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N216 A/B > [216B] Nutrition > Flashcards

[216B] Nutrition Flashcards

1
Q

What are the 2 micronutrients and 3 macronutrients?

A

Micro: vitamins & minerals
Macro: carbohydrates, proteins (amino acid) & lipids (fatty acid)

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2
Q

Macronutrients are a source of ____ and when in excess are stored in ____ tissue

A

energy, adipose

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3
Q

What is the difference between anabolism and catabolism?

A

Anabolism: synthesis
Catabolism: breakdown

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4
Q

What is a basal metabolic rate (BMR)? What’s the average BMR?

A

Amount of energy needed for body maintenance - 10kCal/lb

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5
Q

What are 3 situations where there might be an increased energy requirement for an individual?

A
  • Growth + development phases
  • Illness + infection
  • Exercise
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6
Q

What are the 2 causes of malnutrition?

A
  • Lack of nutrients

- Ineffective utilization of nutrients

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7
Q

What is failure to thrive (FTT)?

A

Inadequate nutrition to support growth + development

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8
Q

What are organic causes of FTT?

A

Pathologies (ie. cancer, GI disease)

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9
Q

What are non-organic causes of FTT?

A

Neglect + poverty

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10
Q

What is the tx for malnutrition + FTT?

A
  • Increase caloric intake

- Hydrate

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11
Q

What is the difference between Kwashiorkor and Marasmus FTT?

A

Kwashiorkor: diets deficient of protein (belly protrudes)
Marasmus: total calorie + protein deficient (muscle atrophy)

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12
Q

What are the 3 types of feeds that can be prepared for enteral nutrition? What is the difference between them?

A
  • Polymeric: intact nutrients + high calories (ie. protein)
  • Oligomeric: digestible components (ie. amino acid)
  • Specialized: if organ disease present
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13
Q

What are the 3 types of timing for enteral nutrition?

A
  • Bolus (like a meal)
  • intermittent (slower bolus)
  • Continuous
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14
Q

Why is continuous feeding ideal for recovery?

A

Avoids dumping syndrome

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15
Q

What is the admin. route for total parenteral nutrition (TPN)?

A

IV (ideally central line)

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16
Q

What are 5 s/e of TPN?

A
  • Fluid overload
  • Infection
  • Electrolyte imbalance
  • Hyperglycemia
  • GI dysfunction
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17
Q

When starving lasts > 5 days, what 3 things does the body do to compensate?

A
  • Lipolysis for energy, increasing serum ketones
  • Depletion of intracellular minerals
  • Reduced organ fx
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18
Q

Why does re-feeding syndrome happen?

A

Glucose surge –> massive hemostatic changes

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19
Q

What is the root reflex?

A

Baby turns to stimulus: poking cheek and opens mouth

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20
Q

What is the suck reflex?

A

Baby sucks

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21
Q

How long should a baby exclusively be breastfed according to Canada guidelines?

A

6 months

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22
Q

Where is vitamin D3 formed?

A

Kidney + liver

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23
Q

How do vitamin D and calcium interact with each other?

A

Drive each other

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24
Q

When are calcium gluconate and calcitriol indicated?

A

Low serum calcium

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25
Q

[T/F] Can vitamin D be overdosed?

A

True

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26
Q

What is osteoporosis?

A

Fragile bones d/t increased bone resorption

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27
Q

What is the most common cause of osteoporosis?

A

Menopause

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28
Q

What is the 3 tx for osteoporosis?

A
  • Vitamin D
  • Calcium
  • Bisphosphonates
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29
Q

What are 2 examples of biphosphonates?

A
  • Alendronate (Fosamax)

- Risedronate (Actonel)

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30
Q

What are the 2 hormones that stimulate lactation?

A
  • Prolactin

- Oxytocin

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31
Q

What are the 3 types of breastmilk?

A
  • Colostrum
  • Transitional milk
  • Mature milk
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32
Q

What is prolactin responsible for in lactation?

A

Milk synthesis

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33
Q

What is oxytocin responsible for in lactation?

A

Milk excretion + ejection

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34
Q

Colostrum occurs - days post delivery and contains:

A

1-3; IgA, EGF, low in lactose

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35
Q

Transitional milk occurs - days post delivery and contains:

A

3-14; lactose, protein, fat

36
Q

Mature milk contains:

A

Foremilk (water, low calorie + fat) and hindmilk (fat)

37
Q 
Breastmilk:
Milk fat: \_\_%
Calories: \_\_/100 mL
Iron: 0.\_\_ mg/L
Iron bioavailability up to \_\_%
A

56, 70, 0.35, 100

38
Q

What is the average milk consumption in infants per day?

A

750 mL

39
Q

What are 3 uses of iron?

A
  • Normal cell function
  • Mitochondrial energy production
  • Hgb synthesis
40
Q

What is the activation pathway for Vit D?

A

7-dehydrocholesterol + UVB exposure > Vitamin D3 (active)

41
Q

What are the normal losses of iron per day in adults and pediatrics?

A

Adults: 1-2 mg
Pediatrics: 0.27 mg

42
Q

What protein does iron bind to in the blood vs within cells?

A

Transferrin vs ferritin + hemosiderin

43
Q

When during pregnancy is iron stored for the baby?

A

3rd trimester of gestation

44
Q

How much mg/L of iron do formulas contain? What is the bioavailability of this iron?

A

4-13 mg/L, 10%

45
Q

What are sources of heme iron vs non-heme iron? Their bioavailabilities?

A

Heme: meat, poultry, fish, 20%

Non-heme: legumes, nuts, eggs, 5%

46
Q

What are some inducers and inhibitors of iron?

A

Inducer: protein, vitamin C
Inhibitor: Calcium

47
Q

What are 4 types of formula? What type of milk are they made with?

A
  • Standard iron fortified (cow)
  • Lactose free (cow)
  • Hypoallergenic (cow)
  • Soy (soy)
48
Q

What are some contraindications to breastfeeding?

A
  • Infection
  • Drugs
  • Galactosemia
  • Lactose intolerance
49
Q

What is the primary active toxic metabolite for galactosemia?

A

Galactitol

50
Q

What are some s&s of galactosemia?

A
  • Vomiting
  • Poor weight gain
  • Fatigue
  • Hypoglycemia
51
Q

What are some complications of galactosemia?

A
  • FTT
  • Brain damage
  • E. coli sepsis
52
Q

What is the tx for galactosemia?

A
  • Soy formula + Ca2+ supplements

- Tx of associated symptoms (ie. antibiotics)

53
Q

Lactose intolerance is the deficiency of what enzyme?

A

Lactase

54
Q

What are the 2 types of lactose intolerances and what are the differences?

A
  • Congenital: genetic

- Primary: loss of lactase with age

55
Q

What are some s&s of lactose intolerance?

A
  • Unabsorbed lactose
  • Diarrhea
  • Gas
  • Bloating
56
Q

What are some tx for lactose intolerance (specifically in infants)?

A
  • Avoid milk products
  • Lactose free formula
  • Soy formula
  • Lactaid
57
Q

What are 2 tests for lactose intolerance?

A
  • Breath test

- Lab test

58
Q

By 1 years old, what are some growth and development benchmarks we should expect to see?

A
  • Brain is 2/3 of adult size
  • Birth weight tripled
  • Begins walking
  • Beginnings of language
59
Q

How can too much milk intake be bad?

A
  • Secondary anemia (interferes with iron absorption)

- Displaces other food from diet

60
Q

Anemia is a ____, not a diagnosis and is defined as an impaired ____ ____ capacity

A

symptom, oxygen carrying

61
Q

What are 2 causes of anemia?

A
  • Low production of Hgb, RBCs or iron

- Loss (ie. hemorrhage)

62
Q

What is the tx for iron deficiency anemia?

A
  • Prevention

- Iron supplements (ie. ferrous sulfate)

63
Q

What are some important labs to order to check for anemia?

A
  • Serum iron
  • Ferritin
  • CBC
  • Hgb
  • Hematocrit
  • MCHC
64
Q

What are some s/e of iron supplements?

A
  • GI pain
  • Constipation
  • Drug-drug-food interactions
65
Q

What are 2 examples of iron supplements given parenterally?

A
  • Iron dextran

- Monoferric (Monofer, Venofer)

66
Q

What are some s&s of iron poisoning? What causes these s&s?

A 
Intestinal hemorrhage:
- Vomiting
- GI pain
Mitochondrial damage:
- Cardiac abnormalities
- CNS abnormalities
67
Q

What is the tx for iron poisoning?

A

Excretion:

  • Evacuation of bowel
  • Deferoxamine (Desferal) IV
68
Q

Acute hemorrhagic anemia is when __-__% of blood volume is lost

A

10-30%

69
Q

What are some s&s of acute hemorrhagic anemia?

A
  • Compensation
  • Hypotension
  • Shock
70
Q

What is the tx for acute hemorrhagic anemia?

A
  • PRBCs
  • Treat cause
  • Iron meds
71
Q

What are some s&s of an allergic transfusion reaction?

A
  • IV site redness + pain
  • Flushed face
  • VS changes
  • Headache
  • Chills/fever
  • Urticaria
  • Back pain
  • N&V
  • SOB
72
Q

What is the tx for an allergic transfusion reaction?

A
  • Glucocorticoids
  • Antihistamines
  • Epinephrine
  • O2
  • NS
  • Antibiotics
  • Monitor organ fx
73
Q

What should we administer to a starving pt before refeeding them (2)?

A

Thiamine & B-complex vitamins (contain 8 diff B vitamins)

74
Q

What is thiamine’s function?

A

Cell fx & repair.

75
Q

Vit C deficiency is called:

A

Scurvy

76
Q

Vit A deficiency is called:

A

Vit A avitaminosis

77
Q

Which vitamin do we give IM to newborns? Why?

A

Vit K: active vit K (K2) must be synthesized in the GI tract, but newborns have no gut flora, so they can’t. Thus, we need to give it to them IM.

78
Q

What is vit K deficiency called?

A

VKDB (Vit K Deficiency Bleeding)

79
Q

Vit B12 deficiency is called:

A

Cobalamin deficiency.

80
Q

Vit B1 deficiency is called:

A

Beriberi

81
Q

Vit B3 deficiency is called:

A

Pellagra.

82
Q

When should a baby be started on solids?

A

6 months

83
Q

When can babies start cow milk?

A

1 year old.

84
Q

If a pt has low ferritin and transferrin, they likely have:

A

iron deficiency anemia.

85
Q

If a pt has high ferritin and high transferrin, they likely have:

A

Hemolytic anemia (RBC destruction = lots of iron available).

86
Q

If a pt’s transferrin is low, but their ferritin is normal, they likely have:

A

a hemorrhage/blood loss

N216 A/B (26 decks)

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