Final Exam - Nutrition

Question 1

CrCrl equation

Answer 1

((140-age)BW)/(72SCr) (*0.85 for females)

Question 2

IBW equation

Answer 2

50kg + (2.3 * inches over 60) (male)
45.5kg + (2.3 * inches over 60) (female)

Question 3

DBW equation and when to use

Answer 3

IBW +0.4(actual wt-IBW)
-use if actual BW is 130% or more of IBW

Question 4

NBW equation and when to use

Answer 4

IBW+0.25(actual wt - IBW)
-use when actual BW is 130% or more of IBW

Question 5

risk factors for malnutrition (8)

Answer 5

1. under BW (20%+ below IBW)
2. involuntary wt loss (>10%) within 6m)
3. NPO >10 days*
4. gut malfunction*
5. mechanical vent*
6. increased metabolic needs (trauma/burn, high dose steroids)
7. alcohol/substance abuse
8. chronic diseases

*ICU pts often

Question 6

high risk score number for NUTRIC

Answer 6

6-10

Question 7

two lab tests to determine inflammation status

Answer 7

CRP
prealbumin

Question 8

kwashnior

Answer 8

provide carbs followed by high protein

Question 9

marasmus

Answer 9

provide well balanced substrate

Question 10

ideal nitrogen balance level

Answer 10

(+3 to +5)

Question 11

nitrogen balance equation

Answer 11

Nin - Nout

Question 12

Nin equation

Answer 12

24hr protein intake (g)/6.25

Question 13

Nout equation

Answer 13

24hr UUN (g) + factor (3-5) (just use 4)

Question 14

kcal/kg/day for hospitalized pts

Answer 14

25-30

Question 15

TEE = ?

Answer 15

REE *1.2

Question 16

RQ = ?

Answer 16

Vco2/Vo2

Question 17

RQ goal value

Answer 17

0.85-0.95
-monitor once weekly
-more than this is overfeeding and less is underfeeding

Question 18

g/kg/day of protein for mild to moderate (floor pts)

Answer 18

1-1.5

Question 19

g/kg/day of protein for severe (ICU/trauma/burn pts)

Answer 19

1.5-2

Question 20

standard NPC (non-protein calories) distribution

Answer 20

70/30
dextrose/fat

Question 21

PN indications (5)

Answer 21

1. anticipated long term NPO (>7 days)
2. gut non-function
   -ileus
   -small bowel resection
   -intractable vomiting/diarrhea
3. fistulas
4. IBD
5. hyperemesis gravidum (pregnancy vomiting

Question 22

is EN or PN more common

Answer 22

EN

Question 23

in PN pts, is central or peripheral more common

Answer 23

central

Question 24

kcal in 1g of protein

Answer 24

4

Question 25

kcal in 1g of fat

Answer 25

10

Question 26

kcal in 1g of carbs

Answer 26

3.4

Question 27

propofol contains 10% lipid solution, how many kcal/mL are in it?

Answer 27

1.1

Question 28

CrCl cutoff to be able to include electrolytes in TPN

Answer 28

50
-less than this, no electrolytes

Question 29

daily monitoring for PN

Answer 29

vital signs
ins/outs
CMP (lytes, BG, BUN/SCr)

Question 30

twice weekly monitoring for PN

Answer 30

wt
CBC
Mg, Phos, Ca,
prealbumin/CRP
*if in ICU –> daily for these

Question 31

weekly monitoring for PN

Answer 31

albumin, transferrin, nitrogen balance
LFTs
TGs
PT/INR
RQ

Question 32

clinical findings of refeeding syndrome

Answer 32

hypophosphatemia (main one)
hypomagnesemia
hypokalemia