Nutrition

Question 1

Strongest indicator for poor nutritional status

Answer 1

Preop albumin <3

Question 2

Only amino acids that are not glucogenic

Answer 2

Leucine and Lysine

Question 3

Anion gap metabolic acidosis, AMS, diabetes insipidus, hyperbilirubinemia, thrombocytopenia; dx and tx

Answer 3

Beri beri, thiamine 100mg

Question 4

Branched chain amino acids

Answer 4

Leucine, Isoleucine and Valine

Question 5

Primary energy source for muscle protein metabolized by muscle itself used in patients with chronic liver disease and encephalopathy

Answer 5

BCAAs

Question 6

Obligate glucose users

Answer 6

RBCs, Neutrophils, Peripheral neurons and adrenal medulla

Question 7

Fuel source for colonocytes

Answer 7

Short chain fatty acids (butyrate, acetate)

Question 8

Fuel source neoplastic cells

Answer 8

Glutamine #1, glucose #2

Question 9

Fuel source stomach, enterocytes, pancreas, spleen

Answer 9

Glutamine

Question 10

Best marker for long-term nutritional status

Answer 10

Albumin, half life 20days

Question 11

ERAS principals

Answer 11

Enteral nutrition with high cal supplements POD1
Multimodal pain control
Catheter removal POD1
Early mobilization POD0

Question 12

Primary fuel source <24hrs fasting

Answer 12

Hepatic glycogen

Question 13

Primary substrate 5-7days NPO

Answer 13

Alanine through gluconeogensis

Question 14

Dry eyes, night blindness, keratomlacia; deficiency

Answer 14

Vit A

Question 15

Conditionally essential amino acids in times of stress

Answer 15

Glutamine and Arginine

Question 16

Adjusted TPN protein for ESRD patietns

Answer 16

1.2-1.5g/kg/day

Question 17

Deficiency caused by Carcinoid tumors; dx and findings

Answer 17

Pellagra (niacin deficiency), diarrhea, dementia and dermatitis

Question 18

Increased energy requirement in lactating women

Answer 18

500 kcal/day

Question 19

Refeeding syndrome abnormalities

Answer 19

Hypophosphatemia, hypomagnesemia, hypokalemia

Question 20

Megablastic anemia s/p gastrectomy; MOA

Answer 20

Loss of parietal cells of the stomach which secrete IF to absorb B12 in TI

Question 21

Macronutrient important to prevent post-op complications in malnutrition preop

Answer 21

Protein

Question 22

Marker for acute nutritional deficiency and its half life

Answer 22

Prealbumin, 2-3days