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SURGERY > M1: Metabolic & Nutritional Support > Flashcards

M1: Metabolic & Nutritional Support Flashcards

0
Q

PN in ICU: Should be administered as a complete all-in-one bag

A

Parenteral Nutrition Admixtures

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1
Q

PN in ICU: Patients should be fed because this is associated with increased morbidity & mortality among ICU patients

A

Starvation/Undernutrition

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2
Q

PN in ICU: ESPN Guidelines on Parenteral Nutrition (Intensive Care) in Acute Illness, aims to provide energy as close as possible to the measured energy expenditure to decrease

A

Negative energy balance

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3
Q

PN in ICU: In the absence of Indirect Calorimetry, ICU patients should receive _________ increasing to target over the next ________.

A

25kcal/kg/day. 2-3 days.

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4
Q

PN in ICU: All patients receiving less than their targeted enteral feeding after 2 days should be considered for

A

Supplementary Parenteral Nutrition

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5
Q

PN in ICU: The minimal amount of carbohydrate required is about

A

2g/kg of glucose per day

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6
Q

PN in ICU: contributes to death in the critically ill patient and should also be avoided to prevent infectious complications.

A

Hyperglycemia

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7
Q

PN in ICU: should be an integral part of Parenteral Nutrition for energy and to ensure essential fatty acid provision in long term ICU patients.

A

Lipid Emulsions

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8
Q

PN in ICU: A balanced amino acid mixture should be infused at approximately ____________ ideal body weight per day in conjunction with an adequate energy supply.

A

1.3-1.5 g/kg

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9
Q

PN in ICU: When Parenteral Nutrition is indicated in ICU patients the amino acid solution should contain _________________.

A

0.4/kg/day of L-glutamine

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10
Q

PN in ICU: All Parenteral Nutrition prescriptions should indicate a daily dose of

A

Multivitamins & of trace elements

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11
Q

EN & PN in Surgical Px: Either by standard oral intake or direct stomach or small intestine administration. Maintains gut integrity and reduces complications. Initiated in hemodynamically stable patients. Not affected by absence or presence of bowel sound and flatus.

A

Enteral Nutrition

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12
Q

EN & PN in Surgical Px: Enteral Nutrition should be started early within the first _________ following admission.

A

24-72hrs

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13
Q

Allows nutrient provision when the GI tract is no longer capable for utilization. Initiated only when EN is not feasible and if there is history of ____________.

A

Parenteral Nutrition. Protein-Calorie Malnutrition.

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14
Q

EN & PN in Surgical Px: Parenteral nutrition is usually via the

A

Superior Vena Cava

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15
Q

EN & PN in Surgical Px: Parenteral nutrition is given ________ preoperatively and continued postoperatively.

A

5-7 days

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16
Q

EN & PN in Surgical Px: Parenteral nutrition should not be initiated in the

A

Immediate postoperative period

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17
Q

EN & PN in Surgical Px: PN suggested dose of goal calories

A

> 50% to 65%

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18
Q

EN & PN in Surgical Px: must be assessed and reduced

A

Aspirations

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19
Q

EN & PN in Surgical Px: may be added to enhance the effect. Such as arginine, omega-3 FA and antioxidants like glutamine, selenium, Vitamin C & D.

A

Pharmaconutrients

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20
Q

EN & PN in Surgical Px: should be utilized to inhibit bacterial growth and aid in toxin elimination, thus, to reduce inflammation.

A

Probiotics

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21
Q

Arg & Glu: Arginine is a precursor of __________ which is a vasodilator. Useful in treatment of medical condition that are improved by vasodilation.

A

Nitric oxide

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22
Q

Arg & Glu: Arginine is required for generation of ________. Removal of toxic ammonia in the body.

A

Urea

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23
Q

Arg & Glu: Stimulates _________ synthesis. Promotes wound healing & body building.

A

Protein

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24
Q

Arg & Glu: Substrate for protein synthesis. Respiratory fuel for cells of immune system and GI system.

A

Glutamine

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25
Q

Arg & Glu: Glutamine blunts inflammatory response by increasing availability of

A

Glutathione

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26
Q

Arg & Glu: Glutamine helps increase arginine levels in human by intestinal conversion of glutamine which leads to the release of ________ from the gut, which after uptake from the bloodstream is converted by the kidneys to _______.

A

Citrulline. Arginine.

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27
Q

O3 FA Post-Op: Polyunsaturated fats that belong under the category of essential fatty acids.

A

Omega 3 FA

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28
Q

O3 FA Post-Op: Three classes of Omega-3

A

Eicosapentaenoic acid(EPA), Docosahexanoic acid(DHA) & Alpha-Linolenic acid(ALA) “EDA”

29
Q

O3 FA Post-Op: Omega 3 FA may have a favorable effect on patients following _____________. Regulating the immune response & the magnitude of inflammatory response.

A

Surgical Gastric Resection

30
Q

O3 FA Post-Op: Omega-3 FA increases the non inflammatory eicosane and thereby reducing the inflammatory eicosane production by competitive inhibition of the _______________ pathway.

A

Arachidonic acid synthesis

31
Q

O3 FA Post-Op: Omega 3 FA increases __________ which in turn lessens the incidence of Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction Syndrome.

A

Anti-inflammatory cytokines

32
Q

O3 FA Post-Op: Omega-3 FA lowers the amount of hepatic damage due to an increase in __________. It also decreases the release of __________ & __________.

A

Liver blood perfusion. Prostaglandin & Leukotrienes.

33
Q

Recommended Micronutrient: Need to have the highest amount of Calcium(1000) , Zinc(10), Phosphorus(1000) & Vitamin A(700).

A

European Male & Female

34
Q

Recommended Micronutrient: Need to have the highest amount Iron(27).

A

Female Filipino

35
Q

Recommended Micronutrient: Need to have the highest amount Vitamin C(75).

A

Female Filipino & Male American

36
Q

Recommended Micronutrient: Need to have the highest amount Magnesium(330).

A

Male American

37
Q

Recommended Micronutrient: Needs least amount of Calcium(750).

A

Male & Female Filipino

38
Q

Recommended Micronutrient: Needs least amount of Iron(6).

A

Male American

39
Q

Recommended Micronutrient: Needs least amount of Zinc(4.5).

A

Female Filipino

40
Q

Recommended Micronutrient: Needs least amount of Phosphorus(580).

A

Male & Female American

41
Q

Recommended Micronutrient: Needs least amount of Vitamin A(500).

A

Female Filipino & American

42
Q

Recommended Micronutrient: Needs least amount of Vitamin C(60).

A

Female & Male European and Female American

43
Q

Recommended Micronutrient: Needs least amount of Magnesium(205).

A

Female Filipino

44
Q

Recommended Micronutrient: True/False. Hospitalized Individuals need more micronutrient intake.

A

True

45
Q

Recommended Micronutrient: There is _______ of all micronutrient requirements for hospitalized patients compared to healthy individuals.

A

Increase

46
Q

Recommended Micronutrient: Dietary requirements vary among different ______. There is a higher need of nutrition for ________.

A

Race. Hospitalized patients.

47
Q

Guidelines for PN in Surgery: is indicated in severely undernourished patients who cannot be adequately orally or enterally fed.

A

Preoperative PN

48
Q

Guidelines for PN in Surgery: is beneficial in undernourished patients in whom enteral nutrition is not feasible or not tolerated. Patients who require postoperative artificial.

A

Postoperative PN

49
Q

Guidelines for PN in Surgery: Commonly used formula of _________ ideal body weight furnishes an approximate estimate of daily energy expenditure and requirements.

A

25kcal/kg

50
Q

Guidelines for PN in Surgery: Under conditions of severe stress, requirements may approach to ________ ideal body weight.

A

30kcal/kg

51
Q

Guidelines for PN in Surgery: Illness/Stressed conditions, a daily nitrogen daily equivalent to a protein intake of ________ ideal body weight is generally effective to limit __________.

A

1.5g/kg. Nitrogen loss.

52
Q

Guidelines for PN in Surgery: Caloric ratio for Protein

A

20%

53
Q

Guidelines for PN in Surgery: Caloric ratio for Fat

A

30%

54
Q

Guidelines for PN in Surgery: Caloric ratio for Glucose

A

50%

55
Q

Guidelines for PN in Surgery: At present, there is a tendency to increase the Glucose:Fat calorie ration from _______ to _______ or even _______ of the non protein calories.

A

50:50. 60:40. 70:30.

56
Q

Human Gut Microbiome: Aids in

A

Digestion

57
Q

Human Gut Microbiome: Internal

A

Shield

58
Q

Human Gut Microbiome: Help ______ valuable nutrients.

A

Circulate

59
Q

Human Gut Microbiome: Assist us to keep our _______ down.

A

Cholesterol

60
Q

Human Gut Microbiome: Play a role in metabolism of

A

Xenobiotics & Antibiotics

61
Q

Human Gut Microbiome: potential novel contributors to the increased prevalence of obesity, metabolic syndrome & DM.

A

Intestinal Microbiota

62
Q

Human Gut Microbiome: shape the physiology of the human gut microbiome

A

Xenobiotics

63
Q

Human Gut Microbiome: Is a lifestyle disease, determined by the interplay of genetic and environmental factors.

A

Metabolic syndrome

64
Q

Human Gut Microbiome: is a significant risk factor for development of the metabolic syndrome.

A

Obesity

65
Q

Human Gut Microbiome: Prevalence of obesity is increasing due to changes in

A

Lifestyle & Diet

66
Q

Human Gut Microbiome: has emerged as an important contributor to the development of obesity and metabolic disorder through its interaction with environmental and genetic factors.

A

Gut microbiota

67
Q

Human Gut Microbiome: Human and Animal studies have shown alterations in the gut microbiome towards increased energy harvest are associated with an __________.

A

Obese phenotype

68
Q

Impt of Lean Body mass: Normal anatomic landmarks are easily ________.

A

Visualized

69
Q

Impt of Lean Body mass: Lowers risk of complications such as ________ & ________ during operation.

A

Increase blood loss & Risk of transfusion

70
Q

Impt of Lean Body mass: Decrease incidence of __________ & _________.

A

Superficial wound infection & DVT.

71
Q

Impt of Lean Body mass: Avoid complications of ________ that result to increased ________, development of ________ and decreased in respiratory muscle _______ & ________. Lesser time for recovery.

A

Malnutrition. Mortality. Pressure ulcers. Strength & Vital capacity.

SURGERY (3 decks)

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