MNT for rheumatic and musculoskeletal disease

Question 1

Rheumatic diseases are always characterized by ________

Answer 1

inflammation

Question 2

other characteristics of Rheumatic disease is ____ of function of connective tissue and supporting body structures and a possible ________ component

Answer 2

loss, autoimmune

Question 3

Rheumatic diseases is usually ____, but can have acute episodes. Therapy designed to ______ symptoms

Answer 3

chronic, manage

Question 4

Inflammation is do to stress on ___ in osteoarthritis

Answer 4

joints

Question 5

Inflammation due to ____ response in rheumatoid arthritis, gout

Answer 5

autoimmune

Question 6

Omega- __ are precursors to pro-inflammatory eicosanoids (promote inflammation, blood clotting, raise in blood pressure)

Answer 6

6 (linoleic acid and arachidonic acid)

Question 7

T/F: linoleic acid is converted into arachidonic acid which is converted to the eicosanoids

Answer 7

True

Question 8

What is the main component of most seed oils, corn and soy bean oil?

Answer 8

Linoleic acid

Question 9

T/F: seed oils are preferred over saturated fats even though they are pro-inflammatory

Answer 9

true

Question 10

Omega-__ are precursors to anti-inflammatory eicosanoids (lower TG, keep blood pressure low, and act as a blood thinner)

Answer 10

3, EPA and DHA (fish, fish oils), Alpha-linolenic acid (flax seeds, chia seeds, hemp, walnuts)

Question 11

T/F: ALA needs to be converted to EPA or DHA to meet the anti-inflammatory eicosanoids

Answer 11

True, that’s why you can eat fish sparingly, but if depending only on plant sources need to consume a lot more.

Question 12

Omega 9 sources

Answer 12

MUFA, avocado, olive oil, canola oil, nuts/ nut oils . neutral in inflammatory

Question 13

What are symptoms of arthritis?

Answer 13

pain, stiffness, loss of function

Question 14

Physical examination of arthritis

Answer 14

redness, swelling (might not be apparent in OA)

Question 15

Biochemical assessment of arthritis

Answer 15

rheumatoid factor (high in RA)
CRP & homocysteine (inflammatory factor, however they aren’t specific to arthritis)

Question 16

Treatment of arthritis

Answer 16

• Analgesics (Tylenol, opioids)
• DMARDs (disease modifying anti-rheumatic drugs) - methotrexate and Humira
• Anti-inflammatories - NSAIDs (ibuprofen, alieve, aspirin) , corticosteroids (usually end in -sone)

Question 17

Risk factors for osteoarthritis

Answer 17

• repetitive motion/ injury
• obesity
• female gender
• aging

Question 18

characteristics of osteoarthritis

Answer 18

cartilage destruction, asymmetric inflammation

Question 19

MNT for osteoarthritis

Answer 19

• weight management
• anti-inflammatory diet
• supplements

Question 20

What are supplements for osteoarthritis?

Answer 20

• S-adenosyl-L-methionine (SAM-e) - may be as effective as NSAID with fewer side effects
• Fish oil
• Chondroitin
• glucosamine
• vitamin D

Question 21

________ is likely effective in knee OA and ____ is possibly effective on OA in general

Answer 21

glucosamine , chrondoitin

Question 22

What foods should be limited in OA?

Answer 22

• red meat / dairy (sat fat/trans)
• refined sugars
• alcohol
• calorie intake
• omega-6
• processed foods

Question 23

nightshades cantain ______ which are pro-inflammatory (green stuff in potatoes)

Answer 23

solanine

Nightshades: potatoes, peppers, tomatoes, eggplants

Question 24

What foods should we promote in OA (anti-inflammatory)

Answer 24

• fish/ lean/ plant proteins
• omega 3
• vitamin D
• whole grain
• probiotics and prebiotics
• phytochemical in veggies/fruit

Question 25

T/F: 3 tbsp olive oil may have the same affect of ibuprofen

Answer 25

true

Question 26

antioxidants for a anti-inflammatory diet

Answer 26

- vitamin C and E - selenium - curcumin (turmeric) - ginger - capsaicin (Chile peppers) - catechin (green tea)

Question 27

Rheumatoid arthritis is correlated to a ________ disease

Answer 27

rheumatoid

Question 28

risk factors of rheumatoid arthritis

Answer 28

- age (40 -60, specifically women) - genetics - female gender - obesity - smoking *more associated with hormonal changes possibly*

Question 29

OA is ___metric

Answer 29

asymmetric (pockets of inflammation)

Question 30

RA is __metric

Answer 30

symmetric (more uniformity in inflammation around the joint)

Question 31

characteristics of RA

Answer 31

symmetric inflammation, bone and cartilage loss, inflamed synovium, swollen joints

Question 32

Nutrition assessment for RA

Answer 32

- weight change, muscle wasting - ability to perform nutrition-related ADLs (can they cook?) - CVD risk

Question 33

MNT for RA

Answer 33

- anti-inflammatory or mediterranean diet - intermittent fasting, fast-mimicking diet - vegan diet - gluten-free diet

Question 34

Energy needs for RA

Answer 34

- depends on weight and mobility - REE may be increased, but physical activity may be reduced

Question 35

Protein needs for RA

Answer 35

1.5-2 g/ day if malnourished or in catabolic phase

Question 36

supplements for RA

Answer 36

- limited evidence for ginger, cinnamon, saffron, cur cumin - fish oil (may need 4 g/day EPA/DHA) - calcium and vitamin D (if on steroids) - folic acids if on MTX - probiotics (better if food source) - Adequate B vitamins to lower homocysteine (inflammatory marker)

Question 37

Gout is a disorder of ______ metabolism, resulting in hyperuricemia

Answer 37

purine

Question 38

gout involved ______ levels of uric acid in the blood, the crystals deposit in joints, tendons, and surrounding tissues

Answer 38

elevated

Question 39

______ urate crystals form and deposit in joints

Answer 39

sodium

Question 40

Gout is associate in sudden and acute onset pain

Answer 40

true

Question 41

risk factors of gout

Answer 41

obesity genetics age, gender (men are at high risk) HTN, CKD sleep apnea lead exposure consumption of alcohol and HFCS

Question 42

MNT for gout, limit:

Answer 42

- seafood, red meat - alcohol - fructose - high purine foods

Question 43

MNT for gout, increase:

Answer 43

fluids low fat dairy products cherries coffee folic acid, vitamin C fish oil supplements

Question 44

gout is a disease of ______

Answer 44

excess, consuming lots of wine, food, beer. gluttony