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RD Exam > MNT > Flashcards

MNT Flashcards

1
Q

Food Allergy

A

abnormal immune response to a protein in a food source (that most individuals are able to consume); may be IgE (histamine rxn) or non-IgE mediated (ie FPIES).

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2
Q

Food Intolerance

A

a reaction (that doesn’t involve the immune system) that occurs to a (generally, non-protein) substance in a food

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3
Q

Most common food allergens for children

A

eggs, fish, shellfish, milk, peanuts, tree nuts, soy

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4
Q

Most common food allergens for adults

A

fish, shellfish, peanuts, tree nuts

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5
Q

HIV/AIDS: laboratory values to monitor for protein status

A

albumin, prealbumin, TIBC, or transferrin

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6
Q

HIV/AIDS: dietary goals and recs

A

maintain/improve nutrition status, avoid malnutrition; food consistency and nutrients evaluated based on symptoms; increase kcal and pro to aid in resistance to infection

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7
Q

HIV/AIDS: dietary modifications

A

nausea- small, freq meals

anorexia/poor appetite - small, freq, nutrient dense meals

xerostomia - moist foods, sauces, gravies; increase fluid intake

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8
Q

Kwashiorkor

A

pro def, adequate kcal; loss of visceral protein, distended abdomen, fatty liver, edema, moon-shaped face

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9
Q

Anasarca

A

massive edema; may occur in Kwashiorkor, organ failure, etc.

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10
Q

Marasmus

A

pro and kcal def; extreme loss of somatic and visceral pro, emaciated, muscle wasting, very low body weight

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11
Q

Diabetes: Dx criteria

A 
FBG - ≥ 126 mg/dL
Random BG ≥200
Two-hour plasma glucose ≥200
A1c ≥ 6.5% 
Confirmed by a second test on a different date
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12
Q

Diabetes: glycemic control goals (A1c, pre-prandial, and 2-hour post-prandial)

A

A1c <180

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13
Q

Diabetes: diet therapy goals

A

Control BG levels, eating a diet balanced with all necessary nutrients; normalize blood lipids, weight maintenance, improve overall health

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14
Q

T2DM: weight loss and insulin resistance

A

10-20 lbs can aid in lowering insulin resistance

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15
Q

Pre-diabetes: dx criteria

A

FBG 100-125

A1c 5.7-6.4%

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16
Q

Pre-diabetes: treatment

A

weight loss, physical activity, healthy diet

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17
Q

Gestational diabetes: risk factors

A

family hx, >25 yrs, prior macrosomia baby, hx of GDM or pre-diabetes, overweight BMI, African American, American Indian, Asian, Hispanic, or Pacific Islander descent.

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18
Q

Gestational diabetes: testing

A

Occurs at 24-28 weeks gestation with OGTT

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19
Q

Diabetes: macronutrient distributions for meal planning

A

CHO 45-60%
Protein 10-20%
Fat <10%
Fiber 20-35 g

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20
Q

Gastroparesis

A

delayed gastric emptying due to damage to the vagus nerve, which causes peristalsis; nutrition intervention = small, freq, low-fat, low fiber meals

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21
Q

Lispro (Humalog) - action onset, peak action, effective duration

A

Rapid Acting

<15 minutes
1-2 hours
3-4 hours

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22
Q

Regular - action onset, peak action, effective duration

A

Short Acting

1/2-1 hour
2-3 hours
3-6 hours

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23
Q

NPH - action onset, peak action, effective duration

A

Intermediate Acting

2-4 hours
4-10 hours
10-16 hours

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24
Q

Glargine (Lantus) - action onset, peak action, effective duration

A

Long Acting

2-4 hours
NONE
20-24 hours

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25
Q

Gout

A

high conc of uric acid in blood; MNT = low purine diet, limiting meats (esp organ meats)

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26
Q

Reactive hypoglycemia

A

improper CHO metab; weakness, shakiness, dizziness, hunger; occurs following a meal due to remaining excess insulin after food is gone; MNT = small meals with protein

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27
Q

Fasting hypoglycemia

A

improper CHO metab; weakness, shakiness, dizziness, hunger; occurs without food or as a result of meds; MNT = small meals with protein

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28
Q

Maple Syrup Urine Disease

A

genetic disorder; prevents b/d BCAA, which results in BCAA accumulation (isoleucine, leucine, valine); blood levels of BCAA should be monitored and dietary restrictions of this AA req. High protein, medically therapeutic foods low in BCAA available.

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29
Q

Phenylketonuria

A

Avoid phenylalanine; increase tyrosine; eliminate aspartame.

30
Q

Prader-Willi Syndrome

A

Genetic disorder; mental disabilities, decreased muscle tone, persistent hunger–> overeating and morbid obesity. MNT = low kcal; limit access to food

31
Q

Cancer: MNT to maintain weight (kcals reqs)

A 
kcal reqs = 1.1-1.45 x BEE
small meals (to decrease nausea); comfort foods; frequent snacking; avoid dietary restrictions; encourage patients to eat when they feel the urge; avoid strong spices if mouth is sore and when taste aversions are found
32
Q

Anemia: Vitamin B12 or folate

A

Macrocytic - megaloblastic; pernicious (B12)

33
Q

Anemia: Iron

A

hypochromic, microcytic; hemorrhage, diet, malabsorption

34
Q

Anemia: normochromic, normocytic

A

may occur in pregnancy, renal disease, overhydration

35
Q

Therapeutic Lifestyle Changes diet

A 
<200 mg cholesterol
25-35% calories total fat, 
50-60% CHO
20-30 g fiber
~15% protein
Increase seafood (n-3 FA), fiber, f/v.
36
Q

Congestive Heart Failure

A

lowered cardiac output affecting Na and fluid retention; MNT = reduced Na diet and meds

37
Q

HTN: Classifications

A

Normal <80

Prehypertension 120-139 or 80-89

Stage 1 HTN 140-159 or 90-99

Stage 2 HTN ≥160 or ≥100

38
Q

HTN: Treatment/MNT

A

Wt loss, Na restriction, exercise, meds; DASH diet

39
Q

Crohn’s disease

A

MNT: low-fiber diet, include adequate calories and protein

40
Q

Dumping Syndrome

A

Disorder of pyloric sphincter leading to food mass in jejunum.

Symptoms: cramping, weakness, nausea, vomiting, and diarrhea quickly after consuming a meal.

MNT: several small meals, high protein and fat, low CHO

41
Q

Cystic Fibrosis

A

High conc Na in sweat; MNT: high calorie, high pro, vitamin supplements, pancreatic enzymes

42
Q

Billroth I

A

remainder of stomach attached to duodenum

43
Q

Billroth II

A

remainder of stomach attached to jejunum

44
Q

Roux-en-Y

A

bypass in which upper part of the stomach is sectioned off into a smaller area and the jejunum is connected.

45
Q

Bariatric surgery: Nutritional Considerations

A

Def - Iron, Ca+, vitamin B12

Slow progression to solid food post-surgery

Meals should include complex CHO, pro, fat

Fluids consumed 1 hr before or after meals

46
Q

Short bowel syndrome

A

Concerns: nutrient malabsorption, fluid and electrolyte imbalances, wt loss

Treatment: TPN for as long as needed; small meals

47
Q

Cirrhosis: MNT

A

Adequate kcal and pro; restricted Na and fluids

48
Q

ESLD

A

Ascites, encephalopathy, portal hypertension

MNT: adequate kcal (increased for ascites or malabsorption), vit/min suppl

For hepatic encephalopathy, BCAA enriched formulas may be indicated among patients with severe encephalopathy who do not respond or comply with lactulose or tolerate std pro

49
Q

Pancreatitis

A

Symptoms: cramping and diarrhea

MNT/treatment: pancreatic enzymes, low-fat diet, avoidance of alcohol

50
Q

Alzheimer’s Disease: treatment for feeding problems and weight loss

A

Meals served w/o distractions; plates/bowls different colors than food; snacks and supplements; finger foods. Be mindful of dysphagia.

51
Q

Epilepsy: MNT

A

Ketogenic diet - useful if not responding to meds; once ketosis is established, rec is 3 or 4 grams of fat per every one gram of CHO and protein COMBINED.

52
Q

CVA: MNT

A

assess (swallow eval), treatment of dysphagia if needed, adequate nutrition, enteral nutrition if needed

53
Q

Osteoporosis: Definition and risk factors

A

progressive bone loss associated with increased risk of fractures.

Risk factors: female, caucasian, Asian, post menopausal, inactivity, smoking, excessive alcohol

54
Q

Osteoblasts

A

BUILD (aid in production of) bone tissue

55
Q

Osteoclasts

A

Catabolize (aid in the breakdown) of bone tissue

56
Q

Osteoporosis: Dowager’s hump

A

Loss of height and curvature of the upper spine

57
Q

Osteoporosis: treatment

A

Ca and vit D, weight bearing exercise, estrogen replacement therapy, meds to decrease bone loss

58
Q

Glomerulonephritis: symptoms and treatment

A

S: edema, htn, proteinuria

T: fluid control, protein control, adequate calories

59
Q

ARF: MNT

A

Protein, fluids, P, Ca, K, Na should all be considered and might require restriction

60
Q

GFR

A

Calculation based on serum creatinine, age, gender, and race.

Normal 90-120 mL/min

61
Q

Serum creatinine

A

Inversely related to GFR

Normal 0.8-1.2 Male; 0.6-1.0 female

Ratio of creatinine to BUN can assess kidney damage. Damage occurs at ratio of 1:10

62
Q

Stage 5 CKD (ESRD)

A

GFR < 15 mL/min

Uremia

Treatment: Dialysis (HD, PD- CAPD or CCPD)

63
Q

CKD: Nutrient Considerations (stage 1-4)

A 
kcal 30-35 kcal/kg
protein = 0.6-0.75 g/kg
Na = 1-3 g/day
K = usually not restricted
Ca = 1.0-1.5 g/day
Fluids = usually unrestricted
Vit/min = B complex, C, D, Fe, Zn
64
Q

CKD: Nutrient Considerations (HD)

A 
kcal 30-35 kcal/kg
protein = >1.2 g/kg
Na = 1-3 g/day
K = 2-3 g/day to adjust to serum levels
Ca = ≤2 g/day
Fluids = urine output + 1000 mL
Vit/min = B complex, C, D, E, Fe, Zn
65
Q

CKD: Nutrient Considerations (HD)

A 
kcal 30-35 kcal/kg
protein = 1.2-1.3 g/kg
Na = 2-4 g/day
K = 3-4 g/day to adjust to serum levels
Ca = ≤2 g/day
Fluids = maintain balance
Vit/min = B complex, C, D, E, Fe, Zn
66
Q

COPD: MNT

A

Increase kcal; macronutrient distribution for a favorable RQ (Fat 30-45%, pro 15-20%, CHO 40-55%); ox of fat req < O2 than CHO does

67
Q

Metabolic acidosis

A

Reduced pCO2, and/or pH. Causes: starvation, low CHO diet, diabetic ketosis, uremia. Body compensates by increased resp, decreased H and increased bicarb excretion in kidneys

68
Q

Metabolic alkalosis

A

Increased pH and bicarb. Causes: diuretic use, persistent vomiting. Body compensates by decreased resps; kidneys decrease H and increase bicarb excretion

69
Q

Respiratory acidosis

A

reduced pH due to hypoventilation secondary to COPD, emphysema, or asthma. Body compensates: increased bicarb resorption.

70
Q

Respiratory alkalosis

A

Increased pH generally due to hyperventilation. Body compensates: increased bicarb excretion.

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