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Clin Med semester 2 > Nutrition (shannon hugh)-Exam 3 > Flashcards

Nutrition (shannon hugh)-Exam 3 Flashcards

1
Q

what is nutrition?

A
  • The study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease.
  • The chemical and functional components of food
  • The physiological effects of food components
  • How human behavior affects food choices
  • The impact of the surrounding environment on food choices
  • Biochemistry!
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2
Q

Medical Nutrition Therapy=

A

Nutritional diagnostic, therapy, and counseling services for the purpose of disease management which are furnished by a registered dietitian or nutrition professional

ex’s of diseases with MNT: DM, HTN, CVD, IBD, IBS, Food allergies, celiac disease , HIV, cystic fibrosis, cancer etc

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3
Q

Main nutritional disorders in the US (list 3)

A

Acute or chronic protein-energy malnutrition (PEM)

Linear growth failure= height

Combination of PEM and linear growth failure

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4
Q

Growth Charts:

WHO (birth to 2 years/5 years) vs CDC

A

WHO (birth to 2 years/5 years):

  • Weight
  • Length/Height
  • Weight-for-length
  • Head Circumference

CDC:

  • Birth to 36 months: Weight, Length, Head Circumference, BMI
  • 2 to 20 years: Height, Weight, BMI
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5
Q

Growth Charts:
Z-score=
-Dx of malnutrition is used with ___

A

Number of SDs from the mean height and weight values for age

(Z score of -2 for weight for age= underweight)
**Dx of malnutrition is used with weight for height and BMI for age!!!!! KNOW

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6
Q

Arthropometrics= used for evaluating ______

A

growth

Age:           Avrg. weight gain
Newborn-->  30 (g/day)
6 months--> 15 (g/day)
12 months--> 10 (g/day) 
1-3 yrs (6 g/day)
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7
Q

Most babies lose about ___% of birth weight and regain by 2-3 weeks of age

A

10%

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8
Q

Most healthy infants double birth weight by __ months of age and triple by 12 months of age

A

6

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9
Q

After 3 months of age, the rate of weight gain in breastfed infant may be ____ than a formula-fed infant

A

lower

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10
Q

BMI=

A

Kg/m2

  • Waist circumference
  • Tool for assessing body fat
  • Fat located in the abdominal region may be associated with greater health risks than fat below the abdomen
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11
Q

weight stigma=

weight bias=

A

=Negative social impact of weight bias and discrimination

=Beliefs & preferencesfororagainstparticular body shapes and sizes
–The inclination to form unreasonable judgements based on a person’s weight

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12
Q

Undernutrition:

  • Acute?
  • Chronic?
A

Acute: weight for age
Chronic: length for age and head circumference

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13
Q

Undernutrition:
-Wasting?

-Stunting?

A

Wasting= <5% tile in weight for height

Stunting= <5% tile for height for age

KNOW!!

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14
Q

Undernutrition:

-Marasmus=

A

severe wasting

<70% IBW (ideal body weight)

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15
Q

Peds undernutrition:

Growth faltering “failure to thrive” =

A

slower rate of growth compared with standards for age and sex

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16
Q

Peds undernutrition:

Wasting=

A

reduced weight for height due to lack of weight gain or acute weight loss

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17
Q

Peds undernutrition:

Stunting=

A

reduced length or height for age (Z-score < -2)

18
Q

PEM: Kwashiorkor=

-PE findings? (skin findings)

A

=Inadequate protein intake, fair to good energy intake

PE findings:
-Normal or nearly normal weight and height for age

  • Anasarca= full body edema
  • Pitting edema in the lower extremities and periorbitally
  • Rounded prominence of the cheeks (“moon-face”)
  • Pursed appearance of the mouth
  • Dry, atrophic, peeling skin with confluent areas of hyperkeratosis and hyperpigmentation
  • Dry, dull, hypopigmented hair that falls out or is easily plucked
  • Hepatomegaly
  • Distended abdomen with dilated intestinal loops
19
Q

PEM: Marasmus=

-PE findings?

A

=Wasting of muscle mass, depletion of fat stores
–Inadequate intake of all nutrients, including energy

PE findings:

  • Diminished weight and height for age
  • Emaciated and weak appearance
  • Bradycardia, hypotension, and hypothermia
  • Thin, dry skin
  • Redundant skin folds caused by loss of subcutaneous fat
  • Thin, sparse hair that is easily plucked
20
Q

Energy (kcal) Requirements: Children:

Approximate daily energy calculation=

A

Approximate daily energy calculation:

1000 kcal +100 kcal for every year over 1 year of age

21
Q

Carbs=

A

main source of energy

4kcal/gram

22
Q

Protein:

-__ essential that are NOT made by the human body (list)

A

*9 essential:not made by the human body
Histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine

(notes: Kids who are pre term and young infant–> it’s essential that they get cystine and tyrosine cuz they don’t have the enzymes to form these)

23
Q

Protein Requirements:Adults

A

10-35% of daily calories

  1. 8 gm/kg for maintenance
  2. 8-1.2 gm/kg for increased needs

> 1.2 gm/kg for hypermetabolic state

24
Q

Lipids/Fat:

-Fx?

A
  • 9 kcal/gm
  • Major energy source
  • Stored body fat for insulation to reduce body heat loss and protective padding for organs
  • Absorption of fat soluble vitamins (A, D, E, and K )
  • Brain and eye development, healthy skin and hair, immune function

-AAP endorses:
No restriction of fat and cholesterol is recommended for infants <2 years of age

25
Q

T/F: Cholesterol is present in breast milk

A

True

26
Q

Vitamin A:

A

=retinol, retinal, retinoic acid)

Action: Vision

27
Q

Vitamin D:

-how can you measure deficiency?

A

*serum 25(OH)D concentration

Deficiency signs:
Osteomalacia, rickets, hypocalcemia, hypophosphatemia, hyper-alkaline phosphatemia, Craniotabes

28
Q

Thiamine (Vitamin B1):

-at risk for deficiency?

A

=Cofactor for protein and carbohydrate metabolism

At-Risk:
Alcohol abuse
Malabsorption

29
Q

Thiamine (Vitamin B1) Deficiency:
“wet” Beriberi:
VS
“dry” beriberi

A

“Wet” beriberi: edema, cardiac failure, +/- “dry”

“Dry” beriberi: peripheral neuropathy, ataxia, ophthalmoplegia, increased ICP, vomiting

(note: Wet beriberi can present with dry beri beri)

30
Q

Niacin (Vitamin B3):

Pellagra=

A

=Fat, protein, and carbohydrate metabolism

Deficiency:
**Pellagra= diarrhea, dermatitis, dementia/encephalopathy
Pellagra= Triple D

31
Q

Long term Isoniazid Pts NEED to be on _____

A

Pyridoxine (Vitamin B6)

32
Q

Worry about this demographic becoming deficient in Vit B12 (cobalmin)

A

vegans

33
Q

Vitamin B12 (Cobalamin): Pernicious anemia

A

Pernicious Anemia: Lack of intrinsic factor made in gastric cells needed to absorb B12 in ileum

34
Q 
Vitamin C (Ascorbic Acid) Deficiency: 
-Scurvy?
A

Scurvy: joint tenderness, petechiae, capillary hemorrhage, gingivitis/bleeding; poor wound healing

35
Q

Copper (Cu) Inborn errors:

  • Wilson’s disease?
  • Menke’s disease?
A
  • Wilson’s disease= Copper excretion, signs of toxicity

- Menke’s disease= Copper absorption, signs of deficiency

36
Q

Monitoring of Nutrition Requirements:

indirect calorimetry=

A

GOLD standard!
-Measures REE and respiratory quotient (ratio of CO2 produced to O2 consumed)

-Used to assess for overfeeding on the ventilator

37
Q

Solid foods can be introduced in infants at ___

A

4-6 months when neuromuscular development is sufficient

38
Q

Infants: Breastfeeding: KNOW!!
-WHO: states infants should be exclusively breastfed until _ months

  • breast milk content?
  • Absolute contraindications for breastfeeding (list 2) ?
A

WHO:

  • Exclusive until 6 months
  • Continued BF until 2 years of age with complementary foods

Breast milk content:

  • IgA, lyzozyme, lactoferrin, bifidus factor, macrophages
  • Protect against GI and upper respiratory tract infections

**Absolute contraindications:
Mother with active TB, galactosemia in infant

39
Q

Foods to avoid under one year of age

A

Hard, round foods (e.g., nuts, grapes, raw carrots, and round candies)

Honey= botulism

40
Q

Maple Syrup Urine Disease

A

these Pts cant process Leucine, isoleucine, valine

41
Q

Know for test!!

Vitamin K deficiency: Hemorrhagic Disease of Newborn (VKDB)

A

Hemorrhagic disease of the newborn! This is why newborns get an injection of vitamin K at birth

Deficiency signs for Vitamin K: Hemorrhage (especially mucosal), ecchymosis, petechiae, elevated PT, INR

Clin Med semester 2 (24 decks)

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