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100 Cards in this Set
- Front
- Back
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What is arm muscle area (AMA) used to measure?
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Measures skeletal muscle mass (somatic protein)
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What are possible causes of hair that is thin, sparse, dull, dry or easily pluckable?
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Chemotherapy, vitamin C, protein deficiency
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What are possible causes of pale, dry eyes or poor vision?
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Vitamin A, riboflavin (B2) or zinc deficiencies
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What are possible causes of swollen, red, dry or cracked lips?
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Riboflavin, niacin, or pyridoxine deficiencies (B2, B3, B6)
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What are possible causes of pale, dry, scaly skin?
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folic acid, iron, zinc deficiency
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What is the most accurate measure of nutritional status?
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Biochemical analysis
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What is the best measure for evaluating protein status and what is the normal range?
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Transthyretin (TTHY), also known as: Prealbumin (PAB)
Normal range: 16 - 40 mg/dl |
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What is the normal range for creatinine and what does it measure?
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.6-1.4 mg/dl
Related to muscle mass/muscle wasting. Together with BUN, assess kidney function |
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What level BUN should a renal patient be?
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under 100 mg/dl
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Describe the drug/nutrient interaction of the following drug: oral contraceptives
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Decrease folate, B6, C
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Describe the drug/nutrient interaction of the following drug: loop diuretics
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Deplete K, Mg, Ca, Na, Cl
ex: Lasix (furosemide) |
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Describe the drug/nutrient interaction of the following drug: thiazide diuretics
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Decrease K and Mg, absorb Ca
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Describe the drug/nutrient interaction of the following drug: isoniazid
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Treats TB
Depletes pyridoxine, peripheral neuropathy Don't take with food, interferes with D, calcium supplements are needed |
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Define incidence and prevalence.
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Incidence = number of new cases of a disease over a period of time
Prevalence = total number of people with a disease at a period of time |
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What are the 5 things that should be monitored in nutritional surveillance?
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Height, weight, hematocrit, hemoglobin, serum cholesterol
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Who administers and who is eligible for the following program: Pediatric Nutrition Surveillance System (PedNSS)?
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HHS
Low income, high risk children |
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Who administers and who is eligible for the following program: Pregnancy Nutrition Surveillance System (PNSS)?
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HHS
Low income, high risk pregnant women |
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Who administers and what does the following survey assess: NHANES?
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CDC
Obtain information on health of all American people NHANES III - large sample over the age of 65: no upper age limit |
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Who administers and what does the following survey assess: Nationwide Food Consumption Survey (NFCS)?
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USDA
Obtain info on food intake of individuals and total households from the entire US, evaluates 7 nutrients |
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Who administers and what does the following survey assess: Behavioral Risk Factor Surveillance System (BRFSS)
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HHS
State level data |
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Who administers and what does the following survey assess: Diet and Health Knowledge Survey (DHKS)?
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USDA
Beliefs about food safety, food labels, knowledge of nutrients |
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Who runs the following program, who is eligible and what services are offered: Temporary Assistance for Needy Families (TANF)?
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States
Determine the eligibility of needy families and the benefits and services those families will receive |
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Who runs the following program, who is eligible and what services are offered: Commodity Food Donation/Distribution Program?
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USDA
Provides food to help meet nutritional needs of adults and children Food is given to school lunch, elderly feeding, supplemental food programs (strengthens agricultural market for food produced by American farmers) |
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Who runs the following program, who is eligible and what services are offered: Commodity Supplemental Food Program (CSFP)?
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USDA
Administered by state health agencies Low income woman (pregnant, breast-feeding, post-partum), kids up to 6, some elderly, with a nutrition risk |
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Who runs the following program, who is eligible and what services are offered: The Emergency Food Assistance Program (TEFAP)?
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USDA
Quarterly distribution of commodity foods, supplements diets of low income households |
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Who runs the following program, who is eligible and what services are offered: National School Lunch Program (NSLP)?
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USDA
Low income children Must meet 1/3 RDA for protein, vitamins A and C, iron and calcium |
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Who runs the following program, who is eligible and what services are offered: School Breakfast Program (SBP)?
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USDA
Low income children Must meet 1/4 RDA for protein, vitamins A and C, iron and calcium |
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Who runs the following program, who is eligible and what services are offered: Summer Food Service Program (SFSP)?
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USDA
Maintain food service to children when school is not in session |
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Who runs the following program, who is eligible and what services are offered: Child and Adult Care Food Program (CACFP)?
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USDA
Supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters |
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Who runs the following program, who is eligible and what services are offered: WIC?
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USDA
Not and entitlement program - cap on federal dollars spent Must be at nutritional risk |
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Who runs the following program, who is eligible and what services are offered: Extension Food and Nutrition Education Program (EFNEP)?
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USDA
Provides grants to universities to assist in public development Trains nutrition aids to educate the public |
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Who runs the following program, who is eligible and what services are offered: Healthy Start?
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HHS
Reduce infant mortality and improve health of low income women, infants, children, families |
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Who runs the following program, who is eligible and what services are offered: Elderly Nutrition Program (ENP)?
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HHS
All people 60+, plus spouse, regardless of income One hot meal each day, 5 days/week, 1/3 recommended intake |
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Who runs the following program, who is eligible and what services are offered: Centers for Medicare and Medicaid Services (CMS)?
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HHS
Medicare - over 65 plus end-stage renal disease Medicaid - joint state and federal, all eligible needy: all ages, blind, disabled, dependent children |
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Who runs the following program, who is eligible and what services are offered: Headstart?
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HHS
Low income children ages 3-5 Kids participate in food activities |
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Who runs the following program, who is eligible and what services are offered: Nutrition Education Training Program (NET)?
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USDA
Amendment to School Lunch Act Provides nutrition education training to teachers and school foodservice personnel |
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Who runs the following program, who is eligible and what services are offered: Senior Farmer's Market Nutrition Program (SFMNP)?
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USDA
Grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmer's markets, CSA, roadside stands |
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What assistance programs/surveys are run by the USDA?
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DHKS - Diet and Health Knowledge Survey
NFCS - Nationwide Food Consumption Surveys Commodity Food Donation/Distribution Program CSFP - Commodity Supplemental Food Program TEFAP - The Emergency Food Assistance Program NSLP - National School Lunch Program SBP - School Breakfast Program Special Milk Program CACFP - Child and Adult Care Food Program WIC - Women, Infants, Children EFNEP - Extension Food and Nutrition Education Program SNAP - Supplemental Nutrition Assistance Program NET - Nutrition Education Training Program SFMNP - Senior Farmers' Market Nutrition Program |
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What assistance programs/surveys are run by HHS?
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PedNSS - Pediatric Nutrition Surveillance System
PNSS - Pregnancy Nutrition Surveillance System BRFSS - Behavioral Risk Factor Surveillance System YRBS - Youth Risk Behavior Survey WLPS - Weight Loss Practice Survey Maternal and Child Health Block Grant Healthy Start ENP - Elderly Nutrition Program CMS - Centers for Medicare and Medicaid Services HeadStart |
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Who wrote the 2010 Dietary Guidelines for Americans and why?
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USDA and HHS, designed to prevent chronic disease
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What is the difference between goals and objectives?
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Goals = broad direction, general purpose
Objectives = more defined than goals, contain specific target dates |
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What 4 things are required for successful program implementation?
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1. Administrative support
2. Realistic budget 3. Staff commitment 4. Support of target population |
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How do oat bran and soluble fibers decrease serum cholesterol?
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By binding bile acids converting more cholesterol into bile
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What are the complications of losing the terminal ileum?
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Problems absorbing B12, intrinsic factor, bile salts
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What happens if the body loses the ability to reabsorb bile salts and how can this happen and what is the recommended diet therapy?
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Losing terminal ileum, then they are not available to emulsify fat, which means fat should be given in MCT since they do not require bile salts for absorption.
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What are major complications of ulcerative colitis?
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Chronic bloody diarrhea, loss of electrolytes
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What are most severe losses for someone with short bowel syndrome?
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Loss of ileum, ileocecal valve and loss of colon
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What are elevated liver enzymes indicative of?
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Tissue damage
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Name the 4 enzymes that will be elevated in liver disease.
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ALP - alkaline phosphatase
LDH - lactic acid dehydrogenase AST - aspartate aminotransferase ALT - alanine aminotransferase |
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What causes ascites?
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When blood cannot leave the liver, the liver expands, pressure forces fluid through into the peritoneal cavity
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What causes esophageal varices?
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When blood can't enter the liver.
Portal hypertension - blood gets backed up, forces out-pouching of walls |
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What is the recommended diet for cirrhosis? If varices are present? If edema or ascites is present?
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High protein, high calorie, moderate fat
Varices - low fiber Edema/ascites - low sodium |
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What is the recommended diet for hepatic failure? How about one novel theory?
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moderate to high levels of protein
adding BCA when standard therapy doesn't work, to help with altered neurotransmitters |
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How is bile secreted after a cholecystectomy?
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Bile now secreted from liver directly into intestine
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What is one cause of inflammation in pancreatitis?
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Premature activation of pancreatic enzymes leads to auto-digestion (pancreatic enzymes digest the pancreas)
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What is the recommended diet for pancreatitis?
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Elemental (pre-digested) enteral nutrition into the jejunum may be tolerated
Low fat content |
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What are the 3 hormones involved in renal function?
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Vasopressin (ADH) - elevates blood pressure
Renin - vasoconstrictor Erythopoietin (EPO) - stimulates bone marrow to produce RBC |
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What lab values are decreased in renal disease?
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Glomerular filtration rate and creatinine clearance
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What lab values are increased in renal disease?
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Serum creatinine, BUN
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What BUN:creatinine ratio suggests acute kidney damage and what level indicates a need for dialysis?
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> 20:1 = acute kidney damage, may be reversible
< 10:1 = reduced BUN reabsorption, may need dialysis |
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What does the renal solute load measure?
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Mostly nitrogen (60%) and sodium (electrolytes)
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What is the primary dietary therapy for kidney stones?
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High fluid intake to dilute urine and break up stones
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What are the signs of nephrotic syndrome?
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Albuminuria, edema, malnutrition, hyperlipidemia
Incr synthesis and decr clearance of VLDL |
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What is the dietary therapy for nephrotic syndrome?
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Modest protein (.8-1 g/kg) and fat restriction
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When do you restrict protein in chronic kidney damage?
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When GFR falls
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What are normal, impaired and diabetic fasting glucose levels?
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Normal: 70-100
Impaired: 100-125 Diabetic: >126 |
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What are normal, impaired and diabetic post-prandial glucose levels?
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Normal: <140
Impaired: 140-199 Diabetic: >200 |
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What is the A1c goal for diabetics?
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<7 (normal is <5.7)
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What are the goal blood sugar levels for diabetics?
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Fasting: 70-130
Post prandial: <180 |
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What is the dawn phenomenon?
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Natural increase in early morning blood glucose and insulin requirements due to increased glucose production in the liver after overnight fast
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What is ketoacidosis and what are the signs?
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Complication of uncontrolled diabetes
Hyperglycemia due to insulin deficiency or excess CHO intake Signs: dehydration (due to polyuria-excess urine) and a rapid pulse |
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How do you treat ketoacidosis?
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Insulin and rehydration
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How do you prevent postprandial or reactive hyperglycemia?
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Goal: prevent marked rise in blood glucose that would stimulate more insulin
Prevent: Avoid simple sugars, 5-6 small meals/day, spread intake of CHO throughout the day |
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What is the difference between hyperthyroidism and hypothyroidism?
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Hyper- excess secretion of thyroid hormone; elevated T3 and T4
Hypo - deficiency of thyroid hormone; low T4, low or normal T3 |
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What is the cause of galactosemia and what is the treatment?
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Due to missing enzyme, treated solely by diet (galactose and lactose free)
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What is the treatment for urea cycle defects?
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Diet - protein restriction based on tolerance to lower ammonia
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Describe a ketogenic diet, the fat:non-fat grams ratio and the necessary supplements.
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High fat, very low carb (4:1 fat:non-fat grams)
Supplement: Ca, D, folate, B6, B12 |
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What is the recommended diet therapy for pressure ulcers, including kcal/kg?
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High kcal, high protein, normal Ca, adequate fluids
30-40 kcal/day |
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What is the difference between macrocytic and microcytic anemia?
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Macrocytic - megaloblastic anemia, few large cells, filled with hemoglobin; due to folate or B12 deficiency
Microcytic - hypochromic anemia, small, pale cells; due to iron deficiency |
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What is the normal value for MCV (mean corpuscular volume) and for MCH (mean, corpuscular hemoglobin)?
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MCV = 80-95 fL
MCH = 27-32 pg |
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What are the 7 most common allergens?
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Peanuts, tree nuts, eggs, milk, soy, wheat, shellfish
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What are the results of physiologic trauma?
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Hyperglycemia
Hyperinsulinemia Little/No Ketosis Elevated glucagon |
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What is the recommended diet therapy for thrush (from oral infections)?
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Avoid spicy, acidic, strongly flavored foods
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What do blood cholesterol levels look like for a healthy obese person?
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Elevated LDL, normal to low HDL
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What are fluoride recommendations for children?
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Birth-6 mo: oral supplementation not recommended
6-12 mo: fluoridated water, supplements only if prescribed 1-2 years: fluoridated water, supplements only if prescribed 2-3 years: fluoridated water, fluoride toothpaste |
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What are elemental, chemically defined formulas and when are they used?
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Predigested protein or amino acids.
Ex: Peptamen, Vivonex, Alitraq used with malabsorption, compromised GI fxn |
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How many calories are in 10% and 20% fat solutions?
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10% = 1.1 kcal/ml
20% = 2 kcal/ml |
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Name some conditions in which TPN may be indicated.
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Altered GI function, inability to absorb nutrients, malabsorption, diffuse peritonitis, intestinal obstruction, short bowel syndrome, hypermetabolic states, cancer patients on therapy, GI disorders (peritonitis), fistulas, severely malnourished pre-op patients, acute pancreatitis critical care patients if NPO is expected to last for more than 4-5 days and enteral support is not possible
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What is the process by which the water content of a vegetable is replaced by a concentrated salt solution?
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Diffusion
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Which recipe ingredient should be adjusted if a cake has a crunchy crust and compact, moist texture?
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Sugar
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A group of rats being fed gelatin as the sole protein source are not growing well, what is the likely reason?
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Gelatin has no tryptophan and is low in methionine and lysine
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If you replace half and half with whipping cream in ice cream, what will the effects be on the ice crystals?
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Decrease in size because there is more fat
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The best lab value for assessing iron status is?
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Ferritin
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Which is the best flour to use when making cakes (besides cake flour)?
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All-purpose
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Where is lactose best absorbed?
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Small intestine
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Which minerals are involved in CHO metabolism?
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Chromium and Zinc
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Acidic chime becomes neutralized in the duodenum by?
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Mixing with bicarbonate and fluids
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How do you prevent frozen gravy from separating when thawed?
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Prepare it with modified corn starch
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Thiamin, Riboflavin and Niacin are all involved in the metabolism of what?
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CHO
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An increased plasma pyruvate level is an indication of what deficiency?
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Thiamin
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