Nutritional Assessment - Biochemical Data Flashcards
BMI
Weight (kg) / height (m)^2
1 lb =
0.45 kg
I kg =
2.2 lbs
1 ft = ? inch
12 inches
1 inch = ? cm
2.54 cm
% Weight change =
(UBW - CBW) / UBW x 100
Significant loss and severe loss for 1 wk
1-2%
>2%
Significant loss and severe loss for 1 month
5%
>5%
Significant and severe loss of 3 months
7.5%
>7.5%
Significant and severe loss of 6 months
10%
>10%
Significant and severe loss of >6months (unlimited)
10-20%
>20%
% weight change is ____ meaning that is can predict mortality, morbidity and nutritional risks.
Clinically relevant
In % weight change, what information about weight loss is crucial to obtain from patient?
TIME for weight loss to occur
24-hour UUN mmol/L=
(UUNmmol/L) x (24-hour urine volume (L) )
24 hour UUN mmol/L = ? g/L
1 mmol UUN = 0.028 g UUN
Nitrogen balance =
(protein intake / 6.25) - (UUNg + 4)
A nitrogen balance of -2 means what?
We can assume that the balance is sig. negative since NB favours a positive balance. This means that catabolism>anabolism, and we can recommend to increase patients protein intake.
A nitrogen balance of >2 means what?
We can assume that this balance is quite positive since NB favours a positive balance. Recall that PNB is not dangerous, and anabolism > catabolism as the patient probably requires the additional protein. We do not change protein intake.
A nitrogen balance between -1 and +2 mean what?
Zero/Stable nitrogen balance, where anabolism = catabolism
Half-life of serum albumin
17-21 days
Name 2 functions of serum albumin
- Maintain osmotic pressure in vascular walls
- Major transport protein for molecule (Ca, Zn) and medications
When albumin is low, this may be indicative of a decrease in ____ stores
visceral protein
When is albumin HIGH? (1)
During dehydration, as plasma volume has decreased.
When is albumin LOW? (6) MOPE-IP
- Malnutrition
- Over-hydration
- Poor protein intake
- Elderly
- Inflammation (decr by 25% APP)
- Poor synthesis
Mild deficit of albumin (old)
3.0-3.5g/dL
Mild deficit of albumin (new)
30-35g/L
Conversion factor of albumin (old->new)
Multiply OLD by 10 to get new value
Moderate deficit of albumin
2.4-2.99 g/dL
Severe deficit of albumin
<2.4 g/dL
Normal range of glucose (old)
70-110 mg/dL
Normal range of glucose (new)
3.9-6.1 mmol/L
Conversion factor of glucose (old->new)
Multiply OLD by 0.0551 to get new value
Hemoglobin deficit women
<120 g/L
Hemoglobin deficit men
<140 g/L
How is hemoglobin measured?
Measures total amount of hemoglobin in RBCs and NOT within the full blood
When will hemoglobin decrease? (3)
- PEM
- Haemorrhage
- Anemias
Hematocrit deficit men
<40%
Hematocrit deficit women
<37%
Hematocrit is the measure of ___
%RBC (packed cell volume) in TOTAL blood volume
When does hematocrit increase?
Increase during dehydration
When does hematocrit decrease?
- Haemorrhage
- Anemias
- Over-hydration
An male is chair or bed bound, they are ____ and should have a PAL of ___ and PA of ___
Sedentary
- 2
- 0
An male does seated work & little movement, they are ____ and should have a PAL of ___ and PA of ___
Sedentary/Low Active
- 3-1.5
- 0-1.11
An male does seated work but is required to move, they are ____ and should have a PAL of ___ and PA of ___
Low Active/Active
- 60-1.7
- 11-125
An male does standing work, they are ____ and should have a PAL of ___ and PA of ___
Active
- 8-1.9
- 25
An male does strenuous work and is highly active they are ____ and should have a PAL of ___ and PA of ___
Very Active
- 0-2.4
- 48
If a male does an additional 30-60 minutes of strenuous leisure exercise 4-5x/week, what would we add to his existing PAL?
Add 0.3 to existing PAL
PAL 1.0-1.4 PA =
1.0
Sedentary
PAL 1.4-1.6 PA =
1.11
Low Active
PAL 1.6-1.9 PA =
1.25
Active
PAL 1.9-2.5 PA =
1.48
Very Active
___ have the highest stress factor
Burns
1.5-2.1 x REE
_____ will have no stress factors
Healthy individuals with no acute disease
_____ has the lowest stress factor
Surgery
1.0-1.1 x REE
Fever SF should multiple REE by ___ for every ___ above 37C
1.2
1C
Half life of transferrin
8-10 days
Half life of Prealbumin
2-3 days
Half life of Transthyretin (TTR)
2-3 days (same protein as prealbumin)
Half life of Retinol-binding protein (RBP)
10-12 hours
Transferrin is high during
Low iron status (IDA, chronic loss, pregnancy)
Transferrin is low during
Low protein status (poor synthesis)
Acute illness, chronic infection, PEM, systemic disease
TTR is high during
Renal diseases (improper filtration by kidney, stays in circulation) Hodgkins disease (cancer of immune system, enlarged lymph-nodes)
TTR is low during
Liver disease (decreased synthesis, chronic loss, PEM, malabsorption, hyperthyroidism)
RBP is high during
Renal diseases
RBP is low during
- Severe vitamin A deficiency
- Zinc deficiency
- Hyperthyroidism
- Liver disease
In someone with a higher muscle mass, meat intake will have increased/decreased creatinine excretion?
Increased
Someone with an infection, fever, trauma will have increased/decreased creatinine excretion?
Increased
In someone of older age, or with renal failure their creatinine excretion will be increased/deceased
Decreased
In increased age, there is a decrease in both ____ causing decreased creatinine excretion.
Renal function and muscle mass
What is skeletal muscle mass proportional to?
Height
What is the creatinine height index? (CHI)
observed creatinine excretion 24 hours (mg) / expected creatinine excretion 24 hours (mg) x 100
Someone has a CHI of 80-90% which indicates …
Mild depletion of skeletal muscle
CHI of 40-59% ….
Moderate depletion of skeletal muscle
CHI of <40% ..
severe depletion of skeletal muscle
Normal creatinine excretion for men
23 mg/kg of IBW
Normal creatinine excretion for women
18 mg/kg of IBW
(T/F) When measuring creatinine, subjects must consume a vegetarian (meat-free diet)
True, since meat intake can increase creatinine excretion
Erythrocytes in iron deficient anemia
microcytic
hypochromic
Erythrocytes in folate and/or B12 deficient anemia
macrocytic
megoblastic
Erythrocytes in other micronutrient deficient anemias (Vit C, A)
microlytic (lyse and release hemoglobin)
Erythrocytes in chronic diseases
normocytic
normochromc
Just decreased amount of RBCs
Macrocytic RBC
> 100 um^3
Microcytic RBC
<76 um^3
How could we measure weight hemoglobin? What is the visible feature?
Through mean corpuscular hemoglobin - weight is reflective of colour - whether hypochromic or hyperchromic
How could we measure size of RBCs?
Mean corpuscular volume (MCV)
hypochromic
<21 pg/cell
hyperchromic
> 38 pg/cell
(HCT/RBC) x 10 =
MCV (size of RBCs)
Mean corpuscular hemoglobin concentration
measured as a ratio of hemoglobin/hematocrit x 100 (%)in RBCs and NOT full blood
RBC count deficient men
<4.5 x 10^12 RBC / L
RBC count deficient women
<4.2 x 10^12 RBC/L