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ABSITE Review > ABSITE Review - Nutrition > Flashcards

ABSITE Review - Nutrition Flashcards

1
Q

What is the daily caloric need?

A

25kcal/kg/day

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2
Q

Mention the kcal./g of fat, protein, CHO and dextrose.

A

Fat 9kcal/g
Protein 4 kcal/g
Oral CHO 4 kcal/g
Dextrose 3.4 kcal/g

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3
Q

What are the nutritional requirements (protein, fat, CHO) for an average healthy adult male?

A

Protein 1g/kg/day (20% essential AAs)
Fat 30% calories
CHO rest of the calories

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4
Q

Which states of health or disease can increase the kcal requirement?

A

Trauma, surgery or sepsis - 20-40%
Pregnancy increase 300kcal/day
Lactation increase 500kcal/day

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5
Q

How are the protein and kcal requirements affected by burns?

A

Calories: 25kcal/kg/day + (30kcal/day x %burn)
Proteins: 1-1.5 g/kg/day + (3g x %burn)

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6
Q

What is the maximum glucose administration in TPN?

A

3g/kg/hr

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7
Q

What is the fuel for colonocytes?

A

Short chain fatty acids

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8
Q

What is the fuel for small bowel enterocytes and neoplastic cells?

A

Glutamine - MC AA in bloodstream and tissue

Releases NH4 in kidney, helping with nitrogen excretion

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9
Q

What are the half-lives of albumin, transferrin and prealbumin?

A

Albumin - 20 days
Transferrin - 10 days
Prealbumin - 2 days

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10
Q

What are ACUTE indicators of nutritional status?

A

Retinal binding protein, prealbumin, transferrin, total lymphocyte count

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11
Q

What is the the IBW formula for women and men?

A 
Men = 106lb + 6lb for each inch over 5ft
Women = 100lb + 5lb for each inch over 5ft
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12
Q

Mention preoperative signs of poor nutritional status.

A

Acute weight loss >10% in 6 months

Weight < 3.0 - strong risk factor for morbidity and mortality after surgery

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13
Q

What is the respiratory quotient? What is the number for each metabolism?

A

Ratio of CO2 produced to O2 consumed = measurement of energy expenditure
RQ > 1 = lipogenesis (overfeeding) - Tx: decrease CHO & caloric intake
RQ < 0.7 = ketosis and fat oxidation (starving) - Tx: increase CHO and caloric intake
RQ = 7 - pure fat metabolism
RQ = 0.8 - pure protein metabolism
RQ = 1.0 - pure CHO metabolism

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14
Q

How long does the the glycogen stores last in starvation? What is used after they are used?

A

Depleted after 24-36 hours (2/3 skeletal muscle, 1/3 liver) –> body then switches to fats

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15
Q

Where the glucose-6-phosphatase is only found?

A

Liver

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16
Q

What is the primary substrate of gluconeogenesis?

A

Alanine

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17
Q

What are the gluconeogenesis precursors?

A

Amino acids (especially alanine), lactate, pyruvate, glycerol

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18
Q

What is the main source of energy in trauma and starvation?

A

Fat (ketones)

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19
Q

When bacterial translocation is a risk? What cause it?

A

Occurs when the gut is not feed. Bacterial overgrowth occurs due to increased permeanility due to starved enterocytes.

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20
Q

What is the fuel of brain usually? What is it in starvation?

A

Usually glucose

Ketones in starvation.

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21
Q

What are the obligate glucose users?

A

Peripheral nerves, Adrenal Medulla, RBCs, WBCs

22
Q

What occurs when feeding after prolonged starvation/malnutrition? What electrolytes abnormalities are common?

A

Refeeding Syndrome

Results in decrease K, Mg and PO4 –> causes cardiac dysfunction and fluid shifts

23
Q

What is Kwashiorkor?

A

Protein deficiency

24
Q

What is Marasmus?

A

Starvation

25
Q

How much nitrogen contains 6.25g of protein?

A

6.25g of protein contains 1g of nitrogen

26
Q

What AAs are most of the protein breakdown in the skeletal muscle?

A

Glutamine and Alanine

27
Q

What are the fat-soluble vitamins?

A

ADEK

28
Q

Medium and short chain fatty acids enter enterocytes by …

A

Simple diffusion

29
Q

Long chain fatty acids enter enterocytes by …

A

Fusing with membrane in micelles

30
Q

What is the function of the lipoprotein lipase?

A

Present on liver endothelium

Clears chylomicrons and TAGs from the blood, breaking them to fatty acids and glycerol

31
Q

What is the most important rout of entry for dietary cholesterol?

A

VLDL, synthesized in the liver

32
Q

What is the preferred source of energy for the liver, heart and skeletal muscle?

A

Fatty acids (ketones - acetoacetate, beta-hydroxybutyrate)

33
Q

What are the essential fatty acids?

A

Linolenic, Linoleic

34
Q

What are the omega-3 fatty acids?

A

PGI3, TXA3, LTB5 (all odd)

35
Q

What are the omega-6 fatty acids?

A

PGE2, TXA2, LTB4 (all even)

36
Q

Where the CHO digestion starts?

A

Begins with salivary amylase, then pancreatic amylase and disaccharides

37
Q

Where the protein digestion starts?

A

Begins with stomach pepsin, then trypsin, chymotrypsin and carboxypeptidase

38
Q

Who activates trypsinogen?

A

Enterokinase released from duodenum

39
Q

What are the branched-chain amino acids?

A

Leucine, Isoleucine, Valine

40
Q

Vitamin Deficiencies

A

Mention

41
Q

Hyperglycemia + encephalopathy + Neuropathy =

A

Chromium deficiency

42
Q

Cardiomyopathy + weakness + hair loss =

A

Selenium deficiency

43
Q

Pancytopenia

A

Copper deficiency

44
Q

Hair loss + Poor Healing + rash =

A

Zinc deficiency

45
Q

Weakness (failure to wean ventilator) + encephalopathy + decreased phagocytosis =

A

Phosphate deficiency

46
Q

Wernicke’s encephalopathy + cardiomyopathy + peripheral neuropathy =

A

Thiamine (B1) deficiency

47
Q

Sideroblastic anemia + glossitis + peripheral neuropathy =

A

Pyridoxine (B6) deficiency

48
Q

Megaloblastic anemia + peripheral neuropathy + beefy tongue =

A

Cobalamin (B12) deficiency

49
Q

Pellagra (diarrhea, dermatitis, dementia)

A

Niacin deficiency

50
Q

Dermatitis + hair loss + thrombocytopenia =

A

Essential fatty acids

51
Q

What is Cori cycle?

A

Glucose is converted to lactate in the muscle, then goes to liver and is converted to pyruvate and eventually glucose via gluconeogenesis

ABSITE Review (32 decks)

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