Rd Exam Module 8

Front 1

24-hour recall

Back 1

– relies on the patient’s ability to remember how much food was eaten in a 24-hour period.

Front 2

Food frequency questionnaire

Back 2

patient is given a list of foods and asked to report how often he/she eats them.

Front 3

Diet history

Back 3

– record of cooking, eating, shopping habits, includes intolerance/allergies, chewing problems, etc.

Front 4

Food record

Back 4

– written record of amounts and types of foods eaten; generally 3-5 days.

Front 5

Indirect calorimetry

Back 5

- measures energy based on oxygen consumption and carbon dioxide production.
This is the gold standard for energy estimation.

Front 6

Resting Energy Expenditure (REE)

Back 6

amount of energy required to support the body at rest.

Front 7

Mifflin-St. Jeor equation

Back 7

- considered the most accurate in normal and obese people; specific for gender, height, weight, age; equations are based on normal, healthy subjects.
Males = (10 x wt in kg) + (6.25 x ht in cm) - (5 x age in years) + 5
Females = (10 x wt in kg) + (6.25 x ht in cm) - (5 x age in years) - 161

Front 8

Harris Benedict equation

Back 8

- like Mifflin-St. Jeor, Harris-Benedict is specific for gender, height, weight, age and is based on normal, healthy subjects.
Males = 66.47 + (13.75 x weight in kg) + (5.00 x height in cm) - (6.76 x age in years)
Females = 655.10 + (9.56 x weight in kg) + (1.85 x height in cm) - (4.68 x age in years)

Front 9

Activity factors

Back 9

chair bound or bed bound = 1.2
seated work lacking movement and little or no strenuous leisure activity = 1.4-1.5
seated work with movement and little or no strenuous leisure activity = 1.6-1.7
standing work = 1.8-1.9
strenuous work or highly active leisure = 2.0-2.4
Disease specific equations are available for estimating energy needs (e.g. ventilator-dependent, pulmonary disease).

Front 10

Estimated Energy Requirements (EER)

Back 10

- average amount of calories required to maintain energy needs of healthy person.
Developed by the National Academy of Sciences as part of the Dietary Reference Intakes (DRI).
Estimated Energy Requirements have been developed for men, women, children, infants, and women who are pregnant or lactating.

Front 11

Vitamin A - deficiency

Back 11

xerophthalmia, night blindness, cessation of bone growth; toxicity - fatigue, muscle soreness, bone and joint pain, decreased clotting time.

Front 12

xerophthalmia

Back 12

dry eyes

Front 13

Thiamin (B1) - deficiency

Back 13

beriberi: loss of appetite, nausea, vomiting; toxicity - rapid pulse, weakness.

Front 14

beri beri

Back 14

beriberi has been endemic in regions dependent on what is variously referred to as polished, white, or de-husked rice. This type of rice has its husk removed in order to extend its lifespan, but also has the unintended side-effect of removing the primary source of thiamine.[1]

Thiamine Deficiency


Symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate. Edema (swelling of bodily tissues) is common. It may increase the amount of lactic acid and pyruvic acid within the blood. In advanced cases, the disease may cause high output cardiac failure and death.

Front 15

Dry Beri Beri

Back 15

Thiamine Deficiency

Dry beriberi causes wasting and partial paralysis resulting from damaged peripheral nerves. It is also referred to as endemic neuritis. It is characterized by:

Difficulty in walking
Tingling or loss of sensation (numbness) in hands and feet
Loss of tendon reflexes[4]
Loss of muscle function or paralysis of the lower legs
Mental confusion/speech difficulties
Pain
Involuntary eye movements (nystagmus)
Vomiting.

Front 16

Wet beriberi

Back 16

Thiamine Deficiency

Wet beriberi affects the heart and circulatory system. It is sometimes fatal, as it causes a combination of heart failure and weakening of the capillary walls, which causes the peripheral tissues to become edematous. Wet beriberi is characterized by:

Increased heart rate
Vasodilation leading to decreased systemic vascular resistance, and high output cardiac failure[6]
Elevated jugular venous pressure[7]
Dyspnea (shortness of breath) on exertion
Paroxysmal nocturnal dyspnea
Peripheral oedema[7] (swelling of lower legs)

Front 17

Infantile beriberi

Back 17

Thiamine Deficiency


Infantile beriberi usually occurs between two and six months of age in children whose mothers have inadequate thiamine intake. In the acute form, the baby develops dyspnea and cyanosis and soon dies of heart failure. The following symptoms may be described in infantile beriberi:

Hoarseness, where the child makes moves to mourn but emits no sound or just faint moans,[8] caused by nerve paralysis[4]
Weight loss, becoming thinner and then marasmic as the disease progresses[8]
Vomiting[8]
Diarrhea[8]
Occasionally convulsions were observed in the terminal stages[8]
Pale skin[4]
Edema[4][8]
Ill temper[4]
Alterations of the cardiovascular system, especially tachycardia (rapid heart rate).[4]

Front 18

Wernicke–Korsakoff syndrome

Back 18

Thiamine Deficiency

Wernicke's encephalopathy (when mainly affects the central nervous system), Korsakoff's syndrome (when it reaches psychiatric aspects), and Wernicke-Korsakoff syndrome (with both neurologic and psychiatric symptoms).

WE is characterized by the presence of a triad of symptoms;

Ocular disturbances
Changes in mental state
Unsteady stance and gait

KS is described as an acute onset of severe memory impairment without any dysfunction in intellectual abilities.[1][5] The DSM IV lists the following criteria for the diagnosis of Korsakoff's Syndrome:

anterograde amnesia
Variable presentation of retrograde amnesia
One of:

Aphasia
Apraxia
Agnosia
A deficit in executive functions

Front 19

Riboflavin (B2) - deficiency

Back 19

- cheilosis: sore tongue, skin rash; toxicity - rare.

Front 20

Niacin (B3) deficiency

Back 20

- pellagra: diarrhea, dermatitis, dementia, death;

toxicity - diarrhea, nausea, abnormal heartbeat.

Front 21

Pyridoxine (B6) - deficiency

Back 21

- hypochromic, microcytic anemia;


toxicity - depression, fatigue, neurological disorders.

Front 22

Folate/Folic Acid - deficiency

Back 22

- macrocytic/megaloblastic anemia, birth defects;


toxicity - diarrhea, masks B12 deficiency.

Front 23

Cobalamin (B12) deficiency

Back 23

pernicious/megaloblastic anemia;

toxicity - rare.

Front 24

Vitamin C (Ascorbic Acid) - deficiency

Back 24

- scurvy: impaired wound healing, hemorrhages, and weakening of bones, connective tissue and teeth;


toxicity - diarrhea; possible increased risk of kidney oxalate stones.

Front 25

Scurvy

Back 25

is a disease that occurs when you have a severe lack of vitamin C (ascorbic acid) in your diet. Scurvy causes general weakness, anemia, gum disease, and skin hemorrhages.

Front 26

Vitamin D - deficiency

Back 26

rickets, osteomalacia;


toxicity - kidney stones, removal of calcium from bones.

Front 27

Vitamin E -deficiency

Back 27

anemia, red cell breakage;


toxicity - may interfere with anticlotting medications.

Front 28

Vitamin K - deficiency

Back 28

hemorrhaging;


toxicity - may interfere with anticoagulant drugs.

Front 29

Calcium - deficiency

Back 29

osteoporosis, tetany: low blood calcium characterized by spasms and convulsions; toxicity - reduced renal function, kidney stones, elevated serum levels can lead to heart or respiratory failure.

Front 30

Chromium - deficiency

Back 30

- abnormal glucose tolerance;

toxicity - rare.

Front 31

Copper - deficiency

Back 31

anemia, skeletal disorders, Menkes' disease: genetic disorder characterized by retarded growth, impaired keratinization of the hair, deteriorating nervous system, etc.;

toxicity - Wilson's disease

Front 32

Wilson's disease

Back 32

: genetic disorder characterized by copper accumulation in the tissues due to defect in the ability to form ceruloplasmin, in addition, the liver does not release copper into bile as it should.

Front 33

Menkes' disease

Back 33

Menkes syndrome is a disorder that affects copper levels in the body. It is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate (failure to thrive); and deterioration of the nervous system.

Additional signs and symptoms include weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood.

Front 34

Fluoride - deficiency

Back 34

ncreased risk for tooth decay; toxicity - fluorosis: discoloration of teeth.

Front 35

Iodine - deficiency

Back 35

mental retardation, goiter: enlargement of the thyroid gland;


toxicity - may lead to hypothyroidism, goiter, or hyperthyroidism.

Front 36

Iron - deficiency

Back 36

anemia: microcytic, hypochromic; toxicity - hemosiderosis: iron storage disorder through high intakes or genetic defect leading to excessive iron absorption without tissue damage; hemochromatosis: excessive iron storage associated with tissue damage.

Front 37

Magnesium - deficiency

Back 37

nausea, muscle tremors, confusion;

toxicity - rare.

Front 38

Potassium - deficiency

Back 38

rapid heart rate (tachycardia), weakness, paralysis, may be fatal;

toxicity - kidney failure, heart weakness, irregular heartbeat.

Front 39

Sodium - deficiency

Back 39

rare; toxicity - hypertension.

Front 40

Zinc - deficiency

Back 40

rowth retardation, slow wound healing, reduced taste sensitivity;


toxicity - anemia, heart muscle degeneration.

Front 41

ADIME

Back 41

(Assessment, Nutrition Diagnosis, Intervention, Monitoring and Evaluation)

Front 42

SOAP

Back 42

Subjective, Objective, Assessment, Plan

Front 43

DAR

Back 43

(Document, Assessment, Response).

Front 44

Guidelines for documentation include

Back 44

dated and signed including credentials; errors should be indicated with a single line drawn through them noted as an error, dated and initialed.

Front 45

The National Academy of Sciences developed which of the following?
a. REE
b. EER
c. indirect calorimetry
d. Harris Benedict

Back 45

Estimated Energy Requirements (EER) were developed by the National Academy of Sciences as part of the Dietary Reference Intakes.

Front 46

All of the following nutrient toxicities may lead to kidney stones except:
a. vitamin C
b. vitamin D
c. calcium
d. vitamin A

Back 46

Vitamins C, D, and calcium may lead to kidney stones when taken in toxic amounts.

Front 47

A patient with a history of heart problems is referred to you. Of the following nutrient toxicities, which may interfere with anticoagulants?
a. vitamin C
b. vitamin E
c. vitamin A
d. vitamin B6

Back 47

Vitamin E toxicity includes interference with anticlotting medications.

Front 48

Nutrition assessment documentation includes all of the following except: Incorrect
a. all medications
b. diet order
c. patient compliance
d. diet history

Back 48

a. all medications

Nutrition assessment documentation includes diet order, patient compliance, diet history, medications that may affect nutrition status.

Front 49

What vitamin deficiency is associated with hemorrhage?
a. vitamin C, vitamin E
b. vitamin K, vitamin C
c. vitamin E, vitamin A
d. vitamin A, vitamin K

Back 49

A deficiency of vitamin C or K is associated with hemorrhage.

Front 50

Which of the following nutrients may affect the body neurologically in toxic amounts?

a. vitamin B6
b. calcium
c. zinc
d. vitamin B12

Back 50

Toxicities of Vitamin B6 include depression, fatigue, neurological disorders

Front 51

When instructing a patient on keeping a food record, all of the following should be included except:
a. meals eaten outside the home
b. diet on weekdays and weekends
c. appetite
d. how often a food is consumed

Back 51

d. how often a food is consumed

When keeping a food record appetite, meals eaten outside the home, and diet on week days versus weekend days should be included.