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Clinical Nutrition 1 > Nutritional Assessment > Flashcards

Nutritional Assessment Flashcards

1
Q

What is useful to know for evaluating CVD risks?

A

BMI and waist circumference

high BMI and high waist circumference = high risk

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2
Q

Which method of assessing body composition is the gold standard? Which is the current gold standard?

A

Gold standard= hydrodensitometry

Curent-gold standard= magnetic resonance imaging

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3
Q

What are the techniques for measuring body composition (besides anthropometry)

A
  • BIA (bioelectrical impedance)
  • DXA (dual energy X-ray absorptiometry)
  • BODPOD (aire displacement plethysmography)
  • hydrodensitometry
  • MRI (magnetic resonance imaging)
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4
Q

What are subclinical nutrient deficiencies?

A

Nutritional deficiencies before they become severe and show as clinical signs

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5
Q

What is the uniform system of reporting lab values?

A

SI units

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6
Q

What is the synonym for prealbumin?

A

transthyretin (TTR)

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7
Q

Which serum protein has the highest rate of turnover?

TTR, Transferrin, RBP, albumin?

A

RBP

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8
Q

Why is it important to know the half life time of a protein?

A

has to do when you implement a nutritional therapy , you want to test if treatment is effective

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9
Q

In QC, which serum proteins are used to assess protein status?

A

Albumin (and prealbumin if asked)

Not transferrin (is for iron)

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10
Q

A patient has high albumin levels, what does this indicate?

A

dehydration

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11
Q

A patient has low albumin levels, what does this indicate?

A

malabsorption, low protein intake, over hydration, edema, inflammation, ageing

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12
Q

A patient has high transferrin levels, what does this indicate?

A

iron deficiency, pregnancy, chronic loss

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13
Q

A patient has low transferrin levels, what does this indicate?

A

PEM, infection, acute illness, chronic infection

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14
Q

A patient has high TTR (transthyretin) levels, what does this indicate?

A

renal disease, Hodgkins disease

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15
Q

A patient has low TTR (transthyretin) levels, what does this indicate?

A

liver disease, PEM, malabsorption, hyperthyroidism, chronic loss

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16
Q

A patient has high RBP levels, what does this indicate?

A

renal disease

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17
Q

A patient has low RBP levels, what does this indicate?

A

vitamin a or zinc deficiency, hyperthyroidism, liver disease

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18
Q

What is the normal range for albumin in the blood?

A

35g/L

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19
Q

True or False:

CRP is a nutritional marker that can interpret other serum proteins

A

It is not a nutritional marker, but it is useful to interpret other serum proteins

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20
Q

In the nitrogen balance equation, what is factor 4 from?

A

4g of protein from N excretion via skin and feces

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21
Q

If the NB is +2 what does this mean?

A

In reality it is a balance (+5 or +6 would be Positive)

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22
Q

Do errors in NB calculations favour a more positive or negative balance?

A

A more positive balance

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23
Q

What is creatinine excretion proportional to?

A

skeletal muscle mass

24
Q

What do cells look like for an iron-deficiency anaemia?

A

microcytic, hypochromic

25
Q

What do cells look like for a folate/B12-deficiency anaemia?

A

macrocyte, megaloblastic

26
Q

During dehydration, hematocrits is high or low

A

high

27
Q

During water overload and hemorrhage, hematocrits is high or low?

A

low

28
Q

What do you measure to make sure it is folate deficiency and not B12 deficiency?

A
  • serum folate (low=def)
  • rbc folate (low=def)
  • B12 should be normal
29
Q

Which is a better marker of folate: RBC or serum?

A

RBC

30
Q

Which deficiency is easier to measure between folate and vitamin B12?

A

vitamin B12

31
Q

What is the biomarker of vitamin B12 deficiency?

A

High methylmalonic acid

32
Q

What is the biomarker of B12 and folate deficiency?

A

High homocysteine

33
Q

Out of the dietary assessment methods, which data is used for diet counselling?

  • 24h recall
  • Food records
  • food frequency questionnaire
  • direct observation
A

Food records

34
Q

Out of the dietary assessment methods, which data is used for an epidemiological study?

  • 24h recall
  • Food records
  • food frequency questionnaire
  • direct observation
A

food frequency questionnaire

35
Q

What is the gold standard to measure REE?

A

Indirect calorimetry

36
Q

Which REE prediction equation uses the CURRENT weight of the patient?

A

Mifflin-St-Jeor

37
Q

What is the rule of thumb to calculate REE?

A

25-35 kcal/kg body weight for non-obese adults

38
Q

Serum protein have __ sensitivity and specificity for nutritional status

A

LOW

39
Q

Serum proteins are influenced by

A

They are influenced by : poor protein intake, altered metabolism and synthesis, hydration, inflammation, pregnancy, medications, exercise

40
Q

which serum protein binds with RBP ?

A

TTR (transthyretin)

41
Q

When do you have a + NB?

A

growth, pregnancy, athletic training, recovery from illness

42
Q

When do you have a - NB?

A

starvation, trauma, surgery, poor quality protein intake or inadequate protein intake

43
Q

When is creatinine excretion high?

A

exercise, meat intake, menstruation, infection, fever, trauma

44
Q

When is creatinine excretion low?

A

renal failure, age

45
Q

Which assessment looks at the patient’s social, medical and psychological history?

A

clinical assessment

46
Q

What is the best way to measure REE? What is the concept? What does it calculate?

A
  • Indirect calorimetry
  • measures quantity of oxygen consumed to burn an energy substrate versus carbon dioxide produced by energy related processes
  • it calculates heat production
47
Q

According to WHO/FAO the protein requirements for healthy individuals is:

A

0.75g/kg body wt/day

48
Q

Protein requirements vary depending on what?

A

physiological or disease status and age

49
Q

What are methods to estimate fluid requirements?

A
  • weight (100ml first 10kg, 50ml second 10kg, 20ml for rest)
  • weight and age
  • energy (1mL/kcal)
  • fluid balance (urine output + 500mL)
50
Q

What is a fluid?

A

Anything that is liquid at body temperature (ice cream, soup, jello)

51
Q

Sodium, albumin, BUN, creatinine, hematocrits and haemoglobin are increased or decreased during dehydration?

A

increased

52
Q

1kg of weight loss = __ mL water

A

470 mL

53
Q

What should be considered for elderly?

A
  • have a lower REE
  • need more vitamin D and calcium (DRI=1200mg)
  • need more protein
  • need more fluid
54
Q

The functional assessment is based on?

A

handgrip strength measured with a dynamometer (it should be >20kg for W and >30kg for M)

55
Q

What does handgrip strength not tell?

A

Muscle mass

56
Q

What is the prevalence of malnutrition?

A

15-80% range

highest range = in long term care

57
Q

What is the only validated tool to detect presence of malnutrition and risk of developing it during hospitalisation?

A

Nutritional Screening Risk (NSR)

Clinical Nutrition 1 (13 decks)

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