Rose-Test

Front 1

Indications for protein restriction

Back 1

CHRONIC renal failure
ACUTE hepatic encephalopathy

Front 2

the following are all ______:
Acute trauma,surgery,infection
Wound healing / burns
ESLD
ESRD on renal replacement therapy
Traumatic brain injury, SCI
Promote growth in “at risk” neonates and pediatric patients
Pregnancy and lactation
Chronic steroid use
Sports nutrition
Severe caloric restriction for weight loss
Malabsorption/pancreatic insufficiency

Back 2

Indications for increased protein intake

Front 3

this essential fatty acid forms IL-6,IL-10 and is pro-inflammatory

Back 3

Omega-6 (linoleic)

Front 4

this essential fatty acid forms Anti-inflammatory cytokines

Back 4

Omega 3 (alpha-linolenic)

Front 5

Coenzyme in ATP synthesis

Back 5

Thiamine

Front 6

Essential as hydrogen donors/electron acceptors in myriad metabolic reactions

Back 6

Niacin

Front 7

Essential in nucleotide synthesis and amino acid metabolism

Back 7

Folate

Front 8

Biosynthesis of collagen,bile acids and norepinephrine.

Back 8

Vitamin C

Front 9

Coenzyme in ATP synthesis

Back 9

Thiamine

Front 10

Essential as hydrogen donors/electron acceptors in myriad metabolic reactions

Back 10

Niacin

Front 11

Essential in nucleotide synthesis and amino acid metabolism

Back 11

Folate

Front 12

Biosynthesis of collagen,bile acids and norepinephrine.

Back 12

Vitamin C

Front 13

Essential component of more than 100 enzymes including DNA/RNA polymerase (test)

Back 13

Zinc

Front 14

Micronutrients in wound healing

Back 14

vit A, Bs, Cs & zinc

Front 15

starved pt is put on enteral nutrition and develops hypophospatemia,hypokalemia, hypomagnesemia. what is going on?

Back 15

Refeeding syndrome

Front 16

clavicular prominance in men indicates _______

Back 16

malnutrition

Front 17

most sensitive marker of protein levels

Back 17

SIRS-CRP

Front 18

Gap between total protien (high) in albumen(low): can be 3 things what are they

Back 18

1)multiple myaloma 2) renal failure 3) liver failure

Front 19

does BMI account for mm mass

Back 19

no

Front 20

These people have a WHR(waist-hip-ratio) > 80%
android obesety, a strong correlation multiple medical problems & poor clinical outcome. e.g.,metabolic syndrome & NASH

Back 20

Apples

Front 21

these people have a WHR < 80%
gynoid obesity, less association with CAD,HTN, dyslipidemia, increased muscle mass

Back 21

Pears

Front 22

carbohydrate counting

Back 22

2000 kcal/day->divide by 8 = 250 grams CHO
divide by 15 =17 CHO servings
divide by 3 meals/day=
5 CHO per meal

Front 23

A cluster of symptoms that increase risk of CAD. Includes high TG, low HDL, HTN, hyperinsulinemia, high BG

Back 23

Metabolic syndrome

Front 24

what is less expensive enteral or parenteral nutrition

Back 24

enteral

Front 25

when should you start nutrition in pts

Back 25

earlier the better the outcome

Front 26

In Critical illness, how earlier should you start enteral nutriton

Back 26

at hemodynamic stability (ideally w/in 48 h)

Front 27

Absolute contraindications to EN

Back 27

Bowel obsxn

Front 28

Decreasing aspiration risk

Back 28

HOB >30-45 degrees

Front 29

Optimal N-6:N-3 ratio is from ________

Back 29

2:1 to 4:1

Front 30

Excessive ______ can be pro-inflammatory & immunosuppressive.

Back 30

N-6

Front 31

ideal IV lipid dosing

Back 31

~1g/Kg IDEAL for most

Front 32

On giving PN pt presents w/ hypo K, Mg, P, with fluid compartment shifts. What is going on?

Back 32

Refeeding Syndrome

Front 33

The Choice- EN or PN?

Back 33

Enteral should generally be used in preference to PN

Front 34

The following are examples of:
Severe short bowel syndrome
Complicated high output GI fistulas
Severe gut ischemia
Inability to gain enteral accessDiffuse perionitis, Intestinal obstruction, intractable vomiting or diarrhea, ileus, GI ischema

Back 34

When PN istruly indicated?

Front 35

In Celiac disease wheat shold be avoided as should these othe two grains.

Back 35

rye and barley

Front 36

pts with chronic pancreatitis often need more or less nutrients

Back 36

more - Patients are often hypermetabolic/hypercatabolic

Front 37

often times pt w/ chronic pancreatits require supplimentation of these vitamens

Back 37

fat soluable

Front 38

In acute pancreatitis, CMP, & lipid panel will often show

Back 38

Hyperglycemia common
Hypertriglyceridemia

Front 39

giving parenteral feeding and labs show TG>400 what do you do?

Back 39

hold IV feeding

Front 40

Ascites Necessitates a ___ restricted diet. However do not hold _____ unless hyponatremia is present

Back 40

Na
fluids

Front 41

guidelines suggest use of _______ for Porto-systemic encephalopathy refractory to conventional therapy.

Back 41

Branched chain amino acids (BCAA )

Front 42

_________ therapy allows protein sensitive patients with Porto-systemic encephalopathy (PSE) to eat a more liberal diet

Back 42

Lactulose

Front 43

________ may help stabilize cardiac arrhythmias in ischemic cardiac disease. Decrease platelet aggregation. Improve blood pressure via endothelial relaxation

Back 43

Omega 3 fats

Front 44

In pts with advanced cardiac dysfunction restrict ____ to facilitate diuresis, improve hypertension, and encourage foods high in

Back 44

Na+
K+

Front 45

in nutritionally managing pts with COPD do this

Back 45

lots of calories cuz often takes a lot of work to breath and restrict carbs cuz have to blow off the CO2

Front 46

pts with CF have an extremely (high or low) nutrient demand

Back 46

high

Front 47

in pts w/ acute renal failure you may need to restrict Na, K, and _____

Back 47

phos