Exam 2 Flashcards
1
Q
What is MAC
A
midarm circumference
2
Q
how is a MAC measurement performed
A
measure between acromion process and olecranon process, measure circumference in cm
3
Q
how is TSF measurement performed
A
on the right side of the body, measure midpoint between acromion process and olecranon process. Grab about 1cm to 1/2 inch, close tip of caliper and read approximately 4 seconds after pressure from hand is released. Take two measurements. Measure triceps skinfold in mm at the marked point and biceps skinfold at marked point.
4
Q
What is MAMC
A
Midarm muscle circumference
5
Q
How is MAMC measured
A
estimated by creatinine/height index and midarm muscle circumference, [(C - piT)^2] / 4pi where C is cirumference in cm and T is triceps skinfold in millimeters.
6
Q
what are the benefits of MAMC
A
Indirect determination of arm muscle area and arm fat area, determines lean body mass and skeletal protein reserves
7
Q
how to determine bone free AMA in female and males
A
AMA-10 for males, AMA-6.5 for females.
8
Q
What is DEXA
A
Dual-Energy X-Ray Absorptiometry takes energy beam from x-ray tube and measure energy loss depending on type of tissue the beam passes through.
9
Q
What does DEXA scan measure
A
bone mineral density by measuring fat and boneless lean tissue
10
Q
What are the benefits of DEXA scan
A
measures mineral, fat, and lean tissue compartments, easy, low levels of radiation, avaliable in most hospitals.
11
Q
What are the limitations of DEXA scan
A
patient must remain still, which is difficult for those in chronic pain. Hydration status and bone/calcified soft tissue can cause inaccurate readings.
12
Q
Identify significant %WL for 1 week, 1 month, 3 months, and 6 months
A
1-2%,
5%,
7.5%,
10%
13
Q
Identify severe %WL for 1 week, 1 month, 3 months, and 6 months
A
> 1-2%,
5%,
7.5%,
10%
14
Q
Calculate BMI
A
weight (kg)/height (m^2)
15
Q
Calculate IBW for women and men
A
100 for first 5 ft then add 5(x inches over 5ft) for women
106 for first 5ft then add 6(xinches over 5ft) for men
16
Q
Calculate %UBW
A
% UBW = (Actual weight / UBW)* 100
17
Q
What is inflammation
A
the protective response against infection, illness, trauma, chronic disease, and physical stress
18
Q
what is chronic inflammation
A
inflammation where body continues to synthesize inflammatory mediates during normal physiological processes. loss of barrier function, response to normally benign stimuli, overproduction of oxidants, cytokines, and chemokines.
19
Q
Calculate %WL
A
[UBW-CBW] / UBW
20
Q
What are the signs of acute inflammation
A
redness, swelling, heat, loss of function, pain
21
Q
how do you convert lbs to kg
A
divide by 2.2
22
Q
how do you convert inches to cm
A
multiply by 2.54
23
Q
what is acute inflammation
A
short term inflammation mediated by negative feedback mechanisms and where mediators have short life and are quickly degraded.
24
Q
inflammation causes a(n) _______ in positive acute phase proteins
A
increase
25
inflammation causes a(n) _______ in negative actute phase proteins
decrease
26
C-reactive protein
positive acute-phase reactants
27
a-1 antichymotryspin
positive acute-phase reactants
28
a1-antitrypsin
positive acute-phase reactants
29
haptoglobins
positive acute-phase reactants
30
ceruloplasmin
positive acute-phase reactants
31
serum amyloid A
positive acute-phase reactants
32
fibrinogen
positive acute-phase reactants
33
ferritin
positive acute-phase reactants
34
complement and components of C3 and C4
positive acute-phase reactants
35
orosomucoid
positive acute-phase reactants
36
albumin
negative acute-phase reactants
37
transferrin
negative acute-phase reactants
38
prealbumin/transthyretin
negative acute-phase reactants
39
retinol-binding protein
negative acute-phase reactants
40
Declining values of negative acute phase protein indicate
inflammatory processes and severity of tissue injury
41
Can you use lab test to predict nutritional anemia risk
NO
42
what does C-reactive proteins measure
reflect any type of systematic inflammation, sensitive marker for bacterial diseases. Associated with trauma, CV, neoplastic proliferation.
43
what is a normal oral glucose levels
<200 in 1 hr and <140 in 2 hrs
44
what does creatinine measure
used with BUN to assess kidney function, also assess somatic muscle protein status. Creatine should be greater or equal to DRI, low levels in diabetes mellitus.
45
what does albumin measure
Major purpose is to maintain colloid osmotic pressure. Transports major blood constituents, hormones, minerals, medications, fatty acids, ions.
46
what does prealbumin (PAB) /transthyretin (TTHY) measure
USED FOR PROTEIN STATUS AND INFLAMMATION, MALIGNANCY. can indicate protein wasting in intestines and kidneys. complex of retinol-binding protein and vitamin A. Transports thyroid hormone. Related to zinc deficiency.
47
what does retinol-binding protein measure
sensitive protein-energy balance indicator, low levels indicate presence of inflammatory stress, trasnport vitamin A metabolite, rapidly responds tonutrition intervention
48
what does transferrin measure
transprot of iron to bone marrow of hemoglobin production, low levels indicate actue inflammatory reaction, malignancies, collagen vascular disease, liver disease.
49
what does ferritin measure
Fe storage in proteins, best lab to determine IRON DEFICIENCY or toxicity
50
what is the half life for C-reactive proteins
short, 5-7 hours
51
what is the half life of prealbumin/transthyretin
long, 2 days
52
what is retinol-binding protein's half life
12 hours
53
what is transferin half life
long, 8 days
54
Microcytic anemia is associated with
iron deficiency
55
Macrocytic anemia is associated with
B12 or folate deficiency
56
Pernicious anemia is associated with
malabsorption of B12
57
What is TIBC
total iron binding capacity
58
What does TIBC measure
transferrin concentration
59
What is MCV
Mean red blood cell volume
60
What does MCV indicate
low levels mean iron deficiency, renal failure. high levels mean B12 or folate deficiency
61
What is MCH
Mean corpuscular hemoglobin
62
what does MCH indicate
low levels mean iron deficiency, renal failure. high levels mean B12 or folate deficiency
63
what does MCHC indicate
low levels in those with iron deficiency
64
what does ferritin indicate
parallels with iron stores
65
what does transferrin measure
responds to the binding of iron
66
what does hemoglobin test measure
blood hemoglobin concentration
67
what does hematocrit measure
% RBC in whole blood
68
what does homocysteine measure
risk factor for CVD, related to B12 and folate
69
what does C-reactive protein labs indicate for
inflammation, CVD, infection
70
What does LDL test indicate
positive risk factor for CVD
71
what are normal LDL levels?
desireable: <100mg/dL
borderline: 130-159 mg/dL
high risk: >160mg/dL
72
what does HDL test indicate
protective against artherosclerotic vascular developement or negative risk factors
73
what is desirable HDL levels
women: >50mg/dL
men: 40mg/dL
74
what does triglyceride test show for
association with CHD, increase blood viscocity
75
what are normal triglyceride leves
normal: <150mg/dL
borderline: 150-199
high: 200-399
Very high: >500mg/dl
76
what is normal serum glucose range
70-90mg/dL
77
what does A1C indicate
differences between short term hyperglycemia and myocardial infarction
78
what is a normal range for A1C
4-6%
79
what does oral glucose tolerance indicate
establish how effective glucose uptake is
80
what is normal fasting oral glucose tolerance level
70-100 mg/dl
| hr: <200 mg/dL
81
what is ceruloplasmin
a copper-carrying protein in the blood, also in iron metabolism
82
what does ceruloplasmin levels tell us?
increase levels from stress, low levels indicate copper deficiency or malnurition
83
What are the components of the urinalysis
examine appearance, find results of chemically impregnated reagent strips, and microscopic examination of urine sediment
84
what are the analytes of the urinalysis
specific gracity, pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, nitrite, leukocyte esterase
85
Why do we measure specific gravity in urine
Linked to dehydration/overhydration. monitor dilution ability of kidney, hydration status. Low levels indicate diabetes insipidus, high levels indicate fever, adrenal insufficiency, hepatic disease, heart failure
86
why do we measure pH of urine
acidic measurements show in high protein diets, acidosis (starvation), kidney stones. Alkaline associated with urinary tract infection, drugs, and kidney stones
87
why do we measure protein in urine
low levels in those with renal disease or urinary tract disorders. High levels with nephrotic syndro,e, congestive heart failure.
88
why do we measure glucose in urine
positive levels in those with uncontrolled DM
89
why do we measure ketones in urine
positive in those with uncontrolled DM
90
why do we measure blood in urine
blood in urine indicates UTI, neoplasm, trauma, traumatic muscle injuries, hemolytic anemia.
91
why do we measure bilirubin in urine
increased levels in those with liver disease, gallstones
92
why do we measure urobilinogen in urine
increased levels in those with hemolytic conditions, distinguish different hepatic diseases
93
why do we measure nitrite
should be negative value, index of bacteriuria
94
why do we measure leukocyte esterase
it is an indirect test of bacteriuria and detects leukocytes
95
What is a functional nutrition assessment
wholistic, patient focused, evidence based practice that focuses on how environment influences the metabolic processess, GI health, absorption, etc. Will assess physical reserves of micronutrients
96
what are the components of a functional nutrition assessment
food/nutrition history, client history, NFPE, physical measurements, lab and medical test
97
what are the factors identified in a functional nutrition assessment
pattern recognition, under and over nutrition, reduction of toxin exposure, antecedents or events in history that act as a trigger for a response beginning a disease process
98
what is ausculation
use of the naked ear or a stethoscope to listen to body sounds (heart, bowl, lung, blood vessel)
99
what is inspection
general observation that progresses to a more focused observation using the senses of sight, smell, and hearing; most frequently used
100
what are some examples of inspection
patient's appearance, behavior, or movements like facial expression, mood, body habitus, conditioning, skin color, etc.
101
what is palpation
tactile exam to feel pulsations and vibrations; assess body structures, including texture, size, temperature, tenderness, and mobility
102
what is percussion
assessment of sounds to determine body organ borders, shape, and position; not alwayed used in NFPE
103
what are the signs of hypertonic dehydration
loss of more water than salt, high serum Na levels, low extracellular volume, high serum osmolaity
104
what are some signs of hypotonic dehydration
loss of more salt than water, low serum Na, low extracellular volume, low serum osmolarity
105
what are some signs of isotonic dehydration
salt and water loss equal, normal serum Na, low extracellular volume, normal serum osmolarity,
106
how much water loss can cause death, how much may damage body systems?
20% death, 10% damage
107
what labs do you look for in hypertonic dehydration
high serum osmolality, high serum Na, high albumin, high H/H, high BUN, high urine specific gravity
108
which labs do you look for in hypotonic dehydration
low serum osmolality, low serum Na, high albumin, high H/H, high BUN, High urine specific gracvity
109
what are labs to look for in isotonic dehydration
high albumin, high H/H, high BUN, high urine specific gracity
110
what clinical findings do you see with dehydration (NFPE only)
dry mucous membranes, dry tongue, sunken eyes, poor skin turgor, pallor, sweating, clammy or flushed skin
111
what are the clinical findings of dehydration
BP - hypotension, unplanned weight loss, fever, fatigue, faintness, increased thirst, peripheral or pulmonary edema
112
what are some causes of overhydration
heart, lung, or kidney disease
113
what does BUN stand for
blood urea nitrogen
114
what does H/H stand for
hemoglobin and hematocrit
115
what are the biochemical findings for hypertonic overhydration
high serum osmolality, high serum Na, low albumin, low BUN, low H/H
116
what are the biochemical findings for hypotonic overhydration
low serum osmolality, low serum sodium, low albumin, low BUN, low H/H
117
what are the NFPE clinical findings for overhydration
low urine volume, increase thirst, unstable BP/cardiac overload, insterstitial edema, dyspnea, unplanned weight gain
118
what is insterstitial fluid
fluid space between tissue cells, about 16% body weight
119
what is intracellular fluid
fluid within the tissue cells, about 30-40% body weight
120
what is extracellular fluid
interstitial fluid and plasma, consist of about 20% of body weight
121
what are electrolytes
substances that dissocaiate into positively and negatively charged ions when dissolved in water
122
what are the major extracellular electrolytes
sodium, calcium, chloride, bicarbonate
123
what are the major intracellular electrolytes
potassium, magnesium, phosphate
124
what are some rich sources of potassium
avocados, bananas, artichokes, chili, coconut, beet greens, corn,
125
what are some food sources of calcium
dairy products, green vegetables, nuts, canned fish.
126
what are some food sources of sodium
table salt, protein foods have naturally existing sodium. Flavor enhancers, preservatives, convenience foods
127
how does hydration status influence sodium electrolytes
measured by serum osmolality test. regulates extracellular and plasma volume. SIADH results in CNS, pulmonary disorders, tumors. high sodium intake associated with high urinary calcium excretion
128
what are some food sources of magnesium
green leafy vegetables, legumes, and whole grains
129
what are some food sources of phosphorous
animal products (meats and milk) and beans
130
how does magnesium electrolytes influence hydration status
High intake can lead to high alkaline status and enhance mineral-water consumption.
131
how does phosphorous electrolytes influence hydration status
act as buffer in acid-base balance
132
how does potassium electrolytes influence hydration status
osmotic equilibrium
133
what does anuric mean
no urine production
134
what does oliguria mean
decrease or scant urine production
135
what body systems are involved in fluid balance
GI tract, kidney, brain (specifically pituitary and hypothalamus)
136
what are the hormones that control fluid balance
vasopressin (antidiuretic hormone) and renin (stimulates thirst)
137
what are the thirst mechanisms for fluid balance
renin and Na blood levels are stimulated
138
hormonal regulation of fluid balance
baroreceptors in CNS regulate antidiuretic vasopressin, increase serum osmolality/decrease blood volume conserves water, baroreceptrors are stimulated to decrease ECF volume, kidneys release renin to produce angiotensin II that then stimulates vasoconstriction and thirst increases.
139
what is the fluid needs for adults
1ml/Kcal
140
what is the fluid needs for infants
1.5mL/kcal
141
how can stool samples inform on an individual's risk for anemia
fecal occult blood test is done to look for pathogenic bacteria and presence of blood
142
how can stool test inform on an individual's absorption efficiency
gut flora test to find pathogenic flora or imbalance of physiologic flora that influences absorption
143
what is a normal blood pressure reading
<120/<80
144
what is the range for prehypertension
120-139/80-90
145
what is the range for hypertension I
140-159/90-99
146
what is the range for hypertension II
>160/>100
147
what is considered hypertension crisis
>180/>110
148
what are the signs and symptoms of prediabetes
excessive hunger, excessive thirst, fatigue, frequent urination, weight gain, impaired glucose homeostasis, hemoglobin A1C of 5.7 to 6.4%
149
what are the signs and symptoms of type I diabetes
hyperglycemia, excessive thirst, frequent urination, significant weight loss, electrolyte disturbances, weakness, fatigue, irritability, insulin deficiency
150
what are the signs and symptoms of type II diabetes
hyperglycemia, fatigue, excessive thirst, frequent urination, obesity, history of gestational diabetes, physical inactivity, excessive kcal intake
151
what are the signs and symptoms of gestational diabetes mellitus
hyperglycemia, fatigue, excessive thirst, frequent urination, genetic predisposition, obesity, physical inactivity, excessive calorie intake
152
what is a normal fasting (8hr) glucose range
70-100mg
153
what is a normal casual blood glucose range
<200mg/dL
154
what is a normal non-diabetic adult A1C value
2.2-4.8%
155
what lab values classify an individual as having CVD and related MS
HDL <40mg/dL in males and <50mg/dL in females. Triglycerides>150 mg/dL, blood glucose >100mg/dL
156
what are the signs and symptoms of CVD and related MS
large WC, high triglyceride level, low HDL, high BP, high fasting blood sugar, shortness of breath, weakness, dizziness, discomfort in chest, jaw, throat, arm, pounding in chest.
157
what are the lab values found on the complete blood count
RBC, hemoglobin concentration, hematocrit, MCV, MCH, MCHC, WBC
158
what are the two types of metabolic panels
basic metabolic panel and comprehenisve metabolic panel
159
what is a basic metabolic panel (what tests)
basic screening of eight test: glucose, calcium, sodium, potassium, CO2, chlorid, BUN, and creatine
160
what is the comprehensive metabolic panel (CMP)
BMP plus 6 more test including albumin, total protein, ALP, ALT, AST, and bilirubin
161
what is a functional assay
quantitatively measure biochemical or physiological activity that depends on the nutrient of interest
162
what is a static assay
measures the actual level of the nutrient in a specifimen
163
what is normal bp
<120/<80
