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Domain 2: Nutrition Care for Individuals and Groups > Medical Nutrition Therapy - H. Anemia (p. 23), I. Allergies (p. 23-24), J. Fever and Infection (p. 24), K. Inflicted Trauma (p. 24), L. Neoplastic Disease (p. 25), M. Weight Management (p. 25 > Flashcards

Medical Nutrition Therapy - H. Anemia (p. 23), I. Allergies (p. 23-24), J. Fever and Infection (p. 24), K. Inflicted Trauma (p. 24), L. Neoplastic Disease (p. 25), M. Weight Management (p. 25 Flashcards

1
Q

<p>A decrease in total red cell mass - due to FEWER RBCs or SMALLER RBCs with less hemoglobin.</p>

A

<p>Anemia</p>

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2
Q

<p>\_\_\_\_\_\_\_, \_\_\_\_\_ anemia: Small, pale (less HGB) red blood cells. Due to IRON deficiency.</p>

A

<p>Microcytic (small), hypochromic (pale)</p>

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3
Q

<p>\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_ anemia: Few, large cells, filled with HGB (dark red color). Due to FOLATE or B12 deficiency. </p>

A

<p>Macrocytic, megaloblastic</p>

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4
Q

<p>A type of megaloblastic anemia caused by vitamin B12 deficiency - impaired absorption of B-12 because of a lack of intrinsic factor (IF).</p>

A

<p>Pernicious anemia</p>

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5
Q

<p>In microcytic anemia, the MCV (mean corpuscular volume) is \_\_\_\_\_\_, indicating small cell size.

In macrocytic anemia, the MCV is \_\_\_\_\_\_\_, indicating large cells.</p>

A

<p>Microcytic anemia, MCV is low (95).

*NORMAL MCV: 80-95 fL*</p>

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6
Q

<p>In microcytic anemia, the MCH (mean corpuscular hemoglobin) is \_\_\_\_\_\_\_, indicating pale cells with little hemoblogin.

Macroyctic anemia, the MCH is \_\_\_\_\_\_\_\_, indicating dark, red cells filled with hemoglobin.</p>

A

<p>Microcytic anemia, MCH is low (32).

*NORMAL MCH: 27-32 pg*</p>

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7
Q

<p>Foods high in iron include:</p>

A

<p>Foods high in iron:

Liver, kidney, beef, dried fruits, dried peas and beans, nuts, leafy green vegetables, fortified whole grains</p>

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8
Q

<p>The Ag-Ab reaction is when an \_\_\_\_\_\_\_ enters the body, an \_\_\_\_\_\_\_ reacts. This is a natural, protectie mechanism against foreign substances (pollen, flowers).</p>

A

<p>Antigen, Antibody</p>

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9
Q

<p>Immunoglobulin E (IgE) mediated reaction is a reaction to a normally \_\_\_\_\_\_\_ food \_\_\_\_\_\_.</p>

A

<p>Immunoglobulin E (IgE) mediated reaction is a reaction to a normally harmless food protein.</p>

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10
Q

<p>*The most common allergens include:

</p>

A

<p>*
Peanuts
Egg
Milk
Soy
Wheat
Shellfish</p>

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11
Q

<p>Cow's milk protein is the single most common allergen in \_\_\_\_\_\_. </p>

A

<p>Infants</p>

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12
Q

<p>Double-blind, placebo controlled food challenges (DBPCFC) identifies \_\_\_\_\_\_ induced symptoms. This is the GOLD STANDARD for diagnosis.</p>

A

<p>Food-induced</p>

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13
Q

<p>RAST test for identifying food allergies done outside of the body. It is the alternative to a \_\_\_\_\_ test. Serum is mixed with food on paper disk and IgE antibodies are measured.</p>

A

<p>RAST test alternative to a skin test.</p>

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14
Q

<p>\_\_\_\_\_\_\_ is the food LEAST likely to cause an allergy.</p>

A

<p>Rice</p>

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15
Q

<p>A food \_\_\_\_\_\_\_\_\_ is an abnormal physiologic response, but NO antibody production. NON-IgE.</p>

A

<p>Intolerance</p>

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16
Q

<p>In fever and infection, excesive fluid loss may lead to dehydration.</p>

<p>Also, *the BMR INCREASES \_\_% for each degree rise in body temperature.</p>

A

<p>The BMR increases 7% for each degree rise in body temperature.</p>

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17
Q

<p>Burns cause a tremendous increase in need for nutrients. There is a massive loss of \_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_.</p>

A

<p>Massive loss of fluids, electrolytes, and protein.</p>

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18
Q

<p>When treating burns, the first goal is to *\_\_\_\_\_\_\_ \_\_\_\_\_ and \_\_\_\_\_\_.</p>

<p>Then, increase calorie (recovery period) and protein (secondary period) intake (1.5-3.0 g/kg).</p>

<p></p>

<p>May need to supplement water-soluble vitamins, add vitamin C and Zn, and vitamin K if on antibiotics.</p>

A

<p>*Replace fluids and electrolytes*</p>

<p>Then, increase calorie (recovery period) and protein (secondary period) intake (1.5-3.0 g/kg).</p>

<p></p>

<p>May need to supplement water-soluble vitamins, add vitamin C and Zn, and vitamin K if on antibiotics.</p>

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19
Q

<p>The \_\_\_ and \_\_\_ response is a metabolic response to injury. It is a hypermetabolic, catabolic response to trauma.</p>

<p>Lean body mass is catabolized to release glucose for energy, leading to a negative Nitrogen balance.</p>

A

<p>Ebb and Flow response</p>

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20
Q

<p><br></br>
The \_\_\_\_ phase follows fluid resuscitation and the return of oxygen transport. It is characterized by increased oxygen<br></br>
consumption, body temperature, and nitrogen excretion, as well as expedited catabolism of carbohydrate, protein, and fat to meet increased metabolic demands.</p>

A

<p>Flow phase</p>

21
Q

<p>The \_\_\_ phase begins immediately after injury and is identified by decreased oxygen consumption, body temperature. Associated with hypovolemia and tissue hypoxia. Shock.</p>

A

<p>Ebb phase</p>

22
Q

<p>**Results of physiologic trauma include:</p>

<p>-Hyper\_\_\_\_\_\_</p>

<p>-Hyper\_\_\_\_\_\_</p>

<p>-Increased \_\_\_\_\_\_\_</p>

<p>-No ketosis</p>

<p></p>

A

<p>*Hyperglycemia</p>

<p>*Hyperinsulinemia</p>

<p>*Increased Glucagon</p>

<p>*No Ketosis</p>

23
Q

<p>\_\_\_\_\_\_\_\_\_\_\_\_, AKA adrenaline, suppresses insulin and causes hepatic glycogenolysis. Works to increase BG levels, similar to GLUCAGON.</p>

A

<p>Epinephrine</p>

24
Q

<p>Neoplastic disease, or \_\_\_\_\_, is associated with protein-calorie malnutrition and fluid electrolyte balances.</p>

<p>To combat altered taste acuity: add \_\_\_\_\_</p>

<p>Those with meat aversions: may need to eliminate red meat</p>

<p>With thrush, avoid \_\_\_\_\_, \_\_\_\_, strongly flavored foods. Provide bland, soft, chilled choices.</p>

<p>With throat/neck cancer, use \_\_\_\_\_ feeding.</p>

<p>Cancer cachexia associated with cytokines and TNF (inflammatory cytokines-->wt loss, muscle/fat catabolism).</p>

A

<p>Neoplastic disease, or CANCER, is associated with protein-calorie malnutrition and fluid electrolyte balances.</p>

<p>To combat altered taste acuity: add FLAVORING/SEASONING</p>

<p>Those with meat aversions: may need to eliminate red meat</p>

<p>With thrush, avoid SPICY, ACIDIC, strongly flavored foods. Provide bland, soft, chilled choices.</p>

<p>Throat/Neck cancer use PEG.</p>

<p>Cancer cachexia associated with cytokines and TNF (inflammatory cytokines-->wt loss, muscle/fat catabolism).</p>

25
Q

<p>\_\_\_\_\_\_ treatment is associated with loss of taste and xerostomia (dry mouth), esophagitis, malasorption, diarrhea.</p>

<p>For xerostomia, provide moistened foods.</p>

<p>Also associated with \_\_\_\_\_\_\_ (inflammation of mucosal lining of oropharynx and esophagus) - provide soft, bland choices.</p>

A

<p>Radiation</p>

<p></p>

<p>Mucositis</p>

26
Q

<p>Chemica reagents in \_\_\_\_\_\_\_ have toxic effects, and is associated with N/V, anorexia, malabsorption.</p>

<p>Also associated with \_\_\_\_\_\_\_\_, or cracks in the corners of the mouth due to a RIBOFLAVIN deficiency.</p>

<p></p>

<p>Methotrexate, a drug used to treat cancer, is a \_\_\_\_\_\_\_-antagonist.</p>

A

<p>Chemotherapy</p>

<p></p>

<p>Stomatitis</p>

<p></p>

<p>Folate-antagonist</p>

27
Q

<p>\_\_\_\_\_\_\_\_\_\_ is a condition caused by inadequate energy intake in all forms, including protein.</p>

<p></p>

<p>\_\_\_\_\_\_\_\_\_ is protein deficiency with adequate energy intake. Protein deficiency results in an edematous appearance (pot-belly).</p>

A

<p>Marasmus (deficient protein and energy)</p>

<p></p>

<p>Kwashiorkor (deficient protein)</p>

28
Q

<p>**Iatrogenic malnutrition refers to the protein-calorie malnutrition brought on by \_\_\_\_\_\_\_, \_\_\_\_\_\_\_, and \_\_\_\_\_\_.</p>

<p></p>

<p>Iatrogenic: Due to the activity of a physician or therapy</p>

A

<p>Hospitals, treatment, medication</p>

29
Q

<p>Therapy for anorexia is \_\_\_\_\_\_\_\_\_ and includes weight restoration in combination with psychotherapy.</p>

<p></p>

<p>Therapy begins with:</p>

<p>Immediate concern, which is \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_\_.</p>

<p></p>

A

<p>Multidisciplinary</p>

<p></p>

<p>Immediate concern is correcting electrolyte imbalance, namely Potassium.</p>

30
Q

<p>In treatment of anorexia, plan WITH the patient. Focus on \_\_\_\_\_\_\_\_\_ and life-sustaining aspects of food, giving the patient a reason to eat.</p>

<p>Regular mealtimes, varied intake, gradually reintroduce feared foods.</p>

<p>Re-feeding increases \_\_\_\_\_\_\_ load - go slowly.</p>

<p>Recommendation is \_\_-\_\_ kcal/kg, but may need to be set at 100-300 kcal above \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_ to support adherence.</p>

A

<p>Health benefits</p>

<p></p>

<p>Re-feeding increases CARDIAC LOAD - go slowly.</p>

<p></p>

<p>Recommendation is 30-40 kcal/kg, but may need to be set at 100-300 kcal above CURRENT INTAKE to support adherence.</p>

31
Q
A
32
Q

<p>Binging and purging syndrome. Usualy close to normal weight.</p>

<p></p>

<p>Associated symtpoms include damage to teeth, throat, esophagus (vomiting), and rectal bleeding (laxative abuse).</p>

<p></p>

<p>\_\_\_\_\_\_\_ are lost through vomiting and diarrhea.</p>

A

<p>Bulimia</p>

<p></p>

<p>Electrolytes (namely K - hypokalemia)</p>

33
Q

<p>**Obesity begins at BMI \_\_.</p>

A

<p>Obesity begins at BMI 30.</p>

<p></p>

<p>Class 1: 30-34.9</p>

<p>Class 2: 35-39.9</p>

<p>Class 3: >40 (morbid)</p>

34
Q

<p>Rapdi weight loss that occurs in the beginning of ANY diet is \_\_\_\_\_\_\_.</p>

A

<p>Rapid weight loss in the beginning of a diet is water.</p>

<p></p>

<p>As glycogen is utilized as energy source the water in which it is stored is also released.</p>

35
Q

<p>\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is usually the recommended intervention in overweight children.**</p>

A

<p>MAINTENANCE</p>

36
Q

<p>The belief that localized exercise reduces fat stores in the active area - research does NOT support this.</p>

A

<p>Spot Weight Loss Theory</p>

37
Q

<p>When a dieter reaches a plateau, their \_\_\_ has dropped to reflect the loss.</p>

A

<p>BMR</p>

38
Q

<p>Bariatric surgery is appropriate for:</p>

<p></p>

<p>*Class \_\_ obesity (BMI >40)</p>

<p>OR</p>

<p>*Class \_\_ obesity (BMI >35), WITH COMORBIDITIES</p>

A

<p>Bariatric surgery is appropriate for:</p>

<p></p>

<p>Class 3 obesity (BMI >40)</p>

<p>OR</p>

<p>Class 2 obesity (BMI >35), WITH COMORBIDITIES</p>

39
Q
A
40
Q

<p>Gastric bypass and gastroplasty (stapling) reduce the \_\_\_\_\_\_\_ of food that can be eaten at one time, resulting in early \_\_\_\_\_\_\_.</p>

A

<p>Reduce the amount of food eaten at one time, resulting in early satiety.</p>

41
Q

<p>This type of gastric bypass connets the upper portion of the stomach to the jejunum. The lower portion of the stomach is bypassed.</p>

A

<p>Roux-en-Y gastric bypass</p>

42
Q

<p>WIth gastric bypass, it is important to monitor for potential \_\_\_\_\_\_\_\_\_\_, as well as deficiencies including \_\_\_, \_\_\_, \_\_\_\_, and \_\_\_\_. Supplementation is necessary.</p>

A

<p>Anemia</p>

<p>Deficiencies in K, Mg, Folate, B12</p>

43
Q

<p>Procedure using tapling to create a small, gastric pouch, leaving only a small opening into the distal (lower) stomach.</p>

A

<p>Gastroplasty</p>

44
Q

<p>Procedure involving the placement of a fluid-filled inflatable band to create a small gastric pouch. This band can be adjusted to alter the size of the opening.</p>

<p>Fully-reversible.</p>

<p>Does not require iron, folate, B12 supplements.</p>

A

<p>Gastric banding</p>

45
Q

<p>Congenital disorder associated with the deletion of chromosome 15.</p>

<p>Ghrelin is elevated.</p>

<p>SUBnormal lean body mass, SUPRAnormal fat mass.</p>

A

<p>Prader-Willi syndrome</p>

46
Q

<p>In PWS, GHRELIN levels are elevated, stimulating:</p>

<p>\_\_\_\_\_ hormone secretion</p>

<p>\_\_\_\_\_\_, \_\_\_\_\_</p>

<p>\_\_\_\_\_ \_\_\_\_\_ deposition</p>

A

<p>In PWS, GHRELIN levels are elevated, stimulating:</p>

<p>Growth hormone secretion (stimulates growth)</p>

<p>Appetite, Intake</p>

<p>Fat mass deposition</p>

47
Q

<p>Prader-Willi syndrome results in:</p>

<p>-</p>

<p>-</p>

<p>-</p>

<p>-</p>

A

<p>Results in:</p>

<p>Obesity</p>

<p>Hypogonadism</p>

<p>Muscle hypotonia</p>

<p>Failure to thrive</p>

48
Q

<p>*The best treatment of PWS is:</p>

A

<p>*To control access to food and intake.</p>

Domain 2: Nutrition Care for Individuals and Groups (16 decks)

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