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TCM Review: Biomed > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Hypernatremia Causes S/S

A

Hypernatremia
• Usually due to dehydration• Excess sweat with salt
intake• Excess diuretics with salt
intake• Nausea and vomiting with
high salt intake • Burns
S/S: confusion, neuromuscular excitability,
hyperreflexia, seizures, coma, cerebrovascular damage with subcortical or subarachnoid hemorrhage, venous
thrombosis

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2
Q

hyponatremia Causes S/S

A

Hypovolemic hyponatremia
• Extrarenal fluid loss
• Renal fluid loss (diuretic therapy) • Diuretics • Nausea and vomiting • Diarrhea • Burns • Pancreatitis •Rhabdomyolysis• Small intestine obstruction• Opioids, NSAIDs • Addison’s disease• Hypothyroidism• Chronic pain • Cirrhosis • Heart failure• Chronic Renal Disease
S/S: lethargy, confusion, altered mental status, stupor, neuromuscular hyper-excitability, hyper-reflexia, seizures, coma, death

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3
Q

Sodium (Na) Diagnostic

A

Both: serum or urine

electrolyte osmolality

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4
Q

Hyponatremia Treatment

A

Red flag: refer to ER immediately • Saline drip• Fluid restriction• Removal of diuretics

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5
Q

Hyperkalemia Causes

A

Hyperkalemia
• Acute renal failure• Chronic kidney disease• Rhabdomyolysis• Burns• GI bleed• Adrenal insufficiency• Hyper-potassium supplementation • Bleeding ulcers• Penicillin use

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6
Q

Hyperkalemia S/S

A

S/S: flaccid paralysis, cardiac
tonicity with weakness or paralysis (mostly asymptomatic) Caution: ACE inhibitors, potassium sparing diuretics, urinary obstruction, renal
failure, advanced heart failure

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7
Q

Hypokalemia Causes

A

Hypokalemia
• Chronic diarrhea with laxative use• Clay (betonite) ingestion • Vomiting • Protracted gastric suction • Heavy Gan Cao (glycerraziause )or chewing tobacco • Cushing’s syndrome• Bartter syndrome: mutations to diuretic loop, sensitive ion transport in the loop of Henle • Medications• Diuretics: Thiazides, loop diuretics, osmotic diuretics, laxatives, high dose penicillin, theophylline intoxication

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8
Q

Hypokalemia S/S

A 
S/S: muscle weakness, 
cramping, fasciculations, 
paralytic ileus,
hypoventilation, hypotension, 
tetany, rhabdomyolysis, 
polyuria, secondary polydipsia
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9
Q

Hyperkalemia Diagnostic

A 
Hyperkalemia: 
Serum K levels, EKG, Renal 
evaluation 
EKG: if levels
are >5.5 mEq/L, patient will 
have slow conduction with 
increased PR interval, short 
QT which will be tall, peaked 
T wave
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10
Q

Hypokalemia Diagnostic

A 
Hypokalemia: 
Serum potassium, 24 hour 
urine potassium and serum 
mg levels 
EKG: do if serum levels are <3 
mEq/L. 
Reading includes: 
Sagging of
ST segments, depression of T 
wave, elevated U wave
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11
Q

Hyperkalemia Treatment

A 
Hyperkalemia: 
Beta-2 agonist, hemodialysis, 
IV calcium solution, IV insulin 
or glucose
RED FLAG FOR Hyperkalemia: 
Lithium, NSAIDS, 
trimethoprim, Heparin, 
Cyclosporine, Direct Renin 
Inhibitor, Angiotensin
II receptor blockers,
ACE inhibitors, Digoxin, Beta 
blockers, adrenal insufficiency
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12
Q

Hypokalemia Treatment

A 
Hypokalemia: 
Potassium supplements, IV 
potassium (banana bag) 
High-risk in patients on: 
Digoxin, insulin, beta 
antagonists (for asthma), also 
patients with left ventricular 
dysfunction
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13
Q

Hypercalcemia Causes

A 
Hypercalcemia: 
• Hyperparathyroidism
• Cancer with bone 
metastasis
• Paget’sdisease
• Osteoporosis
• Paraplegia, quadriplegia
• Lymphoma
• Multiple myeloma
• Vitamin A &amp; D toxicity
• Tuberculosis
• Contaminated glassware 
with blood 
• Prolonged venous  stasis
due to tourniquet being left 
on too long)
• Myxedema
• Cushing’sdisease
• Addison’sdisease
• Medications: lithium, 
Theophylline, Thiazide
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14
Q

Hypercalcemia S/S

A 
S/S: constipation, anorexia, 
nausea and vomiting, 
abdominal pain, polyuria, 
nocturia, polydipsia, delirium, 
confusion, psychosis, stupor, 
coma  neuromuscular
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15
Q

Hypocalcemia: Causes

A 
Hypocalcemia: 
• Hypoparathyroidism
• Vitamin D deficiency
• Renal Disease
• Magnesium depletion • 
Acute pancreatitis 
• Hypoproteinemia
• Septic shock
• Hyperphosphatemia
• Anticonvulsant use
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16
Q

Hypocalcemia: S/S

A 
S/S: carpopedal spasm, 
parasthesia of
the lips, fingers and feet;
general muscle aching, facial 
spasms, dry scaly skin, brittle 
nails, candida infections, 
brittle, coarse hair, cataracts
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17
Q

Hypocalcemia Diagnostic

A

Blood calcium

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18
Q

Hypercalcemia Diagnostic

A

Total serum, calcium, chest X-ray, urine calcium

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19
Q

Hypocalcemia Treatment

A

Hypocalcemia:
IV calcium gluconate for tetany
Oral calcium and vitamin D for chronic hypocalcemia

20
Q

Hypercalcemia Tx

A

Hypercalcemia:

IV saline and Furosemide, Bisphosphonates, hemodialysis

21
Q

Hyperphosphatemia Causes

A 
Hyperphosphatemia: 
• Hypoparathyroidism
• Excess enema use
• Diabetic ketoacidosis 
• Rhabdomyolysis
• Systemic infections
• Tumor-lysis syndrome
22
Q

Hyperphosphatemia S/S

A

S/S: hypocalcemia, tetany,

soft tissue calcemia

23
Q

Hypophosphatemia Causes

A

Hypophosphatemia:
• Recovery phase of ketoacidosis• Acute alcoholism• Severe burns• Under nutrition • Hyperparathyroidism• Cushing’s syndrome• Hypothyroidism• Hypomagnesemia and hypokalemia• Diureticuse• Theophyllineintoxication• Chronic fasting• Vomiting or diarrhea
• Long term antacid use

24
Q

Hypophosphatemia S/S

A

S/S: usually asymptomatic, anorexia, muscle weakness,
osteomalacia, hemolytic anemia, decreased release of
oxygen

25
Q

Phosphorus (Ph+) Diagnostic (both)

A

Serum phosphorus levels

26
Q

Hyperphosphatemia Treatment

A

Phosphorus restriction or binders

27
Q

Hypophosphatemia Treatment

A

Phosphorus replacement, IV phosophorus

28
Q

Hypermagnesemia Causes

A 
Hypermagnesemia: usually 
uncommon and/or 
asymptomatic 
Hypotension 
• Respiratory depression
• Cardiac arrest
• Excess antacid use
• Excess laxative use
29
Q

Hypermagnesemia S/S

A

S/S: hyporeflexia,
hypotension, respiratory
depression, cardiac arrest

30
Q

Hypomagnesemia Causes

A 
Hypomagnesemia: 
• Alcoholism
• Chronic diarrhea
• Steatorrhea
• Small intestine bypass
• Preeclampsia/eclampsia
• Lactation
• Hypercalcemia
• Removal of parathyroid 
tumor
• Hypersecretion of 
aldosterone
• Thyroid hormone use
• ADH use
• Polyurea
31
Q

Hypomagnesemia S/S

A

S/S: anorexia, nausea and
vomiting, lethargy, weakness,
personality change, tetany,
carpopedal spasm

32
Q

Hyper/Hypomagnesemia Diagnostics

A

Serum Magnesium Levels

33
Q

Hypermagnesemia Treatment

A

Magnsium gluconate Diuretics

Dialysis

34
Q

Hypomagnesemia Treatment

A

IV or IM magnesium sulfate,

Oral magnesium salts

35
Q

Hypernatremia Treatment

A

Free water IV therapy

36
Q

Vitamin B1 (Thiamin)

A

Source: Whole grains, pork, liver, cereal, nuts, legumes, tubers
Function: Carbohydrate, lipid, amino acid, glucose and alcohol metabolism; CNS/PNS cell function, myocardial function
Deficiency/toxicity: Deficiency: Beriberi, Wernicke Korsakoff Enceph

37
Q

Vitamin B2 (Riboflavin)

A

Source: Milk, cheese, liver, meat, eggs, cereals
Function: Carbohydrate and protein metabolism, mucous membrane integrity
Deficiency/toxicity: Deficiency: cheilosis, angular stomatitis, corneal vascularization

38
Q

Vitamin B3 (Niacin)

A

Source: Liver, red meat, fish, poultry, legumes, whole grains
Function:Oxidation reduction, carbohydrate/cell metabolism
Deficiency/toxicity: Deficiency: pellagra (dermatitis, glossitis, GI and CNS dysfunction) Toxicity: flushing

39
Q

Vitamin B6 (Pyridoxine)

A

Source: Organ meats, fish, legumes
Function: Nitrogen metabolism, nucleic acid biosynthesis, fatty acid, lipid and amino acid metabolism
Deficiency/toxicity: Deficiency: seizures, anemia, neuropathies, seborrheic dermatitis Toxicity: peripheral neuropathy

40
Q

Vitamin B12 (Cobalamin)

A

Source: Red meat, organ meat, pork, poultry, egg, cereals, dairy
Function: Maturation of red blood cells, neural functions, DNA, myelin repair
Deficiency/toxicity: Deficiency: megaloblastic anemia, parasthesias, ataxia

41
Q

Folate (Folic Acid/B9)

A

Source: Leafy greens, fruit, organ meats, enriched cereals
Function: Maturation of red blood cells, synthesis of purines, fetal nervous development
Deficiency/toxicity: Deficiency: megaloblastic anemia, neural tube defect, mental confusion

42
Q

Vitamin C (Ascorbic Acid)

A

Source: Citrus fruit, tomatoes, tubers, broccoli, strawberries, sweet peppers
Function: Collagen formation, bone and blood vessel health, carnitine, hormone/amino acid formation, wound healing
Deficiency/toxicity: Deficiency: scurvy (bone defects, gingivitis, loose teeth, hemorrhages)

43
Q

Vitamin A (Retinol)

A

Source: Fish liver oil, liver, egg yolk, butter, dark green/yellow vegetables, carrots, yellow and orange fruit
Function: Photoreceptor pigment of retina, epithelial integrity, lysosome stability, glycoprotein synthesis
Deficiency/toxicity: Deficiency: night blindness, hyperkeratosis, xerophthalmia, keratomalacia, morbidity and mortality in young children

44
Q

Vitamin D (Cholecalciferol)

A

Source: Direct UVB light, fortified foods, fish liver oil, liver
Function: Calcium and phosphate absorption, bone mineralization repair, insulin and thyroid function, increased immunity, reduce autoimmune disease
Deficiency/toxicity: eficiency: rickets, osteomalacia Toxicity: hypercalcemia, anorexia, renal failure, metastatic calcification

45
Q

Vitamin E (AlphaTocopherol

A

Source: Vegetable oil, nuts, legumes
Function: Intracellular antioxidant
Deficiency/toxicity: Deficiency: red blood cell hemolysis, neurologic deficits (Nystagmus) Toxicity: bleeding

46
Q

Vitamin K (Phylloquinone)

A

Source: Green leafy vegetables, soy beans, vegetable oil, bacteria in the GI tract
Function: Formation of prothrombin for coagulation and bone proteins
Deficiency/toxicity: Deficiency: bleeding, osteopenia

47
Q

Common Dietary Deficiencies

A

Vegan: Vitamin B12 (unless eating yeast or fermented foods), low calcium, Iron, Zinc
Fruitarian: Protein and sodium deficiency
Very low calorie diet: Wasting syndrome when in long term
Fad Diets: Tendency to cause: protein and mineral deficiencies leading to renal, cardiac or metabolic disorders
Alcoholism: Tendency to cause: protein and mineral deficiencies leading to renal, cardiac or metabolic disorders

TCM Review: Biomed (11 decks)

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