Nutrition Flashcards
1
Q
Basal Metabolic Rate
- what is it?
- takes into consideration
- age
- equation
- importance
A
- amount of energy expended on daily basis at rest
- lean body mass and size
- decreases
- 10 (kg) + 6.25 (cm) - 5 (age) +5 men//-161 female
- know how much nutrition the patient needs in order to heal
2
Q
visceral fat
- surrounds
- importance
- high amnt related to
- inflammatory state
A
- internal organs
- helps to maintain body temp
- type 2 DM
- athersclerosis
3
Q
Waist to Hip Ratio
- what is it
- male
- female
- high associated with
A
- circumference of waist over circumference of hip
- 0.85-0.9
- 0.75-0.80
- insulin resistance, diabetes, metabolic syndrome
4
Q
Metabolic Syndrome
- what is it
- importance
A
- HTN, high sugar, high cholesterol, excessive fat around waist
- increases risk of diabetes, stroke, heart disease
5
Q
BMI
- equation
- normal
- overweight
- moderately obese
- severely obese
- very severely obese
- athletes
A
- (lb)/ (in) * 703
- 18.5-24.9
- 25-30
- 30-35
- 35-40
- > 40
- have elevated BMI
6
Q
Anorexia
- what is it
- epi
- normal daily caloric intake
- hormones
- signs and sxs
- other dx
- nervous sxs complications
- CV compications: pulse, BP, ECG changes, rhythms; mechanical problems
- Heme complications
- MSK complications
- Renal complications
- GU complications
- GI complications
- prognosis
A
- significantly low weight
- 13-18 yrs; 3-5% of people in world have anorexia
- 600- 800 calories
- amenorrhea bc loss of pulsatile GnRH -> low LH and FSH -> low estrogen -> no ovulation; increased cortisol
- excessive exercise; fine weight hair; hair loss; hypokalemia; meal time rituals; always on diet; depression; fatigue; irrational fear of gaining weight
- OCD
- decreased cognition w/ grey and white matter changes -> white matter is restored with weight gain; seizures; increased pain threshold and changes in thermoregulation
- decreased pulse and BP; AV block; QT prolongation; ST depression; T wave inversion; SVT or Vtach; decreased LV function, increased risk mitral valve prolapse
- Pancytopenia
- SM dysfunction and osteroporosis; increased growth hormone w/ decrease in insulin like growth factor -> growth arrest/ delay
- Proteinuria, decreased GFR, and all electrolytes will be decreased
- increased ammonium urate stones
- abnormal LFT
- 20% die -> arrhythmia and suicide
7
Q
Bulimia Nervosa
- what is it
- body stature
- look for
- health consequences
A
- binging and purging
- normal BMI or slightly over weight
- erosion of teeth, enlarged parotid glands
- HTN, DM2, CAD, OA, Sleep apnea, CA (bc of extra adipose tissue releasing estrogen)
8
Q
Fat soluble vitamins
A
- D, A, K, E
9
Q
Vitamins
A
- A, B, C, D, E, K
10
Q
Minerals
A
-
11
Q
Vitamin D
- source
- used for
- deficiency in kids vs adults
- complications
- activation
- 25 OH D3 function
- 1,25 di-OH D3 function
- PTH
- calcitrol
- breast milk
- vit D resistant rickets
- excess
A
- sunlight or veggies
- Ca homeostasis; intestinal absorption of Ca and phosphate in GI tract
- vit D rickets vs osteomalacia
- DM, bc Ca is responsible for exocytosis of insulin
- goes to liver and become 25 hydroxy D3, then to kidney to become 1-25 di hydroxy D3
- helps w/ atherosclerosis and prevents prostate and breast Ca
- increases insulin, increase mineralization of bone, decrease left ventricular hypertrophy, increases immune system, improves RBC creation
- increases osteoclast activation -> increase Ca and phosphate in blood -> and increase reabsorption of Ca in kidney and decreases reabsorption of phosphate
- decrease absorption of Ca at GI tract
- not sufficient in breast milk -> expose kid to sun or give droplets
- does not respond to only vit D, will continue to pee out phosphate so need to supplement oth vit D and phosphate to maintain Ca levels
- hyper Ca; stones, bones, moans (GI pain), groans, psych problems
12
Q
Vit E
- used for
- intake
- found in
- deficiency
- protects
- connections to Alzheimers
A
- anti- oxidants -> reduces glutathione
- 15 mg/ day
- leafy veggies, avocado, asp, broccoli
- RBC destruction, neuro consequences similar to Friedrichs ataxia, retinopathy, myopathy
- neurons
- delays
13
Q
Vit K
- used for
- source
- activated by
- needed for
- depletes fastest
- warfarin: ROA, pregnancy, moitor with, reversal; time frame; pathway affected
- heparin: MOA, pathway affected; measure with; side effects; reversal
A
- clotting
- 1: plants, 2: stored animal form
- gut flora -> new borns get shot of vit K
- 2, 7, 9, 10, protein C and S –> converts glutamyl into gamma-carboxyglutamate
- protein c which helps to break down clots -> causes a rash so need warfarin bridge
- oral, teratogenic; monitor PT and INR should be 2-3x normal -> means it takes 2-3x longer to clot; reverse warfarin with FFP and vit K; for clots leave on for 3 months; works on extrinsic pathway
- cofactor for anti-thorombin 3; works on intrinsic pathway because blocks thrombin formation and causes it to degrade; measure with PTT; can cause heparin induced thrombocytopenia when antibodies towards heparin start reacting to platelets; protamine sulfate
14
Q
Factor V Leiden
- most common cause of
- genetics
- what happens
- tx; why
A
- spontaneous clots
- auto DOM; arginine replaced wth glutamine on Factor V
- Factor V cannot be inactivated by protein C
- life long warfarin; even though factor V is on, if other factors cannot be activated then it wont react with the turned off factors
15
Q
Vit A
- role
- nyctalopia: what is it
- hereditary retinitis pigmentosa: what is it, caused by, different things seen
- toxic retinopathy
- skin: function, med
- bone: function, excess
- pregnancy: effects
- tox: amount, leads to, acute, chronic
- pseudotumor cerebri: what is it, sigs, sxs, imaging, side effects, tx
A
- vision, gene transcription, skin, bone, CSF
- poor night vision; can happen with decrease in vit A
- degeneration of rods and visual signals cannot be converted into electrical impulses
- optic nerve damage secondary to EtOH (everything turns white), amneodarone, digoxin (everythng turns yellow) and INH
- turns immature skin cells into mature epidermal cells –> accutane
- co-factor for PTH -> too much will increase PTH and cause hyper Ca
- teratogenic: cardiac anomalies, hydrocepahlus
- 10 X daily recommended value -> causes hepatic injury leading to cirrhosis; acute: N/V dizziness, chronic: dry skin
- excessive CSF production; papilledema, headache, CT with enlargement of ventricles -> causes blindness; stop vit A administration and serial lumbar punctures
16
Q
Thiamine
- also known as
- epi of deficient
- function
- dry beriberi: when, sxs
- wet beriberi: what is it, sxs, tx; prognosis w/o tx
- wernicke encephalopathy
- korsakoff
- tx for deficiency
A
- B1
- alcoholics
- required for dehydrogenase enzymes -> glucose metabolism, TCA, PPP
- occurs 2/3 weeks of cessation of intake; peripheral neuroapthy, myalgia, confusion, nystagmus;
- dry beriberi + congestive heart failure; peripheral edema, tachy, DOE, cyanosis; emergency tx with B1 and glucose; death in couple days
- acute onset of , destruction of mamillary bodies, tectal plates (auditory and visual reflexes), and thalamus -> reversible w/ tx
- damage to medial thalamus, mamillary bodies and atrophy of cerebral cortex -? memory impairment, emotional disturbances; not reversible
- thiamine first and then glucose -> if glucose first will cause lactic acidosis
