Last 2nd MNT Test

Question 1

Risk Factors for CHD

Answer 1

Inflammatory markers 
 Blood lipids 
 Lifestyle factors (diet, exercise, smoking) 
 Age 
 Gender 
 Genetics 
 Presence of other diseases

Question 2

Lipoprotein Composition (chylomicrons, LDL, HDL, VLDL) Know the composition 
and characteristics of each one

Answer 2

Chylomicrons: transport dietary fat and
cholesterol to the liver; major component of
triglycerides
 Apolipoproteins: carry lipids in the blood
and control the metabolism of the
lipoprotein molecule
 VLDLs: formed from triglyceride hydrolysis
and considered nonatherogenic
IDL: (Intermediate-density lipoproteins):
atherogenic and are formed from
hydrolysis of triglyceride. Normally taken
up by receptors of the liver or are
converted to LDL.
 LDLs: the primary cholesterol carrier in
blood; formed by the breakdown of VLDL
 HDLs: contain more protein than other
lipoproteins; serve as a reservoir of the
apolipoproteins that direct lipid metabolism.
Helps remove cholesterol from arterial wall
and takes it to the liver.

Question 3

Dietary Guidelines and ethnic groups that are more susceptible

Answer 3

Balance calorie intake and physical activity to achieve or maintain a
healthy body weight.
• Consume a diet rich in vegetables and fruits.
• Choose whole-grain, high-fiber foods.
• Consume fish, especially oily fish, at least twice a week.
• Limit intake of saturated fat to 115 mm Hg
 Smoking
 Diabetes

Question 4

MNT for Hypertension

Answer 4

DASH Diet (Ca, K, Na, Mg) 
 Weight management 
 Alcohol 
 Physical activity 
 Omega-3 fatty acids

Question 5

MNT for CHF

Answer 5

Cardiac cachexia 
 Sodium 
 Fluid 
 Alcohol 
 Caffeine 
 CoQ10

Question 6

MNT for CHD

Answer 6

ATP III TLC dietary pattern 
 AHA recommendations 
– SFA <7% kcal, total fat 25% to 35% kcal, low 
trans-fatty acids 
 Increase physical activity and decrease 
energy intake for weight loss 
 DASH pattern 
 Very–low-fat diets

Question 7

National Cholesterol Education Program
Know foods sources of monounsaturated, polyunsaturated, saturated and trans
fat and high sodium

Answer 7

nuts, donuts , processed foods

Question 8

Blood pressure

Answer 8

Normal: <80 mm Hg 
 Prehypertension: 120–139/80–89 mm Hg 
 Stage 1: 140–159/90– 99mm Hg 
 Stage 2: ≥160 mm Hg /OR greater ≥100 
mm Hg

Question 9

Cholesterol

Answer 9

Total cholesterol 40 mg/dL

Question 10

Diuretics

Answer 10

A diuretic is any substance that promotes the production of urine. This includes forced diuresis

Question 11

Beta-blockers

Answer 11

Beta blockers are a class of drugs that target the beta receptor. Beta receptors are found on cells of the heart muscles, smooth muscles, airways, arteries

Question 12

Anticoagulants

Answer 12

Anticoagulants are a class of drugs that work to prevent the coagulation of blood.

Question 13

Anticholesteremia

Answer 13

Hypolipidemic agents, or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of hyperlipidemias. They are called lipid-lowering drugs.

Question 14

ACE inhibitors

Answer 14

An ACE inhibitor is a pharmaceutical drug used primarily for the treatment of hypertension and congestive heart failure. This group of drugs causes dilation of blood vessels, which results in lower blood pressure.

Question 15

Vasodilators

Answer 15

refers to the widening of blood vessels.[1] It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. In essence, the process is the opposite of vasoconstriction, which is the narrowing of blood vessels.

Question 16

Drug /Nutrient Interactions + possible mineral deficiencies related to medications

Answer 16

kjfalhafhaofh

Question 17

pro-inflammatory markers

Answer 17

C-reactive protein
 Interleukin-6
 Fibrinogen
 Erythrocyte sedimentation rate

Question 18

Explain the role of fiber in cardiovascular disease; know examples of soluble and
insoluble fiber

Answer 18

soluable fiber- oats , barley

insoluble fiber - cellulose

Question 19

How much sodium in a tsp of salt and sodium labeling requirements

Answer 19

1 tsp = 24000
legaldefnitions for the termslow sodium,moderatelylow sodium,andreducedsodium(Iable 32f.6).The dailyvaluefor sodium usedon the food label is set ar 2400 mg. Patientscan use the perc€nt daily value to determine whether a c€rtein food would fit into their dieury prescription.
LiteSalt(contains20Voto 50%lesssodium)canbecalcu- latedinto a mildly restricteddiet. However,it is important to note that LiteSalt containspotassium,a problem when patiens arealsogivenpotassium-sparindgiuretics

Question 20

What type of fiber and food sources reduces cholesterol

Answer 20

soluble and oats and barley

Question 21

Explain Metabolic syndrome and the characteristics

Answer 21

a clusterof metabolicdisorders,in-
cludingtype2diabetesmellitus,hlryertension, anddyslip-
idemia, that is characterizedby insulin resistanc

Question 22

What factors increase & decrease HDL & LDL

Answer 22

exercise decreases

dietary cholesterol increases

Question 23

tlc/ dash/aha

Answer 23

TLCdietarypattern-7 %kcalfromSFA . AHAdietarypattern-7%hkcalfromSFA . DASHdietarypattern
. Weighrteductioinf needed
. Increasedietaryfiberto 25-30gldayor more
. AddstanolasndsterolsQ-3 gldayi)nmultipledoses
. Addomega-f3ats . Addsoyprotein
. Addfruitsandvegatablefosrantioxidants . Reducdeietarycholesterol-<200mglday

Question 24

Calorie, protein, fluid recommendations

Answer 24

idk

Question 25

Signs and symptoms of heart failure

Answer 25

Fatigue, dyspnea, fluid retention

Question 26

Progression of heart failure

Answer 26

ClassI No undue symptoms associatedwith ordinary activity and no limiution of physical activity ClassII Slight limitation of physicalactivity; patient comforuble at rest Class III Marked limitation of physical activity; patient comforable at rest Chss fV Inability to carry out physical activity without discomfort; symptoms of cardiac insufficiency or chestpain at res The progression of HF is similar to that of atherosclerosis becausethere is an asymptomatic phasewhen damage is si- lendy occurring (stagesA and B). Eventually overuse of compensatory systems leads to fur- ther ventricle damage, remodeling, and appearance and then worsening of syrnptoms (stage C). d is heart failure

Question 27

Cardiac Cachexia

Answer 27

Cardiac cachexia is unintentional severe weight loss caused by heart disease. Even with a very good appetite and high calorie intake, some people with heart failure lose muscle mass.

Question 28

Nutritional and medical management of heart failure& CVD/CHD

Answer 28

``` MNT for heart failure Energy: in severe HF, energy needs are 31 to 35 kcal/kg  Fats: should include 1 g daily of omega-3 fatty acids  D-ribose  Mg  Thiamin  Vitamin D ```

Question 29

Medical interventions for heart disease

Answer 29

Percutaneous coronary intervention (PCI) |  Coronary artery bypass graft (CABG)

Question 30

cor pulmonale and tachypnea, hypercapnia, chronic bronchitis

Answer 30

cor pulmonale - a heartcondition characterizedby right ven- tricular enlargementand failure that resultsfrom resistance to the passageof blood through the lungs tachypnea-abnormal rapidity of respirationthagif prolonged, canleadto excesslossof CO2 and respiratory alkalosis hypercapnia - excessive carbon dioxide in the blood chronic bronchitis a chronic, productive cough with in- flammation of one or more of the bronchi and secondary changesin lung tissue

Question 31

Functions of the lungs

Answer 31

breating

Question 32

Change in energy needs, reasons for reduction in intake, and other limitations

Answer 32

``` Increased Energy Expenditure Increased work of breathing Chronic infection Medical treatments (e.g., bronchodilators, chest physical therapy) Reduced Intake Fluid restriction Shortness of breath Decreased oxygen saturation when eating Anorexia resulting from chronic disease Gastrointestinal distress and vomiting Additional Limitations Difficulty preparing food because of fatigue Lack of financial resources Impaired feeding skills (for infants and children) Altered metabolism ```

Question 33

MNT for Aspiration, Asthma, BPD & CLD, COPD, & respiratory failure

Answer 33

d

Question 34

asthma mnt

Answer 34

``` dOmega-3 and omega-6 fatty acids Antioxidant nutrients Magnesium Methylxanthines, such as caffeine Need for evidence-based research Effects of asthma medications on nutrition ```

Question 35

copd mnt

Answer 35

``` Energy Determine individual needs Macronutrients 1.2 to 1.7 g/kg protein Protein 15% to 20% kcal, fat 30% to 45% kcal, carbohydrate 40% to 55% kcal for satisfactory RQ Replete but do not overfeed Vitamins and minerals Individualize Vitamin C supplement for smokers, 16 to 32 mg/d Magnesium and phosphorus Sodium and fluid; potassium Feeding strategies Individualize, interdisciplinary team May need enteral feedings ```

Question 36

bpd mnt

Answer 36

In the acutephase, when infants are kept in controlled temperature environ- ments, are fed parenterally, remain relatively inactive, and arenot growing or aregrowing slowly,energyrequirements maybe50to 85kcal/kg daily.In contrast,during thecon- valescentphase,wheninfans aregrowingrapidly;beingfed orally; and using additional energy for temperature regula- tion, activity, and the work of breathing, they may require 120 to 130 kcal/kg or more daily.

Question 37

cld mnt

Answer 37

like bpd Infans with CLD and BPD have specialshort- and long- term nutritional requirements and careconsiderationsrelated to both their prematurity (seeChapter 43) and their pulmo- nary status.The general goals of nutrition care are to supply adequatenutrient intakes, promote linear growth, maintain fluid balance, and develop age-appropriate feeding skills. Meeting energy and nutrient needsis a major challengein the care of infants and toddlers with BPD

Question 38

respitory failure mnt

Answer 38

The goalsof nutrition carein patientswirh RF areto meet basic nutritional requirements,preseruelean body mass,restorerespiratorymusclemassandstrength,main- tainfuid balance,improveresistancetoinfection,andfa- cilitate weaning from oxygen supporr and mechanical ventilation by providing energysubsrrateswithout exceed- ing the capacityof the respiratorysystemto clearcarbon dioxidProtein is calculatedas 1.5 to 2 glkg of dry body weight. Nonprotein caloriesare evenlydividedbenreenfat andcarbohydrate.Daily moni- toring of eachpatient'sintake is crucia

Question 39

Lung cancer,

Answer 39

Prevention Smoking cessation Fruits and vegetables vs. beta carotene supplements Decrease alcohol Side effects of radiation therapy, chemotherapy, and surgery

Question 40

pneumonia

Answer 40

Infectious or aspiration Result is inflamed alveoli and fluid accumulation EFAs possibly protective Goals are to provide adequate fluids, energy, and protein; small, frequent meals may be better tolerated

Question 41

tb

Answer 41

May have high energy and fluid needs Give isoniazid 1 hour before or 2 hours after meals (food decreases absorption) Isoniazid depletes pyridoxine and interferes with vitamin D metabolism, which can decrease absorption of calcium and phosphorus

Question 42

``` Cystic Fibrosis (MNT, supplementation, ect.) *have additional needs for Na because of losses in the sweat ```

Answer 42

``` Enzyme therapy Individualize according to degree of pancreatic insufficiency and food consumed Distal intestinal obstruction syndrome (DIOS) Energy Individualize Macronutrients Protein: 15% to 20% of kcal Fat: 35% to 40% or more of kcal as tolerated Vitamins and minerals Fat-soluble vitamins Sodium; losses in sweat Feeding strategies Positive eating behaviors Regular and enjoyable mealtimes Strategies to boost energy intake Tube feeding ```

Question 43

What is RQ and how does nutrition impact it ?

Answer 43

(the ratio of CO2 expired to the vol- ume of 02 inspired)Excess sourcesof carbohydrate may abnormally increasethe respi- ratory quotient (R0)