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Medical Nutrition Therapy Flashcards

1
Q

What body shape is healthier: apple or pear? What’s the difference and why?

A

Pear shapes. Apple shapes store fat around the waist (problematic), while pear shapes store fat around the hips and buttocks.

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2
Q

What does leptin do, as a hormone?

A

think LEPTIN - LEOPARDS - as in you’ve eaten so much a leopard could eat it

it receives signals from fat and small intestine to make you stop and is appetite-suppressing*

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3
Q

What does ghrelin do, as a hormone?

A

It is a stomach hormone that signals the hypothalamus that it is TIME TO EAT!!!

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4
Q

What percent of the population has an eating pattern low in veggies and fruits?

A

75%

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5
Q

How have the obesity rates in male/female and ethnic groups changed?
What percent of obesity is the highest ethnic group(s)?

A

Female: stable
Male: increased
African American and Hispanic: increased, 40%

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6
Q

What are the two types of fat? Which is most associated with health risks? What health risks (name 4)?

A

Subcutaneous fat (directly under the skin) and visceral fat (stored within the abdominal cavity). Cardiovascular disease, type 2 diabetes, breast cancer, gallbladder disease

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7
Q

What is the formula for BMI calculation?

A

weight (in POUNDS) * 703 / height (in inches)^2

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8
Q

What are the BMI underweight, healthy weight, overweight, obese ranges?

A

<18.5
18.5 - 24.9
25 - 29.9
>30

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9
Q

What are some limits of BMI?

A

It may underestimate body fat in older people that have lost muscle.

It may overestimate body fat in athletic/younger people that have a muscular build.

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10
Q

What is obesity now being viewed as?

A

A chronic inflammatory disease

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11
Q

What are acceptable and fit body fat percentage ranges for women and men?

A

Women: 25-31% (acceptable), 21%-24%
Men: 18%-24%, 14%-17%

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12
Q

What are the four most common types of bariatric surgery in the US?

A

Adjustable gastric band
Roux-en-Y gastric bypass
Vertical Sleeve Gastrectomy
Biliopancreatic Diversion with a duodenal switch

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13
Q

What BMI indexes are bariatric surgery approved for?

A

BMI >= 40, BMI >= 35 with a serious health problem

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14
Q

What are the complication rates for bariatric surgery now?

A

15%

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15
Q

What is the diet-focus for patients who had bariatric surgery?

A

15%

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16
Q

What percent chance do overweight children have in becoming overweight adults?

A

70%

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17
Q

What percent chance do overweight children have in becoming overweight adults IF THEY HAVE AT LEAST PARENT THAT IS OVERWEIGHT/OBESE?

A

80%

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18
Q

What can cause a person to become overweight (5 reasons)?

A

hyperthyroidism, infection, malabsorption of nutrients, tissue wasting, cancer

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19
Q

What is considered a high-calorie diet?

A

low-bulk, low-fiber, high nutrient, high calorie

(NO RAW VEGGIES, NO SALADS, NO BROTH-BASED SOUPS, ULTRA-FIBER CEREALS)

(YES NUTS, SEEDS, AVOCADO, YOGURT, OLIVE OIL)

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20
Q

What is safe amount of weight loss per week? When is acceptable for more weight loss?

A

1-2 pounds/week
very obese adults can lose 1% of their weight per week

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21
Q

When are weight loss drugs prescribed?

A

BMI above 30, or BMI above 27 with associated disease

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22
Q

What does Orlistat do?

A

It is a lipase inhibitor that prevents absorption of fat into the body

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23
Q

What does Lorcaserin do?

A

acts of receptors in the brain to promote feelings of fullness, encouraging users to eat less

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24
Q

What does phentermine + topiramate do?

A

both decrease appetite and produce feelings of satiety, must be used with birth control in women to prevent child-bearing defects

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25
Q

What do bupropion + naltrexone do?

A

target the hypothalamus, which controls hunger, associated with suicidal thoughts

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26
Q

What might liraglutide do (warningggg)?

A

black box warning as animal studies showed thyroid tumors

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27
Q

What are the three requirements for bariatric surgery?

A

BMI > 40 (obese), adult height (13+ for girls, 15+ for boys), serious health problems linked to weight

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28
Q

What are the three obesity classes?

A

Class I: 30-34.9
Class 2: 35-39.9
Class 3: 40+

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29
Q

What are the disease risks (hypertension, diabetes, CVD) for men and women with a waist circumference < 40 in and < 35 in —- starting from overweight to Class 3 obesity?

A

Increased, high, very high, extremely high

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30
Q

What are the disease risks (hypertension, diabetes, CVD) for men and women with a waist circumference > 40 in and > 35 in —- starting from overweight to Class 3 obesity?

A

High, very high, very high, extremely high

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31
Q

How many calories must an underweight child eat to gain a pound?

A

500 extra calories

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32
Q

What is metabolic syndrome and what are symptoms associated with it (4)?

A

an abnormal ability to metabolize;
abnormal cholesterol, excessive body fat around waist, increased bp and sugar

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33
Q

How many people have diabetes in the US?

A

29 million

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34
Q

What happens when hyperglycemia (an abnormally high amount of glucose in the blood) exceeds the renal threshold?

A

Glycosuria (glucose excreted in the urine)

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35
Q

What is polyuria and polydipsia?

A

(excessive urine and thirst)

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36
Q

What is ketonemia and ketonuria?

A

Ketones collected in the blood, ketones in the urine

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37
Q

Clients with diabetes are more likely to suffer diseases of the ___ system?

A

vascular (circulatory)

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38
Q

What are some symptoms of diabetes (6 symptoms) ?

A

urinating often, feeling thirsty, blurry vision, fatigue, cuts slow to heal, weight loss, nausea, irritability, numbness in extremities

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39
Q

What occurs in 60-70% of clients with diabetes?

A

Neuropathy (damage to nervous system)

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40
Q

What is retinopathy?

A

Damage to small blood vessels in the eye, leading cause of blindness

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41
Q

What are the three requirements for pre-diabetes?

A

fasting glucose of 100 - 125 mg/dl, A1C of 5.7-6.4%, OGTT level of 140-199 mg/dl

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42
Q

Pre-diabetes testing should be considered in…?

A

all adults overweight (BMI > 25) or have additional risk factors

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43
Q

When does type 1 diabetes occur?

A

also called juvenile diabetes, immune system destroys beta cells of pancreas, develops in children & young adults (5%)

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44
Q

What outcome does the American Diabetes Association prefer A1C level to be reduced to?

A

<7%

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45
Q

Between what weeks does gestational diabetes occur? How is it diagnosed?

A

24-28. OGTT.

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46
Q

What chance do women who have gestational diabetes have of developing type 2 diabetes in the next 10-20 years?

A

35-60%

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47
Q

How much moderate-intensity physical activity should people with pre-diabetes do?

A

150 minutes

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48
Q

What type of diet is recommended for the pre-diabetic/diabetic?

A

Low carb, high fiber

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49
Q

What does a high-fiber diet mean?

A

25-35 g/day

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50
Q

How much sweeter than sugar is Sucralose? Why are people hesitant about it?

A

600 times. A study linked it to increased leukemia in mice.

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51
Q

What are the two amino acids in Aspartame. How much sweeter is it than sucrose? Why is it the least recommended?

A

phenylalanine, aspartic acid, 200 times, independent studies showing cancer in rats

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52
Q

How much sweeter is Saccharin than sugar? What did studies on rodents show?

A

350 times, bladder cancer

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53
Q

How much sweeter than sugar is Acesulfame-Potassium?

A

200 times

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54
Q

How much sweeter than sugar is Advantame, and is it viewed as safe? Why?

A

20,000 times
yes, because such small amounts are used in foods

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55
Q

What is exogenous insulin?

A

Insulin produced outside the body

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56
Q

What happens if diabetic clients do not eat the prescribed diet but take insulin?

A

A hypoglycemic episode, coma, maybe death

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57
Q

What are the three ways to get insulin for diabetic patients?

A

Insulin syringes, pumps, and pens

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58
Q

What is the most common type of insulin given to patients? Why is it preferred and better than the other option?

A

Human insulin (not from humans, but made in a laboratory). Very similar to pancreas insulin. Cow/pig insulin contain antibodies that make them less pure.

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59
Q

How are conscious clients that had an episode treated (2 ways)?

A

glucose tablets or beverage containing 15-20 g sugar

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60
Q

What is an oral diabetes medication? Who is it used for?

A

A hypoglycemic agent given orally for type 2 diabetic patients.

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61
Q

What percent of type 2 diabetic patients are overweight?

A

85%

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62
Q

What is the insulin problem in type 2 diabetes?

A

Too little insulin or insulin resistance

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63
Q

How do oral medications help improve blood sugar (3 ways)?

A

stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose

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64
Q

How do oral medications help improve blood sugar (3 ways)?

A

stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose

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65
Q

How do oral medications help improve blood sugar (3 ways)?

A

stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose

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66
Q

How does a myocardial infarction relate to CVD?

A

A sudden (acute) case of CVD is a myocardial infarction (heart attack).

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67
Q

Smokers have a _____ times more risk of dying from a heart attack than non-smokers.

A

2-4

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68
Q

Most heart attacks occur after the age of __.

If you are ___, you have a greater risk of coronary heart disease.

____s are more likely to have heart attacks than the rest.

A
  1. Male. African Americans.
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69
Q

What is the difference between compensated heart disease and decompensated heart disease?

A

If the heart compensates for the disease (by beating unusually fast to maintain blood circulation, heart enlarges) VERSUS can’t maintain circulation

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70
Q

What is the lining and outer covering of the heart called?

A

Lining: endocardium
Outside: pericardium

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71
Q

What is ischemia?

A

Reduced blood flow causing an inadequate supply of nutrients + oxygen to issues

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72
Q

What is another name for a stroke? What is a stroke?

A

Cerebrovascular accident. Lack of blood in the brain.

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73
Q

What are some risk factors for CVD?

A

Male sex, family history, age (45+ for men, 55+ for women), high stress, high bp, smoking, hyperlipidemia

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74
Q

What is the limit for mg cholesterol/day for adults?

A

200 mg

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75
Q

What is the fiber recommendation for men and women to prevent CVD?

A

38g for men, 25g for women

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76
Q

Congestive heart failure is an example of what type of heart disease?

A

Decompensated heart disease

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77
Q

What type of diet should be given to patients that had a heart attack?

A

low-fiber, low-cholesterol, low-sodium (liquid for first 24 hours)

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78
Q

What is prescribed to aid in the diet of someone with CHF? Why can these be dangerous?

A

Diuretics. Blood potassium can decline really quickly.

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79
Q

What is your cholesterol ratio? What is the goal to keep this ratio under?

A

total cholesterol/HDL, at or below 4 to 1

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80
Q

What is a blood lipid profile?

A

medical test that measures cholesterol, HDL, LDL, triglycerides in blood

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81
Q

What is blood serum? What is serum cholesterol, and how is different from dietary cholesterol?

A

watery portion of blood in which materials are suspended (including cholesterol = serum cholesterol). Dietary cholesterol is in foods.

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82
Q

What percent range of the adult population in the US does hypertension affect?

A

20-25%

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83
Q

In ___ percent of cases, the cause of hypertension is unknown. This is called ___ hypertension.

A

90%, essential

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84
Q

What are some examples of causes of secondary hypertension?

A

Kidney disease, adrenal gland problems, oral contraceptives

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85
Q

What is the “silent disease”?

A

Hypertension

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86
Q

What is the purpose of the DASH plan?

A

Reduce sodium, get 8-12 servings of fruits and veggies per day

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87
Q

What mineral lowers blood pressure?

A

Potassium

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88
Q

What mineral lowers blood pressure? How much potassium is recommended?

A

Potassium, 4.7 g (4700 mg)

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89
Q

What foods are okay and what foods are bad (9 okays, 6 not okays) in a sodium-restricted diet?

A

PERMITTED: fruit juices, fresh fruits and veggies, plain pasta or rice, fresh fish and unsalted meat, jams/jellies/honeys, coffee/tea, herbs and spices
NOT PERMITTED: canned veggies, dried/smoked meats, cheeses, ham/hot dogs, baking soda and baking powder

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90
Q

How would one treat angina pectoris (diet-wise)

A

by limiting saturated fats

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91
Q

What diseases would require a sodium-restricted diet?

A

Edema, hypertension, heart failure

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92
Q

What diseases would require a low-cholesterol or low-fat diet?

A

hyperlipidemia, atherosclerosis

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93
Q

A low fat-diet requires what to be taken off meat?

A

visible fat

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94
Q

What are polyunsaturated fats referred to?

A

Oils

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95
Q

What things (1 thing always, 4 things sometimes) are restricted for renal clients?

A

protein, sodium, water, potassium, phosphorus

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96
Q

How many nephrons are in a kidney?

A

1 million aprox.

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97
Q

What is a glomerulus?

A

The filtering unit in the kidney.

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98
Q

How is liquid waste sent through the urinary bladder?

A

2 ureters

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99
Q

What five waste products are end products of protein metabolism?

A

Urea, uric acid, creatinine, ammonia, sulfates

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100
Q

What is oliguria?

A

decreased output of urine to 500 mL per day

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101
Q

What are the five causes of kidney disorders?

A

infection, diabetes mellitus, cysts, renal stones, trauma

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102
Q

What is nephrosclerosis? What is it caused by and what age group is it most common in?

A

The hardening of the renal arteries. Arteriosclerosis and hypertension. Older people.

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103
Q

What is polycystic kidney disease? When does renal failure develop if untreated?

A

Rare, hereditary, cysts form on kidneys. Age 50.

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104
Q

What is nephrolithiasis and what are the 5 stone classifications?

A

Stones form in the kidneys. Calcium oxalate, uric acid, cystine, calcium phosphate, and magnesium ammonium phosphate (known as struvite).

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105
Q

Why is protein limited for those with renal disease?

A

To reduce the amount of excretory work demanded of kidneys and prevent uremia (too much urea in the blood)

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106
Q

Why is fluids and sodium limited for those with renal disease?

A

To prevent edema, hypertension, CHF.

107
Q

Why might phosphorus be limited for those with renal disease?

A

To prevent osteomalacia. Phosphorus is very well-absorbed in those with renal disease, so too much phosphorus and not enough calcium can cause bone problems.

108
Q

Why might potassium be restricted for those with renal disease?

A

Hyperkalemia (excess potassium) tends to occur in those with end-stage renal disease.

109
Q

What three vitamins (and 1 mineral) should be given to renal diseased patients and what should not?

A

B, C, D. A should not be given because level of A tends to be elevated during uremia. E and K are not necessary. Anemia frequently develops so iron is prescribed.

110
Q

What are the two types of dialysis? Which is more common.

A

Hemodialysis, peritoneal dialysis. Hemodialysis is more efficient and uses a machine that contains semipermeable membranes for cleansing. Peritoneal dialysis uses the client’s peritoneum as a semipermeable membrane.

111
Q

Do dialysis patients need additional protein?

A

Yes, 1.2 g/kg of body weight

112
Q

What percent of renal stones are calcium oxalate stones?

A

80%

113
Q

What are some purine-rich foods?

A

meats, fish, poultry (organ meats, anchovies, sardines, broths)

114
Q

What diet is prescribed for struvite stones?

A

Low-phosphorus

115
Q

What foods may contribute to calcium oxalate stones? What intake might decrease stones?

A

beets, wheat bran, chocolate, tea (lots of oxalate), spinach. Increased calcium intake.

116
Q

What is a typical prescribed renal diet?

A

80-3-3, 80g protein, 3g sodium, 3g of potassium a day

117
Q

What are the 5 primary organs in the GI system? What are the 3 accessory organs in the GI system?

A

mouth, esophagus, stomach, SI, LI.

liver, gallbladder, pancreas

118
Q

What is dyspepsia and what are the symptoms?

A

Indigestion - heartburn, bloating, pain

119
Q

What is esophagitis caused by? What are some common symptoms?

A

causes: acute gastroesophageal reflux disease
symptoms: heartburn, regurgitation, dysphagia

120
Q

What is hiatal hernia and how can the symptoms be alleviated?

A

A condition in which part of the stomach protrudes through the diaphragm into the thoracic cavity.

Small, frequent meals. Avoid irritants to the esophagus (carbonated beverages, chocolate, citrus fruit, spicy foods, coffee). Avoid late-night dinner. Lie down for 2-3 hours after eating.

121
Q

What are ulcers? Where might they occur? How are they developed? How are they treated?

A

erosion of the mucosal membrane, gastric (stomach) or duodenal (duodenum)

Developed by helicobacter pylori, genetic predisposition, excessive use of aspirin/ibuprofen, stress.

Antibiotics (kill bacteria), cimetidine (inhibits acid secretion)

122
Q

What is diverticulosis? What is diverticulitis? What is the cause? What diet is recommended?

A

intestinal disorder with pockets in the side of the LI
inflammation in the pockets caused by bacteria and fecal matter
high-diet fiber (this occurs when diet is too low in fiber)

123
Q

What is the diet therapy for diverticulitis?

A

clear-liquid, low-residue diet to allow bowel to rest and heal
THEN, high-fiber diet

124
Q

What is irritable bowel syndrome? What foods aggravate symptoms?

A

cramping, bloating as the GI doesn’t function properly
foods high in fat, milk products, beans/cabbages (gas-producing foods), drinks with alcohol and caffeine

125
Q

What would a low FODMAP diet restrict (think sugars poorly absorbed in the SI and ferment in the colon)?

A

honey, corn syrup, fruits with pits and seeds, milk, wheat, onion, garlic

126
Q

What does ulcerative colitis? What is Crohn’s disease?

A

inflammation and ulceration of the colon
autoimmune disease that can penetrate both SI and LI

CROHN’S DISEASE HAS ULCERS IN COBBLESTONED PATCHES

127
Q

What do clients with UC or C’s need to do to defecate?

A

a surgical opening in the abdominal wall (called a stoma) about the size of a nickel.

128
Q

What is an ileostomy and a colostomy?

A

opening from ileum to abdomen surface
open from colon to abdomen surface

129
Q

What syndrome may result if clients have surgical removal of SI?

A

Short Bowel Syndrome - patient lacks sufficient bowel length/function to support nutrient needs

130
Q

Clients with ileostomies….

A

need more salt and water because of excess losses, vitamin C and B12 supplement/injection

131
Q

What is celiac disease? What are two other names? What three grains have gluten?

A

Gluten-sensitive enteropathy or sprue. Gluten is found in wheat, barley or rye.

132
Q

What fraction of people carry the genes necessary for celiac disease?

A

1/3 of all people

133
Q

What percent of the population test negative for celiac disease but have some degree of gluten sensitivity?

A

6%

134
Q

What grains should be avoided and what should not?

A

Barley, rye, wheat, spelt, triticale

Rice, wild rice, millet, corn, soy

135
Q

What are the functions of the liver?

A

metabolism, most nutrients that are absorbed return to the liver
synthesizes cholesterol
stores iron, copper, zinc, magnesium and fat-soluble vitamins, turn simple sugars to glycogen

136
Q

What is cirrhosis and what are some causes?

A

Liver disease characterized by cell loss (usually caused by alcohol abuse, congenital defects, infections). Fibrosis (hard, stringy tissue) often develops. Ascites (abnormal collection of fluid in abdomen may occur).

137
Q

What is ascites?

A

Abnormal collection of fluid in the abdomen

138
Q

What is hepatitis? What are some cause? What might result? What are the three types?

A

inflammation of the liver - caused by viruses, drugs, alcohol
necrosis (death of cell tissue) may result

hepatitis A - contaminated drinking water, sewage (fecal-oral route)
hepatitis B/C - blood, semen, blood products

139
Q

What is cholecystitis and cholelithiasis? What forms the gallstones?

A

inflammation of gallbladder
inflammation of gallstones

cholesterol that hardens due to cholecystitis causing changes in tissue

140
Q

What diets treat cholelithiasis?

A

clear-liquid diet followed by fat-restricted diet

141
Q

What is pancreatitis? What are some symptoms?

A

inflammation of the pancreas
abdominal pain, nausea, steatorrhea (too much fat in the feces)

142
Q

What is a high-fiber diet and what does it prevent?

A

30g or more of dietary fiber
prevents diverticulosis, constipation, hemorrhoids, colon cancer

143
Q

What are the recommended foods for a high-fiber diet?

A

whole-grain breads and cereals, all fruits, veggies, legumes — MEAT, MILK, FATS HAVE NO FIBER

144
Q

What should be consumed along with the fiber in a high-fiber diet?

A

Eight 8oz glasses of water

145
Q

What is the low-residue diet? What are foods eaten/not eaten?

A

5-10 g of dietary fiber in cases of severe diarrhea, diverticulosis, ulcerative colitis, intestinal blockage

milk, buttermilk, butter, soup broth, applesauce, canned fruits, REFINED breads/cereals, custard, lettuce, salt, sugar, few spices

146
Q

What is the difference between food intoxication and foodborne infection?

A

foodborne infection: pathogens
food intoxication: toxins (from pathogens)

147
Q

What is the difference between enterotoxins and neurotoxins?

A

Enterotoxins: mucous membranes in the digestive tract
Neurotoxins: nervous system

148
Q

One in ___ Americans experience food poisoning every year.

A

6

149
Q

What bacteria is thought to be one of the most prevalent causes of diarrhea? Where is it most commonly found? What are the symptoms?

A

Campylobacter jejuni
intestinal tracts of pigs, cattle, sheep
diarrhea, fever, headache, abdominal pain

150
Q

What foods are campylobacter jejuni associated with?

A

contaminated water, raw/unpasteurized milk, raw/undercooked meat, poultry or shellfish

151
Q

What foods are clostridium botulinum associated with?

A

improperly canned foods, garlic in oil, vacuum packed and tightly wrapped food

152
Q

What are some symptoms of botulism?

A

As the rarest but most deadly, double vision, speech difficulty, paralysis occurs.

153
Q

How can one ensure foods have no botulism spores?

A

Boiling foods for 6 hours to destroy spores (and home canned goods for 10 minutes)

154
Q

What percent of all botulism cases are fatal?

A

5-10%

155
Q

What is clostridium perfringens? What are the symptoms? How to prevent it?

A

cafeteria/buffet germ
nausea, diarrhea, inflammation
hot foods > 140F and cold foods <40F
leftovers heated to 165*F

156
Q

What is cryptosporidium? What is the most common symptom? How is it found?

A

A parasite. Watery diarrhea. Contaminated water, soil from infected stools of animals/humans.

157
Q

How is E.coli transmitted?
What are the symptoms?
What can result from this in children?

A

contaminated water, unpasteurized milk/apple juice, raw or rare ground beef

severe abdominal cramps, diarrhea, nausea
hemolytic uremic syndrome (HUS)

158
Q

Where is listeria monocytogenes found? What are symptoms? What can it develop into?

A

leafy vegetables, intestines
fatigue, fever, chills, diarrhea, backache
spontaneous abortion, meningitis

159
Q

Where can salmonella be found? How is it transmitted? One species of salmonella causes what?

A

raw eggs, poultry, meat, unpasteurized milk, cheese, seafood

eating contaminated food or contact with a carrier

typhoid fever

160
Q

How is shigella usually passed on by?

A

an infected food handler who did not practice proper hand washing after using the toilet

161
Q

Where on the human body is staphylococcus aureus found? Where is it found? What are the symptoms?

A

found on human skin, infected cuts, pimples, nose, throats

meats, poultry, fish, egg dishes

vomiting, diarrhea, abdominal cramps

162
Q

What toxin do molds produce that can causes cancer? Where does it develop? What are some symptoms?

A

aflatoxin
spoiled peanuts and peanut butter, soybeans, grains, rice

163
Q

How is trichinella spiralis transmitted?

A

Eating badly cooked beef or pork

164
Q

What is dysentery caused by? What is it?

A

Protozoa. Severe diarrhea

165
Q

How should one handle and store food to minimize nutrient losses (5)?

A

keep freezer temps below 0, avoid thawing, stored canned foods in a cool/dry area, store milk in opaque containers, store veggies in a crisper

166
Q

What is the primary treatment for most foodborne illnesses?

A

replacing lost fluids and electrolytes to prevent dehydration

167
Q

What is constipation?

A

occurs when chyme moves very slowly through the large intestine, too much water becomes reabsorbed, feces becomes hard

168
Q

Should anti-diarrheal medications be used for patients with bloody diarrhea?

A

NO (loperamide, bismuth)

169
Q

What are 8 typical signs of allergies?

A

hay fever, urticaria (hives), edema, headache, dermatitis, nausea, dizziness, asthma

170
Q

What foods are most likely to cause anaphylaxis?

A

peanuts, tree nuts, seafood, shellfish

171
Q

What is a food intolerance called?

A

A nonallergenic food hyperinsensitivity

172
Q

What are the three most common food intolerances?

A

lactose (milk) gluten (celiac disease) histamine/tyramine (AGED CHEESE, processed meats, wine)

173
Q

What is a fomite?

A

an OBJECT (doorknob, etc) that is contaminated with bactera/viruses and serves in transmission

174
Q

How do most food poisonings occur?

A

Inappropriate handling/processing of food from people in commercial factories

175
Q

What should leftover foods be done with?

A

refrigerated as SOON AS meals are done and covered when it is cold

NO COOLING TO ROOM TEMP

176
Q

The FDA is in charge with all foods except….

A

meat, poultry and eggs

177
Q

What should you never do to frozen meat?

A

Thaw under room temp.

Instead, defrost them in the fridge or place them under cool running water.

178
Q

Using a bleach solution of ___ will help eliminate bacteria?

A

bleach solution of 3/4 teaspoon to a quart of the water

179
Q

What should be done with frozen foods?

A

cooked from frozen state or thawed in the refrigerator

180
Q

What are the top eight allergens?

A

Milk, wheat, eggs, tree nuts, peanuts, soybeans, fish, shellfish

181
Q

What is the simplest treatment for allergies ?

A

Remove the allergen from diet.

182
Q

What is the point of an elimination diet?

A

To pinpoint the allergies

183
Q

Why is PEM so bad for hospitalized clients? What are the symptoms?

A

delay wound healing, contribute to anemia, depress the immune system

weight loss and dry, pale skin

184
Q

What is the term for when malnutrition occurs as a result of hospitalization?

A

iatrogenic malnutrition

185
Q

Before surgery, what 8 nutrients should be given to patients?

5 vitamins, 1 mineral, 2 groups

A

Extra protein for wound healing, extra carbs for energy (glycogen), B (increased metabolism), A/C/Zinc (for wound healing), D (for calcium absorption), K (for blood clotting)

186
Q

What is the amount of calories per kg of body weight for adults after surgery?

A

35-45 calories

187
Q

What syndrome might happen 15-30 minutes after gastric surgery?

A

Dumping syndrome (dizziness, weakness, cramps, vomiting, diarrhea)

188
Q

What does enteral nutrition mean?

A

Bringing nutrients directly into the digestive tract

189
Q

What is tube feeding and when is it used?

A

Feeding by tube directly into stomach or intestine via vein, if client can’t take food by MOUTH but has a functioning GI

190
Q

What happens if the client cannot have enteral nutrition through a nasogastric tube (through nose)?

A

gastrostomy or jejunostomy (holes directly into stomach or jejunum)

191
Q

What is the difference between polymeric and (elemental/hydrolyzed) formulas?

A

Polymeric: contains intact proteins, carbs, fats
Elemental/Hydrolyzed: products of digestion of these nutrients

192
Q

When is parenteral nutrition used?

A

If the GI system isn’t functional

193
Q

How are nutrient solutions in TPN administered for less than two weeks and more than two weeks?

A

Less: peripheral
More: central

194
Q

Where is TPN inserted into? Why?

A

A subclavian vein or vena cava. To dilate the solution, reducing the chance of thrombosis or phlebitis.

195
Q

Where is TPN inserted into? Why?

A

A subclavian vein or vena cava. To dilate the solution, reducing the chance of thrombosis (blood clot) or phlebitis (vein inflammation).

196
Q

What is a possible complication of TPN?

A

Sepsis (infection at site of catheter).

197
Q

For patients with burns, what is given immediately and what is not?

A

Immediately: fluids and electrolytes to prevent shock, protein (for adults - 1.5-2g/kg body weight, children -2.5-3g)
Not Immediately: glucose to avoid hyperglycemia (first three days)

198
Q

What diet is given for patients with burns?

A

high-protein, high-calore

199
Q

What 3 vitamins and 1 mineral, and 2 amino acids are given to patients with burns?

A

C and zinc for wound healing, B for metabolism, A for immune system, amino acids arginine for wound healing and glutamine to prevent bacterial infection

200
Q

Every degree of fever (in F) raises the BMR by ___ percent.

A

7

201
Q

What intake should be increased for clients with a fever and why?

A

Protein, infections.

202
Q

High doses of antibiotics can lead to….

A

oral thrush (caused by yeast).

203
Q

What is an opportunistic infection?

A

Microorganisms that are usually harmless to humans with HEALTHY IMMUNE SYSTEMS cause infections

204
Q

What are some AIDS symptoms? What syndrome may AIDS patients experience?

A

headache, fatigue, night sweats, diarrhea, cough, fevers

PEM/body wasting (referred to as HIV wasting syndrome), hypoalbuminemia (low protein)

205
Q

How should one feed a blind client?

A

Arrange the food as if the plate were a clock.

206
Q

What may occur in bedridden clients? How to treat this?

A

Pressure ulcers. High-calorie diet with protein, C/zinc supplements.

207
Q

During trauma, there is a ____ response in the body…

A

hypermetabolic

208
Q

How should one help a client who requires feeding assistance?

A

small amounts of food placed on the back of mouth with slight pressure on tongue with spoon/fork

209
Q

Dysphagia means ____? What can it result from? What should the diet look like? How should they eat?

A

Difficulty swallowing. Stroke, closed head trauma, Alzheimer’s. Liquids, pureed foods (NO STRAWS). Should eat in an upright position to prevent aspiration.

210
Q

What are crash diets?

A

weight-loss diets that provide less than 1200 calories

211
Q

What is weight-cycling?

A

pattern of repeatedly losing and gaining weight over time, also called yo-yo syndrome

212
Q

What is the percent range for calories coming from carbs for athletes?

A

60-65%

213
Q

How many milligrams of calcium per day do teen girls need?

A

1300

214
Q

What is a good pre-sport diet plan?

A

high-carb meal 3-4 hours before competition, bread/rice cakes/potatoes/juice

215
Q

What small snacks during a long sports even can help improve performance?

A

peanut butter crackers, fig bars, date snacks

216
Q

How many pounds of water can athletes lose at an event? How much water should they drink?

A

4-6 pounds

500-600 mL before event, 200-300 mL every 10-20 min during an event, 600-700 mL for every one pound lost through sweat

217
Q

What is appropriate body fat percentages for male and female athletes?

A

10-15% body fat male

18-24% body fat female – most females stop menstruating at 17% or below

218
Q

How many calories does a teen male and female athlete need a day?

A

3000 and 2200 calories daily

219
Q

What is Maslow’s Hierarchy?

A

five basic levels, lower needs should be met before higher

220
Q

What is self-actualization?

A

reaching full potential

221
Q

What are some physical responses to stress?

A

pituitary responses hormones, eyes widen, pupils dilate, muscles tense and hearing sharpens

222
Q

What are ergogenic acids?

A

substances used to enhance strength and substance

223
Q

What are two examples of drugs interfering with other things?

A

laxatives can reduce the absorption of fat-soluble vitamins

antacids can affect the absorption of iron

224
Q

What are amphetamines?

A

stimulants

225
Q

What are two groups of depressants?

A

barbiturates and tranquilizers

226
Q

What is the chief-altering ingredient in Marijuana?

A

THC

227
Q

What can LSD cause?

A

flashbacks

228
Q

What is alcohol?

A

a depressant

229
Q

What are anabolic steroids?

A

artificial hormones used to build a more muscular body

230
Q

What are some negative effects of anabolic steroids?

A

Females: deeper voice, facial hair growth, infertility

Males: enlarged breasts, decreased testicle size and sperm count

231
Q

What is the difference between pasteurization and ultrapasteurization?

A

ultra is higher temp, shorter time (2 seconds compared to 15)

both can affect food flavor and destroy heat-sensitive nutrients

232
Q

What is food irradiation?

A

exposing foods to ionizing/radiant energy

233
Q

What three diseases/disorders have been linked to foodborne illness?

A

spontaneous abortions, kidney failure, arthritis

234
Q

What are the 3 most common symptoms of foodborne illness?

A

vomiting, stomach cramps, diarrhea

235
Q

What is the Supplemental Nutrition Assistance Program?

A

food stamp program

236
Q

How is fat absorbed in the GI?

A

absorbed in a bile complex package called a MICELLE and then travels through the lymph

237
Q

What is flatus?

A

intestinal gas caused by secretions of colonic bacteria (CO2, methane, H2)

238
Q

Why are sugar alcohols kind of weird?

A

they do not form dental caries (sorbitols, mannitols, etcera)

239
Q

Lack of glycogen can cause….

A

ketoacidosis

240
Q

What is the length range of an oligosaccharide?

A

3-10 glucose units

241
Q

What is the ONLY DIETARY FIBER that is not a carbohydrate?

A

Lignin

242
Q

How many conditionally dispensable essential amino acids are there?

A

6 (can’t be synthesized in enough amounts)

243
Q

How many dispensable nonessential amino acids are there?

A

5 (fully synthesized in body)

244
Q

Where is most fat in the body? What are fat cells called? How much (%) is needed for men and women?

A

subcutaneous (directly under skin)
adipocytes
3% for men, 12% for women

245
Q

What are the four categories of disorders that LEAD to weight-related problems?

A

anatomic, metabolic, neoplastic (tumors), degenerative

246
Q

What bacteria is a major cause after surgery?

A

listeria monocytogenes (gram-positive rod bacteria)

247
Q

What is the difference between food poisoning and food infection?

A

poisoning - eating food with lots of bacteria
infection - toxins in bacteria before food was eaten

248
Q

What virus type is responsible for more than 1/2 of all gastro-enteritic cases?

A

noroviruses (NO CURE, FRUITS/VEGGIES/SHELLFISH)

249
Q

What is a fetus scientifically?

A

offspring from 7-8 weeks after gestation to birth

250
Q

What is infertility scientifically?

A

trying to conceive after 12 months with no birth control with FAILURE

251
Q

What is the most common outcome of gestational diabetes for the infant?

A

macrosomia (larger than average body size), jaundice

252
Q

What is sarcopenia?

A

loss of muscle mass due to aging (usually for 40 years and above)

253
Q

What is the difference between primary and secondary amenorrhea?

A

primary is delay of FIRST PERIOD after 16, secondary is stopping of period after first period

254
Q

What is a menarche?

A

first period

255
Q

How many appetite-suppressing medications are approved by the FBI?

A

6

256
Q

Before surgery, how should nutrition be provided? How much carbs should be given?

A

enterally, 150 g/day

257
Q

What are some indications for parenteral (veinous) nutrition?

A

obstructions to intestinal tract, persistent diarrhea

258
Q

What is anastomosis?

A

surgical joining of two ducts to allow flow from one to another

259
Q

What is a vagotomy and what is its purpose?

A

cutting parts of the vagus nerves (which secrete gastric acids) to control gastric ulcers

260
Q

What is paresthesia?

A

strange sensations like skin crawling or prickling

261
Q

What can cruciferous veggies inadvertently cause?

A

the compounds in veggies like cauliflower, broccoli — called INDOLES – can cause increases in drug metabolism

262
Q

What is pyrosis?

A

medical term for heartburn

263
Q

What are the four names for types of strokes?

A

coronary thrombosis (blood clot develops in blood vessel)
coronary embolism (piece of clot or other substance get stuck in blood vessel and cause clot)
subarachnoid hemorrhage (on surface)
cerebral hemorrhage (in brain)

264
Q

What is hypercapnia?

A

excess carbon dioxide in the blood

nt (3 decks)

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