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Advanced Pharmacology Exam 1 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

adult maintenance fluid requirements

A

1500 ml + 20ml/kg over 20 kg

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2
Q

weight change concerning for malnutrition

A

> 10% in past 6 months

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3
Q

Mifflin-St. Jeor Equation

A

equation used to calculate fluid needs for obese patients

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4
Q

concentration of protein

A

4 kcal/g

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5
Q

concentration of lipids

A

9 kcal/g

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6
Q

calorie density of lipid solutions

A 
20% = 2 kcal/ml
30% = 3 kcal/ml
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7
Q

concentration of dextrose/CHO

A

3.4 kcal/g

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8
Q

most detrimental consequence of refeeding syndrome

A

hypophosphatemia

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9
Q

fat soluble vitamins

A

A, D, E, K

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10
Q

water soluble vitamins

A

B, C

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11
Q

required dose of folate for pregnancy

A

800 mg

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12
Q

dietary sources of vitamin K

A

green leafy vegetables

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13
Q

vitamin D deficiency

A

serum concentration <30ng/mL

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14
Q

Components of enteral nutrition solution

A

proteins
fiber
micronutrients
water

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15
Q

protein-nitrogen balance

A

6.25 g of protein contains 1 g of nitrogen

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16
Q

nepro, novasource renal, magnacal renal

A

enteral formulas for renal failure

low protein, high amino acids, designed to minimize BUN

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17
Q

hepatic AID

A

enteric formula for hepatic failure

high conc of branched amino acids, low conc of aromatic amino acids, decrease risk for hepatic encephalopathy

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18
Q

pulmocare, novasource pulmonary, nutrivent

A

enteral formulas for pulmonary disease

low conc of carbs, high conc of fats, minimize accumulation of CO2

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19
Q

glucerna, diabetisource

A

enteral formulas for diabetes

low carbohydrates, high fat/fiber, better glc control

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20
Q

maximum concentration of TPN that can be delivered peripherally in adults and peds

A

adults - 10% dextrose

peds - 900 mOsm/L dextrose/10%, 4% amino acids, 40 mEq/L K, no Ca

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21
Q

peds monitoring for TPN protein

A

BUN, LFTs, albumin, pre-albumin

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22
Q

peds monitoring for TPN lipids

A

triglycerides, bilirubin

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23
Q

lipids infusion rate in infants

A

max 0.15 g/kg/h

infused over 18-24 h (over 12 h in older children and adults)

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24
Q

peds monitoring for TPN carbohydrates

A

serum glc, urine glc

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25
Q

GIR (glucose infusion rate)

A

((rate)(concentration))/6(weight in kg)

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26
Q

optimal calcium/phosphate ratio

A

preterm infants - 2.6 mEq Ca: 1 mMol PO4

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27
Q

who needs vitamin K supplementation?

A

TPN infusion > 2 weeks

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28
Q

similac special care, enfamil premature formula

A

premature formulas

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29
Q

neosure, enfacare

A

transitional formulas

30
Q

similac, enfamil, enfaml enspire, enfamil AR, similac for spit up

A

term formulas

31
Q

enfamil gentlease, enfamil sensitive, similac total comfort, enfamil reguline

A

allegy formulas

32
Q

isomil, prosobee

A

soy formulas

33
Q

progestimil, alimentum, nutramigen, enflora LGG

A

casein hydrolysate formulas

34
Q

puramino, neocate, elecare

A

elemental formulas

35
Q

contraindication to receiving parenteral lipids

A

egg allergy

36
Q

treatment for high gastric residuals

A

metoclopramide, erythromycin

37
Q

what peds need iron supplementation?

A

preterm infants w/o formula or breastmilk fortifier, other infants at high risk/anemic, term infants at 4 mo if exclusively breastfedw

38
Q

what peds need vitamin D supplementation?

A

preterm if not on formula/fortifier, all term breastfed infants

39
Q

what peds need multivitamins?

A

preterm if not on formula/fortifier, high risk infants >6mo

40
Q

s/s of vitamin D deficiency

A

rickets, osteomalacia, osteoporosis, cancer, DM, HTN, HF, infections

41
Q

groups at risk for thiamine deficiency

A 
chronic alcoholics
post bariatric surgery
HIV/AIDS
DM
malnourished
42
Q

s/s of thiamine deficiency

A

beriberi syndrome

  • dry (neurotoxicity) - sensory disturbances, peripheral neuropathy, depression
  • wet (cardiovascular) - dyspnea, tachycardia, cardiac failure

wernicke-korsakoff syndrome

  • wernecke’s encephalopathy - reversible neuro disorder w/ confusion, nystagmus, ataxic gate
  • korsakoff’s - irreversible neuro disorder w prolonged memory impairment
43
Q

tx for thiamine deficiency

A

50-100 mg IV, then or PO

high dose - 100-500 mg IV or PO q8 x3-5 d

44
Q

groups at risk for vitamin B12 deficiency

A

bariatric surgery
vegetarians
IBD

45
Q

s/s of vitamin B12 deficiency

A

tingling, weakness, numbness, fatigue, memory loss

affects tissues w high turnover rate - hematopoietic/nervous systems

46
Q

assessment of vitamin B12 deficiency

A

serum normal level 200-900 pg/ml

schilling test

47
Q

tx for B12 deficiency

A

cyanocobalamin 100 mcg IM/SC weekly x4 weeks, then monthly

B12 1000 mcg PO QD

48
Q

s/s of folic acid deficiency

A

megaloblastic anemia

49
Q

tx for folic acid deficiency

A

folic acid supplementation can reverse hematopoietic manifestations but not neuro s/s

oral/IV 1 mg QD
400 mg OTC

50
Q

normal plasma folate

A

4-20 ng/ml

51
Q

s/s of vitamin B6 deficiency

A

peripheral neuropathy, glossitis, confusion

52
Q

groups at risk for B6 deficiency

A

protein malnutrition, malabsorption, ETOH, hyperthyroidism

53
Q

what is the most accurate biomarker of nutritional status?

A

pre-albumin

54
Q

advantages of breast milk

A

immunologic properties reduce risk of immune-mediated diseases
psych and cognitive advantages
emotional bonding
excellent bioavailability of certain component

55
Q

american academy of pediatrics recommendation for breastfeeding

A

exclusive breastfeeding for the first 6 months of life and continuation for the second 6 months

56
Q

formula for infant w milk allergy

A

similac alimentum advance

57
Q

meds w enteral feeding interactions

A

decreased absorption - levothyroxine, fluroquinolones, carbamazepine, phenytoin

obstruction - sucralfate, sevelamer

clotting - warfarin

58
Q

what amino acid supplementation is used for infants in the first year of life?

A

trophAmine

59
Q

harris-benedict equation

A

used to determine total caloric needs

60
Q

contraindications for enteral nutrition

A 
GI obstruction
ileus
severe malabsorption
severe GI bleeding
IBD
61
Q

polymeric tube feeds are used for

A

patients with normal digestive process

62
Q

partially hydrolyzed/oligomeric tube feeds are used for patients

A

with malabsorptive processes

63
Q

how long can TPN run through PIV?

A

2 weeks

64
Q

component of parenteral nutrition

A 
fluids
dextrose
amino acids
fats
electrolytes
micronutrients
65
Q

what trace element is not in TPN that needs to be supplemented?

A

vitamin K

supplement if on TPN >1 week

66
Q

schofield equation

A

used to calculate caloric needs for peds

67
Q

peds indications for TPN

A 
premature neonates
resp distress
congenital GI anomalies
abdominal wall defects
necrotizing enterocolitis
chronic diarrhea
IBD
metabolic error
pancreatitis, chylothorax, obstruction
hypermetabolic - trauma, cancer
anorexia
cystic fibrosis
chronic renal failure
hepatic failure
68
Q

conditionally essential amino acids

A

**peds don’t break down all aminos - give more cysteine, taurine, tyrosine

accumulation of other aminos - give less phenylalanine and methionine

69
Q

conditions that decrease calcium/phos solubillity

A

increased pH
increased temperature
increased concentration
increased exposure time

70
Q

what is the benefit of adding cystine to premature formula?

A

increasing the potential amount of calcium and phos

70
Q

what is the benefit of adding cystine to premature formula?

A

increasing the potential amount of calcium and phos

71
Q

multivitamins for peds

A

<11 - MVI with A, D, E, K

>11 - MVI-12 + vitamin K supplement

Advanced Pharmacology Exam 1 (4 decks)

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