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[Mine] core curric - 2016 > Micronutrients > Flashcards

Micronutrients Flashcards

1
Q

What micronutrient should you consider supplementing?

  • Recurrent or prolonged N/V (>2 weeks),
  • rapid weight loss (>1#/day),
  • and/or prolonged poor PO intake
A

Supplement thiamin

(Ideally, 100-250mg via IV)

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2
Q

Check the following labs: Cheilosis, stomatitis, glossitis

A
  • Vitamin B12
  • Vitamin C
  • Vitamin B2 (riboflavin)
  • Vitamin B6
  • Zinc
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3
Q

Check the following labs: Skin disorders/dermatitis/rashes

A
  • Niacin
  • Vitamin A
  • Vitamin B2 (riboflavin)
  • Vitamin B6
  • Zinc
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4
Q

Check the following labs: Neuropathy, myelopathy, gait disturbance

A
  • Copper
  • Vitamin E
  • Vitamin B1 (thiamin)
  • Vitamin B12
  • Vitamin B6
  • Niacin
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5
Q

Check the following labs: Vision changes

A
  • Vitamin A
  • Vitamin E
  • Copper
  • Thiamin
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6
Q

Commonly affected nutrients in IBD

A

Vit A
Vit C
Vit D
Vit B12 (terminal ileum resection)

Calcium, magnesium, iron

Zinc & selenium - significant diarrhea

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7
Q

Vitamin C deficiency sx

A

Arthritis

Fatigue

Skin findings (rash, hyperpigmentation)

Easy bruising

Poor wound healing

Gingivitis

Perifollicular findings (hemorrhage, folliculitis)

Alopecia

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8
Q

Mechanisms of malabsorption in SBS

A

1- acid hypersecretion, which inactivates panc enzymes = maldigestion & malabsorption

2- rapid intestinal transit

3- loss of SB surface area (magnesium absorbed in ileum, difficult to maintain)

4- bacterial overgrowth (loss of ileocecal valve, decreased pH, sluggish peristalsis)

5- bile acid wasting (absorbed in terminal ileum)

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9
Q

Acute pancreatitis – NG vs NI feeds

A

Trial gastric feeds before going to SB feeds

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10
Q

Nutrients affected by chronic pancreatitis

A

Vit B12

Fat soluble vitamins (ADEK) – malabs

Vit A, Vit E, selenium, lycopene, xanthine, beta carotene – lower levels of antioxidants

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11
Q

What mineral to monitor closely in acute pancreatitis

A

Calcium – esp in ICU

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12
Q

MN affected by alcoholism

A
  • Thiamine
  • Folate
  • Niacin
  • Magnesium
  • Zinc
  • Selenium
  • Vitamin B6
  • Vitamin B12
  • Vitamin A
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13
Q

Severe liver disease & pancreatic and/or SB involvement

A

Steatorrhea
Impaired abs of ADEK

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14
Q

Impaired hepatic metabolism/storage

A
  • AA
  • CHO
  • Fats
  • Folate
  • Vit D
  • Vit B6
  • Vit B12
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15
Q

Vitamin A deficiency symptoms

A

Night blindness
Acne

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16
Q

Vitamin D deficiency symptoms

A

Fatigue
Muscle pain
Lower extremity muscle weakness

17
Q

Vitamin B12 deficiency symptoms

A

LE numbness
Sensory loss
Loss of taste
Glossitis

18
Q

Zinc deficiency symptoms

A

Frontal hair loss
Dermatitis
Altered taste

19
Q

Bile drainage results in what nutrient alteration?

A

Copper loss increased

Fat-soluble vitamins may be malabsorbed

20
Q

Why are Vitamin D and Vitamin K impacted by liver failure?

A

Ability to activate Vitamin D is decreased

Vitamin K level decreased

21
Q

Ostomy loss / diarrhea

A

Zinc loss increased

22
Q

What nutrients are affected in Renal failure?

A

Altered metabolism - Vit D, phosphorous, calcium

Decreased - iron d/t depressed erythropoietin

Increased - Vitamin A

Decreased excretion - magnesium, zinc

Decreased zinc level in dialysis pts

23
Q

Steatorrhea

A

ADEK decreased
Calcium level decreased

24
Q

When is fluid restriction indicated?

A

When hyponatremia and fluid overload are present

25
Q

When is sodium restriction indicated?

A

When fluid retention is severe

26
Q

When should you switch to a cyclic TF schedule?

A

PO intakes meet 50% of pt’s EEN

27
Q

Acute thiamin deficiency

A

Lactic acidosis with urinary electrolyte losses

May be clinically recognized by:
- hypotension
- AMS
- kussmaul’s respiration

28
Q

What should be carefully evaluated in patients receiving thiazide diuretics?

A

Calcium supplementation

Reduces renal calcium excretion, which leaves soft tissues and blood vessel walls as alternate sites for deposition

29
Q

Which bronchodilator decreases serum thiamin?

A

Theophylline

[Mine] core curric - 2016 (22 decks)

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