EN PN

Question 1

Which visceral proteins / acute phase reactants have the shortest half-life?

Answer 1

The half life of negative acute phase reactants:

insulin-like growth factor 1 (IGF-1) ~2-6 hours
retinol binding protein (RBP) ~10 hours
prealbumin or transthyretin ~2-3 days
transferrin ~8-10 days
albumin ~20 days

The half life of positive acute phase reactants:
CRP ~19 hours
Ferritin ~19-20 hours

Question 2

SGA scale and ratings

Answer 2

SGA is based on a 7-point rating scale. Lower ratings (1-2) indicate severe malnutrition, moderate ratings (3-5) indicate moderate-to-mild malnutrition, while high ratings (6-7) indicate good nutrition

Question 3

When performing a nutrition focused physical exam, which 2 areas can show subcutaneous fat loss?

Answer 3

Subcutaneous fat loss can be seen in the orbital fat pads, triceps, and chest or rib area. Muscle wasting can be assessed in the clavicle, shoulder, calf, and scapula.

Question 4

Calculate the energy provided from glucose containing dialysate in CRRT with 30% uptake with 2.5% dialysate at 999 mL/h

Answer 4

Energy (kcal) = dialysate flow rate (ml/h) * 24 h * dialysate glucose (g/mL) * 3.4 kcal/g dextrose * % uptake = 999 mL/h * 24 h * 0.025 g/mL * 3.4 kcal/g dextrose * 0.30 = 611 kcal/24h

Question 5

What is the recommended amino acid amount for TPN in someone who has CKD and is not on dialysis

Answer 5

0.6-1g/kg
1.This estimate may be impacted by other conditions such as healing from injury or infection