Nutrition Flashcards

1
Q

Why are vitamins and minerals required in the body?

A

They play a key role as co-factors or co-enzymes in mot metabolic reactions

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2
Q

Give examples of water soluble vitamins

A
Vit C - ascorbic acid
Vit B1 - Thiamine 
Vit B2 - Riboflavin 
Vit B3 - Niacin / Nicotinic acid
Vit B5 - Pantothenic acid 
Vit B6 - Pyridoxine 
Vit B7 - Biotin 
Vit B9 - Folic acid 
Vit B12 - Cyanocobalamin
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3
Q

Give examples of fat soluble vitamins

A

Vit A - retinol
Vit D - Cholecalciferol
Vit E - 𝜶 tocopherol
Vit K - Phytomendione

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4
Q

Where are water soluble vitamins absorbed?

A

In the duodenum

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5
Q

Where are fat soluble vitamins absorbed?

A

In the ileum

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6
Q

What absorbs Vit B12?

A

Intrisic factor in the ileum

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7
Q

Apart from the diet, what is another source of Vit D?

A

Sunlight

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8
Q

What does Vit A deficiency cause?

A

Poor night vision

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9
Q

What does Vit B1 deficiency cause?

A

Wernickes encephalopathy

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10
Q

What does Vit B7 deficiency cause?

A

Hair loss

Anaemia

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11
Q

What does Vit B9 deficiency cause?

A

Megaloblastic anaemia

Neural tube defects

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12
Q

What does Vit B12 deficiency cause?

A

Pernicious anaemia

Peripheral neuropathy

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13
Q

What does Vit C deficiency cause?

A

Painful joints

Scurvy

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14
Q

What does Vit D deficiency cause?

A

Rickets

Osteoporosis

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15
Q

What does Vit K deficiency cause?

A

Abnormal clotting

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16
Q

What do folic acid supplements do in pregnancy?

A

Prevent neural tube defects - spina bifida

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17
Q

What dose of folic acid should given to a woman with no previous history of neural tube defects?

A

400mcg OD until 12th week

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18
Q

When should a woman be given a dose of 5mg folic acid?

A
  • Previous history of neural tube defects

- Epilepsy / on anti-epileptics

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19
Q

What are minerals and trace elements required for?

A
  • Formations of bones and teeth
  • Body fluids and tissues
  • Enzyme systems
  • Nerve function
  • Blood constituents
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20
Q

Give examples of minerals

A
  • Calcium
  • Magnesium
  • Phosphorous
  • Sodium
  • Potassium
    Required in large amounts
21
Q

Give examples of trace elements

A
Iron
Zinc
Iodine
Fluoride 
Selenium 
Copper
22
Q

What does potassium and magnesium deficiency cause?

A

Cardiac arrhythmias

23
Q

What does calcium and magnesium deficiency cause?

A

Osteoporosis
Muscle cramps
Tetany

24
Q

What does zinc deficiency cause?

A

Hair loss

Poor wound healing

25
What does iron deficiency cause?
Anaemia
26
What is Wilson's disease?
Build up of copper and excessive copper deposits due to an enzyme deficiency
27
What are the problems associated with supplements?
``` Toxicity / accumulation Supplements are expensive Complacency No control because of legal status Difficult to offer advice as they are not medicines ```
28
What does folic acid interact with?
Methotrexate
29
What does vitamin C interact with?
Iron
30
What are the consequences of malnutrition
- Weakness and loss of muscle mass - Apathy and depression - Reduced immune system - Poor wound healing - Increased morbidity and mortality
31
What are the normal feeding aims?
Energy: 25-35 kcal / kg / day Protein: 0.8 - 1.5g / kg / day Fluid: 30 - 35ml / kg / day
32
What are the methods that can be used to feed patients?
- Normla diet - Enteral nutrient - IV fluids - Parenteral nutrition
33
How is enteral nutrition administered?
Via gastrointestinal tract
34
What are the benefits of EN?
- More physiological - Less risk of infection - Maintain GIT - Gut bacteria translocation - Lower cost - Easier for home patients - Patient ease - Calorie control
35
Which patients would benefit from EN?
- Patients with eating / swallowing difficulties - Severe intestinal malabsorption - Increased nutritional requirements - Eating disorders - Self neglecting patients
36
What are the routes of EN administration?
Oral Naso gastric tube Percutaneous endoscopic gastronomy (tube passed through abdominal wall) Percutaneous endoscopic jejunostomy
37
What are the problems associated with EN?
- diarrhoea - regurgitation - abdominal distention - blocked feeding tube - problems with the pump - taste/acceptability - dislocation
38
How should drugs be administered in EN patients?
- Use liquid preparation where possible - Give each drug separately - Flush with >20ml water before and after - Crushed tablets may block tube - Not MR or e/c
39
Which drug directly interact with EN feed?
``` Ciprofloxacin Albumin antacids Theophylline Phenytoin Penicillamine ```
40
When should TPN be used?
- When EN is not an option - When patient can't take food in orally - Digestion / absorption problems - Unavailable GIT
41
What are short term indications for TPN?
- waiting for feeding tubes - bowel obstruction - excisional surgery - ICU patients with multi-organ system failure - severe pancreatitis - pre-term neonates - acute intestinal failure
42
What are long term indications for TPN?
- radiation enteritis - Crohns disease - motility disorders - bowel infarction - cancer surgery - chronic intestinal failure
43
How is short term TPN administered?
via cannula (Venflon)
44
How is long term TPN administered?
Peripherally inserted central catheter (PICC) Hickman line Central line : intrajugular, subclavian, femoral
45
What needs to be monitored when a patient is on TPN?
``` Clinical history U&Es Glucose Vitamins LFTs FBS Trace elements Fluid balance Weight ```
46
What are TPN complications?
- air embolism / insertion problems - catheter blockage - line infections - metabolic problems - bone disease - re-feeding syndrome
47
What is re-feeding syndrome?
It is characterised by abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypophosphatemia, hypermagnesaemia and hypokalaemia
48
How is re-feeding syndrome prevented?
By introducing feed at no more than 50% of the normal requirements. Start at 10kcal / kg / day and increase slowly to meet full needs by 4-7 days
49
What supplements should be given in re-feeding?
Oral thiamine 200-300mg daily Vitamin B co-strong 1-2 three times daily Multivitamin