Clinical Nutrition Midterm

Front 1

What is the relationship between oral health and bacteremia and endocarditis?

Back 1

bacteremia happens when bacteria get in to the blood stream; that can happen if oral health is not good. if this happens then the bacteria can latch on to the heart valves; this can often happen in patients with rheumatic fever.

Front 2

What are dental caries?

Back 2

demineralization of tooth

Front 3

what factors must be present to lead to dental caries?

Back 3

1. tooth
2. microorganism
3. fermentable carbohydrates
4. time

Front 4

what influences the cariogenecity of the food?

Back 4

dependent on:
saliva, plaque build up, genetics, frequency, type of form that it is in

Front 5

cariostatic

Back 5

no drop in salivary ph, proteins

Front 6

cariogenic

Back 6

fermentable carbohydrates, pretzels, raisins

Front 7

anticariogenic

Back 7

cheese and xylitol gum

Front 8

what is plaque

Back 8

sticky colorless mass of microorganisms, salivary proteins and polysaccharides

Front 9

what is the relationship of plaque to periodontal disease

Back 9

periodontal disease is inflammation of the gingiva,plaque is a significant contributor to periodontal disease

Front 10

what is the role of saliva in dental health

Back 10

helps buffer the ph, neutralizes acid, clears food from around the teeth, saturated with calcium and phosphorus

Front 11

things that interfere with saliva

Back 11

fasting state, how healthy you are, sjorgen syndrome, radiation, medications

Front 12

how does tooth decay work?

Back 12

basically you eat sugars, bacteria convert these to long chain sugars; colonization of plaque, bacteria which leads to caries then you lose calcium and phosphate ions

Front 13

how does fluoride act as an anti caries agent?

Back 13

repairs via remineralization

Front 14

what are the medications for periodontal disease?

Back 14

periostat: 20 mg, arestin: both of these are collagenase inhibitors
there is also dentaplex

Front 15

how does dental health affect systemic diseases

Back 15

aids and renal disease have oral manifestations that can alter nutrition status

Front 16

what are some of the features of bulimia nervosa

Back 16

lots of eating followed by inappropriate compensatory purging without anorexia;

irregular menses, dental erosion, enlarged salivary glands, laxative dependence, mood disturbances

Front 17

physiological characteristics of anorexia

Back 17

lanugo, anemia, osteoporosis, decreased brain mass, high cholesterol

Front 18

physiological characteristics of bulimia

Back 18

russels sign, dental erosion, salivary gland enlargement

Front 19

why do we need to treat diabetes?

Back 19

because it can lead to other complications, kidney disease, nerve damage

Front 20

goals of treatment (include complications of diabetes)

Back 20

neuropathies, kidney diseases, nerve damage, treat acute symptoms!!

Front 21

what is blood pressure

Back 21

BP= cardiac output x peripheral vascular resistance

cardiac output= stroke volume x heart rate

Front 22

prehypertension levels

Back 22

120-139/80-89

Front 23

hypertension

Back 23

140-159/90-99

Front 24

stage 2 hypertension

Back 24

160/100

Front 25

risk factors for developing hypertension

Back 25

obesity, diabetes, high salt, high fat diet, african american, male, stress

Front 26

health consequences of elevated bp

Back 26

hypertension, insulin resistance, obesity, ORGAN DAMAGE, eye diseases, stroke, kidney diseases, peripheral vascular disease

Front 27

what can lower bp

Back 27

decrease alcohol intake, renin-angiotensin drugs, thiazide, reduce salt,

Front 28

micronutrient supplementation for hypertension?

Back 28

magnesium, calcium, potassium

Front 29

considerations when recommending dietary supplements

Back 29

race, ethnicity, too much of one thing can be bad

Front 30

dash diet

Back 30

fruits and vegis and beans, not good for people in chronic kidney diseases in stage 3 or 4

Front 31

metabolic syndrome

Back 31

cluster of metabolic disorders characterized by dyslipidemia, high blood glucose, hypertension and abdominal obesity

Front 32

what does metabolic syndrome predispose you for risk of

Back 32

CVD and type 2 diabetes

Front 33

who definition of metabolic syndrome

Back 33

bad fasting glucose: high bp, high tgs, low hdl

Front 34

ncep definition of

Back 34

high waist circumference, high tgs, high bp, high fasting glucose

Front 35

what is cholesterol

Back 35

cholesterol is a steroid hormone that is present in all animal cells

Front 36

what is the role of cholesterol in the body

Back 36

necessary for bile production and steroid hormones, also critical for testosterone, estrogen, glucocorticoids

Front 37

how do statins work

Back 37

they work on the level of hmg-coa reductase so that the liver stops producing cholesterol and thus the receptor is unregulated and once that happens then the cholesterol can be removed from the blood

Front 38

what might be the underlying cause and treatment for increased levels of ldl

Back 38

receptor deficiency, ldlr, apoE, apoB, intracellular, protein folding problems

Front 39

what are the clinical features of hyperlipidemia

Back 39

corneal arcus, tendon xanthomas, premature CHD

Front 40

lipoprotein-lipid handling in the body

Back 40

well you eat and then the fat comes in to in the forms of chylomicrons, get repackaged and then you have the remnants those go to the liver where it can get to the LDLR and then the liver can repackage it; uses apoB and apob 48 and 100; they both use a poE.

Front 41

describe Reverse cholesterol transport

Back 41

you have HDL. gets converted to cholesteryl esters by LCAT.

CETP helps to exchange it to tgs to other lipoproteins such as LDL and VLDL and these can be taken up by the liver

Front 42

what would you recommend for hypertriglyceridemia

Back 42

low fat, fib rates, weight loss, niacin

Front 43

what is a structure function claim

Back 43

the role of nutrient in the body:
ex: calcium in bone formation, folate in DNA synthesis

Front 44

what is a health claim

Back 44

relationship of food or food supplement with the risk of a disease: saturated fat and heart disease

Front 45

why is fiber good for you

Back 45

reduces CHD, stroke, hypertension, diabetes:

Front 46

what is the potential mechanism of action for fiber

Back 46

increases bile acid excretion, and it can inhibit cholesterol synthesis ; helps w. colon fermentation of fiber

Front 47

portfolio diet

Back 47

mix of health foods that will achieve maximum reduction of cholesterol

Front 48

soy protein: mechanism of action

Back 48

upregulates LDLreceptor, binds bile acids

Front 49

nuts: mechanism of action

Back 49

because of plant sterols, fiber, unsaturated fatty acids

Front 50

plant sterol mechanism of action:

Back 50

blocks cholesterol from the lumen, increases bile salt excretion, displaces cholesterol from micelles

Front 51

fiber: mechanism of action

Back 51

increases bile acid excretion

Front 52

what are the 3 different stages of sleep

Back 52

NREM 1 and 2, NREM 3 and REM

Front 53

what is the difference between REM and nonRem

Back 53

rem is a crazy state, heart rate increases, BP increases,

NREM 1 and 2 are light and then NREM 3 is slow wave and it is regulated by homeostatic processes; REM is circadian rhythm.

REM: heart rate increases, brain blood flow increases, increases in the motor sensory areas of the brain

Front 54

metabolic effects associated with NREM sleep

Back 54

decreased glucose utilization, no prolactin, fsh and lh alterations, associated with cell injury due to release of free radicals;

Front 55

metabolic affects associated with chronic sleep deprivation

Back 55

increases in insulin resistance, sympathetic nervous system activity, raises in cortisol levels, decreased glucose utilization, diabetes, increased bmi

Front 56

osa

Back 56

obesity, daytime sleepiness, hypopoxemic, pickwickian syndrome, low o2 sat, bp changes, decreased cardiac output, cytokines

Front 57

3 stages of sleep

Back 57

NREM, REM 1 and 2, REM 3

Front 58

difference between rem and non-rem

Back 58

nrem is non-rapid and in stages 1-2 it is light sleep, slow wave sleep
nrem 3 is slow wave and it is critical for metabolism.

rem is not slow wave sleep

Front 59

characteristics of rem sleep

Back 59

paralyzed, increases in motor and sensory areas, heart rates increase, increases in brain blood flow, air, muscle, sympathetic nervous system, bp

Front 60

which process is driven by homeostatic processes

Back 60

NREM 3

Front 61

which process is driven by circadian rhythm?

Back 61

rem and also nrem 2

Front 62

what are the metabolic effects associated with NREM sleep

Back 62

decreased glucose utilization, less prolactin, cell injury because of free radical release

Front 63

metabolic effects associated with chronic sleep deprivation

Back 63

insulin resistance, sympathetic nervous system activity which could raise cortisol levels, decreased glucose utilization, diabetes, increased bmi,

Front 64

what are some of the metabolic effects associated with OSA

Back 64

obesity, excessive daytime sleepiness, metabolic syndrome, sympathetic surges, bp changes, low o2 saturation, decreased cardiac output, inflammatory cytokinas,

Front 65

what is syndrome z

Back 65

metabolic syndrome and obstructive sleep apnea

Front 66

how does sleep deprivation cause obesity

Back 66

could be because it increases hunger or because it alters thermoregulation

Front 67

sharma study of CPAP for metabolic syndrome in OSA

Back 67

same people but for sham CPAP they weren't the same biochemically, CPAP: decreased bp and more metabolic syndrome

Front 68

what were the limitations of the cpap and metabolic syndrome study

Back 68

didn't take bp measurements, follow up data wasn't collected

Front 69

results of studies of sleep duration and obesity in children

Back 69

weight circumference decreased in children with increased sleep duration

Front 70

biases inherent in a study identifying sleep and obesity

Back 70

observational data, perspective studies, prejudice against those that are obese, self reports

Front 71

what is the importance of carbs in athletes diet

Back 71

replaces muscle glycogen, maintains blood glucose

Front 72

importance of protein in athletes diet

Back 72

maintain body weight, optimal use and performance

Front 73

fat

Back 73

source of energy, fatty acids,

Front 74

hydration requirements

Back 74

you can use american college of sports medicine position stand

Front 75

hydration before

Back 75

2 ml/pound

Front 76

during

Back 76

between .3-2.4 you don't want to lose too much

Front 77

hydration after

Back 77

2-3 cups for every pound lost

Front 78

underhydration effects

Back 78

muscle cramps, muscle fatigue

Front 79

overhydration effects

Back 79

headaches, confusion

Front 80

vegetarian diet concerns

Back 80

b12, protein intake, zinc, IRON!

Front 81

micronutrients importance

Back 81

energy production, hemoglobin synthesis, bone health, immune function, oxidative damage