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House Clinical Pathology > Clinical Nutrition > Flashcards

Clinical Nutrition Flashcards

1
Q

There are four components to the NCP:

nutrition _______

nutrition ________

nutrition _________

nutrition _________________

A

assessment

diagnosis

intervention

monitoring and evaluation.

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2
Q

Nutrition _________ is defined as a “systematic process of obtaining, verifying, and interpreting data in order to make decisions about the nature and cause of nutrition-related problems.”

A

assessment

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3
Q

The “A–E of Nutrition assessment.”

A— _________________ or _____________
B — ____________ analyses
C— __________ usually performed by the physician
D— __________ analysis and assessment to determine usual ______
E— __________ assessment

A

anthropometric or body composition measurements

biochemical

clinical examination

dietary; food intake

environmental

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4
Q

Dietary analysis of a patient is generally performed by the ______

A

Registered dietitian

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5
Q

anthropometric or body composition measurements include:

BMI
_____ circumference
______ thickness,
_______ weighing,
____________(ADP)
______________ (DEXA)
__________________________ (BIA),

A

Waist

Skinfold

Hydrostatic

Air-displacement plethysmography

Dual energy x-ray absorptiometry

Bioelectrical impedance analysis

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6
Q

Biochemical assessment markers are divided into 2- __________ and _______ markers.

A

macronutrients and micronutrients

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7
Q

The macronutrients include markers of ________,_________, and _______ metabolism and utilization.

A

carbohydrate, protein, and fat

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8
Q

Micronutrients measurements are not important.

T/F

A

F

Micronutrients measurements are also very important.

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9
Q

Liver function will be affected if there is insufficient ______ and excess _____.

A

protein; fats

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10
Q

An excessive intake of protein may also be harmful to kidney function

T/F

A

T

due to the excess of non-protein nitrogen compounds formed that must then be removed.

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11
Q

The clinical component of the nutrition assessment

This consists of the _____ (_____,_______, and ________) and ___________

A

history

present , past and family

physical examination

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12
Q

Metabolic syndrome is defined by utilizing information derived from the ________ components (____) of a nutrition assessment

A

first three ; A–C

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13
Q

The parameters include for metabolic syndrome include:

  1. An elevated waist circumference. In women,____ inches (____ cm); in men, ____ inches (____ cm)
  2. Elevated triglyceride levels > ____ mg/dL (1.7mmoles/L)
  3. Elevated fasting glucose > ____ mg/dL (____ mmoles/L)
  4. Reduced HDL cholesterol. In women, ____ mg/dL(1.3mmoles/L); in men, ____ mg/dL(1.03mmoles/L)
  5. Elevated blood pressure > ___/___ mm Hg
A

35;88;40;102

150; 110;6.1

50; 40

130/85

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14
Q

There are several ways to assess adequacy of intake

__________________ System.

___________________ [RDA]

___________ [AI]

tolerable __________

A

the USDA Food Guidance

Recommended Dietary Allowance

adequate intake

upper limits

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15
Q

Examples of tools used by the registered dietitian to determine dietary adequacy include the ________, the _______ record or diary, and/or the ________ questionnaire.

A

24-hour recall

3-day food

food frequency

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16
Q

The ideal proteins markers have a (short or long?) biologic half-life

A

Short

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17
Q

Serum albumin half-life??

Serum pre-albumin half life??

A

20 days

2 days

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18
Q

Serum albumin is a good indicator of short-term protein and energy deprivation

T/F

A

F

Serum albumin is not a good indicator of short-term protein and energy deprivation

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19
Q

Serum albumin is a good indicator of chronic deficiency.

T/F

A

T

20
Q

Albumin’s function as a biochemical marker

1) to identify chronic protein deficiency under conditions of ________________(eg _______)

2) presence of ________ in which metabolic adaptations keeps ________________( eg __________)

A

adequate non–-protein-calorie intake; kwashiorkor

caloric insufficiency; protein levels within reference range.

marasmus

21
Q

Serum albumin levels of ___/L are considered normal.

Albumin levels of _____ to ___ g/L indicate mild malnutrition

Levels of _____ to _____ g/L indicate moderate malnutrition Levels

less than ______ g/L indicate severe malnutrition.

A

35 g

28–30 ; 35

23–25 ; 28–30

23–25

22
Q

Half-life

Transferrin

Albumin

Prealbumin

RBP

A

9 days

20days

2days

12hours

23
Q

Transferrin
It is synthesized in the _____ and binds and transports ____ iron.

A

liver; ferric

24
Q

Transferrin synthesis is regulated by ________.

When hepatocyte iron is absent or low, transferrin levels (rise or drops?) in proportion to the deficiency.

A

iron stores

rise

25
Q

the (elevated or depressed?) transferrin is the (first or last?) analyte to return to normal when iron deficiency is corrected.

A

Elevated

Last

26
Q

Which is most likely to indicate protein depletion first between transferrin, prealbumin and albumin?

A

Prealbumin

Transferrin

Albumin

27
Q

________ and _______ are considered the major transport proteins for thyroxine and vitamin A,

A

Transthyretin and RBP

28
Q

Concentrations of transthyretin appear to be significantly influenced by fluctuations in the hydration state, liver disease or renal disease.

T/F

A

F

Concentrations of transthyretin do not appear to be significantly influenced by fluctuations in the hydration state, liver disease or renal disease.

29
Q

RBP interacts strongly with plasma _______ and circulates in the plasma as a __:___ mol/L

________-________ complex.

A

transthyretin

1:1

transthyretin–RBP

30
Q

A potential problem exists in using RBP as a nutritional marker, however. Although RBP has a shorter half-life than transthyretin (_____, compared with __________), it is _______, and its concentration _____eases more significantly than transthyretin in patients with renal failure.

A

12 hours

2 days

excreted in urine

incr

31
Q

The molecular size and structure of IGF-1 is similar to proinsulin.

T/F

A

T

32
Q

In the healthy adult population, anabolic and catabolic rates are _________, and the nitrogen balance approaches _____.

A

in equilibrium

zero

33
Q

Therefore, the determination of ________________ is a method for estimating the amount of nitrogen excretion.

A

24-hour urinary urea nitrogen (UUN)

34
Q

Nitrogen balance, as calculated by this equation, is not valid in patients with severe ______ or ______ or in patients with __________

A

stress or sepsis

renal disease

35
Q

The two common PEM states are ________ and ________

A

Marasmus and Kwashiorkor

36
Q

Marasmus : ______ undernutrition affecting __________ especially insufficiency of ________________________

A

Generalized

all food nutrients

both protein and CHO.

37
Q

non-oedematous PEM = _________

A

Marasmus

38
Q

In marasmus

______________ causes serum protein and electrolytes to remain within reference range hence no oedema

A

Starvation adaptation

39
Q

In marasmus,

Presence or absence of edema

A

Absence

40
Q

Absence of oedema with muscle wasting is characteristic of __________

A

marasmus

41
Q

Kwashiorkor is a condition caused by severe _______ in individuals with _____ energy intake.

A

protein deficiency

adequate

42
Q

Kwashiorkor

Characterised by anorexia, severe _____ with hypoproteinaemia, _______ hair and skin, ________ abdomen due to ______.

A

odema; depigmented

distended; fatty liver

43
Q

Kwashiorkor is A disease of weaning.

T/F

A

T

44
Q

Biochemistry of Kwashiorkor

(Low or high?) protein to energy ratio causes
-(low or high?) insulin
-(low or high?) cortisol
-increased uptake of amino acid into _____, diverting them from the _____

A

Low

High

Low

muscle; liver

45
Q

Biochemistry of Kwashiorkor

  • ____eased albumin synthesis
    -____eased plasma oncortic pressure leading to _____
    -Insulin promotes lipo_____ leading to the storage of ____ in hepatocytes causing ________.
A

Decr

Decr; odema

genesis; LDL; fatty liver

46
Q

Parenteral nutritional preparations are usually administered through a _________.

A

subclavian catheter

47
Q

TPN administration bypasses normal absorption and circulation routes

T/F

A

T

House Clinical Pathology (45 decks)

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