Fluid, Electrolytes, Nutrition

Question 1

FeNa: _ (value)
Urine Na: _
BUN/Cr: _
All indicative of low volume, ‘pre-renal’

Answer 1

FeNa < 1
Urine Na < 20
BUN/Cr > 30
All indicative of low volume, pre renal

Question 2

Saliva K conc: _
Gastric K conc: _
Pancreatic/duodenal K conc: _ (meq)

Answer 2

Saliva 20, Gastric 10, pancreatic/duodenal 5

Question 3

Branched chain amino acids are metabolized where? (a.a.’s _, _, _)

Answer 3

Metabolized in muscle (leucine, isoleucine, valine); all essential

Question 4

Vitamin D is made in the _ (organ), then to _ (organ) as 25 OH, then to the _ (organ) then active

Answer 4

skin to liver to kidney

Question 5

Vitamin D:

Mech: increases _ binding to _ in order to _ (increase/decrease) _ (absoprtion/explusion) of _

Answer 5

Increases Ca binding to PROTEIN to incr intestinal absorption of Ca

Question 6

Vitamin A reverses _

Answer 6

adverse effects of steroids on wound healing

Question 7

TBW:
Infant _ %
Men _%
Women _%
Obese _%

Answer 7

infant 80%
men 60%
women 50%
10% less if obese (less h2o in fat)

Question 8

Water distribution, if TBW is 60%
_% cellular
_% intestinal
_% plasma

Answer 8

40% cellular
15% intestinal
5% plasma

Question 9

Carbs have _ kcal/g
Protein has _ kcal/g
Fat has _ kcal/g

Answer 9

carbs 3.4
protein 4
fat 9

Question 10

Basal calorie expenditure: _ kcal/kg/day

Answer 10

25 kcal/kg/day (~1g protein/kg/day needed)

Question 11

Respiratory quotient:
Definition: ratio of _ produced to _ consumed
_ = fat used
_ = carb used

Answer 11

ratio of co2 produced to o2 consumed

0. 7 fat used
1. 0 carb used

Question 12

_ g of protein contains 1 g of nitrogen

Answer 12

6.25g of protein contains 1 g of nitrogen

Question 13

N balance

Answer 13

N in - N out = (Protein/6.25) - (24hrs urine N + 4g)

Question 14

_ preferred fuel of the colon

Answer 14

Short chain fatty acids

Question 15

_ preferred fuel of the small bowel

Answer 15

glutamine

Question 16

1 amino acid in blood stream

Answer 16

glutamine

Question 17

Glutamine levels during stress _ (increase/decrease) in order to _

Answer 17

see decr levels with stress as glutamine goes to kidney to form AMMONIUM to help acidosis

Question 18

Glutamine shown to _ (incr/decr)translocation

_ (incr/decr) mucosal health with chemo or RT to bowel

Answer 18

Decr translocation

Incr mucosal health with chemo or RT

Question 19

Fat Digestion:

_ to _ to _ to _

Answer 19

Micelles to enterocytes to chylomicrons to lymphatics (to jxn LIJ/SCV) (Every Year)

Question 20

Only _ and _ go to portal system

Answer 20

Medium and short chain triglycerides go to portal system with aa’s and carbs

Question 21

Chromium deficiency:

_ , _

Answer 21

hyperglycemia (relative diabetes); neuropathy

Question 22

Zinc deficiency:

_, _, _, _

Answer 22

perioral rash, hair loss, poor healing, change in taste

Question 23

Phosphate deficiency:

_, _

Answer 23

weakness (respiratory), encephalopathy (needed for ATP)

Question 24

Copper deficiency:

_, _

Answer 24

anemia; neutropenia

Question 25

``` Linoleic acid (essential fatty acids) deficiency: _, _, _ ```

Answer 25

dermatitis, hair loss, change in vision

Question 26

Vitamin A vs. Vitamin C

Answer 26

Vitamin A can decrease Vitamin C stores

Question 27

Cori Cycle: | _ to _, to the _, to _

Answer 27

Glucose to lactate, to the liver, to glucose

Question 28

Starvation: | Brain begins using _ from _

Answer 28

Ketones from fatty acids (normally brain and RBCs are dependent on glutamine)

Question 29

Late starvation: | _ shifts to _ as _ is depleted

Answer 29

Gluconeogenesis shifts to kidney as liver is depleted of alanine

Question 30

Normal saline is _ (meqs)

Answer 30

154 meq Na and Cl

Question 31

Lactate ringer is _ (meqs)

Answer 31

Na 130, K 4, Ca 2.7, Cl 109, bicarb 28

Question 32

Alkalosis causes _ (K) by _ (mech)

Answer 32

Causes hypokalemia by driving K into cells and into urine (exchange for H+)

Question 33

Hyperkalemia EKG findings

Answer 33

peaked T wave, wide QRS)

Question 34

``` HyperK Rx: _ first _, _ + _ _ _ if severe ```

Answer 34

Ca to protect heart Bicarb, insulin + glucose Kayexalate Dialysis if severe: 'C Big K die'