Rd Exam Domain I (12%)

Front 1

mEq formula

Back 1

(# mg/atomic weight) x valence

Ex: how many mEq in 1 g Sodium?
(1000 mg/23) x 1 = 43.5 mEq

Front 2

Atomic weights/Valence e- of:
Cl
K !
Ca !
Mg
P
Na !

Back 2

Cl = 70
K = 39/1 (know this)
Ca = 40/2 (know this)
Mg = 24
P = 30.9
Na = 23/1 (Know this)

Front 3

NaCl is what % Na

Back 3

40%

Front 4

Extracellular electrolytes

Back 4

Sodium, calcium, chloride, bicarbonate

Front 5

Intracellular electrolytes

Back 5

potassium, magnesium, phosphorus

Front 6

The BCAAs

Back 6

Valine
Leucine
Isoleucine

Front 7

Low Cholesterol

Back 7

<20 mg/svg

Front 8

Low Calorie

Back 8

no more than 40 kcal/svg

Front 9

Low Fat

Back 9

less than or equal to 3 g/svg

Front 10

Low sodium

Back 10

less than 140 mg/svg

Front 11

Very low sodium

Back 11

less than 35 mg/svg

Front 12

Low saturated fat

Back 12

less than 1 g/svg

Front 13

Calorie free

Back 13

<5 cal/svg

Front 14

Saturated Oils

Back 14

Coconut
Butter
Animal fat
Beef tallow
Palm oil
palm kernel
cocoa butter

Front 15

Monounsaturated Fats

Back 15

Olive oil
Canola Oil
Peanut oil
sunflower oil

Front 16

Polyunsaturated fats

Back 16

Safflower
Corn
Soybean
Cottonseed
Sunflower

Front 17

RDA means

Back 17

meets needs of almost all (97-98%) of individuals in a group

Front 18

Adequate intake

Back 18

used when RDA for a nutrient cannot be determined d/t lack of evidence. Level will meet/exceed for all individuals

Front 19

EAR

Back 19

median requirement to meet needs of 1/2 individuals

Front 20

Water Soluble Vitamins

Back 20

Thiamin: 0.9-1.1 mg
Niacin: 12-16 mg
Riboflavin: 0.9-1.3 mg
Pyridoxine/B6: 1.0-1.7 mg
Folate: 300-400 ug
B12/Cobalamin: 1.8-2.4 ug
Biotin: 20-30 ug
Pantothenic Acid: 4-5 ug
Vit C: 45-90 mg

Front 21

Fat Soluble Vitamins

Back 21

A: 600-900 ug
D: 5-15 ug
E: 11-15 mg
K: 60-120 ug

Front 22

Digestible polysaccharides

Back 22

starch, dextrin, and glycogen

Front 23

Dietary starch is

Back 23

glucose chains

Front 24

dietary dextrin is

Back 24

a product of starch breakdown

Front 25

Indigestible polysaccharides

Back 25

Fiber: soluble/Insoluble

Front 26

Insoluble fiber

Back 26

cellulose, hemicellulose and lignin
Increases transit

Front 27

Soluble fiber

Back 27

gums & pectin
decreases transit time
thickening quality

Front 28

Limiting amino acid in legumes/nuts

Back 28

Methionine

Front 29

Limiting amino acid in grains

Back 29

Lysine

Front 30

Limiting amino acid in corn/gelatin

Back 30

Tryptophan

Front 31

Low calorie

Back 31

< 40 cal/svg

Front 32

Reduced/Fewer calories

Back 32

Less than 25% than comparison

Front 33

Fat Free
Sat Fat Free
Low Fat
Low Sat Fat
Reduced/Less Fat
Reduced/Less Sat Fat

Back 33

Fat Free <.5 g/svg
Sat Fat Free <.5 g/svg
Low Fat < 3g/svg
Low Sat Fat <1 g/svg
Reduced/Less Fat 25% reduced
Reduced/Less Sat Fat 25% reduced

Front 34

Cholesterol Free

Back 34

<2mg

Front 35

Low Cholesterol

Back 35

20 mg or less

Front 36

Reduced/less cholesterol

Back 36

25% less

Front 37

Sodium Free

Back 37

<5 mg/svg

Front 38

High fiber

Back 38

5 g or more

Front 39

Good Source of Fiber

Back 39

2.5-4.9 g

Front 40

More/Added fiber

Back 40

2.5 g more

Front 41

Sugar Free

Back 41

<0.5 g/svg

Front 42

No added sugar

Back 42

naturally present sugar w/ same amount as would naturally be there

Front 43

Reduced sugar

Back 43

25% less

Front 44

Labeling: "Healthy"

Back 44

no more than 3 g fat
no more than 1 g sat fat
no more 350 mg Na or 60 mg cholesterol
10% DV of one of these: Vit A/C, Ca, Fe, Pro, or fiber

Front 45

Bacterial Growth Conditions (Acronym)

Back 45

F- food
A - a ph of >4.6
T - Temp 41-140
T - time; 4 hrs
O - 02
M - Moisture

Front 46

Nutrition Screening Initiative for Elderly Acronym

Back 46

DETERMINE

Front 47

DETERMINE stands for

Back 47

Disease
Eating poorly
Tooth loss
Economic hardship
Reduced social contact
Multiple medications
Involuntary weight loss/gain
Needs assistance
Elder > 80 yrs

Front 48

P-value

Back 48

means significance of results, want is CLOSER to 0
(no more than 0.05)

Front 49

What is r in research

Back 49

R is the correlation of data
want is closer to 1 or -1

0.4-0.7 = moderate
0.7-0.9 = strong
0.9-1.0 = very strong

Front 50

Standard deviation

Back 50

degree of dispersion about the mean value of a distribution

Front 51

Jewish Diet

Back 51

kosher
no pork
no meat or dairy

Front 52

Islam Diet

Back 52

no pork
Ramadan
No alcohol
Haram "forbidden"
Halal "lawful"

Front 53

Catholic Diet

Back 53

no meat on friday/ash wed/lent

Front 54

Seventh Day Adventist

Back 54

No pork/shellfish/alch/caffeine
vegan/vegetarianism

Front 55

Mormon Diet

Back 55

No alch/caffeine
fasting
less meat consumed

Front 56

Native american Diet

Back 56

lactose intolerance

Front 57

Asian Indian Diet

Back 57

Lacto-vegetarian
curry

Front 58

Hindu Diet

Back 58

Lactoveg
no beef
foods = mood enhancers

Front 59

Buddhists

Back 59

Lacto-ovo, depends on sect

Front 60

Gluconeogenesis

Back 60

The formation of glucose from glycogen

Front 61

Glycogenesis

Back 61

formation of glycogen from glucose/pyruvic acid (Liver)

Glucose-6-phosphatase is a liver enzyme, not found in muscle so cannot store only use glycogen.

Front 62

Gluconeogenesis

Back 62

Formation of glucose from protein or fat

Front 63

Glycolysis

Back 63

Aerobic breakdown of glucose to pyruvate
goal: to produce pyruvate for krebs
Glucose enters cell (insulin) > combines w/ phosphorus (in presence of magnesium) > G6P > pyruvate
Anaerobic glycolysis > lactate

Front 64

Glycogenolysis

Back 64

conversion of glycogen into glucose in body tissues

Front 65

Vitamin A

Back 65

Carotenoids are precursor
Fxn: skin, vision
Def s/s: Bitot's spots, Night blindness -nyctalopia (reversible) > Xeropthalmia (irreversible), hyperkeratosis - dry, scaly skin
Sources: yellow-orange F/V
liver tox (UL 10,000 IU)

Front 66

Vitamin K

Back 66

Syn by bacteria in lower intestinal tract
blood clotting--> prothrombin --> thrombin --> fibrin
Def: hemorrhage
Affected by: mineral oil, antibiotics, anticoag
Natural forms:
-phylloquinone (k1)
-menaquininone (k2)
Synthetic form:
-menadione (k3)

Front 67

Vitamin E

Back 67

Sources: veg oils, whole grains, green veg, almonds
Antioxidant
Alpha-tocopherol (active form)
Least toxic vitamin

Front 68

Vitamin D

Back 68

functions with Ca & P for maintain bones
Precursors: cholesterol, needs UV light
Hydroxylated in the liver and kidney to be metabolically active
Def s/s: rickets (children)/osteomalacia (adults)

Front 69

Calcium

Back 69

Requires active vit D (D3 - calcitriol) for abs
PTH increases blood Ca- resorb (kidney) and releases from bones
High blood Ca+ - less PTH released, Calcitonin inhibits: Ca release by bone, abs by intestine, and kidney resorption = excrete excess in urine
Mass development of bone 9-18 yrs
Binds to oxalates and phytates in GI tract

Front 70

Iron

Back 70

Heme: animal
Non-heme: cereals/veg (poorly abs)
Enhance Abs: gastric jc, Vit C, MFP factor (meat, fish, poultry) enhance abs
Inhibit Abs: Ca+, phytates (grains, nuts), tannic acid (tea)
Tox: Hemosiderosis/Hemochromatosis

Front 71

Descriptive research

Back 71

Generates data at particular time
Quality, case reports, surveys

Front 72

Analytical Research

Back 72

allows causal relationships to be determined
- Experimental design

Front 73

# 10 can

Back 73

6 /case
6 lbs 9 oz = 96-105 oz
13 cups
20-25 svgs

Front 74

RQ

Back 74

VCO2/VO2

CHO 1
Pro 0.82
Fat 0.7
Mixed 0.85

Front 75

Surimi

Back 75

Purified and frozen minced fish with preservative (imitation crab)

Front 76

Eggs

Back 76

80 cal
6 g pro
5 g fat
Vitamins A, D, riboflavin
More protein in yolk
protein coagulates at 62-70 F

Front 77

Custards

Back 77

% sag = tenderness
higher = higher

Front 78

Milk

Back 78

87% water
3.7 % fat
4.9% CHO/lactose
3.5% pro (complete)
- Whey - drains off
- Casein - PPT at 4.6 pH

Front 79

Wheat flour is enriched with

Back 79

Thiamin
Riboflavin
Niacin
Iron
Folic Acid

Front 80

When does formative evaluation occur

Back 80

beginning or during

Front 81

Summative evaluation

Back 81

after program

Front 82

Blooms:
Psychomotor, cognitive and affective

Back 82

Psychomotor:Movement/coordination
Cognitive: intellectual skills
Affective: Confidence/attitude/feelings

Front 83

3 properties needed for experimental design study

Back 83

randomization
control
manipulation

Front 84

validity

Back 84

measuring instrument is consistent AND accurate

Front 85

Vitamin like glucose structure

Back 85

Vitamin C

Front 86

Thiamin/1000 calories

Back 86

0.5

Front 87

Niacin/1000 calories

Back 87

6.6

Front 88

Riboflavin/1000 calories

Back 88

0.6

Front 89

Iron/1000 calories

Back 89

6

Front 90

Where is betacarotene converted to Vitamin A

Back 90

Intestine

Front 91

kcal/kg infant

Back 91

80-140

Front 92

What hormone stimulates protein synthesis

Back 92

growth hormone

Front 93

which nutrient increases serotonin release

Back 93

carbohydrate

Front 94

Pepsin and trypsin help hydrolyze which macronutrient

Back 94

protein

Front 95

What does glucagon do

Back 95

converts glycogen to glucose

Front 96

Where is lactase produced

Back 96

SI

Front 97

Lipase is released by what organs

Back 97

stomach and pancreas

Front 98

Long chain fatty acids are transported via__

Back 98

chylomicrons- not to the lymphatic system

Front 99

Triglycerides are absorbed as

Back 99

chylomicrons - to lymphatic system

Front 100

4 states ketones are produced

Back 100

fasting
uncontrolled DM
decreased CHO intake
starvation

Front 101

Omega 3 will lower one but not another

Back 101

lowers TG but not cholesterol

Front 102

Who develops RDAs

Back 102

Food and Nutrition Board of the National Research Council

Front 103

Fever is associated with which FBIs

Back 103

listeria and salmonella

Front 104

Delaney clause

Back 104

"no food can be considered safe if it is found to produced cancer when fed to man or animal"

Front 105

Anaerobic FBIs

Back 105

botulism and clostridium perfringes

Front 106

Mold stabilizers

Back 106

calcium propionate, calcium sorbate, and EDTA

Front 107

What do nitrates do

Back 107

prevent growth of C.Bot as an antimicrobial

Front 108

Fastest onset of FBI is from

Back 108

Stapyhylococcus Aureus

Front 109

What FBI grows at fridge temps

Back 109

Listeria (miscarriages)

Front 110

pH of milk

Back 110

6.6

Front 111

FBI common among those <1 yrs old

Back 111

camplyobacter

Front 112

Zinc

Back 112

Excess = copper or iron def
Fxn: increases taste acuity (sharpness), enhances insulin action
Sources: animal proteins
Inhibit abs: copper, phytates (grains, nuts)
Def: dec immune fxn, poor wound healing, hypogeusia

Front 113

Phosphorus

Back 113

second most abundant mineral
Fxn: Phospholipids transport fat through lymph and blood, bone, teeth
Sources: animal proteins

Front 114

Folate

Back 114

Water sol PABA is precursor
Fxn: DNA syn, RBCs formation (bone marrow), prevent NTDs
Sources: Fort cereal, liver, green leafy, citrus, lentils, beans

Front 115

B12

Back 115

Cyanocobalamin
Bound by IF in gastric jc
Fxn: protein syn, forms RBCs
Sources: animal proteins
Def: pernicious anemia following gastrectomy or ileum resection d/t lack of IF

Front 116

B6

Back 116

Pyridoxine
Fxn: coenzyme in amino acid metabolism: deamination, transamination. Increased protein intake = Increased pyridoxine needs
Sources: meat, wheat, corn, yeast, pork, liver, RTE cereals

Front 117

Pantothenic acid

Back 117

Fxn: synthesis of fatty acids
Sources: animal foods, grains, legumes
Def: rare

Front 118

Vit C

Back 118

Ascorbic acid
Most easily destroyed, structure like glucose, antioxidant
Fxn: changes Proline>hydroxyproline>collagen; wound healing, aids Fe abs
Def: bleeding gums

Front 119

Biotin

Back 119

Synthesized by intestinal bacteria
Fxn: coenzyme in fatty acid synthesis
Sources: liver, kidney, egg yolk, yeast
Def: glossitis, dermatitis, muscle pain

Front 120

Copper

Back 120

Attached to protein ceruloplasmin
Fxn: Hemoglobin syn, aids iron abs
Sources: liver, kidney, shellfish
Def: Wilson's dz: low serum copper (ends up in tissues/organs)

Front 121

Chromium

Back 121

Aids insulin action

Front 122

___& ___help insulin move glucose inside the cell

Back 122

Zinc, Chromium

Front 123

Choline

Back 123

Component of Lecithin - Lipotrophic factor
Fxn: transports lipids as acetylcholine to prevent fat buildup in liver

Front 124

How many mg Sodium in 87 mEq?

Back 124

mEq = (# mg/atomic wt) x # valence
87 = (x / 23) x 1
87/1 = x/23
x = 2001 mEq

Front 125

Sodium

Back 125

Extracellular electrolyte
Normal: 136-145 mEq/L
40% of NaCl is Na
Reabsorbed by aldosterone, and retained by steroids

Front 126

Potassium

Back 126

Intracellular electrolyte
Normal: 3.5-5 mEq/L
Sources: f/v, meat
Aldosterone increases excretion

Front 127

Calcium

Back 127

Extracellular Electrolyte
Normal: 4.5-5.5 mEq/L (9-11 mg/dl)

Front 128

Magnesium

Back 128

Intracellular electrolyte
Normal: 1.5-2.5 mEq/L (1.8-3 mg/dl)

Front 129

Fluid balance

Back 129

Osmosis: FLUID moves from LESS to MORE concentrated
Diffusion: PARTICLES move from MORE to LESS concentrated
Effect of protein: exerts colloidal osmotic pressure; - when ALB drops > pressure drops causing fluid to leak out - water moves from extracellular (plasma) to interstitial spc.
- Low serum protein > edema and ascites
Serum sodium BEST assessment parameter of fluid status, if Na out of balance will affect all other values
- Hypernatremia = dehydration;
- Hyponatremia = overhydration

Front 130

Anasarca

Back 130

extreme generalized edema (widespread swelling) associated with heart, liver, and renal failure and extreme PEM

Front 131

Dehydration

Back 131

S/S: nausea, dizziness, sunken eyes, increase in solutes (BUN), tachycardia
Hypernatremia is associated with dehydration and

Front 132

Acid base balance

Back 132

Lungs control carbonic acid (H2CO3)
- Hyperventilation = loss of acid
Kidneys regulate bicarb (NaHCO3)
- excretion of bicarb = loss of base
Change in one buffer brings change in the other
Normal:
pH = 7.35-7.45
pCO2 = 35-45
HCO3 = 24-28

Front 133

Recommended weight gain during pregnancy

Back 133

# wt gain recommended
25-35# for normal wt BMI 18.5-24.9
28-40# for underwt BMI <18.5
15-25# for overwt BMI 25-29.9
11-20# for obese BMI >30
Target: at least achieve low end of range

Front 134

Rate of weight gain during pregnancy

Back 134

1#/month first 3 months
1#/week thereafter
At risk: failure to gain 4#/month in last half of pregnancy

Front 135

Increased nutrient needs for adolescent pregnancy

Back 135

iron, calcium, zinc

Front 136

Normal birthweight

Back 136

2500-4000g

Front 137

Infancy caloric needs

Back 137

0-6 months: 550 kcals
7-12 months: 700 kcals

Front 138

Human milk vs infant formula

Back 138

20 kcals/oz each
human milk: antibodies
formula: more pro, more iron

Front 139

Breastfeeding Recommendation

Back 139

Exclusive 4-6 months
Supplemented w/foods at least up to 12 months

Front 140

Infant Feeding Recommendations

Back 140

formula//breast milk: 2.5 oz/lb/day
add solids at 4-6 months, when sitting and extrusion reflex diminishes
NO whole cow's milk during first year of life
NO low/non fat cow's milk until 2 yrs
If cannot tolerate cow/soy formulas use casein hydrosylate (Pregestimil)

Front 141

Childhood Recs

Back 141

Limit fruit jc to 4 oz/day up to age 6
At least 60 min PA/day

Front 142

CDC Growth Charts

Back 142

Wt for length/stature: infants/young children 5-95%
- detects short term changes in nutr status
Stature/Length for age (0-36 mos recumbent/2-20 yr ht)
- reflects long term nutrition status changes
- <5% = short
Wt for age (5-95%) NOT very useful as does not include ht; cannot distinguish stunt/waste
BMI for age %iles (>=2 yrs)

Front 143

CDC Growth charts - BMI for Age %iles

Back 143

BMI for age %iles (2+ yrs)
- Underweight <5th
- Healthy 5-84th
- Ovwt 85-94yh
- Obese >=95th

Front 144

CDC/NCHS growth charts - other growth factors

Back 144

measure head circumference until age 3
Until age 2 measure length
Growth does not deviate by more than 25% from established patterns of growth

Front 145

FTT in children

Back 145

Illness, poor appetite, or lack of fiber (chronic constipation/diminished intake)

Front 146

Lead poisoning s/s

Back 146

irritability, lethargy, anorexia, vomiting, diarrhea

Front 147

RDA protein (adults)

Back 147

W: 46 g
M: 56 g

Front 148

Elderly nutrition needs

Back 148

Young old: 65-74, oldest old 85+
Often lack Ca and Fe (decreased abs d/t decreased HCl)
Encourage folate-rich foods, supplement B6, B12 may be needed

Front 149

Athlete Hydration

Back 149

Water during PA: 16 oz for every 1# lost
DURING continuous MVPA (1-4 hrs):
-100% of fluid lost PLUS CHO and Na
-5.5-15% CHO, and 55-164 mEq Na
AFTER 100-150% of fluid lost during PLUS CHO & Na
- 7% CHO, 60-1200 mg/dl Na+

Front 150

Substrate use during prolonged exercise

Back 150

CHO to provide PYRUVATE for continued lipid ox

Front 151

Supplements associated with blood clotting issues

Back 151

Black Cohosh + 4 G's: Garlic, Ginger, Gingko, Ginseng

Front 152

Supplement to avoid with liver disease

Back 152

Valerian

Front 153

Digestion in the stomach

Back 153

protein digestion begins
Proteolysis by protease pepsin and HCl

Front 154

Digestion is mostly completed by this point

Back 154

middle of jejunum
Nutrients abs: AA, FA, glycerol, simple sugars, V/M

Front 155

Bacterial Digestion (colon)

Back 155

LI abs: water, salts, and vitamins syn by bacteria (Vit K, B12, thiamin, riboflavin)

Front 156

Absorption and Metabolism: CHO

Back 156

Simple sugars: SI > liver> converted to glucose or gly

Front 157

Sources of glucose

Back 157

dietary, liver glycogen,products of intermediate metabolism (reconversion of lactic and pyruvic acids)
Dietary:
- 100 % CHO
- 58% Protein (glucogenic AAs)
- 10 % fat - glycerol
Fatty acids and muscle glycogen are only used locally, do not contribute to body supply

Front 158

Hormones affecting blood glucose

Back 158

Lower BG: insulin
Raise BG: glucagon (glycogen >>glucose)
Raise BG: glucocorticoids (protein >>glucose)
Raise BG: epinephrine (glycogen >>glucose); (-) insulin during stress

Front 159

End products of energy metabolism

Back 159

Energy, CO2, Water

Front 160

Cori Cycle

Back 160

pyruvic acid can form lactic acid for muscle contractions during oxygen debt (anaerobic)
Cori Cycle: lactate released from tissue, transported to liver, converted back to pyruvate

Front 161

Vitamins and Minerals req'd for energy production

Back 161

Pyr(3c) > Acetyl CoA(2c) requires all of these:
thiamin (TDP), Niacin (NAD), riboflavin (FAD), pantothenic acid (CoA), magnesium, lipoic acid

*Thiamin deficiency shows up as increase plasma pyr

Front 162

Krebs/TCA cycle

Back 162

Step 1: OAA (from pyr + AAs) combines with ACETYL CoA to form CITRIC ACID

---OAA is main CHO fuel for TCA/Krebs, if not enough then Acetyl CoA from fat is diverted to form ketone bodies

Front 163

Acetyl CoA

Back 163

Intermediate breakdown of all 3 macronutrients (CHO, PRO, Fat)

Front 164

Nitrogen Balance

Back 164

(protein intake (g)/6.25) - (UUN + 4)

nitrogen in - nitrogen out

Front 165

3 methods to determine quality of protein in foods

Back 165

BV - biologic value
NPU - Net protein utilization
PDCAAS - protein digestibility corrected amino acid score

Front 166

Protein Metabolism

Back 166

AAs > intestinal villi capillaries > portal vein > tissues
Req: pyridoxine (B6) for AA transport

Front 167

Exercise increases oxidation of ___, a BCAA

Back 167

leucine

Front 168

Protein synthesis

Back 168

regulated by DNA

Front 169

Protein catabolism

Back 169

#1 deamination (liver)
#2 NH2 > NH3 (ammonia)
#3 ammonia > urea > excreted in urine
#4 some ammonia > purines > uric acid
OR ammonia + ketoacid > nonessential AAs (transamination)
#5 remaining carbon chain is ketoacid > oxidized for energy

Front 170

Fat metabolism - 3 substances absorbed directly into portal blood

Back 170

1) glycerol (water sol)
2) SCFA (<12c)
3) some phospholipids

Front 171

Fat Metabolism - Mono-, Diglycerides, and LCFA

Back 171

combine with bile salts to form micelles
1) bound to protein to form lipoprotein (chylomicron)
2) penetrate intestinal mucosa > LYMPH > blood