Misc

Question 1

VIt deficiency with:

Poor or extreme low fat diet

Answer 1

Vit A def
- findings:
eyes, epithelium, infxns

Foods: preformed
- liver, dairy, egg yolk, fish oil
Precursor:
carrots, pumpkin, spinach, broccoli

Question 2

VIt deficiency with:
Low sun, dark pigment,
obesity,
breast feeding,
liver/kidney dz

Answer 2

Vit D
- findings:
osteopenia/malacia

Question 3

VIt deficiency with:

Prematurity

Answer 3

Vit E
- findings:
Neurologic (irreversible, ophthalmoplegia), 
hemolytic anemia
- bleed too much

Question 4

VIt deficiency with:

Newborn, antibiotics, poor diet

Answer 4

Vit K
- findings:
Impaired clotting

Foods:
Leafy greens, brocolli,
fruits, seeds, beef liver

Question 5

Name the best diet for:

Resp failure

Answer 5

Higher fat and less calories

- high carb and overfeeding increases your respiratory quotient

Question 6

Name the best diet for:

Liver disease

Answer 6

Lower in aromatic AA

Higher in branched chain AA

Question 7

Name the best diet for:

Renal failure

Answer 7

Decrease Na and water - overload problem

Give more protein

• urinary protein loss with nephrotic syndrome
• increased protein catabolism

Question 8

Name the best diet for:

Burns and trauma

Answer 8

Increased E (30-35) and protein requirement (1-1.5)

Question 9

Refeeding should begin with:

Answer 9

IV Thiamin, folate, and multivitamin soln

SLOW

Question 10

Complications of refeeding

Answer 10

HYPOphosphatemia
HYPOkalemia
diarrhea
Wernicke enceph

Question 11

Cofactors for

1. aminotransferase
2. Hyp and Hyl
3. gamma- carboxylation

Answer 11

aminotransferase
- PLP (deriv of B6)

Hyp and Hyl
- Vit C

y-carboxylation
- Vit K

Question 12

OTC def

findings on test

Answer 12

High orotic acid in urine
low cirtrulline
low BUN

XR - INFANTS!!!

do genetic test: Ezn assay degrades very quickly
- carbamoyl phosphate cannot make citrulline

Question 13

DGAC 2010 Sat FA levels and cholesterol lvl + Trans FA lvl +Sodium intake recommendation

Question 14

what drug inhibits xanthine oxidase (purine synth)?

Answer 14

allopurinol

Question 15

Hereditary hemochromatosis due to defect in?

Answer 15

hepcidin
absorption excessive Fe –> accumulate Fe –>
Liver damage

Question 16

Causes of high HDL

Answer 16

CETP deficiency

CETP is used to lower HDL levels by exchanging cholesterol esters from HDL for triglycerides from VDL and LDL

Question 17

familial combined hyperlipidemia
+
Familial dysbetalipoproteinemia (broad beta disease)

Answer 17

these leads to high cholesterol and TG levels

high VLDL?

Question 18

Statins are the first line treatment for high lvls of lipids, what other tx could be used?

Answer 18

1. Ezetimibe
2. Bile acid binding resins
   - not rec. 4 pt w/ familial combined hyperlipidemia
3. PCSK9 inhibitors
   - great for FCH, when statins dont work
4. Fibrate (TG)

Question 19

when triglycerides are greater than 400 mg/dl, ________ particles are present. Above 1,000 mg/dl almost all of the additional triglycerides are from _________.
- What is causing the elevated cholesterol levels?

Answer 19

chylomicron , chylomicrons

• chylomicrons have about 2-8% cholesterol, with very HIGH degree of hypertriglyceridemia, an accumulation of VLDL and chylomicrons occurs, causing the elevated total cholesterol levels.

Question 20

calc amt of protein you give pt in hospital?

Answer 20

Urinary N (g) x 6.25

Question 21

Acquired causes of hypertriglyceridemia

Answer 21

1. Diet
2. Oral estrogen treatment
3. Uncontrolled diabetes.
4. Hypothyroidism,
5. Renal failure, liver disease, alcohol use
6. Anti-retroviral medications.

Question 22

Genetic causes of hypertriglyceridemia

Answer 22

1. Familial hypertriglyceridemia,
2. Familial combined hyperlipidemia
3. Apo C2 deficiency
4. LPL deficiency.
5. Broad beta disease caused by an abnormal ApoE
   - causes moderate elevation of TG

Question 23

Broad beta disease caused by

Answer 23

ApoE abnormality

• Get chylomicron remnants
• Plantar, palmer, tuberoeruptive xanthomas

Question 24

Cretin child

Answer 24

Deaf and blind child as a result of mom with iodide deficiency

Question 25

WEight loss drug associated with suicide risk

Answer 25

naltrexone/bupropion

• lower seizure threshold
• raise bp too