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1. Clin Med III > 1- Nutrition > Flashcards

1- Nutrition Flashcards

1
Q

What function to provide energy, promote muscle growth/ repair, and support cell function?

A

Macronutrients

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2
Q

What is the primary fuel source?

A

Carbohydrates

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3
Q

What is the primary digestive enzyme of carbohydrates?

A

Amylase

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4
Q

What is the primary digestive enzyme for protein?

A

Protease

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5
Q

What is the primary digestive enzyme of fat?

A

Lipase

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6
Q

What function to support cellular metabolic processes, biochemical reactions, hormone function, nerve impulse propagation, and muscle function?

A

Micronutrients

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7
Q

What are the water-soluble vitamines?

A

B1-3, B5-6, B12, biotin, folate, vit C

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8
Q

What are the fat-soluble vitamines?

A

Vit A, D, E, K

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9
Q

What water-soluble vitamin binds to intrinsic factor?

A

B12

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10
Q

What water-soluble vitamin aids in iron absorption?

A

Vit C

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11
Q

What fat-soluble vitamin contributes to vision?

A

Vit A

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12
Q

What fat-soluble vitamin contributes to Ca absorption?

A

Vit D

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13
Q

What fat-soluble vitamin contributes to clotting?

A

Vit K

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14
Q

What are the components of micronutrients?

A

Water-soluble vitamins, fat-soluble vitamins, major minerals, trace elements

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15
Q

What are the macronutrients?

A

Carbohydrates, fats, proteins

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16
Q

Where are minerals absorbed?

A

Stomach

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17
Q

Where does vit B12 bind to intrinsic factor? Where is the complex absorbed?

A

Binds in stomach, absorbed in ileum

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18
Q

What are the manifestations of a thiamine deficiency?

A
  • Beriberi (peripheral neuropathy, edema)
  • Wernicke-Korsakoff syndrome (neurologic sequela)
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19
Q

What are the manifestations of a B2, B3, or B6 deficiency?

A

Cheilitis, angular stomatitis, glossitis

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20
Q

What are the manifestations of a B3 deficiency?

A

Pellagra (diarrhea, dermatitis, dementia)

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21
Q

What are the manifestations of a folate deficiency?

A

Macrocytic anemia

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22
Q

What are the manifestations of a B12 deficiency?

A

Macrocytic anemia, peripheral neuropathy

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23
Q

What are the manifestations of a vit D deficiency?

A

Rickets, osteomalacia

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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)

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25
Q

What are the manifestations of a sodium deficiency?

A

Confusion, hypotension, tachycardia

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26
Q

What are the manifestations of a zinc deficiency?

A

Taste disturbance, impaired wound healing

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27
Q

What are the manifestations of an iodine deficiency?

A

Goiter

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28
Q

What are the manifestations of a calcium deficiency?

A

Fractures, tetany

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29
Q

What are the manifestations of a potassium deficiency?

A

Muscle cramping, fatigue, EKG w/ U-waves

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30
Q

What are the manifestations of an iron deficiency?

A

Fatigue, pallor, pale conjunctiva, pica, koilonychia

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31
Q

What are the manifestations of a vit C and K deficiency?

A

Bleeding gums, easy bruising, poor healing wounds, petechiae/ purpura

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32
Q

What are the manifestations of a vit E deficiency?

A

Sensory and motor neuropathy

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33
Q

What are the manifestations of a fluoride deficiency?

A

Tooth decay

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34
Q

What are the manifestations of sodium toxicity?

A

Edema

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35
Q

What are the manifestations of potassium toxicity?

A

Weakness, vomiting, EKG w/ peaked T-waves

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36
Q

What are the manifestations of niacin toxicity?

A

Flushing

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37
Q

What are the manifestations of fluoride toxicity?

A

Tooth discoloration

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38
Q

What are the manifestations of copper toxicity?

A

Golden-brown discoloration or iris

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39
Q

Folic acid is necessary during pregnancy to decrease the risk of what?

A

Neural tube defects

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40
Q

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
A

Pregnant women

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41
Q

What should an infant solely be consuming in the first 4-6 months of life?

A

Breastmilk or formula

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42
Q

Exclusively breastfed infants should receive supplementation with what?

43
Q

In addition to promotion of whole grains, fruits/ vegetables, dairy, and lean meats, what should be avoided with respect to childhood nutrition?

A

Sweetened foods and beverages

44
Q

Nutrition in adulthood should consist of a well-balanced nutrient rich diet with a focus on what? (4)

A
  • Healthy food choices
  • Portion control
  • Food prep/ meal planning
  • Mindful eating
45
Q

A diet in adulthood should encourage intake of what?

46
Q

A diet in adulthood should avoid/ limit intake of what?

A

Avoid processed/ refined foods

Limit trans fat, saturated fat, dietary cholesterol, sodium

47
Q

What should be promoted/ recommended for healthy nutrition in adulthood?

A

MyPlate Method

48
Q

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)
A

Increased nutritional risk

(also a/w normal aging)

49
Q

What is the goal for nutrition in older adults?

A

Liberalize diet, incorporate high calorie foods, oral nutrition supplements prn

(also optimize medical care, reconcile meds)

50
Q

A healthy adult diet should consist of how much fiber daily and how many servings of fruits/ vegetables daily?

A

~25-35 g of fiber daily, >5 servings of fruits/ vegetables daily

51
Q

What dietary component regulates bowels, increases satiety, lowers cholesterol, improves glycemic control, and lowers risk of colorectal cancer?

52
Q

It is recommended to obtain vitamins/ minerals from what source?

A

Foods (rather than supplements)

53
Q

What populations may warrant vitamin and mineral oral supplements?

A

Inadequate oral intake, increased nutrient demand, malabsorptive process

54
Q

What is the premise behind a well-balanced macronutrient diet?

A

Improves satiety and regulates glucose absorption/ insulin release

55
Q

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?

A

High glycemic index indicative of rapid digestion absorbtion, low glycemic index indicative of slow digestion/ absorption

56
Q

What is the goal of the DASH diet?

A

Reduce sodium and increase potassium, calcium, magnesium containing foods

57
Q

What is the premise of a very low calorie diet? (200-800 kcal/ day)

A

Severely restrictive caloric deficit promotes therapeutic rapid weight loss

58
Q

What are the greatest concerns associated with a very low calorie diet?

A

Loss of lean muscle mass, electrolyte abns, bile stasis, constipation

59
Q

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?

A

Keto diet (promotes ketosis)

60
Q

What are the concerns with the keto diet?

A

Nutrient deficiencies, poor sustainability, concern for heart disease/ chronic disease

61
Q

The keto diet is used a treatment for what condition?

A

Refractory cases of epilepsy

62
Q

What is the concern with a vegan diet?

A

B12 deficiency

63
Q

What type of diet/ eating pattern promotes weight loss and improves metabolic health through influence on hormone regulation and inflammatory response?

A

Intermittent fasting

64
Q

What are the concerns with intermittent fasting?

A

Feasibility, safety, sustainability

65
Q

A positive nutrition screen (aims to identify individuals at nutrional risk) prompts what?

A

Referral to a dietitian for complete nutrition assessment

66
Q

What are the 5 components of a nutrion assessment?

A
  1. Food/ nutrition hx
  2. Pt hx
  3. Anthropometric measurements
  4. Nutrition-focused exam
  5. Lab indicators
67
Q

Alcohol use disorder increases risk of what?

A

Thiamine deficiency

68
Q

What are the important components of patient hx in nutritional assessment?

A

Medical, surgical, social

69
Q

What surgical hx may have nutritional implications?

A

Major abd surgery (bariatric, intestinal resection), high output fistula or ostomy

70
Q

What factors are assessed with respect to anthropometrics in a nutrition assessment?

A

Height, weight, BMI, weight pattern/ unintentional weight loss

71
Q

What is included as part of a nutrition focused exam?

A

Targets body weight, muscle wasting, fat stores, volume status, signs of nutrient deficiencies

72
Q

Why should serum albumin and pre-albumin be interpreted with caution?

A

Can be influenced by inflammation

73
Q

A nutrition intervention involves a dietician identifying macro and micronutrient requirements and taking steps such as what to improve nutrition-related conditions?

A

Dietary adjustments, oral nutrition supplements, nutrition support

74
Q

What is the goal of dietary adjustments in nutrition intervention?

A

Specialized/ modified/ altered consistency diets as appropriate (diet liberalization in certain circumstances)

75
Q

What do oral nutrition supplements provide?

A

Concentrated source of kcals, protein, vitamin/ minerals

76
Q

What type of nutrition support is given to individuals who cannot meet their nutrition requirements by mouth?

A

Enteral nutrition (EN) = preferred, more physiologic

Parenteral nutrition (PN)

77
Q

What is enteral nutrition?

A

Delivered into GI tract bypassing oral cavity (appropriate if functioning GI tract)

78
Q

What are the different routes of enteral nutrition?

A

Gastric vs small bowel

Bolus vs continuous feeding

79
Q

Short-term vs long-term access for enteral nutrition is what time frame?

A

Short-term < 4-6 weeks

Long-term > 4-6 weeks

80
Q

What complications are associated with enteral nutrition?

A

Mechanical (tube), metabolic abns, intolerance, pulmonary aspiration

81
Q

How is parenteral nutrition delivered and when is it indicated?

A

Directly into vein

Use if non-functioning GI tract, oral intake/ EN not feasible/ c/i’d

82
Q

What are the types of access for parenteral nutrition?

A

Peripheral (PPN) and total (TPN)

83
Q

When is TPN used?

A

*More commonon*

Used for long term (> 7 days) via central venous catheter or PICC (peripherally inserted central catheter)

84
Q

What complications are a/w parenteral nutrition?

A

Mechanical (sepsis, thrombus/ embolus, pneumothorax), metabolic, fatty liver

85
Q

What is important to monitor for with respect to nutrition support management?

A

Refeeding syndrome (intracellular shift of electrolytes)

86
Q

What is defined as individualized therapeutic dietary interventions used in the management of medical conditions?

A

Medical nutrition therapy (MNT)

87
Q

What diet is recommended for GERD?

A

Anti-reflux diet

88
Q

What diet is recommended for gastroparesis?

A

Small frequent low fat/ fiber meals

89
Q

What diet is recommended for celiac disease?

A

Gluten free diet

90
Q

What diet is recommended for IBS?

A

Low FODMAP diet

91
Q

What diet is recommended for IBD?

A

Well-balanced nutrient rich diet with avoidance of refined/ processed foods

92
Q

What diet is recommended for CV disease?

A

Mediterranean and DASH

(HTN = DASH, CHF = low sodium, fluid restriction)

93
Q

What diet is recommended for DM?

A

Macronutrient balance/ glycemic control, optimize A1c, BP, cholesterol

94
Q

What are the specific risks for iron deficiency?

A

Blood loss, H.pylori, PPI use

95
Q

The following are a/w what nutritional deficiency?

Vegan, pernicious anemia, TI Crohns/ TI resection, pancreatic complications, metformin

A

B12 deficiency

96
Q

Poor renal function can lead to what?

A

Sodium/ fluid restriction, hyperkalemia, hyperphosphatemia

97
Q

For a pt with renal disease, in addition to individualized protein, Na, K, PO4, and Ca intake, what else is used for nutrition management?

A

Phosphorus binders (and consult dietician)

98
Q

What consistency should be maintained with Coumadin use?

99
Q

What should be avoided with statins?

A

Grapefruit juice

100
Q

What meds should be administered separately?

A

Calcium and thyroid meds

101
Q

What drug can cause fat-soluble vitamin deficiencies?

A

Cholestyramine

102
Q

What drugs can cause folic acid deficiency?

A

Sulfasalazine, methotrexate

103
Q

What drug can cause vit B6 deficiency?

1. Clin Med III (29 decks)

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