consuming in the first 4-6 months of life?
Breastmilk or formula
42
Exclusively breastfed infants should receive supplementation with what?
Vit D
43
In addition to promotion of whole grains, fruits/ vegetables, dairy, and lean meats, what should be avoided with respect to childhood nutrition?
Sweetened foods and beverages
44
Nutrition in adulthood should consist of a well-balanced nutrient rich diet with a focus on what? (4)
* Healthy food choices
* Portion control
* Food prep/ meal planning
* Mindful eating
45
A diet in adulthood should encourage intake of what?
Fiber
46
A diet in adulthood should avoid/ limit intake of what?
Avoid processed/ refined foods
Limit trans fat, saturated fat, dietary cholesterol, sodium
47
What should be promoted/ recommended for healthy nutrition in adulthood?
MyPlate Method
48
The following are influencing factors on what in older adult populations?
* Multiple medical problems/ polypharmacy
* Malignancy, dementia
* Physiological changes
* Decreased functional status
* Social implications (poverty, isolation, depression)
Increased nutritional risk
(also a/w normal aging)
49
What is the goal for nutrition in older adults?
Liberalize diet, incorporate high calorie foods, oral nutrition supplements prn
(also optimize medical care, reconcile meds)
50
A healthy adult diet should consist of how much fiber daily and how many servings of fruits/ vegetables daily?
~25-35 g of fiber daily, \>5 servings of fruits/ vegetables daily
51
What dietary component regulates bowels, increases satiety, lowers cholesterol, improves glycemic control, and lowers risk of colorectal cancer?
Fiber
52
It is recommended to obtain vitamins/ minerals from what source?
Foods (rather than supplements)
53
What populations may warrant vitamin and mineral oral supplements?
Inadequate oral intake, increased nutrient demand, malabsorptive process
54
What is the premise behind a well-balanced macronutrient diet?
Improves satiety and regulates glucose absorption/ insulin release
55
Glycemic index is a measure of how quickly a food causes blood sugar to rise. A high glycemic index is indicative of what? A low glycemic index is indicative of what?
High glycemic index indicative of rapid digestion absorbtion, low glycemic index indicative of slow digestion/ absorption
56
What is the goal of the DASH diet?
Reduce sodium and increase potassium, calcium, magnesium containing foods
57
What is the premise of a very low calorie diet? (200-800 kcal/ day)
Severely restrictive caloric deficit promotes therapeutic rapid weight loss
58
What are the greatest concerns associated with a very low calorie diet?
Loss of lean muscle mass, electrolyte abns, bile stasis, constipation
59
What diet consists of a high-fat, moderate protein, low carbohydrate eating pattern and promotes breakdown of fat for energy, leading to quick weight loss?
Keto diet (promotes ketosis)
60
What are the concerns with the keto diet?
Nutrient deficiencies, poor sustainability, concern for heart disease/ chronic disease
61
The keto diet is used a treatment for what condition?
Refractory cases of epilepsy
62
What is the concern with a vegan diet?
B12 deficiency
63
What type of diet/ eating pattern promotes weight loss and improves metabolic health through influence on hormone regulation and inflammatory response?
Intermittent fasting
64
What are the concerns with intermittent fasting?
Feasibility, safety, sustainability
65
A positive nutrition screen (aims to identify individuals at nutrional risk) prompts what?
Referral to a dietitian for complete nutrition assessment
66
What are the 5 components of a nutrion assessment?
1. Food/ nutrition hx
2. Pt hx
3. Anthropometric measurements
4. Nutrition-focused exam
5. Lab indicators
67
Alcohol use disorder increases risk of what?
Thiamine deficiency
68
What are the important components of patient hx in nutritional assessment?
Medical, surgical, social
69
What surgical hx may have nutritional implications?
Major abd surgery (bariatric, intestinal resection), high output fistula or ostomy
70
What factors are assessed with respect to anthropometrics in a nutrition assessment?
Height, weight, BMI, weight pattern/ unintentional weight loss
71
What is included as part of a nutrition focused exam?
Targets body weight, muscle wasting, fat stores, volume status, signs of nutrient deficiencies
72
Why should serum albumin and pre-albumin be interpreted with caution?
Can be influenced by inflammation
73
A nutrition intervention involves a dietician identifying macro and micronutrient requirements and taking steps such as what to improve nutrition-related conditions?
Dietary adjustments, oral nutrition supplements, nutrition support
74
What is the goal of dietary adjustments in nutrition intervention?
Specialized/ modified/ altered consistency diets as appropriate (diet liberalization in certain circumstances)
75
What do oral nutrition supplements provide?
Concentrated source of kcals, protein, vitamin/ minerals
76
What type of nutrition support is given to individuals who cannot meet their nutrition requirements by mouth?
Enteral nutrition (EN) = **preferred**, more physiologic
Parenteral nutrition (PN)
77
What is enteral nutrition?
Delivered into GI tract bypassing oral cavity (appropriate if functioning GI tract)
78
What are the different routes of enteral nutrition?
Gastric vs small bowel
Bolus vs continuous feeding
79
Short-term vs long-term access for enteral nutrition is what time frame?
Short-term \< 4-6 weeks
Long-term \> 4-6 weeks
80
What complications are associated with enteral nutrition?
Mechanical (tube), metabolic abns, intolerance, pulmonary aspiration
81
How is parenteral nutrition delivered and when is it indicated?
Directly into vein
Use if non-functioning GI tract, oral intake/ EN not feasible/ c/i'd
82
What are the types of access for parenteral nutrition?
Peripheral (PPN) and total (TPN)
83
When is TPN used?
\*More commonon\*
Used for long term (\> 7 days) via central venous catheter or PICC (peripherally inserted central catheter)
84
What complications are a/w parenteral nutrition?
Mechanical (sepsis, thrombus/ embolus, pneumothorax), metabolic, fatty liver
85
What is important to monitor for with respect to nutrition support management?
Refeeding syndrome (intracellular shift of electrolytes)
86
What is defined as individualized therapeutic dietary interventions used in the management of medical conditions?
Medical nutrition therapy (MNT)
87
What diet is recommended for GERD?
Anti-reflux diet
88
What diet is recommended for gastroparesis?
Small frequent low fat/ fiber meals
89
What diet is recommended for celiac disease?
Gluten free diet
90
What diet is recommended for IBS?
Low FODMAP diet
91
What diet is recommended for IBD?
Well-balanced nutrient rich diet with avoidance of refined/ processed foods
92
What diet is recommended for CV disease?
Mediterranean and DASH
(HTN = DASH, CHF = low sodium, fluid restriction)
93
What diet is recommended for DM?
Macronutrient balance/ glycemic control, optimize A1c, BP, cholesterol
94
What are the specific risks for iron deficiency?
Blood loss, H.pylori, PPI use
95
The following are a/w what nutritional deficiency?
Vegan, pernicious anemia, TI Crohns/ TI resection, pancreatic complications, metformin
B12 deficiency
96
Poor renal function can lead to what?
Sodium/ fluid restriction, hyperkalemia, hyperphosphatemia
97
For a pt with renal disease, in addition to individualized protein, Na, K, PO4, and Ca intake, what else is used for nutrition management?
Phosphorus binders (and consult dietician)
98
What consistency should be maintained with Coumadin use?
Vit K
99
What should be avoided with statins?
Grapefruit juice
100
What meds should be administered separately?
Calcium and thyroid meds
101
What drug can cause fat-soluble vitamin deficiencies?
Cholestyramine
102
What drugs can cause folic acid deficiency?
Sulfasalazine, methotrexate
103
What drug can cause vit B6 deficiency?
Isoniazid
