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Gastro 3 > Nutrtional History > Flashcards

Nutrtional History Flashcards

1
Q

Dietary history includes

Methods to determine quality of food/bevs

24 day diet

pros

cons

A

quality/availability of meals, diets/suplements, alcohol/drugs/meds/activity/illness

24 hour recall or multiday diet record

retrospective

accurate

may not reflect avg day, foods forgotten, estimates quantity

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2
Q

Multiday diet record

good analysis of

con

A

prospective

quantity, nutrient analysis

indiv eat different when recording

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3
Q

Signif barrier to nutrition

Special diets risk

food consumption altered by

Calorie intake dependent on

A

availability of foods/bevs

malnutrition- diff appropriate nutrition

alcohol, drugs, meds (anorexia, excessive intake)

Activity, chronic dz, acute illness

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4
Q

Nutrient loss cause

C\_\_\_
E\_\_\_\_\_
I\_\_\_\_\_\_
M\_\_\_\_\_
W\_\_\_\_\_\_
A

CKD- hemo/peritoneal dialysis

Enteric fistula/obs

IBD

Malabsorption

Wounds

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5
Q

Hypermetabolic nutritional issues

A\_\_\_
B\_\_\_
C\_\_\_\_
C\_\_\_\_\_
F\_\_\_\_\_
M\_\_\_\_\_\_\_
S\_\_\_\_\_
T\_\_\_\_\_\_
A 
AIDS
Burns
CP Dz
Cirrhosis
Fever
Malignancy
Sepsis
Trauma
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6
Q

Anti nutrient substances

A_____ ____
C______
I_______
A______

A

Alcohol abuse
Chronic steroid use
Immunosuppresants
Antimetabolites (Metho, Antitumor)

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7
Q

Infant/young child, assess for nutritional status via

Children vs adults (BMI)

Underweight
Normal
Over
Obesity (Class 1/Class 2)
Morbid Obesity
A

weight/length/head circ/weight for length

C- <5, 5-85th, 85-95, (95-120)/(120-140), >140

A- <18.5, 18.5-25, 25-30, (30-35/>35), >40

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8
Q

Be concerned w wl

Muscle wasting areas involved

Measure muscle masss at

Value suggesting dec skeletal muscle mass

Body fat stores measured in

Tricep skin fold less than ___ indicates exhausted fat stores

A

> 5% over month, >10% over 6 mn

Temporal of head, interosseus of hands

1/2 olecranon process/acromion (Mean upper arm circum)

<22 (women) <23 male

triceps fold thickness (but most subQ)

3

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9
Q

Xerophthalmia indicates

Corneal scarring

Hyperkeratosis

A

Vitamin A def

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10
Q

Best surrogates for nutritional adequacy

Most senstivie measure of long term nutrition

Short term

Dec suggest

May also be low bc of

Both are ___, may be elevated in

A

Serum albumin/prealbumin

Albumin, prealbumin

undernutrition (proportional to protein calorie undernutrition)

anabolism (burn/trauma/illness), HF, nephrotic syndrome, LD

Acute phase reactant, inflamm states

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11
Q

Measure skeletal muscle mass

Low levels indicate

Also seen in

A

Serum creatinine

calorie undernutrition/muscle wasting

RF, dehydration, ACE/ARB/trimethoprim, cirrhosis

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12
Q

BUN indicates, low for

High values can occur despite protein undernutrition in

Low levels despite adequate nutrition in

A

protein intake, dec short term intake

RF, HF, GI hem

LD/anabolism

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13
Q

Serum cholesterol can indicate

Low levels in

High levels can be seen in

A

calorie undernutrition

calorie undernutrition, chronic debilitating dz

genetics, chronic dz

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14
Q

Total lymphs

in healthy indiv, low count indicates

also seen in

A

poor indicator

calorie-protein undernutrition

AIDS, bone marrow suppression, cancer, CS

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15
Q

Basal energy expenditure (BMR)

Men estimated

Women estimated

A

estimates daily calories needed based on oxygen cons at rest

26-30 kcal/kg (12-14 per pound)

22-24 kcal/kg (10-11 per pound)

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16
Q

Total energy expenditure

calculate

Sedentary (>30 min exercise daily)

Light (30-60)

Active (>60 min)

A

estimates daily calories taking into account activity/streess

BMR X adjustment

  1. 3
  2. 6
  3. 8
17
Q

sickness results in need for

Indirect calorimetry

process

also estimates

based on

A

inc calories, due to inc metabolic rate/healing

precise measurement of resting energy expenditure

Pt in plexiglass canopy, measure O2 cons, CO2 prod, urine N2

fuel metabolism via respiratory quotient (CO2 to O2)

biochemical processes that oxidize lipids/carbs or generates lipids

18
Q

RQ of 7 .7 indicates

RQ of 1 indicates

RQ > 1 indicats

A

insufficient caloric supply, lipid oxidation and body fat breakdown

balanced caloric intake, carb oxidation

excessive caloric intake, lipogenesis

Gastro 3 (25 decks)

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