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CDR Exam > Domain 1 > Flashcards

Domain 1 Flashcards

1
Q

What color fruits and vegetables is calcium found in?

A

Orange, Green

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2
Q

What does crispness of vegetables depend on?

A

Osmotic Pressure and water filled vacuoles

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3
Q

What is the limiting amino acid in soy?

A

Methionine

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4
Q

Protein content of soy 1. Flour 2. Concentrate 3. Isolate

A
  1. 50% 2. 70% 3. 90%
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5
Q

What is textured protein products?

A

The end product of a series of steps producing fibers from soy beans.

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6
Q

What causes chemical changes during ripening?

A

Enzymes

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7
Q

What gas is used to accelerate the ripening of fruit during storage?

A

Ethylene

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8
Q

Which fruits ripen best at room temperature?

A

Avocados, Pears, Bananas and Tomatoes

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9
Q

Foods low in what lead to quick browning? How do you prevent browning?

A

Ascorbic Acid.
To prevent this… dip them in an acidic solution. Acids prevent enzymatic oxidation.

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10
Q

Density of syrup is measured in ____ by a ____

A

% by weight of sucrose; Brix hydrometer

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11
Q

Green pigments are due to____

A

Chlorophyll

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12
Q

Is chlorophyll insoluble or soluble in water?

A

insoluble

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13
Q

When Chlorophyll is heated in an acid, it turns into _______

A

pheophytin (olive green color)

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14
Q

When Chlorophyll is heated in an alkaline it turns into _______

A

chlorophyllin (bright green)

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15
Q

Yellow, orange pigments are due to____

A

carotenoids

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16
Q

Carotenoids are insoluble or soluble in water?

A

insoluble

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17
Q

What contributes to red coloring of fruits/vegetables?

A

Lycopenes (antioxidant, phyotochemical)

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18
Q

What are the two flavonoids?

A

Anthocyanins and Anthoxanthins

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19
Q

Red, blue and purple pigments are due to ____

A

Anthocyanins

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20
Q

White pigments are due to _______

A

Anthoxanthins

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21
Q

Anthocyanin are soluble or insoluble in water?

A

soluble

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22
Q

Anthocyanins turn ___ in acid and ___ alkaline

A

Red; blue

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23
Q

Anthoxanthins are soluble or insoluble in water?

A

soluble

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24
Q

Anthoxanthins are ___ in acid and ___ in alkaline

A

colorless; yellow

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25
Q

What causes astringent feeling in the mouth?

A

tannins

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26
Q

Fruit and vegetable grading system (Grade A, B, C) and who grades it?

A

Grade A. Desserts, Salads (fancy); Grade B. Processed (choice); Grade C. Puddings, Pies (standard)
Graded by USDA

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27
Q

What is milliard reaction?

A

The reaction between reducing sugars and proteins by the impact of heat.

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28
Q

10 can (#/case; Net weight; Measure; #servings)

A

6; 6 lbs.9oz; 13 cups; 20-25

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29
Q

What are the two types of protein in meat?

A

Collagen and Elastin

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30
Q

Collagen is hydrolyzed to ______ in heat.

A

Gelatin

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31
Q

What does the finish of meat refer to?

A

Amount of fat cover on carcass

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32
Q

What determines the cut of meat?

A

Shape of bone

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33
Q

Pork is a good source of _______

A

Thiamine

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34
Q

______ is high in fish canned with bones, oysters and shrimp

A

Calcium

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35
Q

What is the main contributor to meat color?

A

myoglobin +oxygen

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36
Q

Muscle protein brought about by enzymes increase ______ of the muscle?

A

Water holding capacity

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37
Q

What is MAP

A

Modified atmospheric packaging (air is removed and replaced with gases (CO2 or N)

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38
Q

Who inspects and grades meat at slaughter?

A

USDA

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39
Q

Standard grades have the _____ (least/most) marbling and prime the ______ (least/most)

A

Least; Most

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40
Q

The most tender meat cuts come from ______

A

Least used muscles (loin, backbone)

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41
Q

Medium tender meat cuts come from _____

A

shoulder (chuck)

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42
Q

Least tender meat cuts come from ______

A

Most used muscles (flank, brisket)

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43
Q

145 F is minimum safe internal temperature for_______.

A

Pork, Beef, Lamb, Veal, Steak, Roast, Fish

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44
Q

160 F is minimum safe internal temperature for _______.

A

Ground beef, ground veal, ground lamb

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45
Q

165 F is minimum safe internal temperature for ______.

A

Turkey, chicken , duck

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46
Q

Cured meats are pink from _____

A

Nitrites (prevents botulism)

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47
Q

Why does interior of meat change from red to pink to brown?

A

Heat denatures globin and iron is oxidized

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48
Q

Dry heat cooking methods

A

Frying, Broiling, Roasting, Grilling

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49
Q

Moist heat cooking methods

A

Braising, simmer, steam, stewing (water is involved)

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50
Q

Grading of eggs is based on _____

A

Candling (pass an egg in front of a bright light to view contents) Judged by thickness of white, location and condition of yolk – AA, A or B

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51
Q

Uses of Eggs:

A

Coagulation (custard), Leavening, Emulsification, Cooking, Processing, Storage

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52
Q

What is syneresis?

A

Liquid released from a coagulated product when too much heat is used.

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53
Q

What helps yolk act as an emulsifier?

A

Lecithin

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54
Q

How to measure tenderness of custard?

A

The larger the % sag (objective measurement) , the more tender the gel

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55
Q

What are the two milk proteins

A

80% casein, whey (lactose, lactalbumin, lactoglobulin, water soluble vitamins, minerals)

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56
Q

What is pasteurization?

A

Destroys pathogenic bacteria. 145 F for 30 min or 160 F for 15 seconds

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57
Q

To prevent curdling add ____ slowly and agitate.

A

an acid. (an acid precipitates casein).

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58
Q

How is cheese produced?

A

Warm up milk, add lactic-acid bacteria, add enzyme rennet to coagulate casein, forming the curd.

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59
Q

What prevents fat from separating and smoothes cheese?

A

Disodium phosphate

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60
Q

The endosperm is rich in ____

A

Protein

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61
Q

The scutellum in germ has the most _____

A

Thiamine

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62
Q

Quick cooking cereals have ____ added to increase swelling quickly?

A

disodium phosphate

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63
Q

Wheat flour is enriched with______

A

thiamin, riboflavin, niacin, iron, folic acid

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64
Q

Leavening is created by ______

A

steam, air or carbon dioxide

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65
Q

Quick breads are leavened with_____

A

Steam, air, chemical leavening agents (flour and egg)

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66
Q

What are the four ingredients in pastries?

A

Flour, Fat, Liquid, Salt

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67
Q

Straight dough method

A

All ingredients are added before dough is allowed to rise

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68
Q

Sponge method

A

Combine liquid with yeast and part of flour and allow batter to ferment.

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69
Q

Continuous bread baking method

A

substitutes intense mechanical energy for traditional bulk fermentation

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70
Q

How to adjust baking at high altitudes.

A

Decrease baking powder, increase liquid.
Decreased pressure causes gas to expand faster, steam forms earlier.

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71
Q

Starch is composed of ________

A

amylose and amylopectin molecules

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72
Q

Amylose is responsible for ______

A

Geletion (solidifying)

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73
Q

Define gelatinization

A

The swelling that occurs when starch is heated in water close to the boiling point.

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74
Q

Define retrogradation

A

Occurs in starches with a high proportion of amylose. After a starch paste has been cooled, it becomes less soluble and recrystallizes. It is Undesirable. (e.g. Pudding held in refrigerator for many days or harsh texture of bread after days in storage.)

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75
Q

What is gelatin?

A

Incomplete protein- no tryptophan , low in methionine and lysine. Keeps sugar and ice crystals small in candy and ice cream.

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76
Q

When coffee is heated above 203 F what is extracted?

A

Tannins-causing bitterness

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77
Q

Who controls additives in products?

A

FDA

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78
Q

Emulsifier

A

Helps two liquids mix (monoglycerides, diglycerides, lecithin, disodium phosphate)

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79
Q

Humectant

A

Retains moisture (glycerol monostearate)

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80
Q

Stabilizer

A

Preserves structure (carrageenan, pectin, cellulose, gelatin, vegetable proteins)

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81
Q

Anti-caking

A

Prevents ingredients caking together (Sodium stearate)

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82
Q

Nitrites

A

Fixes color, inhibits spores of clostridium botulinum

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83
Q

Propionate

A

Preservative, mold inhibitor

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84
Q

Ascorbic Acid

A

Prevents browning

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85
Q

Functional Foods

A

provide more benefits than the basic nutrition benefits

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86
Q

Examples of functional foods

A

conventional foods (whole foods), modified (fermented, enriched, enhanced) medical foods, special dietary foods (gluten free)

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87
Q

Phytochemicals

A

Biologically active naturally occurring chemical compounds in plant foods, act as natural defense (terpenes, carotenoids, lycopene, Limonoids, phenols, flavonoids, etc.)

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88
Q

Food synergy

A

The additive influence of foods and constituents which when eaten have a beneficial effect on health.

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89
Q

Pedagogy

A

The science of teaching children

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90
Q

Andragogy

A

Adults are mutual partners in learning

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91
Q

Sales promotion

A

Short term incentive to encourage purchases (coupons)

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92
Q

Personal promotion

A

Formal/informal presentation, health fairs, cooking demonstrations.

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93
Q

What are the 3 types of domains of learning?

A

Cognitive: acquisition of knowledge (factual learning)
Affective: acquisition of attitudes or values
Psychomotor: acquisition of muscular skills

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94
Q

6 steps of the plan-theory-based nutrition education

A
  1. decide behavior change goals
  2. explore determinants of change
  3. select the theory you will use
  4. indicate general objectives
  5. generate plans
  6. develop evaluation plan
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95
Q

Describe the three behavior modification methods

A
  1. positive reinforcement- encourages repetition of a given behavior
  2. avoidance learning- learn to escape from unpleasant consequences
  3. extinction- reduce undesired behavior
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96
Q

Describe the 5 stages of Transtheoretical Stages of Change model.

A
  1. pre contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
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97
Q

Health belief model

A

a person must perceive the severity for the threat to be a behavior-motivating factor.

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98
Q

Diffusion of innovation

A

how an innovation, idea or behavior spreads
- Positions: innovators, early adopters, early majority, late majority, laggards

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99
Q

Synergy

A

The groups decision is superior to what the most resourceful individual within the group could have come up with on their own.

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100
Q

Steps of interviewing

A
  1. preparation
  2. build rapport
  3. collect data
  4. closing
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101
Q

Non verbal communication: kinesics

A

physical communication (eye contact, arms folded)

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102
Q

Non verbal communication: paralinguistics

A

How the client’s message is delivered (anxious, sensitive, stuttering)

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103
Q

Non verbal communication: proxemics

A

Personal space

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104
Q

Ethical principle of autonomy

A

Respect other’s right to self-determine a course of action or support independent decision making

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105
Q

Cognitive behavior therapy

A

Focuses on identifying behaviors and thoughts that have a negative impact on desired behaviors and goals and apply strategies to change those.

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106
Q

Describe Motivational Interviewing(MI)

A

Helps client recognize and begin to resolve their concerns and problems.

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107
Q

What are the principles of MI

A
  1. express empathy
  2. develop discrepancy (between where he is and where he wants to be)
  3. avoid arguments
  4. roll with resistance
  5. support self efficacy
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108
Q

Explain the 4 steps of the educational process

A
  1. assessment
  2. planning
  3. implementation
  4. evaluation of outcomes
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109
Q

2 types of evaluation of educational outcomes

A

Formative: Made during the course of education
Summative: designed at planning stage but conducted at the end (did we achieve what we planned)

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110
Q

Nutritional informatics

A

the intersection between nutrition, information and technology

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111
Q

Types of nutritional informatics

A
  1. electronic health record
  2. personal health record
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112
Q

Patient centered medical home (PCMH)

A

focuses on the relationship between the patient and personal physician

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113
Q

describe legislation

A

The interaction between the legislative, executive and judiciary branches

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114
Q

describe the legislative branch

A

(congress, senators, representatives) may introduce and enact a law and can override a veto by the executive branch

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115
Q

describe the executive branch

A

(president) may veto legislation or sign it into law

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116
Q

describe the judiciary branch

A

may disregard a law if it considers it in violation of a person’s basic rights and freedoms

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117
Q

Stages of how a bill becomes a law.

A
  1. legislation enters as a bill or a resolution
  2. the bill is sent to committees.
  3. the committee revises bill during a markup session and puts it into final form
  4. needs approval from both houses (representatives and senate) and the president
  5. differences between the two houses are worked out in a joint house-senate conference committee and ultimately pass a reconciliation bill
  6. appropriations must be passed to provide funding
  7. formulate regulations that interpret and operate the law
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118
Q

Describe the federal trade commission (FTC)

A

Regulates content of food ads; enforces truth in labeling; challenges product claims when product crosses state lines

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119
Q

describe the Food and Drug Administration (FDA)

A

ensures safety of some domestic and important food products

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120
Q

Describe federal communications commission (FCC)

A

licenses radio and tv

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121
Q

Child Nutrition Reauthorization covers which educational programs _______

A

NSLP, SBP, CACGP, SFSP, SMP, WIC

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122
Q

Describe the farm bill

A

Covers national and international nutrition education, research and funding

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123
Q

Describe the older Americans act

A

funds nutrition programs in the community and those that are homebound

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124
Q

Describe the 7 steps in research

A
  1. Identify a relevant and important topic
  2. Develop well-considered research question
  3. research question leads to a hypothesis
  4. prepare research protocol: methodology to solve the problem
  5. organize methods and materials
  6. collect and analyze data
  7. study results and make decisions
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125
Q

Describe meta-analysis

A

a formal, defined system that combines the result of numerous small studies to increase the strength of belief in the observed effect.

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126
Q

Descriptive vs analytical research

A

descriptive: describes state of nature at a point in time. provides baseline data and monitors changes over time. Establishes associations among factors but does not allow causal relationships to be determined.
analytical: tests hypotheses concerning the effects of specific factors of interest and allows causal associations to be determined.

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127
Q

Describe the 4 types of descriptive research

A
  1. Qualitative - explore a phenomenon of interest as a prelude to theory development. Data is collected through interviews, observations, questionnaires.
  2. Case report- report of observations on one subject or more than one subject.
  3. Surveys- research designed to describe and quantify characteristics of a defined population; defined time frame; pinpointed problems.
  4. Correlation studies or ecological studies- compare frequency of events in different populations.
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128
Q

Describe the 5 types of analytic research

A
  1. experimental model- uses experimental and control groups
  2. Quasi-experimental design- time series. series of measurements at periodic intervals before the program begins and after the program ends.
  3. cohort studies- cohort= any group whose members have something in common. carried out over a long period of time (longitudinal) and prospective (future-oriented)
  4. case control studies- focus on specific disease. both groups recall past behaviors to study how the groups differ
  5. cross-sectional studies/prevalence- one time data collection counting all of the cases of a specific disease among a group of people at a particular time.
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129
Q

What is the gold standard of the experimental model?

A

Randomized control trial with comparison placebo control group.

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130
Q

Define the institutional review board

A

committee established to review and approve research involving human subjects to ensure it is conducted within all ethical and federal guidelines.

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131
Q

relevance or validity

A

ability to measure phenomenon it intends to measure.

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132
Q

internal validity

A

tests whether the difference between the two groups is real.

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133
Q

external validity

A

tests whether or not a generalization can be made from the study to a larger population.

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134
Q

define reliability and give examples of reliability in experiments.

A

consistency or reproducibility of test results.
examples:
- test, then retest
- parallel forms: two separate but similar forms of the same test at the same time
- split halves: divide the test in half
-precision: amount of variation that occurs randomly

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135
Q

tools for analysis of variance

A

ANOVA- asks whether the difference between samples is a reliable one that would be repeated.

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136
Q

define sensitivity in statistical evaluation

A

proportion of afflicted individuals who test positive

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137
Q

define specificity in statistical evaluation

A

proportion of non afflicted identified as non afflicted

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138
Q

define variables in statistical evaluation

A

characteristics that may have different values from observation to observation
- nominal (non ordered) variables that fit into a category with no special order (gender, race, marital status)
- rank order (ordinal scale)
- numeral discrete (data with numbers) e.g. number of clinic visits
- numerical continuous (underlying continuous scales) e.g. blood pressure

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139
Q

Levels of significance is measured by a p-value. the lower p value, the _____ the significance of your results

A

Higher
p<0.0001 very very significant, reliable results
p>0.5 not very significant, not reliable results

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140
Q

Mortality

A

rate of death

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141
Q

Morbitity

A

rate of disease

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142
Q

inferential statistics

A

techniques that allow conclusions to extend beyond an immediate data set

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143
Q

nonparametric test

A

does not depend on a normal distribution

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144
Q

dichotomous scores

A

only two events are possible (heads, tails)

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145
Q

continuous scores

A

measured on a continuous scale

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146
Q

pilot study

A

scaled down version of a larger investigation

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147
Q

chi square test

A

Determines if a difference between observed data and expected data is due to chance, or if it is due to a relationship between the variables you are studying.

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148
Q

t test

A

tests significance between the means of two different populations. tests null against alternative hypothesis.

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149
Q

where is glycogen stored in the body?

A

liver and muscles

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150
Q

define gluconeogenesis

A

conversion of non carbohydrate sources into glucose (from glycerol and amino acids)

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151
Q

Cellular oxidation

A

oxidation reaction in which glucose is oxidized and oxygen is reduced

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152
Q

which coenzymes are essential in energy production?

A

pantothenic acid, thiamin, riboflavin, niacin

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153
Q

define enzymes

A

proteins, organic catalysts that control reaction

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154
Q

define coenzyme

A

enzyme activators

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155
Q

define substrate

A

substance upon which an enzyme works

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156
Q

define cofactor

A

assists enzymes; minerals

157
Q

hormones

A

chemical messengers that trigger enzymes (example: thyroxine regulates metabolism and rate of oxidation)

158
Q

anabolism

A

synthesis of a more complex substance

159
Q

catabolism

A

breakdown; releases energy

160
Q

what 3 things contribute to total energy expenditure (TEE)

A

basal energy expenditure
energy expended in physical activity
thermic effect of food

161
Q

What are the measures of energy utilization

A

basal metabolic rate
resting metabolic rate
weight control
calorimetry

162
Q

what is basal metabolic rate measuring/how is it measured

A

measures oxygen consumed; measured by protein bound iodine (PBI). measured in the morning after a fasting state.

163
Q

what factors influence basal metabolic rate?

A

sex, age, body composition, endocrine glands, exercise

164
Q

define resting metabolic rate

A

energy expenditure measured similarly to basal metabolic rate

165
Q

define indirect calorimetry

A

measures oxygen consumed and carbon dioxide excreted using a portable machine .

166
Q

define direct calorimetry

A

measures heat produced in respiration chamber

167
Q

formula of respiratory quotients

A

RQ= Vco2 expired/Vo2 oxygen consumed

168
Q

RQ if carbohydrates alone are being consumed

A

1

169
Q

RQ if fats alone are being consumed

A

0.7

170
Q

RQ if protein alone is being consumed

A

0.82

171
Q

3 monosaccharides

A

glucose, fructose, galactose

172
Q

3 disaccharides

A

sucrose (glucose and fructose)
maltose (glucose and glucose)
lactose (glucose and galactose)

173
Q

5 polysaccharides

A

starch (glucose chains)
cellulose (resistant to digestive enzyme amylase, adds bulk)
pectin (non-digestible, thickening quality, fruits)
glycogen (animal starch, from glucose, stored in muscle and liver)
dextrin (intermediate product of starch breakdown)

174
Q

define sorbitol

A

alcohol from glucose; absorbed more slowly than glucose by passive diffusion; converted to fructose; excess may cause diarrhea

175
Q

3 main functions of carbohydrates

A
  1. energy
  2. protein sparing action- allows most of protein to be used for tissue synthesis
  3. regulation of fat metabolism- a carbohydrate restriction leads to ketosis
176
Q

which 3 amino acids have sulfur

A

cysteine, cycstine, methionine

177
Q

Amino acids have an acid and a base, what are they?

A

Amino group (NH2)- base
Carboxyl group (COOH)- acid

178
Q

What are the essential amino acids?

A

threonine, valine, tryptophan, isoleucine, leucine, lysine, phenylalanine, methionine, histidine (TV TILL PMH)

179
Q

which amino acids are conditionally essential during catabolic stress?

A

arginine, glutamine

180
Q

what is the precursor for serotonin and niacin

A

tryptophan

181
Q

simple proteins

A

amino acids

182
Q

conjugated proteins

A

simple plus non protein substance (lipoprotein)

183
Q

derived

A

fragments from simple and conjugated (peptide)

184
Q

2 main functions protein

A
  1. tissue synthesis, maintains growth, regulates body processes.
  2. inefficient energy source- nitrogen must be removed first
185
Q

soybeans are low in _____ amino acid(s)

A

methionine

186
Q

legumes are low in _____ amino acid(s)

A

methionine, cystine and tryptophane

187
Q

gelatin is low in ______ amino acid(s)

A

methionine, cystine and tryptophan

188
Q

3 types of fats

A
  1. simple (triglycerides- 3 fatty acids, 1 glycerol) - most food
  2. compound (simple fat plus other component)- example is phospholipids
  3. derived (fat substance derived from a simple or compound fat by hydrolysis or enzymatic breakdown; fatty acid, glycerol, steroid)
189
Q

describe saturated fatty acids

A

all available bonds of carbon chain are filled with hydrogen; solid and hard at room temperature

190
Q

describe unsaturated fatty acids

A

one or more double bonds

191
Q

monounsaturated fatty acids

A

one double bond

192
Q

polyunsaturated fatty acids

A

two or more double bonds

193
Q

Most polyunsaturated fatty acid

A

safflower

194
Q

most unsaturated fatty acid

A

olive

195
Q

2 essential fatty acids

A
  1. linoeic acid (w-6) - deficiency causes eczema, poor growth rate and petechiae
  2. a-linolenic (w-3)- for retinal function and brain development
196
Q

explain the structure of fatty acids

A
  • straight hydrocarbon chains terminating in a carboxyl group (cooh) at one end and a methyl group (CH3) at the other end
  • classified by the number. of carbons in the chain, the position of the first double bond and the number of double bonds.
197
Q

understand how to name fatty acids (example linoleic acid)

A

18:2w6
18 carbons, two double bonds, the first double bond is at the 6th carbon

198
Q

hydrogenation

A

the process of adding hydrogen (at the double bond) to unsaturated fatty acids to increase saturation and stability

199
Q

trans fatty acids

A

hydrogens are across from each other; pack tightly; influence membrane fluidity and could be harmful to cell function

200
Q

cis fatty acids

A

hydrogens on same side at the double bond; most natural fats and oils

201
Q

2 functions of fat

A
  1. energy, insulation, depresses gastric secretion so delays emptying
  2. has less oxygen, more carbon than carbohydrates so provides more energy (more carbon atoms for oxidation)
202
Q

fat soluble vitamins

A

A, D, E, K

203
Q

sources of vitamin A

A

yellow, orange fruits; dark leafy green vegetables, cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato

204
Q

sources of vitamin D

A

sunlight, egg yolk, fortified milk

205
Q

sources of vitamin E

A

vegetable oils, whole grains, green vegetables, almonds

206
Q

sources of vitamin K

A

spinach, kale, broccoli, green, leafy vegetables

207
Q

sources of B1

A

grains, wheat germ, pork, liver

208
Q

sources of B2

A

liver, kidney, meat, milk

209
Q

sources of niacin

A

protein, peanuts, ready to eat cereals, chicken, rice, yeast, milk

210
Q

sources of folate

A

fortified dry cereal, liver, kidney, green leafy vegetables, citrus fruits, lentils, beans

211
Q

sources of B6

A

meat, wheat, corn, yeast, pork, liver, ready to eat cereals

212
Q

sources of B12

A

liver, meat, milk, kidney, eggs, fish, cheese

213
Q

sources of pantothenic acid

A

animal food, grains, legumes

214
Q

sources of vitamin C

A

citrus fruits, potatoes, papaya, dark green, yellow vegetables

215
Q

sources of biotin

A

liver, kidney, egg yolk, yeast

216
Q

sources of myo-inositol

A

outer husks of cereal grains, dark leafy green vegetables

217
Q

sources of calcium

A

diary products, leafy vegetables, legumes

218
Q

sources of iron

A

animal foods, meats, fish, poultry, cereals, vegetables

219
Q

sources of magnesium

A

milk, bread

220
Q

sources of zinc

A

meat, liver, eggs, fish

221
Q

sources of iodine

A

seafood, salt

222
Q

sources of flouride

A

soil, water

223
Q

sources of copper

A

liver, kidney, shellfish

224
Q

sources of selenium

A

soil, grains, meat, fish, poultry, dairy

225
Q

sources of manganese

A

whole grains, legumes, nuts

226
Q

sources of chromium

A

yeast, oysters, potatoes, liver

227
Q

sources of sulfer

A

meat, eggs, fish, poultry

228
Q

sources of choline

A

fat in eggs, milk , liver, soybeans

229
Q

deficiencies in vitamin A

A

night blindness, dry scaly skin

230
Q

deficiencies in vitamin D

A

rickets, osteomalacia

231
Q

deficiencies in vitamin E

A

hemolytic anemia

232
Q

deficiencies in vitamin K

A

Hemorrhage

233
Q

deficiencies in vitamin B1

A

beriberi, muscle weakness, foot drop, memory loss, tachycardia

234
Q

deficiencies in vitamin B2

A

growth failure, cheilosis (cracked lips), angular stomatitis, magenta tongue

235
Q

deficiencies in niacin

A

pellagra, dermatitis, diarrhea, dementia, beefy, bright red tongue, symmetrical, pigmented rash

236
Q

deficiencies in folate

A

megaloblastic, microcytic anemia, diarrhea, fatigue

237
Q

deficiencies in vitamin B6

A

seizures, anemia, dermatitis, glossitis, peripheral neuropathy

238
Q

deficiencies in vitamin B12

A

macrocytic, megaloblastic anemia

239
Q

deficiencies in pantothenic acid

A

paresthesia in feet

240
Q

deficiencies in vitamin c

A

scurvy, poor wound healing, bleeding gums, petechiae

241
Q

deficiencies in biotin

A

muscle pain, dermatitis, glossitis

242
Q

deficiencies in calcium

A

tetany

243
Q

deficiencies in iron

A

pale tongue, fatigue, anemia, spoon shaped nails, pale conjuctiva

244
Q

deficiencies in magnesium

A

tremors

245
Q

deficiencies in zinc

A

reduced immune function, alopecia, poor wound healing, hypogeusia

246
Q

deficiencies in iodine

A

goiter

247
Q

deficiencies in fluoride

A

dental caries

248
Q

deficiencies in copper

A

anemia, neutropenia, wilson’s disease, genetic absence of liver enzyme

249
Q

deficiencies in selenium

A

myalgia, cardiac myopathy

250
Q

deficiencies in chromium

A

insulin resistance

251
Q

How is concentration of electrolytes expressed in mEq

A

mEq= (mg/atomic weight) x valence

252
Q

normal ranges of cations (Na, K, Ca, Mg)

A

Na 136-145
K 3.5-5
Ca 4.5-5.5
Mg 1.5-2.5

253
Q

normal ranges of anions (Cl, P)

A

Cl: 96-106
P: 3-4.5

254
Q

High potassium sources

A

meats, bananas, oranges, tomato, potato, cantaloupe

255
Q

Low potassium sources

A

apple, cranberry, blueberry, carrots, corn

256
Q

anasarca

A

extreme, generalized edema and swelling of skin due to effusion of fluid into extracellular space. Low serum protein leads to edema and ascites

257
Q

How are acids and bases regulated in the body?

A

acids release hydrogen ions, bases pick up hydrogen ions

258
Q

define a buffer

A

mixture of acid and base components to protect against a strong acid or strong base

259
Q

Role of the lungs in regulating acid/base balance

A

control supply of carbonic acid. amount altered by rate and depth of breathing. Hypoventilation-retention of acid; hyperventilation-loss of acid

260
Q

role of kidneys in regulating acid/base balance

A

kidneys control bicarbonate (base). If kidneys retain bicarbonate-level of base increases, and if kidneys release bicarbonate-level of base decreases.

261
Q

acidosis from respiratory system.

A

retention of CO2 by lungs (decreased ventilation) to compensate, kidneys increase absorption of base

262
Q

alkalosis from respiratory system

A

loss of carbonic acid (increased ventilation). to compensate, kidneys excrete additional base

263
Q

acidosis from renal system

A

kidneys either produce or retain too much hydrogen or kidneys excrete too much base. to compensate, respiration increases to remove CO2 to decrease carbonic acid.

264
Q

alkalosis from renal system

A

loss of hydrogen due to loss of acid or increased retention of base. to compensate, ventilation decreases to retain CO2 to make carbonic acid

265
Q

weight gain guidelines for pregnant women

A

28 - 40 lb for underweight
25-35 lb for normal weight
15-25 lb for overweight
11-20 lb for obese

266
Q

calorie guidelines for pregnant women

A

+340 kcal 2nd trimester
+452 kcal 3rd trimester
during lactation:
+330 kcal first 6 months
+400 kcal 6-12 months

267
Q

recommended hemoglobin/hematocrit levels during pregnancy

A

hemoglobin 11 g/dl
hematocrit 33%

268
Q

weight gain trends for pregnant women

A

1 lb/month first 3 months; 1 lb per week thereafter

269
Q

pregnant adolescents are at higher risk for deficiencies in

A

zinc, iron and calcium

270
Q

recommended supplements for pregnant women

A

ferrous sulfate (30 mg) during 2nd and 3rd trimesters – not to be taken with milk, tea or coffee
folic acid 400 mcg

271
Q

What hormone develops the placenta after implantation

A

progesterone

272
Q

DRI recommend ___ linoic acid during pregnancy

A

1.4 g/day and 1.3 g/day during lactation
- for development of fetal nervous system

273
Q

Normal birth weight

A

2500-4000 grams (5.5-9 lb)

274
Q

Low birth weight

A

<2500 g (<5.5 lb)

275
Q

very low birth weight

A

<1500 g (<3.3 lb)

276
Q

extremely low birth weight

A

<1000 g (<2.2 lb)

277
Q

small for gestational age

A

<10th percentile birth weight for gestational age

278
Q

appropriate for gestational age

A

10-90th percentile birth weight for gestational age

279
Q

large for gestational age

A

> 90th percentile birth weight for gestational age

280
Q

calorie/protein/water/fat needs for 0-6 month old

A

calorie: 520 (female) 570 (male)
protein: 9.1 g
water: 125-155 ml/kg (depends on age)
Fat: minimum of 30 g per day

281
Q

calorie/protein/water/fat needs for 7-12 month old

A

calorie: 676 (female) 743 (male)
protein: 11 g
water: 1.5 ml/kcal
Fat: minimum of 30 g per day

282
Q

parameters for 0-6 months old (weight, length)

A

weight 6 kg
length 24 inches

283
Q

parameters for 6-12 months old (weight, length)

A

weight 9 kg
length 28 inches

284
Q

parameters for hemoglobin and hematocrit in newborns

A

hemoglobin (16.5-19.5)
hematocrit (49-54%)

285
Q

prolactin

A

stimulates milk production

286
Q

oxytocin

A

moves milk through ducts

287
Q

kcal/oz human breast milk

A

20

288
Q

colostrum

A

yellowish transparent fluid secreted from the breast during the first few days. Has more protein, less fat and carbohydrates than mature milk.

289
Q

human composition of milk vs cows milk

A

Human: 7% PRO, 28% CHO, 55% FAT *has more lactalbumin
Cows: 20% PRO, 30% CHO, 50% FAT

290
Q

how much vit D and fluoride do breast fed infants need from birth per day

A

vit d 400 IU
fluoride 0.25 mg

291
Q

Describe infant formula

A

20 kcal/oz; need 2/5 oz/lb/day
higher protein, more iron than human milk, less antibodies
formula fed babies only need fluoride supplementation after 6 months

292
Q

hyperbilirubinemia

A

unconjucateqd bilirubin levels elevated within the first week of life as a result of increased breakdown of red blood cells or decreased intestinal mobility. Encourage 9-12 feedings/day to promote hydration and intestinal motility

293
Q

at what age do fetal iron stores decrease?

A

3-4 months

294
Q

When should solid foods be introduced to an infant?

A

4-6 months
when sitting posture can be sustained and extrusion reflex diminishes. Start with iron fortified cereal then strained fruits/veg

295
Q

when should large finger foods be introduced?

A

6-8 months
when infant can secure food with a palmar grasp

296
Q

when should small finger foods be introduced?

A

9-12 months
when infant can secure food with pincer grasp

297
Q

why should infants have one serving of vit c rich foods by 6 months?

A

to enhance iron absorption from non-heme sources

298
Q

RDA of protein for ages 1-3, 4-8. 9-13

A

1-3: 13 g
4-8: 19
9-13 34 g

299
Q

how long is length used to describe height?

A

0-36 months

300
Q

how long is weight for age used to describe BMI

A

0-2 years

301
Q

how long should head circumference be measured until?

A

until 3 years old

302
Q

how long should it take a newborn to regain 6% loss of birth weight?

A

10-14 days

303
Q

when should birth weight be doubled? tripled?

A

doubled: month 4-5; tripled: one year

304
Q

how long is normal gestation?

A

40 weeks.

Example: an infant born at 28 weeks is 12 weeks premature. when he is 4 months old, his corrected age would be 1 month. (4 months-12 weeks)

305
Q

Macronutrient needs for adults (in %)

A

45-65% carbohydrates
20-35% fat
10-35% protein

306
Q

RDA protein for males 14-18 years old

A

52 grams

307
Q

RDA protein for females 14-18 years old

A

46 grams

308
Q

RDA protein for males >/= 19 years old

A

56 grams

309
Q

RDA protein for females >/=19 years old

A

46 grams

310
Q

Adequate intake for calcium for pregnancy/ lactation

A

</= 18 years old 1300 mg
> 18 years old 1000 mg

311
Q

Adequate fiber intake for adults under 50

A

Men 38 ; Women 25

312
Q

Adequate fiber intake for adults over 50

A

Men 30; Women 21

313
Q

adequate fluid intake for adults >19 years old

A

Men: 3.7 L/day
Women: 2.7 L/day

314
Q

adequate sodium for adults >19

A

1.5 g/day

315
Q

adequate intake (g/day) for linolenic acid; linoleic acid

A

linolenic acid: males= 1.6, females= 1.1
linoleic acid: males= 17, females =12

316
Q

What causes constipation in the elderly

A

decreased gastric motility, decreased HCL secretion

317
Q

Elderly are usually deficient in what?

A

calcium , iron, folate, B6/B12

318
Q

how much water should athletes be drinking for every 1 lb body weight lost

A

16 oz

319
Q

Pre activity hydration recommendations

A

10 ml/kg high sodium containing beverage prior to activity that is 1-4 hours long

320
Q

during activity hydration recommendations

A

hydration should equal 100% of body weight lost plus 5.5-15% CHO and 55-164 mEq Na for vigorous activity

321
Q

after activity hydration recommendations

A

within 1-2 hours after activity. should equal 100-150% of fluid lost in exercise and contain 6-7.6% CHO and 57.5-1159 mg/dl Na.

322
Q

at rest, what are our primary energy source

A

fat (80-90%)

carbs (5-18%) and protein (2-5%)

323
Q

exercise above 60-65% of maximal oxygen uptake, what is needed as the fuel source

A

Carbohydrates

324
Q

herbals, botanicals and supplements are regulated by the ______

A

Dietary Supplement Health and Education Act 1994

325
Q

purpose of black cocosh

A

ease menopause symptoms

326
Q

purpose of echinacea

A

prevent moderate cold symptoms

327
Q

purpose of Ephedra

A

promote weight loss

328
Q

Purpose of garlic

A

may lower cholesterol, blood pressure

329
Q

purpose of ginger

A

antiemetic

330
Q

purpose of ginkgo biloba

A

vasodilation

331
Q

purpose of ginseng

A

immunity and endurance

332
Q

purpose of kava

A

relieve anxiety

333
Q

purpose of milk thistle

A

may help protect the liver

334
Q

purpose of st john’s wort

A

antidepressive, serotonin-enhancing

335
Q

purpose of licorice root

A

ulcers

336
Q

purpose of saw palmetto

A

relieve symptoms of enlarged prostate

337
Q

purpose of valerian root

A

calm nerves

338
Q

purpose of yohimbe

A

sexual dysfunction

339
Q

What are the three large glands in the mouth

A

parotid, submaxillary, sublingual

340
Q

Describe the route in which food takes during digestion

A

enters the oral cavity/mouth. food passes into the stomach via the esophagus through the cardiac valve into the fundus. food is forced into the small intestine through the pyloric valve. Complete digestion and absorption of food takes place in the small intestine. undigested food and water pass through the ileocecal valve into the large intestine.

341
Q

where is bile produced and stored

A

produced in the liver and stored in the gall bladder.

342
Q

where is glycogen stored and glucose synthesized?

A

the liver

343
Q

describe the function of the hormone CCK cholecystokinin

A

released from duodenum when fat enters. contracts the gall bladder releasing bile and stimulates the pancreas

344
Q

describe the function of the hormone secretin

A

released from duodenum, stimulates flow of pancreatic juice (bicarbonate) and water into the duodenum, inhibits gastric acid secretion

345
Q

What macronutrients are being chemically digested in the mouth?

A

carbohydrates by the enzyme amylase

346
Q

what macronutrients are being chemically digested in the stomach?

A

carbohydrates by the enzyme amylase
Protein undergoes proteolysis

347
Q

What macronutrients are being absorbed in the small intestine?

A

carbohydrates by maltase, sucrase, lactase, pancreatic amylase
protein
fat

348
Q

How long does gastric emptying usually take for a meal

A

2-6 hours

349
Q

where is most digestion completed by

A

middle of the jejunum

350
Q

peristalsis

A

rhythmic movements of small intestine

351
Q

describe bacterial digestion

A

-large intestine absorbs water, salts, and vitamins synthesized by bacteria
-colonic salvage: anaerobic fermentation and absorption of end-products of carbohydrate, fiber and amino acid breakdown
- converts malabsorbed carbs and fibers into short changed fatty acids and gases H2 CO2 N CH4

352
Q

sources of glucose

A

dietary, liver glycogen, products of intermediate metabolism

dietary sources come from carbohydrates (100%), protein (58% from glucogenic amino acids-alanine especially) and fat (10% from glycerol*fatty acids and muscle glycogen do not contribute to the body’s supply of glucose)

353
Q

Uses of glucose

A

energy, storage (glycogenesis, lipogenesis), small amount is converted into other carbohydrate compounds (e.g. ribose needed to form RNA and DNA)

354
Q

describe insulin

A

released from BETA cells of pancreas
-increases cell permeability to glucose; fosters glycogenesis and lipogenesis

355
Q

describe glucagon

A

released from ALPHA cells of pancreas
- induces glycogenolysis

356
Q

describe glucocorticoids

A

protein is converted into glucose (gluconeogenesis)

357
Q

describe epinephrine

A

released by the adrenal medulla
- stimulates sympathetic nervous system
-stimulates liver and muscle glucogenolysis (glycogen to glucose)
- decreases release of insulin from pancreas DURING catabolic stress; blood sugar rises

358
Q

describe growth hormone, ACTH adrenocorticotropic

A

insulin antagonists

359
Q

Where does glycolysis occur?

A

in the cytoplasm

360
Q

what is the end product of aerobic glycolysis

A

pyruvate

361
Q

what is the end product of anaerobic glycolysis

A

lactate

362
Q

Where does the krebs cycle occur?

A

in the mitochondria

363
Q

full oxidation of 1 molecule of glucose yields how many ATP?

A

38

364
Q

Describe protein metabolism

A

amino acids enter intestinal villi capillaries and then most are transferred into the portal blood stream and to tissues.

365
Q

nitrogen balance formula

A

[protein intake (g)/6.25] - [urinary urea nitrogen + 4]

366
Q

How to determine the quality of protein in foods

A

Biological value: uses nitrogen balance techniques to determine the fraction of absorbed nitrogen retained for growth and maintenance.
Net protein utilization: measures the amount of protein actually used (Nintake-Noutput/ Nintake)- scores higher in animal products
Protein digestibility corrected amino acid score: represents amino acid score after correcting for digestibility. protein coefficient of digestibility estimates % protein in each food category that is actually digested.

367
Q

Protein anabolism

A

synthesis: DNA deoxyribose nucleic acid

368
Q

Protein catabolism

A

pyridoxine is involved.
1. step one is deamination- splitting off the NH2 by hydrolysis in liver
2. NH2 is converted into ammonia (NH3)
3. most ammonia is converted to urea and excreted by the kidneys and some is converted into purines and some is used to make nonessential amino acids through transamination.
4. the remainaing carbon chain is a ketoacid; it can be oxidized for energy.

369
Q

define transamination

A

transfer of amino group to a ketoacid to form a new amino acid

370
Q

What hormones stimulate protein anabolism

A

pituitary growth hormone, insulin, thyroid hormone, testosterone

371
Q

what hormones stimulate protein catabolism

A

adrenal steroids (glucocorticoids)

372
Q

what are the end products of fat digestion

A

monoglycerides, diglycerides, glycerol, fatty acids

373
Q

which products of fat digestion are absorbed directly into the portal blood?

A

glycerol, short chained fatty acids (<12 carbones), some phospholipids

374
Q

which products of fat digestion combine to bile salts to form micelles?

A

monoglycerides, diglycerides, long chained fatty acids

375
Q

describe cholesterol

A

found in all cells, important in cell structure, some absorbed with bile salts. Most absorbed with cholesterol esterase–> converted into cholesterol esteres –> excreted by liver as bile

376
Q

describe lipogenesis

A

synthesis/deposition
-adipose= most active site : fatty acids+glycerol to triglycerides
-liver= synthesizes fat but should not store fat. to prevent fat accumulation, lipotropic factors produce lipoproteins which transfer fatty acids out of the liver.

377
Q

understand lipoproteins

A

chylomicron largest (mostly made of triglycerides)
VLDL is half size of TG
LDL is smaller (mostly made of cholesterol)
HDL is rich in protein

378
Q

lipolysis

A

breakdown of fats by hydrolysis.
oxidation forms acetyl coA which enters the Krebs cycle

379
Q

hormones used in lipolysis

A

growth hormone, glucagon- insulin antagonist
glucocorticoids, thyroxine, epinephrine, ACTH increase rate of fat mobilization

380
Q

hormones used in lipogenesis

A

insluin (anabolic)

381
Q

normal fat metabolism vs abnormal fat metabolism

A

normal- requires adequate carbs for complete fat oxidation
abnormal- inadequate carbs results in incomplete fat oxidation and buildup of ketones

382
Q

describe active transport

A

most nutrients (glucose, amino acids, Na, K, Mg, Ca, Fe)
-sodium pump
- needs energy from ATP; sodium plays

383
Q

describe simple diffusion

A

some water and electrolytes
-higher to lower concentration: intestine to blood to lymph

384
Q

describe passive diffusion

A

carrier facilitated-water soluble nutrients
- higher to lower concentration

385
Q

describe the hypothalamus

A

key brain structure involved in the control of food and energy intake

386
Q

serotonin

A

a neurotransmitter that increases carbohydrate appetite

387
Q

leptin

A

produced by fat cells in response to food intake, induces satiety

388
Q

ghrelin

A

produced in the stomach and intestine stimulated appetite and growth hormone secretion

CDR Exam (4 decks)

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