Primer Section 4 - 5 Flashcards by Olga Arnold

For infants, there’s no difference between breastfeeding and formula feeding…

True or Fale

False…breastfeeding is preferred

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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

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Growth patterns in children are best represented by

Height measurements
Weight measurements
Growth velocity curves
Waist to hip ratios

Growth velocity curves

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3 major growth phases…what are the age ranges for?

Infancy
Childhood
Puberty

0-2 yrs
2-10 yrs
10-12 yrs

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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

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Which nutrient deficiency can exacerbate acne in adolescents?

Calcium
Zinc
Magnesium
Copper

Zinc

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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

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How many additional grams of protein per day are needed on average during a pregnancy?

3 grams
6
9
12

6 grams

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What is the average additional need for lactation?

250 kcal
450
650
850

650

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Lactation, on average, requires how many grams per day of protein?

15 g/day
20
25
0

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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

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Is dietary protein effective in raising serum albumin in elderly patients?

Yes or No

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Less than what amount of serum albumin indicates malnutrition in an elderly patient?

< 5 g/dL
< 3.5
< 2
< 1

< 3.5 nd/dL

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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

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Some clinical signs of malnutrition can mimic signs of aging, thus making clinical assessment more challenging.

True or False

True

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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

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Which nutrient recommendation is likely set too high for the elderly?

Vit A
Vit E
Vit K
Vit D

Vit A

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Is the protein in vegetarian diets more or less digestible than the protein in diets containing animal protein?

Less digestible

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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

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If strict vegan/vegetarian AND exercising heavily, protein requirements increase to….

2 g/kg/day
6
8
2

1.6 g/kg/day

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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

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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

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Vegetarian sources of Calcium?

Nuts,
Leafy Greens
Fortified beverages (soy milk, oj)
calcium supplements

ALL of these!!

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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

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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

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 ```