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Medical Conditions 3 > Nutrition > Flashcards

Nutrition Flashcards

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USMLE® Step 1 flashcards
1
Q

Malnutrition

A
  • an acute, subacte or chronic state of nutrition in which a combination of varying factors of over nutrition or undernutrition with or without inflammatory activity have led to a change in body composition and dminished function
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2
Q

Malnutrition

incidence

A

15-60% of hospitalized patients, depending on the patient population and criteria used to identify malnutrition

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3
Q

Malnutrition

etiology

A
  • stavartion
  • inadequate consumption of appropriate foods
  • acute or chronic illness
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4
Q

Malnutrition

impact on patient outcomes

A

increased length of stay
complications
costs
mortality
readmissions

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5
Q

Malnutrition increase vs decreases

A

increase

  • complications
  • infections
  • length of stay
  • readmissions
  • mortality/treatment

decrease

  • wound healing
  • convalescence
  • quality of life
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6
Q

Nutrition risk factors

A
  • Poor appetite or early satiety
  • PO intolernace
  • dysphagia
  • inability to feed self
  • oral thrush: infection
  • alterantive route of feeding
  • edema dehydration
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7
Q

malnutrition:

prevalence based on location

A
  • hospital 30-50%
  • long term care: 21-51%
  • outpatient and homecare: 13-30%
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8
Q

Malnutrition

at increased risk

A
  • older adults
  • critically ill patients
  • patients wit comorbid chronic disease
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9
Q

screening for malnutrition

A
  • academy nutrition and dietetics/american society or parenteral and enteral nutrition (ASPEN)
  • subjective global assessment (SGA)
  • malnutrition screening tool (MST)
  • mini nutritional assessment MNA
  • malnutrition universal screening tool (MUST)
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10
Q

nutrition focused clinical exam

A
  • weight status:
  • indications of nutrient deficiencies
  • functional status: ambulatory, bedridden
  • fluid assessment: edema turgor tests
  • wound status
  • mental status
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11
Q

Medications related to nutirtion

A
  • appetite enhancers: appetite stimulants, antipsychotics and antidepressants
  • anti-emetics: ondanestron, aprepitant, metoclopramide, meclizine, canabinoids
  • Bowel regimens
  • negative effects: chemo, tricyclic antidepressants, pain medications, steroids
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12
Q

Medication, food and drug interactions

A
  • coumadin and vitamin K, brussel sprouts, collard greens, swiss chard, chamomile tea, mango
  • Zyvox, MAOIs and tyramine-containg foods, fermented foods and alcohol
  • lithium and caffeine or salt
  • cholesterol-lowering statins and grapefruit jucie
  • digoxin, coumadin and natural black licorice
  • digoxin, AC inhibitors and salt substitutes
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13
Q

Supplements are beneficial for

A
  • individuals restricting caloric intake or following restrictive diets
  • pregnent women
  • vegetarians
  • vegans
  • anyone >50
  • individuals with wounds
  • vitamsn are not run through the same screening process - look for USP
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14
Q

Timing Nutrition for exercise

pre-workout

A
  • eat 1-3 hours prior to workout
  • peanut butter and banana
  • greek yogurt with berries
  • turkey and cheese sandwhich on whole wheat bread
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15
Q

Timing nutrition for exercise

post-workout

A
  • eat CHOs and protein as soon as possible
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16
Q

Whey protein supplementation

A
  • water soluble and allows for faster gastric emptying
  • processed into isolates, concentrates and hydrlysates
  • isolates have higher concentrations of protein little or not lactose and have minimal mineral and fat in smaller volumes
  • concentrates have lower concentration of protein and higher concentraction of lactose
  • hydrolysates are pre-digested and partially hydrolyzed to be more easily absorbed
17
Q

casein protein supplementation

A
  • clots in the acid environemnt of the stomach, delays gastric emptying and has slower release of amino acids
18
Q

Protein bars

A
  • help to curb hunger and increase satiety

what to look for

  • less than 200 calories
  • at least 3g of fiber
  • at least 4g of protein
  • aim for less than 12-15g of surgar
19
Q

Paleo diet do eat

A
  • grass-produced meats
  • fish/seafoods
  • fresh fruits and veggies
  • eggs
  • nuts and seeds
  • healthful oils
20
Q

paleo dont eat

A
  • cereal grains
  • legumes
  • dairy
  • refined sugar
  • potatoes
  • processed foods
  • refined vegtable oils
21
Q

gluten free diet

A
  • main way to manage celiac disease
  • autoimmune disease caused by sensitivity to gluten
  • has become a fad diet in the past several years
  • non-celiac gluten sensitivity
22
Q

gluten containing grains

A
  • wheat
  • barley
  • rye
  • triticale
23
Q

Organic vs non-organic

A
  • organic = foods grown without using artificial materaials such as pesticides and antibiotics
  • according to the AICR at this time it is not known whether organic foods help to reduce cancer
  • use the environment working groups the shopper’s guide to pesticides in produce
24
Q

EWG’s dirty dozen plus two

A
  • apples
  • strawberries
  • grapes
  • celery
  • peaches
  • spinach
  • sweet bell peppers
  • nectarines
  • cucumber
  • cherry tomatoes
  • snap peas
  • potatoes
  • hot peppers
  • kale/collard greens
25
Q

EWG’s clean 15

A
  • avocadoes
  • sweet corn
  • pineapple
  • cabbage
  • sweet peas (frozen)
  • onions
  • asparagus
  • mangoes
  • papayas
  • kiwi
  • eggplant
  • grapefruit
  • cantaloupes
  • cauliflower
  • sweet potatoes
26
Q

GMOs

A
  • a plant or meat product that has had DNA artificially altered in a lab by genes from other plants, animals, viruses or bacteria in order to produce foreign compounds in that food
  • FDA regulates GE crops in conjunection with the US department of agriculture and envirnmental protection agency
  • most common GE foods are cotton corn and soybeans
  • US and canda do not require labeling of GMOs
27
Q

macronutrients and micronutrients

A

macronutrients and building blocks

  • carbs => glucose
  • proteins => amino acids
  • fats => fatty acids

micronutrients:

  • vitamins - fat soluble and water soluble
  • minerals carbon, hydrogen, oxygen and nitrogen etc
28
Q

bariatric surgery

A
  • sleeve gastrectomy
  • LAP band (can come off = complication)
  • Roux-en-Y bypass - deficiences
  • duodenal switch - deficiencies in nutrients
29
Q

goal before surgery

A
  • practice eating slowly and chewing foods thoroughly
  • wean off beverages containing caffeine, carbonation and sugar
  • choose foods with < 3g fat per ounce or per serving
  • start eating protein at each meal
  • purchase and trial protein supplements
  • purchase vitamin and mineral supplements
30
Q

after bariatric surgery 1st week

A
  • no conentrated sweets
  • no caffeine
  • no carbonation
  • each meal should equal 3 ounces
  • sip liquids slowly take a minimium of 15 minutes
31
Q

after bariatric surgery

2nd week

A
  • no concentrated sweets
  • no caffeine
  • no carbonation
  • each meal should equal 3 ounces
  • sip liquids slowly should take a minimum of 15 minutes
32
Q

after bariatric surgery

3rd and 4th week

A
  • 3 pureed meals per day plus 11-15 oz
  • make each meal last 30 minutes
  • only drink fluids between meals
  • eat protein foods first
33
Q

after bariatric surgery: 5th week

A
  • 3 meals per day plus 2 protein rich snacks
  • make each meal last 30-45 minutes
  • chew foods thoroughly
34
Q

medications for weight loss

A
  • semaglutide under brand names such as
  • ozempic, rybelsus and wegovy
  • for long term treatment of type 2 diabetes or obesity
35
Q

how does semaglutide work

A
  • incretin glucagon-like peptide-1 GLP receptor agonists:
  • increases insuling production when blood glucose is elevated
  • slows gastric emptying
  • acts on parts of brain resposible for hunger and cravings
36
Q

risk with semaglutide

A
  • nausea, vomiting, diarrhea, constipation
  • increased risk of pancreatitis, kidney failure and medullary thryoid carcinoma
  • gall bladder disease
  • ozempic faces- loss of fat and skin sagging
  • possible nutrient deficiences
  • possible muscle loss
  • regainning weight within a year of stopping

Medical Conditions 3 (14 decks)

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