Primer Section 4 - 5 Flashcards
For infants, there’s no difference between breastfeeding and formula feeding…
True or Fale
False…breastfeeding is preferred
Solid foods are not usually recommended until about which age?
2-3 months
4-6 months
9-12 months
24 months
feeding baby green says 4-6. months, pg 153
Nutrition through the life cycles says ~6 months pg 239
Growth patterns in children are best represented by
Height measurements
Weight measurements
Growth velocity curves
Waist to hip ratios
Growth velocity curves
3 major growth phases…what are the age ranges for?
Infancy
Childhood
Puberty
0-2 yrs
2-10 yrs
10-12 yrs
During the growth spurt in adolescence, the RDAs and DVs for calcium, zinc, and magnesium are perfectly appropriate.
True or False
False….they are likely inadequate
Which nutrient deficiency can exacerbate acne in adolescents?
Calcium
Zinc
Magnesium
Copper
Zinc
During pregnancy, the average total increase in energy needs per day is
100-200 kcal
200-300
300-400
400-500
300-400 kcal /day
How many additional grams of protein per day are needed on average during a pregnancy?
3 grams
6
9
12
6 grams
What is the average additional need for lactation?
250 kcal
450
650
850
650
Lactation, on average, requires how many grams per day of protein?
15 g/day
20
25
0
15
Which two nutritional biochemical assessment are focused on in the elderly specifically because the standard adult reference ranges are not appropriate for this group?
Hemoglobin and WBCs
Albumin and WBCs
Hemoglobin and Albumin
Albumin and Bilirubin
Hemoglobin and Albumin
Is dietary protein effective in raising serum albumin in elderly patients?
Yes or No
No
Less than what amount of serum albumin indicates malnutrition in an elderly patient?
< 5 g/dL
< 3.5
< 2
< 1
< 3.5 nd/dL
Age related body composition changes in the elderly include
Loss of lean body mass and bone density Relative increase in body fat Redistribution of adipose tissue All of these None of these
All of these
Some clinical signs of malnutrition can mimic signs of aging, thus making clinical assessment more challenging.
True or False
True
Which nutrients are likely needing to be increased for elderly?
B2, b3, b6, Vt D
Vit D, B2, B6, folate
Vit A, Vit D, B2, b12
B2, B6, B12, Vit D
B2, b6, b12, vit D
Which nutrient recommendation is likely set too high for the elderly?
Vit A
Vit E
Vit K
Vit D
Vit A
Is the protein in vegetarian diets more or less digestible than the protein in diets containing animal protein?
Less digestible
For strict vegetarians (vegans), what should the recommended daily protein intake be increased to?
- 0 g/kg/day
- 5
- 0
- 5
1.0 g/kg/day
roughly a 15-25% increase
If strict vegan/vegetarian AND exercising heavily, protein requirements increase to….
- 2 g/kg/day
- 6
- 8
- 2
1.6 g/kg/day
Regarding complementary protein practices for vegans/vegetarians, which two foods should be combined to provide essential amino acids?
Grains and Root vegetables
Nuts/seeds/Legume vegetables and Root vegetables
Grains and Nuts/Seeds/Legumes
Grains and cruciferous vegetables
Grains AND nuts/seeds/legumes
The calcium absorption in vegan diets is roughly 20% greater or less than that of animal based diets?
LESS than, so need to compensate with more calcium intake
Vegetarian sources of Calcium?
Nuts,
Leafy Greens
Fortified beverages (soy milk, oj)
calcium supplements
ALL of these!!
Vegetarian diets do or do not enhance the absorption of dietary iron or zinc?
DO NOT, so need to have adequate intake of whole grains, nuts, fruits and legumes
Riboflavin can be provided by which vegetarian approved foods?
Green leafy vegetables
Whole Grains
Legumes
All of the above
ALL of the above
Double-strength infant formula can cause
Mental impairment
Colic
Dehydration
sleepiness
Dehydration
Which research design a contemporaneous determination of disease status (prevalence) and dietary exposure?
Ecological studies
Cohort
Cross-sectional
Case-control
Cross-sectional: Cross-sectional studies or surveys measure both the exposure and outcome in a sample of the population at a point in time
The classic type of cross-sectional study is the survey: A representative group of people – usually a random sample – are interviewed or examined in order to find out their opinions or facts. Because this data is collected only once, cross-sectional studies are relatively quick and inexpensive. They can provide information on things like the prevalence of a particular disease (how common it is). But they can’t tell us anything about the cause of a disease or what the best treatment might be.
Cross-sectional studies can answer questions such as these:
How tall are German men and women at age 20?
How many people have cancer screening?
Which design is the examination of correlations between disease status and dietary exposure of several populations or of one population observed at several times?
Ecological studies
Cohort
Cross-sectional
Case-control
ecological
Which research design is forward-looking (prospective) or backward-looking (retrospective) observation, often, over time of the occurrence of disease in subgroups within a population that have been formed based on degree of exposure to a risk factor?
Ecological studies
Cohort
Cross sectional
Case control
Cohort
Which research design looks at contemporaneous (simultaneous) or retrospective examination of any relationship between disease risk and dietary exposure of individuals matched or paired on the basis of common characteristics other than disease status and dietary exposure; but who are otherwise as similar as possible.
Ecological studies
Cohort
Cross-sectional surveys
Case-control
Case-Control
Case-control studies compare people who have a certain medical condition with people who do not have the medical condition, but who are otherwise as similar as possible, for example in terms of their sex and age. Then the two groups are interviewed, or their medical files are analyzed, to find anything that might be risk factors for the disease. So case-control studies are generally retrospective.
Case-control studies are one way to gain knowledge about rare diseases. They are also not as expensive or time-consuming as RCTs or cohort studies. But it is often difficult to tell which people are the most similar to each other and should therefore be compared with each other. Because the researchers usually ask about past events, they are dependent on the participants’ memories. But the people they interview might no longer remember whether they were, for instance, exposed to certain risk factors in the past.
Do HPV infections increase the risk of cervical cancer?
Is the risk of sudden infant death syndrome (“cot death”) increased by parents smoking at home?
In the urinary tract, which two nutrients solubilize other minerals to reduce stone formation risk?
Calcium and citrate salts
Magnesium and citrate salts
Calcium and oxalate
Magnesium and oxalate
Magnesium and citrate
Which 3 minerals, if any is taken in a large amount, will impair the absorption and utilization of the other two?
Calcium, magnesium, phosphorous
Copper, Zinc, manganese
Iron, copper, zinc
calcium, iron, copper
Iron, copper, and zinc
Toxic levels of cadmium interfere with the absorption of which?
Magnesium
Iron
Potassium
Vitamin K
Iron
Which two vitamins can interact with dietary nitrites to impair/prevent their conversion to mutagenic nitrosamines?
Vitamins C and E
Vitamins C and D
Vitamins E and A
Vitamins K and A
Vitamins C and E
Vit C, citric acid, tricarboxylic acids, amino acids, and sugars promote the absorption of which?
Heme Iron
Vitamin E
Vitamin D
Non heme iron
Non heme iron
Carbonates, phosphates, oxalates, fiber components, and tannins impair the absorption of
Heme Iron
Vitamin E
Vitamin D
Non heme iron
non heme iron
Anthracyclines (cancer drugs like doxorubicin) inhibit the endogenous synthesis of which nutrient?
Niacin
B6
CoQ10
Vitamin D
CoQ10
Nitrous oxide accelerates the clearance of which nutrient?
Vitamin A
b12
Vit D
Folate
B12
Which class of drugs interferes with vit D activation and osteoblast function?
ACE inhibitors
Antacids
Anticoagulants
Antibiotics
Anticoagulants
Which increase intestinal pH and decrease folate and B2 absorption?
ACE inhibitors
Antacids w/magnesium
Antacids - H2 antagonists
Antibiotics
Antacids with Mg
Antibiotics are lethal to intestinal microbes and impair their ability to ferment fiber, resorb water in the colon, and produce which vitamin?
A
E
D
K
K
Tricyclic antidepressants inhibit the actions of enzymes requiring which nutrient?
CoQ10
Niacin
Riboflavin
Mg
CoQ10
Hydralazine and isoniazid anti-HTN meds inhibit the actions of enzymes requiring which nutrient?
CoQ10
B6
B3
b2
B6
The bioavailability of vitaminB6 is reduced by food processing, large amounts of dietary fiber, oral contraceptives, hydrazine dyes, drugs (isoniazid, hydralazine, dopamine, penicillamine), and concurrent consumption of alcohol.
Which meds chelate iron and inhibit its absorption, inhibit potassium excretion, and increase urinary zinc excretion?
H2 antagonists
ACE inhibitors
Beta Blockers
NSAIDs
ACE Inhibitors
Which meds inhibit the resorption of calcium, iron, zinc, folate, b12 and vit D?
Beta blockers
Colchicine
H2 antagonists (antacids)
Anticoagulants
antacids (H2 antagonists: cimetidine, famotidine, nizatidine, ranitidine):
NSAIDs inhibit the absorption of which nutrient?
Zinc
Iron
Folate
B7
Folate
Which group of drugs increase appetite and CHO craving, inhibit the actions of enzymes requiring B6, cause sensitivity to dietary tyramine?
Beta blockers
Colchicine
Methyldopa antihypertensives
MAOI antidepressants
MAOI
Which accelerate vit D inactivation in the liver and its excretion in bile, decrease calcium absorption, increase hepatic accumulation of vit A, accelerate metabolic clearance of Vit C and D, and inhibit the absorption of biotin, folate, and b12?
Anti-gout colchicine
Anticonvulsants
Beta blockers
Alpha blockers
Anticonvulsants
Which med induces the malabsorption of B12 and dietary sugars, and inhibits mucosal cell replication?
Anti-gout colchicine
Antihypertensive methyldopa
Beta blockers
Alpha blockers
Antigout colchicine
Which meds inhibit the absorption of iron, folate, B12 and the actions of enzymes requiring CoQ10?
Beta blockers
Alpha Blockers
Methyldopa antihypertensives
Diuretics
Methyldopa antihypertensives
Which meds chelate dietary calcium and inhibit enzymes requiring coq10?
Diuretics
Beta Blockers
Alpha Blockers
Antihistamines
Beta Blockers
HMG CoA reductase inhibitors (statin, lipid lowering) also inhibit the regulatory enzyme in the pathway that creates which nutrient?
CoQ10
Potassium depleting and loop diuretics increase urinary excretion of which 3 nutrients?
Thiamin, Magnesium, potassium
Potassium, Calcium, Riboflavin
Potassium, Zinc, Niacin
Biotin, Vitamin D, Copper
Thiamin, Mg, K
Sulfasalazine, used to treat rheumatoid arthritis, ulcerative colitis, and Crohn’s disease, inhibit the uptake of which nutrient?
B12
Folate
Calcium
Zinc
Folate
Which type of medications inhibit the absorption of divalent (copper, iron, zinc) and trivalent (boron, chromium, manganese and molybdenum) cations by chelating them?
Antineoplastics (like cisplatin)
Antipsychotics
Estrogens
Tetracyclines
Tetracyclines
Which accelerate calcium and magnesium deposition into the bones?
Tetracyclines
Estrogens
Contraceptives
Glucocorticoids
Estrogens
Which antimicrobials can produce structural defects in bile ducts, decreasing bile acid transport to the intestine and inhibiting the absorption of AAs, FAs, calcium, sodium, potassium, iron, magnesium, vit A, folate, and B12?
Cisplatins
Methotrexate
Anti-tubercular
Cycloserine and “mycin” antibiotics
Cycloserine and “mycin”
Antipsychotics inhibit the actions of enzymes requiring which coenzyme?
P5P
CoQ10
CoA
NAD+
CoQ10
Estrogen containing contraceptives inhibit the absorption of which 3 nutrients?
B12, niacin, and folate
Vitamin A, Vitamin D, Vitamin K
Vitamin A, Vitamin C, and folate
Magnesium, Calcium, Folate
Vit A, Vit C, Folate
contraceptives also reduce B6
Which nutrient do potassium sparing diuretics inhibit the urinary excretion of?
Potassium
Zinc
Calcium
Sodium
Potassium (sparing!)
Cisplatin (antineoplastic) accelerates the urinary excretion of
Zinc and Calcium
Magnesium and Calcium
Potassium and Zinc
Magnesium and Potassium
Magnesium and potassium
Methotrexate, an antineoplastic drug that inhibits the maturation and proliferation of malignant cells, arrests enterocyte mitosis, causing structural defects and enzyme deficiencies in the intestine, which inhibits the absorption of
Folate, B12, Calcium
Folate, B12, Magnesium
Zinc, Magnesium, Calcium
Potassium, Magnesium, Folate
Folate, B12, Calcium
Which medications inhibit b12 and folate absorption, block vitamin D activation, inhibit the conversion of Trp to Niacin, and inhibit action of enzymes requiring B6?
Glucocorticoids
Antituberculars (isoniazid, rifampin)
PPIs
Antacids
Antituberculars
Which drugs inhibit calcium and folate absorption and accelerate bone demineralization?
Glucocorticoids
Antiretrovirals
PPIs
Antacids
Glucocorticoids
Reverse transcriptase inhibitors (antiretroviral drugs used to treat HIV infection or AIDS) inhibit the absorption of
Zinc, Copper, B12
Zinc, Copper, Manganese
B12, Folate, B6
B12, copper, Manganese
Zinc, Copper, B12
Cholestyramine (to reduce cholesterol) binds bile acids, cholesterol, bile salts and nutrients, decreasing the digestion and absorption of fatty acids and which vitamins?
Fat solubles, iron, B12, and beta-carotene
Fat solubles, Mg, Ca, B12
Fat solubles only
Fat solubles, B12, iron, Beta carotene
Glutethimide (sedative) inhibits absorption of
Vit A and folate
Vit D and K
Calcium and folate
B12 and folate
Calcium and folate
Clofibrate (hypocholesterolemic) Interferes with the absorption of
Vitamin A, C , E, and B5
Vitamins A, D, E, and B12
Vitamins A, D, E, K and folate
Calcium, Vit A, vit K, Vit D
Vitamins A, D, E, and b12
PPIs inhibit the absorption of
B12, iron, Magnesium
B12, Zinc, Magnesium
B12, Calcium, Iron
B12, Iron, Zinc
B12, Iron, Zinc
B12 and minerals according to primer
Colestipol (lipid lowering) decreases absorption of
Fat soluble vitamins
Calcium
B12
Vitamin C
Fat soluble
Potassium repleting drugs inhibit the absorption of
Mg
Calcium
B2
B12
B12
Which decreases the absorption of calcium, potassium, beta-carotene, vitamin A, D, and K?
Hypoglycemics
PPIs
Laxatives
Laxatives
Oral hypoglycemics cause malabsorption of
B2
B3
folate
B12
B12
- anesthetic (nitrous oxide): accelerates metabolic clearance of vitamin B12
- antacids (H2 antagonists: cimetidine, famotidine, nizatidine, ranitidine) inhibit the absorption
- anticonvulsants (carbamazepine, phenobarbitol, phenytoin, primidone, valproic acid): inhibit the absorption
- anti gout - colchicine
- anti- hypertensives
- antimicrobial
- antineoplastic
- antitubercular
- hyper/hypocholesterol
- hypoglycmics
- potassium repletion
- PPI
- reverse transcriptase inhibitor
Use of a thiazide diuretic can produce low plasma concentrations of
Calcium
Potassium
Uric Acid
Phosphorous
Potassium
Antineoplastic drugs most significantly affect nutritional status by
Damaging immune function
Affecting the intestinal mucosa/reducing nutrient absorption
Increasing nutrient excretion
Causing abnormal metabolism
Affecting the intestinal mucosa/reducing nutrient absorption
Anticonvulsants can deplete reserves of
Folate and Vit D
B1 and B2
Folate and B5
B6 and biotin
Folate and Vit D
Iron Status is reflected in the ____ and plasma ____ concentration. They are two of the most reliable indicators of the degree of anemia or polycythemia.
hematocrit, hemoglobin
___ is a measure of the concentration of red blood cells within the blood (the proportion of blood volume
consisting of red blood cells).
Hematocrit
____ serum iron level, ___ total iron binding capacity and___ transferrin saturation value are characteristic of iron deficiency anemia.
decreased, elevated, low
____ is the most sensitive test to determine iron deficiency anemia. It is a good indication of Fe stores.
ferritin
Fe RDA adult male : adult female: female 14-18: pregnancy: Lactation:
adult male : 8 mg adult female: 18 mg female 14-18: 15 mg pregnancy: 27 mg Lactation: 9mg
