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Family Medicine > Nutrition + Health > Flashcards

Nutrition + Health Flashcards

1
Q

How to calculate total daily energy expenditure

A

35 cal/kg

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2
Q

Describe motivational strategies for behavioural changes

A 
Pre-contemplation = consider possibility of change 
Contemplation = encourage change
Preparation = explore options, develop plan 
Action = design rewards for success, support + reinforce 
Maintenance = maintain motivation
Relapse = help pt to view as learning experience
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3
Q

Canada food guide for adults

A

6-8 servings grains
7-10 servings of fruit + veg
2 servings milk/ alternatives
2-3 servings of meat/ alternatives

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4
Q

Dietary guide for reducing CVD risk

A 
Fat intake at 26% of total energy 
Reduce trans fat intake 
>2 servings of oily fish a week 
<2400mg salt per day 
Max 10-15 drinks a week 
DASH diet 
Diet high in fruit + veg, low fat dairy, whole grains, poultry, seeds + nuts
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5
Q

How to lose weight

A

Aim for 500-1000 cal less than TDEE

1lb lost for every 3500 burnt

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6
Q

Low BMI associations

A

Osteoporosis
Eating disorders
Under-nutrition
Pregnancy complications

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7
Q

Classification of weight by BMI

A 
<18.5 = underweight 
18.5-25 = normal 
25-30 = overweight 
30-35 = obesity class 1 
35-40 = obesity class 2 
>40 = obesity class 3
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8
Q

Signs of hyperlipidemia

A 
Atheromata
Xanthelasma 
Tendinous xanthoma 
Eruptive xanthoma 
Lipernia retinals 
Corneal arcus
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9
Q

What score do you use to assess risk of T2DM?

A

CANRISK or FINRISC

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10
Q

When is bariatric surgery recommended?

A

If lifestyle changes have failed + BMI >35 + RF or >40 without RF

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11
Q

When is pharmacotherapy for obese pts recommended?

A

If BMI >27 + RF or >30 + no RF

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12
Q

What score do you use to assess dyslipidemia?

A

Framingham or Cardiovascular Life Expectancy Model (CLEM)

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13
Q

When are statins given?

A 
Framingham >10%
LDL >3.5
Non HDL >4.3 
Men >50, women >60 with RF
Age >30 + 25yr duration of T1DM
CKD
AAA
Clinical atherosclerosis
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14
Q

What add-ons can you add to statins if optimal target not achieved?

A

Ezetimibe 1st line
BAS
PCSK9 inhibitors

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15
Q

What is the definition of metabolic syndrome?

A 
Central obesity 
Men = waist >94cm 
Women >80cm 
AND 
2 RF:
High TG, low HDL, high BP or high fasting glucose
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16
Q

What is Ezetimibe?

A

Cholesterol absorption inhibitors

17
Q

What is isolated hypertriglyceridemia?

A

Normal HDL + TC, high TG
Does not increase CV risk
Risk of pancreatitis

18
Q

Management of hypertriglyceridemia?

A

Nicotinic acid

Fibrates

19
Q

Exercise guidelines for adults

A

150 mins of moderate to vigorous aerobic activity a week, in bouts of 10 mins or more
Beneficial to add muscle/ bone strengthening activities 2 days a week

20
Q

What are the 5 As for patients quitting smoking?

A 
Ask if they smoke
Advise to quit 
Assess willingness to quit 
Assist in quit attempt 
Arrange follow up
21
Q

What is the 2-3 pattern of smoking cessation?

A 
Onset of withdrawal = 2-3hrs 
Peak withdrawal = 2-3 days 
Expect improvement of withdrawal = 2-3 weeks 
Resolution of withdrawal = 2-3 months 
Highest relapse within 2-3 months
22
Q

What is the STAR technique for developing smoking cessation plan?

A

Set quit date
Tell family + friends
Anticipate challenges
Remove tobacco-related products

23
Q

What are the CAN-ADAPTT guidelines?

A

Update tobacco use status
Clearly advise all pts to quit
Monitor mental health while quitting

24
Q

Pharmacological therapy to help quit smoking

A

Nicotine replacement
Antidepressants - Bupropion
Varenicline - nicotinic receptor agonist + antagonist

25
Q

SE of nicotine gum

A

Mouth soreness
Hiccups
Dyspepsia
Jaw ache

26
Q

SE of nicotine patches

A

Skin irritation
Insomnia
Palpitations
Anxiety

27
Q

SE of nicotine inhaler or nasal spray

A

Local irritation

Coughing

28
Q

Mechanism of action of bupropion

A

Inhibits reuptake of dopamine + norepinephrine

29
Q

SE of bupropion

A

Insomnia, dry mouth

30
Q

CI to bupropion

A

Seizures, eating disorder

31
Q

Mechanism of action of varenicline

A

Nicotinic receptor agonist + antagonist

32
Q

SE of varenicline

A

N/V, constipation, headache, dream disorders, insomnia, psychosis, depression, suicidal ideation

33
Q

What are the 5 Rs for motivational intervention in a pt unwilling to quit smoking?

A 
Relevance to pt 
Risks of smoking
Rewards/ benefit 
Roadblocks? 
Repetition

Family Medicine (10 decks)

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