Domain I: Principles of Dietetics: Nutrition Science Flashcards
Carbohydrates provide ___ kcal/gram, protein provides ___ kcal/gram, and fat provides ____ kcal/gram
4, 4, 9
The brain uses ____ exclusively as an energy source
Glucose
During starvation, the brain uses ____ for energy
Ketones
Glucose is stored as ____ in liver and muscles
Glycogen
Fat from ____ tissue can be made into glucose
Adipose
Glucose can also be made from ___ stores (cellular mass)
Protein
_____ is the conversion of non-carbohydrate sources into glucose (from glycerol and amino acids)
Gluconeogenesis
____ is the state of equilibrium of the internal environment of the body
Homeostasis
____ are proteins and organic catalysts that control a reaction
Enzymes
A ____ is an enzyme activator, some of them are vitamins
Coenzyme
What are some examples of coenzymes?
-Pantothenic acid
-Thiamin (B1)
-Riboflavin (B2)
-Niacin (B3)
A ____ is a substance upon which an enzyme works
Substrate
A ____ assists enzymes; many are minerals
Cofactor
____ are secretions from endocrine glands; they are chemical messengers that trigger enzymes
Hormones
_____ is a thyroid hormone that regulates metabolism and rate of oxidation; it influences physical and mental growth
Thyroxine (T4)
Thyroxine also stimulates liver ____ and ____ in order to raise blood glucose
Glycogenolysis; gluconeogensis
_____ is the synthesis of a more complex substance
Anabolism
____ is the breakdown of complex substances; uses and releases energy
Catabolism
Catabolism creates a constant energy ____, which must be supplied by food
Deficit
___ ____ ____ is the minimum amount of energy needed at rest in fasting (amount needed to carry out involuntary work of the body, activity of internal organs, and internal temperature)
Basal energy expenditure
Basal energy expenditure is affect by extremes in environmental temperatures; a tropical clinical increases BEE by ___-___%
5-20
Caffeine, alcohol, and nicotine stimulate metabolic rate by ___-___%
7-15
Energy expended in ____ ____ is highly variable
Physical activity
The energy burned from physical activity is also known as ____ ____
Activity thermogenesis
The thermic effect of food accounts for ____% of total energy expenditure; energy needed to digest, absorb, and assimilate nutrients
10
The thermic effect of food is greater after consumption of ___ and ____
Carbohydrates and protein
____ ____ ____ is measured in the morning when reclining, awake, relaxed, at normal body temperature, at least 12 hours after the last meal, and several hours after strenuous activity
Basal metabolic rate
Basal metabolic rate measures ____ consumed and ___ ___ produced
Oxygen; carbon dioxide
Basal metabolic rate is affected primarily by…
-Sex
-Age
-Body composition, body surface area
-Endocrine glands (thyroid)
Women have ___-___% lower basal metabolic rate than men
5-10
What age group has the highest basal metabolic rate?
0-2 years of age
Older adults have less activity, less lean body mass, and more body fat, which makes them have ____ basal metabolic rate
Lower
Basal metabolic rate is measured by ___ ____ ____
Protein-bound iodine
Protein-bound iodine measures the activity of the ____
Thyroid
What hormones are produced by the thyroid gland?
-Thyroxine (T4)
-Triiodothyronine (T3)
When protein-bound iodine is elevated, basal metabolic rate is ____
Elevated
Protein-bound iodine measures ____ ____, and measures the level of thyroxine (T4) produced (not a nutritional assessment parameter)
Energy metabolism
Protein-bound iodine is higher during…
-Periods of rapid growth
-Pregnancy
-Lactation
-Fever
-Some diseases that increase cell activity (cancer, HTN)
-Exercise
Fever can increase protein-bound iodine by ___% for each degree rise in temperature
7
Calculated basal metabolic rate is ____ ____ ____
Basal energy expenditure
Basal energy expenditure is calculated using…
-Age
-Sex
-Body surface area (height, weight)
____ ____ ____ is energy expenditure that is measured similar to basal metabolic rate after a short rest and controlled intake of caffeine and alcohol
Resting metabolic rate
Resting metabolic rate is more frequently measured than basal metabolic rate; estimates higher energy expenditure than basal metabolic rate by ____-____%
10-20
Of the predictive equations, the ____ ____ _____ equation predicts resting metabolic rate within 10% of indirect calorimetry; can use with normal-weight or obese individuals
Mifflin St. Jeor
When calculating resting metabolic rate with the Mifflin St. Jeor equation, use ____ bodyweight for underweight, overweight, and obese individuals
Actual
Following changes in _____ is the most practical way of measuring energy balance
Weight
____ ____ measures heat produced in a respiration chamber (limited usefulness)
Direct calorimetry
____ ____ measures oxygen consumed and carbon dioxide excreted using a portable machine (practical way of measuring which nutrients are being used for energy, and determining caloric needs)
Indirect calorimetry
Indirect calorimetry is especially useful in what two populations?
-Burn victims
-Athletes
____ quotient is measured as the carbon dioxide expired divided by oxygen consumed
Respiratory
Respiratory quotient (RQ) is dependent on the ____ mixture being metabolized; carbohydrates alone have an RQ of 1, protein alone have an RQ of 0.82, fat alone have an RQ of 0.7, mixed intake has an RQ of 0.88
Fuel
Someone will have a lower respiratory quotient with higher ____ intake
Fat
Carbohydrates are composed of what 3 monosaccharides (simple sugars)?
-Glucose
-Galactose
-Fructose
Sucrose is a disaccharide made up of what two monosaccharides?
Glucose and fructose
Lactose is a disaccharide made up of what two monosaccharides?
Glucose and galactose
Maltose is a disaccharide made up of what two monosaccharides?
Glucose and glucose
Examples of polysaccharides:
-Starch
-Cellulose
-Pectin
-Glycogen
-Dextrin
Starch is made up of ____ chains and makes up 50% of carbohydrate intake
Glucose
Cellulose is resistant to ____ ____ and adds bulk within the GI system
Digestive enzymes
Pectin is a non-digestible component of fruits and has a _____ quality
Thickening
_____ is an animal starch made from glucose and it is stored in the muscle and liver
Glycogen
Dextrin is an intermediate product of ____ breakdown
Starch
_____ is an alcohol derived from glucose
Sorbitol
Sorbitol is absorbed more ____ than glucose by passive diffusion
Slowly
Sorbitol is converted to _____
Fructose
Excess sorbitol may cause _____
Diarrhea
Different carbohydrates in order of sweetness:
-Fructose
-Invert sugar
-Sucrose
-Glucose
-Sorbitol
-Mannitol
-Galactose
-Maltose
-Lactose
What elements make up carbohydrates?
-Hydrogen
-Carbon
-Oxygen
Sources of carbohydrates include…
-Flour
-Cereals
-Fruits
-Vegetables
-Dairy products
Functions of carbohydrates:
-Energy
-Protein-sparing action (allows most of protein to be used for tissue synthesis)
-Regulation of fat metabolism
A carbohydrate restriction leads to _____
Ketosis
What elements make up a protein molecule?
-Carbon
-Hydrogen
-Nitrogen (16%)
-Sulfur (sometimes)
What two amino acids contain sulfur?
-Cysteine
-Methionine (essential)
Amino acids that have an ____ group are bases, while amino acids that have ____ groups are acids
Amino; carboxyl
Essential amino acids:
-Threonine
-Valine
-Tryptophan
-Isoleucine
-Leucine
-Lysine
-Phenylalanine
-Methionine
-Histidine
TV TILL PMH
What two amino acids are conditionally essential during catabolic stress?
-Arginine
-Glutamine
_____ is a precursor to serotonin and niacin
Tryptophan
Phenylalanine converts to _____
Tyrosine
Methionine converts to _____
Cysteine
A ____ protein is one that has all essential amino acids in sufficient quantity and ratio to maintain body tissues and promote growth (HBV- high biological value)
Complete
For someone with a low-protein diet, they should be given mostly ___ biological value proteins
High
An ____ protein is one that is deficient in one or more essential amino acids
Incomplete
____ protein are amino acids
Simple
A ____ protein is one that is a simple protein plus a non-protein substance (lipoprotein)
Conjugated
_____ proteins are fragments from simple and conjugated proteins (peptide)
Derived
Sources of protein:
-Meat
-Poultry
-Fish
-Eggs
-Milk
-Legumes
Functions of protein:
-Tissue synthesis
-Maintains growth
-Regulated body processes
Protein is an inefficient energy source, as _____ needs to be removed first
Nitrogen
____% of protein can be converted to glucose
58
A normal person requires ____ g/kg of body weight
0.8
Protein should make up ___-___% of total energy intake
10-15
Soybeans are low in what essential amino acid?
Methionine
____ protein is equivalent in protein quality to animal protein
Soy
Legumes are low in what three amino acids?
-Methionine
-Cysteine
-Tryptophan
Gelatin is low in what low 2 amino acids?-
-Methionine
-Lysine
Gelatine contains none of what amino acid?
Tryptophan
Fat molecules are composed of what elements?
-Carbon
-Hydrogen
-Oxygen
Simple fats, or _____, are made up of 3 fatty acids and 1 glycerol molecule (most food fat is a triglyceride)
Triglycerides
A ____ fat is a simple fat plus another component
Compound
An example of a compound fat is ____, which is found in cell membranes and allows control of what passes in and out of the cell
Phospholipid
Most phospholipids are lecithins, which contain _____, a lipotropic factor
Choline
Lecithins/choline helps prevent ____ accumulation in the liver
Fat
Lecithin/choline functions in the transport and utilization of fatty acids and cholesterol through the enzyme _____
LCAT (lecithin-cholesterol acetyltransferase)
A ____ fat is a fat substance made from a simple or compound fat by hydrolysis or enzymatic breakdown
Derived
Examples of derived fat:
-Fatty acid
-Glycerol
-Steroid
With ____ fatty acids, all available bonds of carbon chains are filled with hydrogen; they are solid and hard at room temperature
Saturated
____ fatty acids have one or more double bonds
Unsaturated
A fat with one double bond is a ____ fatty acid; a fat with two or more double bonds is a ____ fatty acid
Monounsaturated; polyunsaturated
The most polyunsaturated fat is ____ oil, while the most unsaturated fat is _____ oil
Safflower; canola
____ fats are most likely to experience rancidity
Polyunsaturated (safflower)
The absence of essential fatty acid(s) will create a specific ____ disease
Deficiency
Deficiency of linoleic acid (omega 6) causes…
-Eczema
-Poor growth rates
-Petechiae (red/purple skin spots)
If linoleic acid (omega 6) replaces cholesterol in the diet, LDL ____ and HDL ____
Decreases; Increases
If linoleic acid (omega 6) replaces saturated fat in the diet, total cholesterol _____ and HDL ____
Decreases; decreases
_____ oil is the best source of linoleic acid (omega 6)
Safflower
Alpha-linolenic acid (omega 3) is responsible for…
-Retinal function
-Brain development
Deficiency of alpha-linoleic acid (omega 3) causes…
-Blurred vision
-Neurological changes
-Numbness
Alpha-linoleic acid (omega 3) comes mainly from…
-Fish oils
-Walnuts
-Flaxseeds
-Canola
Fish oils contain ____ and ____
-EPA (eicosapentaenoic acid)
-DHA (docosahexaenoic acid)
Alpha-linolenic acid (omega 3) decreases hepatic production of ____ (inhibits VLDL synthesis)
Triglycerides
Alpha-linolenic acid (omega 3) has little effect on total ____level
Cholesterol
Fatty acids are straight hydrocarbon chains terminating a ____ group on one end and a ____ group at the other end
Carboxyl; methyl
Fatty acids are classified by the number of ____ in the chain, as well as the position of the first double bond, and the number of double bonds
Carbons
The location of the first double bond, counted from the methyl ends of the fatty acid, is designated by the ____ sign
Omega
Linoleic acid has ____ double bonds, while alpha-linolenic acid has ____
2; 3
_____ is a reduction process of adding hydrogen at the double bond to unsaturated fatty acids to increase saturation and stability
Hydrogenation
With ____ fatty acids, hydrogens are across from each other; they pack as tightly as saturated fatty acids
Trans
Trans fatty acid intake can influence membrane ____ and may be harmful to cell function
Fluidity
Trans fats are found in ____ fat (4-8%), as well as margarine, shortening, and frying fats as a product of partial hydrogenation of polyunsaturated fatty acids
Milk
____ fatty acids have hydrogens on the same side as the double bond; occur in most natural fats and oils
Cis
Saturated fats, from most saturated to least:
-Coconut oil
-Palm kernel
-Cocoa butter
-Butter
-Palm oil
-Canola
____-____ ____ are saturated fatty acids that have between 5 and 12 carbons
Medium-chain triglycerides
Where are medium-chain triglycerides found?
-Milk fat
-Coconut oil
-Palm kernel oil
Examples of monounsaturated fats, from most monounsaturated to least:
-Olive oil
-Canola oil
-Peanut oil
-Sunflower oil
-Coconut oil (MCT source)
Examples of polyunsaturated fats, from most polyunsaturated to least:
-Safflower oil
-Corn oil
-Soybean oil
-Cottonseed oil
-Palm kernel oil
Butter contains a combination of what three types of fat, in order from most to least?
-Saturated fatty acids
-Monounsaturated fatty acids
-Polyunsaturated fatty acids
Margarine contains a combination of what three types of fat, in order from most to least?
-Polyunsaturated fatty acids
-Monounsaturated fatty acids
-Saturated fatty acids
Most heart-healthy lipids have ____ grams of trans fat, no partially hydrogenated oils, and are liquid plant oils
0
Functions of lipids:
-Energy
-Insulation and padding
-Depressing gastric secretion, therefore delaying gastric emptying
Fat has less ____ and more ____ than carbohydrates, therefore provides more energy
Oxygen, carbon
Fat should make up no more than ____% of total energy intake
30
Alcohol is metabolized as fat and is ____ kcal/g (kcal from alcohol= (0.8)(proof)(ounces)
7
Alcohol requires no _____, and is readily absorbed by simple diffusion through the stomach or small intestine lining and transported unaltered into the bloodstream
Digestion
Alcohol ____ beta-oxidation of fatty acids
Decreases
Alcohol promotes ____ synthesis
Triglyceride
Alcohol is an established risk factor for ____ ___ ____ cancer, and may increase risk for breast cancer
Head and neck
_____ oils are found in salad dressings; they don’t crystallize when cold and are clear, not cloudy
Winterized
What are three examples of winterized oils?
-Corn oil
-Soy oil
-Cottonseed oil
“Christmas cold sweater”
Folate is a ____-soluble vitamin
Water
____ is a precursor to folate
PABA
Folate is ____-dependent
Zinc
Functions of folate:
-DNA synthesis
-Forms red blood cells (with B12) in bone marrow
-Prevents neural tube defects
Sources of folate:
-Fortified dry cereal
-Liver
-Kidney
-Green leafy vegetables
-Citrus fruits
-Lentils
-Beans
An adult needs ____ micrograms of folate, with needs increasing to ____ during pregnancy
400; 600
Deficiency of folate can cause…
-Megaloblastic, macrocytic anemia
-Diarrhea
-Fatigue
-Irritability
-Dyspnea
Vitamin B6 is also known as ____
Pyridoxine
_____ is a drug that acts as an antagonist to B6 (pyridoxine)-> must supplement with B6 to avoid deficiency
Isoniazid
B6 (pyridoxine) acts as a ____ in amino acid metabolism during deamination and transamination
Coenzyme
With increased ____ intake, there is increased levels of pyridoxine
Protein
Sources of B6 (pyridoxine):
-Meats
-Wheat
-Corn
-Yeast
-Pork
-Liver
-Ready-to-eat cereal
B6 (pyridoxine) needs for a female:
1.2-1.7 mg/day
B6 (pyridoxine) needs for a male:
1.3-1.5 mg/day
Deficiency of B6 (pyridoxine) causes…
-Seizures
-Anemia
-Dermatitis
-Glossitis
-Peripheral neuropathy
Vitamin B12 is also known as _____
Cyanocobalamin
B12 (cyanocobalamin) contains _____
Cobalt
B12 (cyanocobalamin) is bound by ____ ____ in gastric juice
Intrinsic factor
B12 (cyanocobalamin) is a coenzyme in _____ synthesis
Protein
B12 (cyanocobalamin) is involved in ____ ____ ____ formation
Red blood cell
B12 (cyanocobalamin) is found in…
-Liver
-Meat
-Milk
-Kidney
-Eggs
-Fish
-Cheese
If someone has ____ protein in their diet, it is unlikely that they would be deficient in B12 (cyanocobalamin)
Animal
Daily needs of B12 (cyanocobalamin) are ____ micrograms
2.4
Deficiency of B12 (cyanocobalamin) is most common in vegans and can lead to…
-Macrocytic, megaloblastic anemia
-Pernicious anemia (after gastrectomy of removal of the ileum, due to lack of intrinsic factor)
Vitamin B5 is also known as ____ ____
Pantothenic acid
Vitamin B5 (Pantothenic acid) is a key precursor to ___ ___, which produces energy
Coenzyme A
Vitamin B5 (Pantothenic acid) is also involved in the synthesis of ___ ___
Fatty acids
Vitamin B5 (Pantothenic acid) is found in…
-Animal foods
-Grains
-Legumes
The adequate intake (AI) for Vitamin B5 (Pantothenic acid) is ____ mg
5
While it is rare to be deficient in Vitamin B5 (Pantothenic acid), a deficiency could cause ____ in feet
Paresthesia (tingling)
Vitamin C is also known as ____ ____
Ascorbic acid
Vitamin C is the most easily destroyed vitamin; can be destroyed by things like…
-Heat
-Alkaline pH
-Oxidation
Vitamin C has a structure very similar to ____
Glucose
Vitamin C requires an ____ pH level
Acidic
Vitamin C changes proline into hydroxyproline and then that into ____, which strengthens intercellular substances
Collagen
Vitamin C is vital for the process of ____ ____
Wound healing
Vitamin C aids in the absorption of ____
Iron
Vitamin C is found in…
-Citrus fruits
-Potatoes
-Papaya
-Dark green vegetables
-Yellow vegetables
-Strawberries
Daily vitamin C needs are ___-___ mg
75-90
Deficiency of vitamin C can cause…
-Scurvy
-Poor wound healing
-Bleeding gums
-Petechiae
-Dull hair
Biotin is synthesized by intestinal ____
Bacteria
Biotin is inactivated by ____, which is the protein in raw egg whites
Avidin
Biotin is a coenzyme in ____ ____ synthesis
Fatty acid
Biotin converts pyruvate to _____ in gluconeogenesis
Oxaloacetate
Biotin is found in…
-Liver
-Kidney
-Egg yolk
-Yeast
The adequate intake (AI) for biotin is _____ micrograms
30
Deficiency of biotin can cause…
-Muscle pain
-Dermatitis
-Glossitis
Myo-Inositol exists in plants as ____ ____
Phytic acid
Myo-Inositol is related to _____
Sugar
Myo-inositol contains _____, and it a vitamin-like factor
Phosphorus
Myo-Inositol blinds the membrane structure of ____, ___, and ____
Calcium, zinc, iron
Myo-Insitol is found in…
-Outer husks of cereal grains
-Leafy green vegetables
____ is the most abundant mineral
Calcium
Calcium is regulated by ____ hormone
Parathyroid
What three things aid in the absorption of calcium?
-Vitamin D
-Acid
-Lactose
_____ lowers serum calcium by inhibiting the resorption of calcium from the kidney
Calcitonin
Role of calcium:
-Blood clotting
-Cardiac function
-Nerve transmission
-Smooth muscle contractility
Sources of calcium:
-Dairy products
-Leafy vegetables
-Legumes
Adults need between ____-____ mg of calcium per day
1000-1200
_____ is a precursor to vitamin A
Carotene
Vitamin A is a ____, which means that it is a nutrient that is changed into a vitamin
Provitamin
Hypocalcium leads to ____
Tetany (involuntary muscle contractions)
Women need ____ micrograms of vitamin E (RE)
700
Vitamin A is ____ soluble
Fat
Vitamin A is stored in the _____
Liver
Deficiency in vitamin A leads to…
-Night blindness (nyctalopia; is reversible)
-Xerophthalmia (corneal damage; not reversible)
-Bitot’s spots on conjunctiva
-Dry, scaly skin (hyperkeratosis)
Vitamin A is important for ____ and ____
Skin and vision
Sources of vitamin A:
-Yellow and orange fruits
-Dark green leafy vegetables
-Cantaloupe
-Fish
-Liver
-Carrots
-Fortified skim milk
-Apricots
-Sweet potatoes
Men need ____ micrograms of vitamin A (RE)
900
Vitamin A is converted in intestinal ____ cells
Mucosal
Vitamin A becomes toxic at levels of ____ IU
10,000
Vitamin D is ____ soluble
Fat
____ is a precursor to vitamin D
Cholesterol
Vitamin D can be obtained from ____ ____
UV light
7 dehydrocholesterol->D3 cholecalciferol-> ____
D2 (Ergocalciferol)
Vitamin D is important for the metabolism of ____ and ____
Calcium and Phosphorus
Sources of vitamin D:
-Sunlight
-Egg yolk
-Fortified milk
The AI for vitamin D is between ___-___ micrograms/day for adults
5-15
Infants need ____ IU/day of vitamin D
400
Deficiency of vitamin D causes…
-Rickets (soft bones)
-Osteomalacia
Vitamin E is fat-soluble and also known as _____
Tocopherol
The upper limit of vitamin E (tocopherol) is ____ mg
1000
Vitamin E is one of the least ____ vitamins
Toxic
Vitamin E (tocopherol) acts as an antioxidant and resists ____ of red blood cells
Hemolysis
Sources of vitamin E (tocopherol):
-Vegetable oils (cottonseed)
-Whole grains
-Green vegetables
-Almonds
Adults need _____ mg of vitamin E (tocopherol)
15
Deficiency of vitamin E (tocopherol) results in ____ ____
Hemolytic anemia
Vitamin K is a ____ soluble vitamin
Fat
Vitamin K is synthesized by ____ in the lower intestinal tract
Bacteria
Vitamin K has no ____ symptoms
Toxicity
Vitamin K forms ____ in the liver, which aids in blood clotting
Prothrombin
Vitamin K is given pre-_____
Surgery
Vitamin K is also involved in _____ metabolism (promotes bone binding)
Calcium
Sources of vitamin K:
-Spinach
-Kale
-Broccoli
-Green, leafy vegetables
Men need ____ micrograms of vitamin K per day
120
Women need ____ micrograms of vitamin K per day
90
Deficiency of vitamin K can lead to ____
Hemorrhage (blood is slow to clot)
Vitamin K is affected by…
-Mineral oil antibiotics
-Anticoagulants/blood thinners (Ex: Warfarin)
Vitamin B1 is also known as _____
Thiamin
Vitamin B1 (thiamin) is lost as ____ or ____ increases
Temperature or pH
Vitamin B1 (thiamin) is heat stable in ____
Acid
Vitamin B1 (thiamin) is involved in the oxidation of _____
Carbohydrates
With high carbohydrate intake, there is a ____ need for more vitamin B1 (thiamin)
Increased
Vitamin B1 (thiamin) is important for the metabolism of _____
Pyruvate
Sources of vitamin B1 (thiamin):
-Grains
-Wheat germ
-Pork
-Liver
Men require _____ mg of vitamin B1 (thiamin)
1.2
Women require _____ mg of vitamin B1 (thiamin)
1.1
Deficiency of vitamin B1 (thiamin) can cause…
-Beriberi
-Muscle weakness
-Foot drop
-Memory loss (Wernike-Korsikoff)
-Tachycardia
What are two indicators of vitamin B1 (thiamin) deficiency?
-Low erythrocyte transketolase
-High plasma pyruvate
Vitamin B2 is also known as _____
Riboflavin
Vitamin B2 (riboflavin) is lost in ___ ___
UV light
Vitamin B2 (riboflavin) acts as a ____
Co-enzyme
Vitamin B2 (riboflavin) is required for energy release from _____
Protein
Vitamin B2 (riboflavin) is also involved in ___ ___ ___ production
Red blood cell
Sources of vitamin B2 (riboflavin):
-Liver
-Kidney
-Meat
-Milk
Men need ____ mg/day of vitamin B2 (riboflavin)
1.3
Women need ____ mg/day of Vitamin B2 (riboflavin)
1.1
Deficiency of vitamin B2 (riboflavin) can cause…
-Growth failure
-Cheilosis (cracked lips)
-Angular stomatitis (cracks in the corner of the mouth, sore throat)
-Magenta tongue
Niacin is a precursor to _____
Tryptophan
Niacin is essential in all cells for ____ production and metabolism
Energy
Niacin is involved in the metabolism of…
-Carbohydrates
-Protein
-Fat
Sources of niacin include…
-Protein
-Peanuts
-Ready-to-eat cereals
-Chicken
-Rice
-Yeast
-Milk
Men require ____ niacin equivalents per day
16
Women require ____ niacin equivalents per day
14
Deficiency of niacin can result in…
-Pellagra (4 D’s)
-Beefy, bright, red tongue
-Symmetrical, pigmented rash in sunlight
Niacin deficiency, or Pellagra, causes…
-Diarrhea
-Dermatitis
-Dementia
-Death
Phosphorus is the second most ____ mineral; it is part of DNA, RNA, and ATP
Abundant
Phosphorus (phospholipids) are responsible for transporting ____ through the lymph and blood
Fat
Phosphorus also exists in ___ and ___
Bones and teeth
Phosphorus deficiency is rare because it exists in things like…
-Meat
-Milk
-Poultry
-Eggs
-Fish
-Cheese
Adults need ____ mg/day of phosphorus
700
Iron is a ____ mineral
Trace
Iron is part of ____
Hemoglobin
Iron from food is known as ____ iron
Ferric
Absorbable iron is known as ____ iron
Ferrous
Stored iron is known as ____
Ferritin
Iron overload is known as _____, and is treated with iron chelation therapy
Hemochromatosis
Iron is involved in ____ transport
Oxygen
Heme iron can be found in…
-Animal foods
-Meat
-Fish
-Poultry
Non-heme iron can be found in…
-Cereals
-Vegetables
Non-heme iron is poorly ____
Absorbed
Absorption of non-heme iron is aided by…
-Gastric juice
-Vitamin C
-Calcium (sometimes)
Calcium can only help in the absorption of non-heme iron if there are ____ present, which are found in fruits, vegetables, nuts, and grains
Oxalates
What foods hinder the absorption of non-heme iron?
-Eggs
-Tea
-Milk
-Cheese
A deficiency in iron can lead to…
-Pale tongue
-Fatigue
-Anemia
-Spoon-shaped nails (Koilonychia)
-Pale conjunctiva (mucous membranes that line the eyelid)
Men require ____ mg/day of iron
8
Women require ____ mg/day of iron
18
Babies have enough iron stores to last for about the first ____ months of life
6
Magnesium is part of ____
Chlorophyll
Magnesium exists 50% in ____ and 50% in ____
Bone; cells
With high protein, calcium, or vitamin D, someone would need ____ magnesium
Additional
Magnesium is involved in ___ and ___ ___ synthesis
Protein and fatty acid
Magnesium also stabilizes the structure of ____
ATP
Magnesium ____ is rare because it exists in most food, including milk and bread
Deficiency
Men require ____ mg/day of magnesium
420
Women require ____ mg/day of magnesium
320
While rare, magnesium deficiency can cause ____
Tremors
Zinc is a ____ mineral
Trace
Excess zinc leads to ___ and ___ deficiency
Copper; iron
Zinc increases _____ acuity
Taste
Zinc can also enhance ____ action
Insulin
Zinc stabilized ___ and ____ and is also involved in cell division and growth
DNA; RNA
Sources of zinc include…
-Meat
-Liver
-Eggs
-Fish
What two things decrease the absorption of zinc?
-Phytates
-Copper
Men require ____ mg/day of zinc
11
Women require ____ mg/day of zinc
8
Deficiency of zinc can lead to…
-Reduced immune function
-Alopecia
-Poor wound healing
-Hypogeusia
-Growth retardation
-Sexual immaturity in adolescents
Iodine is a trace mineral that is part of ____, a thyroid hormone
Thyroxine
Sources of iodine include…
-Seafood
-Iodized salt
Adults require ____ micrograms of iodine
150
Deficiency of iodine can cause a ____
Goiter
Fluoride is a trace mineral that exists in ___ and ___
Teeth and bones
Sources of fluoride include…
-Soil
-Water
Men require ____ mg/day of fluoride
4
Women require ____ mg/day of fluoride
3
Deficiency of fluoride may cause ____ ____
Dental caries
Copper is a trace mineral that, when attached to protein, is known as _____
Ceruloplasmin
Copper is involved in ____ synthesis and aids in iron absorption
Hemoglobin
Sources of copper include…
-Beef liver
-Kidney
-Oysters
-Shellfish
-Seeds and nuts
-Dark, leafy greens
Adults require ____ micrograms of copper
900
Copper deficiency is rare, but can result in…
-Microcytic anemia
-Neutropenia
-Wilson’s disease (low serum copper)
Wilson’s Disease is a genetic absence of liver enzymes that normally transport copper to bile; causes build-up of copper in the…
-Liver
-Brain
-Eyes
Selenium is a trace mineral that cooperates with vitamin ____
E
Selenium acts as an antioxidant and is important for tissue ____
Respiration
Sources of selenium include…
-Soil
-Grains
-Meat
-Fish
-Poultry
-Dairy
Men require ____ micrograms/day of selenium
55
Women require ____ micrograms/day of selenium
45
Deficiency of selenium can lead to…
-Myalgia (muscle aches)
-Cardiac myopathy
Manganese is a trace mineral that is important for function of the ___ __ ___
Central nervous system
Sources of manganese include…
-Whole grains
-Legumes
-Nuts
Adults require ____-___ mg/day of manganese
1.8-2.3
Deficiency of manganese is ____
Unlikely
Chromium is an ultra-trace mineral; the absorption of chromium is enhanced by what two substances?
-Vitamin C
-Niacin
Chromium aids the action of _____ and is involved in glucose metabolism
Insulin
Sources of chromium include…
-Oysters
-Yeast
-Potatoes
-Liver
Adults require ___-___ micrograms of chromium
25-35
A deficiency in chromium may lead to ____ ___
Insulin resistance
Cobalt exists with vitamin ____
B12 (cyanocobalamine)
Cobalt is stored in the _____
Liver
Cobalt is involved in the maturation of ___ ___ ___
Red blood cells
A cobalt deficiency is related to a ____ deficiency
B12 (cyanocobalamine)
Sulfur exists in what two amino acids?
-Cysteine
-Methionine
Sulfur is a component of ____ molecules
Organic
Sources of sulfur include…
-Meat
-Fish
-Eggs
-Poultry
The adequate intake (AI) for sulfur is ___-___ mg
425-550
Choline is a component of ____
Lecithin
Choline functions to transport lipids and _____
Acetylcholine
Sources of choline include…
-Eggs (fat)
-Milk
-Liver
-Soybeans
High dose vitamin E might antagonize vitamin ___
K
Hypersensitivity to light may be due to deficiency of ____ ____
Beta carotene
Infants and adolescents have a higher prevalence of ____ deficiency
Iron
Calcium deficiencies are associated with ____ and ____ deficiencies
Vitamin D, magnesium
____ water is water within the cells
Intracellular
Extracellular water is water that exists in…
-Plasma
-Lymph
-Interstitial
-Intercellular
Water serves as a medium for cell ____
Metabolism
Normal insensible water loss (from skin and breathing) is about ___-___ L/day
0.8-1.2
____ ____ fluid includes both extracellular and extravascular fluid
Third space
____ dissociate into ions in water as anions or cations
Electrolytes
The concentration of electrolytes in expressed in _____
Milliequivalents
Formula for determining milliequivalents of an electrolyte:
(mg/atomic weight) x (valence)
Examples of extracellular electrolytes:
-Na+ (main cation)
-Ca++
-Cl-
-HCO3- (bicarbinate)
Sodium chloride is ___% sodium
40
One teaspoon of salt has ___ grams of NaCl, so it has 2.4 grams of sodium
6
Sodium is reabsorbed by ____ and retained by ____
Aldosterone; steroids
Electrolyte composition of normal saline (0.9% NaCl) per liter:
-154 mEq Na
-154 mEq Cl
What are three intracellular electrolytes?
-K+
-Mg++
-P
What are foods high in potassium?
-Meat
-Banana
-Orange
-Tomato
-Potato
-Cantaloupe
What foods are low in potassium?
-Apple
-Cranberry
-Blueberry
-Carrot
-Corn
_____ increases the excretion of potassium
Aldosterone
Hyperkalemia causes ____ irregularities
Cardiac
Normal range for sodium levels:
136-145 mEq/L
Normal range for potassium levels:
3.5-5 mEq/L
Normal range for calcium levels:
4.5-5.5
With _____, fluid moves from the less to the more concentrated side of the membrane
Osmosis
With ____, particles more from the more to the less concentrated side of the membrane
Diffusion
Protein exerts ____ ____ pressure
Colloidal osmotic
____ exerts pressure on blood vessel wall which keeps water within the blood vessels
Albumin
When albumin drops, the ___ drops, causing fluid to leak out
Pressure
With hypoalbuminemia, water moves from the extracellular space (plasma), to the ____ space (between and around cells)
Interstitial
Low serum protein leads to ____ and ____
Edema and ascites
____ is extreme, generalized edema and widespread swelling of the skin due to effusion of fluid into extracellular space
Anasarca
Anasarca is associated with what conditions?
-Heart failure
-Liver failure
-Renal failure
-Extreme protein/calorie malnutrition
____ is caused by decreased water intake, excessive water output, or heavy solute load
Dehydration
Dehydration causes what symptoms?
-Nausea
-Dizziness
-Sunken eyes
-Fever
-Hyperventilation
-Excessive sweating
-Concentrated urine
-Dry, inelastic skin
-Increase in solutes (BUN)
-Tachycardia
-Headache
-Fatigue
-Decreased appetite
-Rapid weight loss
Serum ____ is the best assessment parameter for fluid status
Sodium
_____ is associated with dehydration, while ____ is associated with over-hydration
Hypernatremia; hyponatremia
Acid-base balance refers to the regulation of ____ concentration
Hydrogen
____ release hydrogen ions while ____ take up hydrogen ions
Acids; bases
A ____ is a mixture of acid and base components to protect against a strong acid or strong base
Buffer
What are two examples of major buffers?
-Carbonic acid (H2CO3)
-Sodium bicarbonate (NaHCO3)
The pH scale goes from 0, very ____, to 14, very ____
Acidic; alkaline
Lungs control the supply of ____ ____ (carbon dioxide, water); altered by the rate and depth of breathing
Carbonic acid
Hypoventilation causes _____ of acid, while hyperventilation causes ____ of acid
Retention; loss
The kidneys control _____
Bicarbonate
The kidneys regulate ____ ion secretion and _____ reabsorption
Hydrogen; bicarbonate
If the kidneys retain bicarbonate, the level of base ____, whereas if the kidneys excrete excess bicarbonate, the level of base _____
Increases; decreases
A change in one side of the buffer brings about a ____ change in the other side to maintain balance (maintain a pH close to 7.4)
Compensatory
If there is a problem with acid-base balance related to the pulmonary system, it is either ____ acidosis or alkalosis
Respiratory
Respiratory acidosis is caused by retention of ___ ____ by the lungs
Carbon dioxide
____ leads to respiratory acidosis
Hypoventilation
To compensate for respiratory acidosis, the kidneys increase absorption of _____
Bicarbonate
Respiratory alkalosis is caused by increased excretion of ___ ___ (carbonic acid)
Carbon dioxide
_____ leads to respiratory alkalosis
Hyperventilation
A problem with acid-base balance that is related to the renal system is either ____ acidosis or alkalosis
Metabolic
With metabolic acidosis, the kidneys either produce too much or retain too much ____ leading to an increase in carbonic acid production, or the kidneys excrete too much base
Hydrogen
To compensate during metabolic acidosis, respiration ____ to remove carbon dioxide to decrease carbonic acid
Increases
Metabolic alkalosis is caused by the loss of ____ due to loss of acid, or an increased retention of base
Hydrogen
To compensate for metabolic alkalosis, ventilation ____ to retain more carbon dioxide to make carbonic acid
Decreases
The first step in evaluating an acid-base abnormality is to check the ____- is it moving towards acidosis or alkalosis (over 7.4 or under 7.4?)
pH
After assessing the pH, check for the ____ (indicates something wrong with lungs) and ____ (indicates something is wrong with the kidneys) to determine if the cause is respiratory or metabolic;
pCO2; HCO3
