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Advanced Medical Nutrition Therapy > MNT for Psychiatric Disorders > Flashcards

MNT for Psychiatric Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

The brain is made up of about ___% fat

A

80

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2
Q

The fatty acid composition of neuronal cell membranes reflects ___ ___

A

Dietary intake

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3
Q

Essential fatty acids are involved in the synthesis of _____

A

Neurotransmitters

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4
Q

Effect of nutrients on mental health:

A

-Support the normal development of the brain and central nervous system
-Maintain structure and function of neurons
-Serve as precursors and cofactors for neurotransmitter production
-Provide an energy source for the brain
-Support mood and sense of well-being

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5
Q

What amino acids are needed for neurotransmitter production?

A

-Phenylalanine
-Tyrosine
-Tryptophan
-Glutamine

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6
Q

What vitamins are needed for neurotransmitter production?

A

-B1
-B2
-B3
-B6
-B12
-Folate

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7
Q

What minerals are needed for neurotransmitter production?

A

-Zinc
-Copper
-Iron
-Iodine
-Selenium
-Magnesium

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8
Q

___ ___ are also needed for neurotransmitter production

A

Fatty acids

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9
Q

The gut contains about ____ million neurons

A

100

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10
Q

What are three major neurotransmitters in the enteric nervous system?

A

-Acetylcholine
-Serotonin
-Norepinephrine

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11
Q

Neural activity in the gut is triggered by receptors responding to what three types of stimuli?

A

-Mechanical
-Osmotic
-Chemical

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12
Q

Bidirectional information continually passes between the ___ and ___

A

Gut, CNS

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13
Q

Gut bacteria and byproducts influence brain ____ and ____

A

Function and behavior

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14
Q

Rapid and abrupt increases in blood glucose can trigger rapid and excessive release of ____, followed by a rapid drop in blood glucose

A

Insulin

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15
Q

The body compensates for this rapid drop in blood glucose by raising levels of ____ and ____, which can trigger emotional changes and erratic behavior

A

Epinephrine and cortisol

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16
Q

Reducing ____ carbohydrate and sugar intake can decrease these blood glucose fluctuations considerably

A

Refined

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17
Q

What are two examples of of Omega-3 Fatty Acids?

A

-Eicosapentaenoic acid (EPA)
-Docosahexaenoic acid (DHA)

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18
Q

Omega 3 fatty acids are the preferred fatty acids in the ___ and ___ ____

A

Brain and nervous system

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19
Q

EPA and DHA (omega-3s) may have benefits in the management of…

A

-Anxiety
-Depression
-Post-partum depression
-Bipolar disorder
-Schizophrenia

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20
Q

Higher intake of fish (high in omega-3) is associated with decreased risk of ____, especially for women

A

Depression

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21
Q

____ is an essential coenzyme for neurotransmitters (like serotonin) that are potential targets for antidepressant therapies

A

Thiamin

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22
Q

Vitamin B12 deficiency may be involved in the pathogenesis of…

A

Depression
Bipolar
Panic disorders
Psychosis
Phobias

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23
Q

Folate deficiency is associated with…

A

Depression
Schizophrenia

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24
Q

Vitamin D deficiency is associated with…

A

Major and minor depression in older adults

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25
Q

Iron deficiency is associated with ____

A

Depression

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26
Q

Magnesium deficiency can cause ____

A

Anxiety

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27
Q

Selenium deficiency is linked to ____

A

Depression

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28
Q

____ may reduce depressive symptoms

A

Zinc

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29
Q

Amino acids are precursors for what three neurotransmitters?

A

-Serotonin
-Dopamine
-Norepinephrine

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30
Q

____ and ____ are targeted by depression medication

A

Serotonin and dopamine

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31
Q

Amino acids are precursors for the antioxidant ____

A

Glutathione

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32
Q

Research suggests that ____ found in plant-based foods are important for normal brain function and mental health

A

Phytochemicals

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33
Q

____ have antioxidant activity and protect and preserve brain cell structure and metabolism

A

Flavonoids

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34
Q

What foods contain flavonoids?

A

-Berries
-Onions
-Kale
-Red cabbage
-Grapes and red wine
-Tea
-Curcumin
-Dark chocolate
-Citrus fruit

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35
Q

What are specific nutrition factors to consider for someone with a psychiatric disorder?

A

-Increase or decrease in appetite
-Increase or decrease in activity level and therefore calorie requirements
-Use of medications that cause dry mouth, thirst, constipation, and weight change
-Decrease in ability to concentrate, understand, and follow directions
-Altered nutritional needs due to use of alcohol or tobacco
-Possible decrease in ability for self-care such as adequate income, shopping, or meal preparation
-History of comorbid conditions that may have resulted in suboptimal nutritional intake
-Use of nutrition supplements

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36
Q

_____ disorders are the most common type of mental illness in the United States

A

Anxiety

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37
Q

Common to anxiety disorders are ____ and poorly controlled emotional, somatic, and neurological symptoms triggered by a specific situation

A

Heightened

38
Q

The underlying etiology of anxiety is not well understood, but may be related to…

A

-Genetics
-The stress of an adverse childhood experience can constitute a significant etiologic factor for anxiety that may impact the individual into and throughout adulthood

39
Q

What are 3 classes of medication that may be used for medical management of anxiety?

A

-Benzodiazepines
-Selective serotonin reuptake inhibitors (SSRI)
-Serotonin and norepinephrine reuptake inhibitors (SNRI)

40
Q

What are two examples of Benzodiazepines?

A

-Alprazolam
-Clonazepam

41
Q

What are food-drug interactions with Benzodiazepines?

A

-Avoid concurrent ingestion of alcohol
-Limit/avoid caffeine

42
Q

What are two examples of selective serotonin reuptake inhibitors (SSRIs)?

A

-Sertraline
-Fluoxetine

43
Q

What are food-drug interactions with selective serotonin reuptake inhibitors (SSRIs)?

A

-May increase appetite and weight
-May cause dry mouth
-Avoid St. John’s Wort
-Avoid alcohol

44
Q

What is one example of a serotonin and norepinephrine reuptake inhibitor (SNRI)?

A

Duloxetine

45
Q

What are food-drug interactions with serotonin and norepinephrine reuptake inhibitors (SNRIs)?

A

-Avoid St. John’s Wort
-Avoid alcohol

46
Q

MNT for management of anxiety:

A

-Eat regularly schedules meals with protein and low glycemic carbohydrates to promote stable blood glucose
-Eliminating caffeine for 3-4 weeks to see if anxiety decreases
-Consider MVI with minerals if dietary intake does not meet the DRI for folate, B12, zinc, magnesium, and vitamin D
-Include dietary sources of omega-3 fatty acids
-Encourage physical activity

47
Q

Major depressive disorder (MDD) affects ___% of Americans

A

6.7

48
Q

What gender is more commonly affected by major depressive disorder?

A

Women

49
Q

No definitive ___ of major depressive disorder has been identified

A

Cause

50
Q

About ____ of people do not respond adequately to treatment for depression

A

1/3

51
Q

What are contributing factors to the development of major depressive disorder?

A

-Genetics
-Nutrition
-Environmental stressors
-Hormonal disruption (especially in the hypothalamic-pituitary-adrenal axis)
-Alterations in neurotransmitter biology and function (monoamine deficiency theory)

52
Q

The ___ ____ theory states that deficiency of serotonin, dopamine, and norepinephrine, or altered receptor function, is the main pathophysiologic factor of depression

A

Monoamine deficiency

53
Q

What 3 classes of drugs are used for medical management of depression?

A

-SSRIs
-SNRI
-Norepinephrine-dopamine reuptake inhibitors

54
Q

What SSRIs are used for treating depression?

A

-Fluoxetine
-Paroxetine
-Sertaline

55
Q

What SNRIs are used for treating depression?

A

-Duloxetine
-Venlafaxine

56
Q

What is one example of a norepinephrine-dopamine reuptake inhibitor?

A

-Bupropion

57
Q

Food-drug interactions with norepinephrine-dopamine reuptake inhibitors:

A

-May cause increased or decrease appetite and weight
-May cause dry mouth
-May cause taste change
-May cause stomatitis
-N/V
-Take with food to decrease GI irritation
-Limit/avoid alcohol
-Avoid St. John’s Wort

58
Q

MNT for depression:

A

-Mediterranean dietary pattern may protect against the development of depressive symptoms later in life and decrease risk of Major Depressive Disorder
-Encourage regular meals and snacks that help maintain blood glucose levels
-Ensure adequate folate, vitamin B12, vitamin D, and omega-3 fatty acid intake (treat deficiencies of B12 or folate)
-Social eating if possible
-Recommend exercise
-Curcumin may be beneficial due to anti-inflammatory effects
-Zinc deficiency may play a role in depression, so treat deficiencies
-Monitor for weight changes
-Assess for food-drug interactions
-Caution must be used if treating depression with St. John’s Wort

59
Q

Zinc may reduce depressive symptoms by…

A

-Decreasing dopamine reuptake
-Increasing conversion of thyroid hormone T4 to T3
-Promoting excitatory neurotransmitter function

60
Q

Why should we use caution if someone is using St. John’s Wort to treat depression?

A

-Food-drug interactions
-Increases risk of triggering “serotonin syndrome” if patient is taking a SSRI or SNRI

61
Q

____ ____ causes episodes of an elevated or agitated mood known as mania alternating with episodes of depression

A

Bipolar disorder

62
Q

The average age of onset of bipolar disorder is ___ years old

A

25

63
Q

There is a genetic component to the development of bipolar disorder, but other factors that trigger the illness include…

A

-Hormones
-Neurotransmitter abnormalities
-Stress

64
Q

Medical management of bipolar disease is done with ____

A

Lithium

65
Q

Food drug interactions with Lithium:

A

-A stable, moderate amount of sodium is needed to stabilize lithium levels
-Drink 2-3 liters of fluid/day
-Limit caffeine
-Monitor for weight gain
-Can cause N/V/D

66
Q

____ is a severe mental disorder that presents as psychosis, often with paranoia and delusions

A

Schizophrenia

67
Q

Diagnosis of Schizophrenia requires at least one of the following three symptoms:

A

-Delusions
-Hallucinations
-Disorganized speech

68
Q

Symptoms typically appear in ____ during their late teens to early 20s, and in ____ during their 20s to early 30s

A

Males; females

69
Q

The ____ of Schizophrenia is poorly understood, but could be a heterogenous disorder generated by a combination of biochemical, genetic, structural, nutritional, and environmental factors, including infections and toxins

A

Pathophysiology

70
Q

Medical management of Schizophrenia is a combination of…

A

-Dopamine-blocking antipsychotic medications
-Antidepressants
-Tranquilizers

71
Q

What are two examples of dopamine-blocking antipsychotic medications?

A

-Haloperidol
-Risperidone

72
Q

Side effects of antipsychotics:

A

-Dry mouth
-Constipation
-Increased appetite
-Weight gain

73
Q

Schizophrenia is associated with altered ____

A

Metabolism

74
Q

Schizophrenia ____ energy needs

A

Reduces

75
Q

Schizophrenia ____ visceral fat

A

Increases

76
Q

We should monitor weight in people with Schizophrenia; a weight gain of ___% should trigger assessment for metabolic syndrome

A

7

77
Q

We should refer those with schizophrenia to ___ ___ ___ programs as needed

A

Behavioral weight management

78
Q

MNT for schizophrenia:

A

-Recommend regular meal pattern and trial of a low-glycemic, dairy free, Mediterranean diet
-Recommend sources of EPA and DHA (omega 3)
-Rx screening for celiac disease
-Assess for vitamin D and folate deficiency (associated with worse symptoms)
-Assess for food-drug interactions
-Avoid alcohol

79
Q

We should caution against including ____ in the diet for someone with schizophrenia and it can cause increased blood levels of certain antipsychotic medications

A

Grapefruit

80
Q

Addiction involves numerous _____

A

Neurotransmitters

81
Q

The production of ____ produces a sense of pleasure

A

Dopamine

82
Q

Production of dopamine is triggered by use of…

A

-Heroin
-Amphetamines
-Marijuana
-Alcohol
-Nicotine
-Cocaine

83
Q

___ and ____ are also involved in addiction

A

Serotonin and glutamate

84
Q

Effects of addiction on nutrition status:

A

-Poor appetite
-Craving for sugar and sweets
-Constipation
-Lack of motivation to prepare meals
-Malnutrition

85
Q

Malnutrition in someone with addiction may be due to…

A

-Insufficient food or nutrient intake
-Alterations in absorption, digestion, metabolism, or excretion of nutrients

86
Q

____ million people age 12 and up have alcohol use disorder (5.3% of this age group)

A

14.5

87
Q

What screening tool is used to identify people at risk for alcohol use disorders?

A

AUDIT

88
Q

MNT for alcohol use disorder:

A

-Assess dietary intake, GI function, risk of malnutrition, and for potential micronutrient deficiencies
-Prescribe biochemical assessment of thiamin, folic acid, magnesium, and selenium
-Rx multivitamin with minerals for 6 months
-Provide nutrition education

89
Q

In addition to a multivitamin with minerals, what additional supplementation should be given to those with alcohol use disorder?

A

-Thiamin: 50-100 mg
-Folic acid: 1 mg daily

90
Q

We should recommend a nutritionally adequate diet with ___-___% of kcal from high quality protein for those with alcohol use disorder

A

25-30

91
Q

For those with alcohol use disorder, we should prescribe an omega-3 fatty acid supplement of ___-___ mg/day

A

800-1000

Advanced Medical Nutrition Therapy (14 decks)

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