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Question 1

Mention the main gluconeogenic substrates

Answer 1

glicerol
lactate
alanine
glutamine

Question 2

extracellular electrolytes

Answer 2

Na, Ca, Cl

Question 3

intracellular electrolytes

Answer 3

K, Mg, P

Question 4

name at least two of the
main micronutrients with antioxidant properties, and therefore are used to modulate the metabolic response to stress

Answer 4

selenio, vitamin c, a, e, d, zinc

Question 5

the mineral has an important role in insuline resistence

Answer 5

chromium

Question 6

this minerals have an important role in wound healing

Answer 6

selenium and zinc

Question 7

this vitamin works ad FAD in the hydrogen transport from krebs cycle to respiratory chain

Answer 7

riboflavin

Question 8

the deficiency of this vitamin can be diagnosed with megaloblastic anemia and hyperhomocysteinemia

Answer 8

cobalamin

Question 9

this vitamin works as NAD in the hydrogen transport from krebs cycle to respiratory chain

Answer 9

niacin

Question 10

the deficiency of this vitamin may cause sideroblastic anemia

Answer 10

pyridoxine

Question 11

the deficiency of this vitamin cause beri beri

Answer 11

thiamine

Question 12

this vitamin works to unite acetil co a into the krebs cycle

Answer 12

pantothenic acid

Question 13

one of the main functions of this vitamin is in the maturation of erythrocytes

Answer 13

folic acid

Question 14

main substrate in the first phases of starvation

Answer 14

hepatic glycogen and protein

Question 15

mais substrate in the second phases of starvation

Answer 15

lipids from adipose tissue

Question 16

mention 2 characteristics of each phases of the metabolic response to stress: Ebb phase

Answer 16

inflammation
the glut is hypoperfused

Question 17

mention 2 characteristics of each phases of the metabolic response to stress: flow phase (catabolic)

Answer 17

more REE
lipid (TAG) mobilization

Question 18

mention 2 characteristics of each phases of the metabolic response to stress: flow phase (anabolic)

Answer 18

less REE
more protein requirements

Question 19

nutrition screening tool recommended by ESPEN for hospitalized patients

Answer 19

NRS

Question 20

nutrition screening tool recommended for older adults

Answer 20

MNA

Question 21

nutrition screening tool used in the ICU to assess nutritional support

Answer 21

NUTRIC-SCORE

Question 22

nutrition screening tool recommended for general population

Answer 22

MUST

Question 23

absolute gastrointestinal contraindications for enteral nutrition

Answer 23

b and c are correct:: intestinal obstruction and ileus and severe peritonitis

Question 24

post-pyloric tube feeding is used for px with:

Answer 24

all the answers are correct: aspiration, gastroparesis, gastro-oesophageal reflux

Question 25

bolus feeding is:

Answer 25

associated with higher rates of GI symptoms compared to continuous infusion and convenient option in stable px wiht PEG

Question 26

modern nasogastric feeding tubes:

Answer 26

cannot be used for more than 4-6 weeks

Question 27

the correct position of a NG tube should be confirmed by

Answer 27

pH of the stomach <5 and/or abdominal X ray

Question 28

there are formulaes with intact nutrients

Answer 28

polymeric

Question 29

there are formulaes with hydrolyzed nutrients

Answer 29

oligomeric

Question 30

mention the water content on each type of formulae

Answer 30

standard polymeric (1 kcal/ml)-> 80%
hypercaloric (1-2 kcal/ml) -> 75%
hypercaloric (2 kcal/ml) -> 50%

Question 31

when monitoring EN which indication regarding gastric residue should be taken into consideration to start prokinetic and/or slow down the infusion

Answer 31

all of the above: over 600 ml in 24 hr, half of the volumen infused in the last hour, 500 ml in a soul measurement

Question 32

mention the parameter with which we calculate gastric capacity for the bolius

Answer 32

5-7 ml/kg per bolus

Question 33

according to ASPEN and ESPEN, how do we advance the infusion rate for continuous EN:

Answer 33

start with 20 ml/hr and increase 20 ml/hr every 6-8 hr according to tolerance until you achieve the infusion rate goal

Question 34

what do i do if the px didn´t tolerate the EN infusion rate increase

Answer 34

identify the cause and return to last volume tolerated

Question 35

in the order to prevent refeeding syndrome we need to supplement 300 mg of thiamine (name of the vitamin) via IV (administration) 30 min before we start the nutrition administration

Answer 35

answers: 300 mg of thiamine
vía IV–> administration
30 min before

Question 36

this are frequent electrolyte imbalance in refeeding syndrome

Answer 36

hypophosphatemia and hypokalemia

Question 37

fill in the gaps according to the way we manage a px with risk of developing refeeding syndrome

Answer 37

day 1 (BMI below 14)-> 5 kcal per kg per day
day 1 (BMI above 14)-> 10 kcal per kg per day
day 2 to 10–> increase 5 kcal per kg per day

Question 38

in the management of anemia in a px with refeeding syndrome, in which way iron supplementation should be administered

Answer 38

after 7 days started nutritional therapy

Question 39

in the even of having signs of refeeding syndrome you should give:

Answer 39

300 mg of thiamine

Question 40

in acute pancreatitis, which should be the preferred via of administration for the nutrition?

Answer 40

nasojejunal tube

Question 41

consequence of overfeeding an ICU px:

Answer 41

difficulty to wean from ventilator, increased cardiac output and hyperglycaemia

Question 42

euglycemic concept in ICU px:

Answer 42

140-180 mg/dL

Question 43

in ERAS protocol for surgical px, which of the following is suggested to minimize risk at the surgery and improve catabolism

Answer 43

clear fluids until 2 hr before the surgery or glucose 20% IV