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

[216B] Nutrition Flashcards

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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
[T/F] Can vitamin D be overdosed?
True
26
What is osteoporosis?
Fragile bones d/t increased bone resorption
27
What is the most common cause of osteoporosis?
Menopause
28
What is the 3 tx for osteoporosis?
- Vitamin D - Calcium - Bisphosphonates
29
What are 2 examples of biphosphonates?
- Alendronate (Fosamax) | - Risedronate (Actonel)
30
What are the 2 hormones that stimulate lactation?
- Prolactin | - Oxytocin
31
What are the 3 types of breastmilk?
- Colostrum - Transitional milk - Mature milk
32
What is prolactin responsible for in lactation?
Milk synthesis
33
What is oxytocin responsible for in lactation?
Milk excretion + ejection
34
Colostrum occurs _-_ days post delivery and contains:
1-3; IgA, EGF, low in lactose
35
Transitional milk occurs _-_ days post delivery and contains:
3-14; lactose, protein, fat
36
Mature milk contains:
Foremilk (water, low calorie + fat) and hindmilk (fat)
37
``` Breastmilk: Milk fat: __% Calories: __/100 mL Iron: 0.__ mg/L Iron bioavailability up to __% ```
56, 70, 0.35, 100
38
What is the average milk consumption in infants per day?
750 mL
39
What are 3 uses of iron?
- Normal cell function - Mitochondrial energy production - Hgb synthesis
40
What is the activation pathway for Vit D?
7-dehydrocholesterol + UVB exposure > Vitamin D3 (active)
41
What are the normal losses of iron per day in adults and pediatrics?
Adults: 1-2 mg Pediatrics: 0.27 mg
42
What protein does iron bind to in the blood vs within cells?
Transferrin vs ferritin + hemosiderin
43
When during pregnancy is iron stored for the baby?
3rd trimester of gestation
44
How much mg/L of iron do formulas contain? What is the bioavailability of this iron?
4-13 mg/L, 10%
45
What are sources of heme iron vs non-heme iron? Their bioavailabilities?
Heme: meat, poultry, fish, 20% | Non-heme: legumes, nuts, eggs, 5%
46
What are some inducers and inhibitors of iron?
Inducer: protein, vitamin C Inhibitor: Calcium
47
What are 4 types of formula? What type of milk are they made with?
- Standard iron fortified (cow) - Lactose free (cow) - Hypoallergenic (cow) - Soy (soy)
48
What are some contraindications to breastfeeding?
- Infection - Drugs - Galactosemia - Lactose intolerance
49
What is the primary active toxic metabolite for galactosemia?
Galactitol
50
What are some s&s of galactosemia?
- Vomiting - Poor weight gain - Fatigue - Hypoglycemia
51
What are some complications of galactosemia?
- FTT - Brain damage - E. coli sepsis
52
What is the tx for galactosemia?
- Soy formula + Ca2+ supplements | - Tx of associated symptoms (ie. antibiotics)
53
Lactose intolerance is the deficiency of what enzyme?
Lactase
54
What are the 2 types of lactose intolerances and what are the differences?
- Congenital: genetic | - Primary: loss of lactase with age
55
What are some s&s of lactose intolerance?
- Unabsorbed lactose - Diarrhea - Gas - Bloating
56
What are some tx for lactose intolerance (specifically in infants)?
- Avoid milk products - Lactose free formula - Soy formula - Lactaid
57
What are 2 tests for lactose intolerance?
- Breath test | - Lab test
58
By 1 years old, what are some growth and development benchmarks we should expect to see?
- Brain is 2/3 of adult size - Birth weight tripled - Begins walking - Beginnings of language
59
How can too much milk intake be bad?
- Secondary anemia (interferes with iron absorption) | - Displaces other food from diet
60
Anemia is a ____, not a diagnosis and is defined as an impaired ____ ____ capacity
symptom, oxygen carrying
61
What are 2 causes of anemia?
- Low production of Hgb, RBCs or iron | - Loss (ie. hemorrhage)
62
What is the tx for iron deficiency anemia?
- Prevention | - Iron supplements (ie. ferrous sulfate)
63
What are some important labs to order to check for anemia?
- Serum iron - Ferritin - CBC - Hgb - Hematocrit - MCHC
64
What are some s/e of iron supplements?
- GI pain - Constipation - Drug-drug-food interactions
65
What are 2 examples of iron supplements given parenterally?
- Iron dextran | - Monoferric (Monofer, Venofer)
66
What are some s&s of iron poisoning? What causes these s&s?
``` Intestinal hemorrhage: - Vomiting - GI pain Mitochondrial damage: - Cardiac abnormalities - CNS abnormalities ```
67
What is the tx for iron poisoning?
Excretion: - Evacuation of bowel - Deferoxamine (Desferal) IV
68
Acute hemorrhagic anemia is when __-__% of blood volume is lost
10-30%
69
What are some s&s of acute hemorrhagic anemia?
- Compensation - Hypotension - Shock
70
What is the tx for acute hemorrhagic anemia?
- PRBCs - Treat cause - Iron meds
71
What are some s&s of an allergic transfusion reaction?
- IV site redness + pain - Flushed face - VS changes - Headache - Chills/fever - Urticaria - Back pain - N&V - SOB
72
What is the tx for an allergic transfusion reaction?
- Glucocorticoids - Antihistamines - Epinephrine - O2 - NS - Antibiotics - Monitor organ fx
73
What should we administer to a starving pt before refeeding them (2)?
Thiamine & B-complex vitamins (contain 8 diff B vitamins)
74
What is thiamine's function?
Cell fx & repair.
75
Vit C deficiency is called:
Scurvy
76
Vit A deficiency is called:
Vit A avitaminosis
77
Which vitamin do we give IM to newborns? Why?
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
What is vit K deficiency called?
VKDB (Vit K Deficiency Bleeding)
79
Vit B12 deficiency is called:
Cobalamin deficiency.
80
Vit B1 deficiency is called:
Beriberi
81
Vit B3 deficiency is called:
Pellagra.
82
When should a baby be started on solids?
6 months
83
When can babies start cow milk?
1 year old.
84
If a pt has low ferritin and transferrin, they likely have:
iron deficiency anemia.
85
If a pt has high ferritin and high transferrin, they likely have:
Hemolytic anemia (RBC destruction = lots of iron available).
86
If a pt's transferrin is low, but their ferritin is normal, they likely have:
a hemorrhage/blood loss

N216 A/B (26 decks)

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