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130 Cards in this Set

  • Front
  • Back
The most commonly appreciated essential function of iron in nutrition is to support the synthesis of ___ in red blood cells fro the transport of oxygen from the lungs to tissues.
hemoglobin
Iron is also a component of ___ and a number of dehydrogenase enzymes in skeletal muscle, dehydrogenases in braind and enzymes that scavenge or neutralize toxic radicals and chemical.s
myoglobin
The presence of ascorbic acid and other ___ (reducing or oxidizing) agents retards the ____ (oxidation or reduction) of ferrous iron. The reduced from is also more stable in acidic solutions.
reducing, oxidation
Short-term courses of TPN generally ___ (omit or include) exogenous iron administration
omit
Menstrating women have average iron losses that are ___ or ___ times greater than those of the non-menstrating subject.
two or three
___, ____, ____ and ____ are prerequisites for the efficient incorporation of parenteral iron into new erythrocytes.
Vitamin B12, folic acid, copper and pyridoxine
IV administration of iron dextran in patients with rheumatoid arthritis may ___ (exacerbate or benefit) joint inflammation.
exacerbate
Iron infused as iron dextran has a large propensoty to be taken up by the ___ system.
reticuloendothelial system
Only ___% of the iron from iron dextran is incorporated into new RBS of anemic subjects three weeks after administration.
39
___'s disease (inflammatory bowel disease) presents unique problesm regarding the bioavailability of parenteral iron since the inflammation produces an internal block inthe participation of iron in erythropoiesis.
Crohn's
The fully replete adult male contains about ___ g of total body iron, ___g of which is in the storage pool.
4, 1
The body's iron reserves are equally distributed in three parts among ____ _____, _____, and ____ _____.
reticulo-endothelial cells and hepatocytes and skeletal muscle.
______ is the primary transport protein for iron inthe blood.
Transferrin
During infection, iron is redistributed from the circulating compartment into the ____ under the influence of leukocytic endogenous mediator.
liver
The ____ mucosa regulates the entrance of dietary iron into the body in response to body iron reserves and the activity of erythropoiesis.
intestinal
In pre-menopausal women, __ to __ mg of iron or more can be lost in the monthly discharge.
30 to 150
It is essential that a test dose of __ mL (___mg) iron be administered before each dose to screen for an anaphylactic reaction.
0.5 (25)
Intramuscular iron should always be given by ___-track technique designed for deep IM administration.
Z
Iron deficiency, not unlike copper deficiency is reflected by ___ cytic, ____chronic morphology of the erythrocyte.
micro, hypo
Soluble transferrin receptor (sTfR), unlike ferritin, is not influenced by ___ or ____.
infection, inflammation
Zinc and ___ (trace element) compete for intestinal uptake.
copper
Under usual circumstances the fully zinc-replete adult contains ___ to ____ g of zinc
2 to 3
About ___% of body zinc is in the skeleton, a pool which is not readily mobilized for use during periods of deficient zinc intake, except when bone is being actively reabsorbed.
20
The liver has a zinc concentration of __g.
1.5
Tissue concentrations generally range from 20 to 400 microg/g with ____ (organ), retinal and gonadal tissue having higher concentration (600-800 microg/g).
pancreatic
Between ___ and __ mg of zinc are present in the cell-free portion of the systemic circulation.
3;4
___% is tighting bound to an ___2-____ (a zinc metalloprotein) fraction of serum proteins and is not available for nutritional or metabolic uses.
40; a2-macroglobulin
About __% of zinc is loosely bound to albumin; this appears to be the nutritional transport fraction.
55
About ___% of zinc is associated with free amino acids and other low-molecular-weight species in the plasma. The fraction represents the zinc filterable by the kidneys (0.5 mg to 1 mg/day excreted).
5
The albumin of patients with alcoholic cirrhosis has a ___ (decreased or increased) affinity for zinc.
decreased
Short-term fasting and tissue necrosis increase serum zinc, while corticosteroid therapy, exogenous estrogens and pregnancy ___ (decrease or increase) serum zinc concentrations.
decrease
Infectious or inflammatory stress will mediate a major, acute sequestration of circulating zinc by the liver, producing up to a __% decline in plasma zinc concentrations.
50
In the determination of zinc concentrations, external contamination of glassware or plastic ware, hemolysis and prolonged venous occlusion during venipuncture can all falsely ___ (elevate or decrease) zinc concentrations.
elevate
The storage sites for the metabolically active zinc in the body are the ___ (organ) and, most probably, skeletal muscle.
liver
The normal route of excretion of zinc from the body is via the ___ ___, largely in meal-stimulated pancreatic secretions.
intestinal tract
Increased sweat losses can increase the surface loss of zinc up to __-__times normal losses.
2-3
Approximately 3-10% of the RDA or __-__ mg/day is lost from the skin surface.
0.5-1.5
Low ___ ____ (liver enzyme) are associated with low plasma zinc concentrations in bone marrow transplant children
alkaline phosphatase.
The most common feature of reactions catalyzed by cuproenzymes is the involvement of molecular ___ or a derivative; thus, unlike the metalloenzymes of zinc, cuproenzymes almost universally govern the rate-liniting steps in the respective biochemical pathways.,
oxygen
The ___ (oxidized or reduced) cupric form is the more stable and by far more stable and by far the more soluble in water.
oxidized
Copper can form complexes with organic cations (such as amino acids) to various extents depending on ___ and competing cations in the soluton.
pH
___ and ___ are known to exercise competitive mineral-mineral interactions with copper at the level of intestinal absorption; however, they probably have no effect in an IV delivery situation.
iron and zinc
____ acid has an antagonistic effect on copper nutriture in biological systems, but this is thought to derive from an interaction in the gut.
ascorbic
The free ___ acids of TPN solution may produce copper diuresis.
amino
Chelating agents such as D-____ produce excessive renal excretion of copper.
penicillamine
Diseases, such as ___'s, external biliary obstruction and diseases producing intrahepatic cholestasis (such as primary biliary cirrhosis) would be conditions in which exogenous copper mught be contraindicated.
Wilson's
In the severe protein-depleted patient, a delay in the onset of nutritional participation of infused copper could conceivably occur if ____ synthesis were limited.
ceruloplasmin
The healthy adult body contains ___ micorg of copper.
120
The ____ is the central terminal for copper storage and metabolism.
liver
__% of circulating copper is bound to ceruloplasmin; the remaining __% is bound loosely to albumin and amino acids.
94, 6
Women have ____ (higher or lower) mean copper concentrations than men, due to the stimulation of ceruloplasmin release by estrogens.
higher
____ (condition) and ____ (medications) exaggerate estrogen release, driving serum copper concentrations of women in these categories to or exceedign 300 microg/dL.
pregnancy and oral contraceptives
Ceruloplasmin concentrations and, consequently, copper concentrations, tend to be significantly higher in ___ (smokers or nonsmokers).
smokers
It is likely that copper is stored on n___ (protein) in the liver cell.
metallothionein
The major route of copper excretion from the body is via ___.
bile
Malignancies generally ___ (raise or lower) circulating concentrations of copper and ceruloplasmin.
raise
Parenteral amino acid infusion causes ___ (greater or lesser) copper in urine in both adults and children.
greater
Massive introduction of copper into the circulation results in ___ ___ and ___ ___, often with a fatal outcome.
hemolytic anemia and hepatic necrosis
The hematological parameters are not well-defined for copper deficiency although the combination of ___ and a microcytic, hypochromic anemia with a low reticulosyte count in the presenc of adequate iron nutriture is very suggestive of copper depletion.
neutropenia
___ (disease) patients may be at risk for copper deficiency.
Crohn's
Chromium participates in metabolism as a component of a small, organic entity known as __ ___ ___ or _ _ _.
glucose tolerance factor or GTF
GTF is believed to potentiate the action of ___ at the cellular level, participating in the transmission of the hormonal message to the receptor cell.
insulin
The ___ form of chromium is of major biological importance as a nutrient.
chromic
____ _____ analysis is probably the analytical method of choice for chromium analysis, but it requires a nuclear reactor facility.
neutron activation
Free, ionic ___ is a potential chromium antagonist sinceit might saturate the binding sites on ____, which is also the transport protein for chromium.
iron, transferrin
For chromium to function in metabolism, ___ must be available; in the ttally ___ state, chromium supplementation will not improve glucose tolerance.
insulin, insulinopenic
Supplementation of chromium to a deficient pateint might substantially decrease his or her insulin requirement and careful monitoring of blood sugar required during the early period of chromium addition to avoid ____.
hypoglycemia
The total body content of chromium is estimated to be __ to ___ mg.
6 to 10
Approximately ___ mg of chromium is found in a transport form in the circulation bound to transferrin.
1
Chromium also enters the circulation, presumably as glucose tolerance factor, in response to _____ (Macronutrient) meals..
carbohydrate.
The ____ _____ _____ chromium (active) is more filterable than the ____- bound (transport) chromium.
glucose tolerance factor, transferrin
Carbohydrates that provoke greater insulin responses induce _____ (higher or lower ) post-prandial excretion of chromium in urine.
higher
Manganese is found in at least two metalloenzymes of manganese-____ ____ and _____ ____.
superoxide dismutase and pyruvate carboxylase
___ ____ analysis probably provides a more precise and accurate determination of manganese concetration inadditives and TPN fluids that atomic absorption spectrophotometry.
neutron activation
Since manganese is excreted in the bile, the administration of parenteral manganese to patients with ____ conditions mighe be contraindicated.
cholestatic
The total body content of manganese in an adult is estimated to be ___mg.
20
Manganese is concentrated in the ___ (organ) and in other mitochondrion-rich tissues.
liver
In the blood, manganese is found both in the ___ ___ ___ (whole blood constituent), associated with hemoglobin, and in teh serum, associated wth a beta-1-globulin.
red blood cells
Manganese is largely excreted fromt he body into the fecal stream in ____ and to a lesser extent in intestinal secretions.
bile
One gram of sodium fluoride provide ___ grams of fluoride.
0.452
The only recognized role of fluoride in man is to be incorporated into ___ and ___ ____.
bone and tooth enamel
Fluoride is commonly used as an ____ agent for the collection of blood samples.
anticoagulant
Fluoride prevent normal coagulation by precipitating ___ as a ____: fluoride complex.
calcium, calcium
About ___% of the fluoride present in most diets (0.5-5.0 mg) is available for absorption fromt he stomach and intestines via [assive diffusion.
80
Only about ___% of the fluoride that enters the systemic circulation is stored in the body.
20
About ___% of retained fluoride is avidly taken up by and deposited as fluoroapatite by the skelton.
95
About ___% of fluoride is elminated from the body via pH-dependent renal excretion into the urine.
50
An excessive consumption of fluoride during the period of tooth formation willl result in dental ____.
fluorosis
Blood and urine levels ___ (may or may not) necessarily reflect fluoride content in tissues, biological activity or balance status,
may not
The lethal dose of ingested sodium fluoride is __-___ g.
5-10
The lethal dose of ingested sodium fluoride is __--___g.
5-10
Once the compound reaches the stomach, the acidity of the gastric contents converts the salt to free ___ ___, which produces a dark red corrosion of the mucous memebrane.
hydrofluoric acid.
Appreciable amounts of fluoride ___ (cannot, can) be leached from the glass.
can
____ is the major dietary source of fluoride.
water
The current practice is to provide fluoride in public water supplies at a concentration os about ____ .
1 ppm
An adequate supply of fluoride should be present during ____ and ____ to be maximally effective.
infancy and childhood
A role for fluoride in the treatment of osteoporosis ____ (has, has not) been established.
has not
IV requirements for fluoride supplementation ____ (have or have not) been defined.
have not
The principal function of iodine in man concerns the formation of the thyroid hormones, ____(T_) and _______ (T_).
triiodothyronine (T3) and thyroxine (T4)
The most common manifestation of iodine deficiency is ______.
goiter
Thyroid dysfunction is estimated to be present in __ to ___ % of hospitalized patients.
2-5
Iodine in any form is essentially ____% bioavailable.
100
Iodine is distributed throughout the body in the extracellular fluid but is concentrated primarily in the ____ ______.
thyroid gland
Other tissues that can also concentrate iodine are the ____ _____, _____ and _____ _______.
salivary glands, stomach and mammary glands
Excess iodine can be temporarily stored in the ____, ____ and _____.
liver, skin and lungs
Adults have a total body pool of ___ to ____ mg of iodine of which 70-80% is present in the thyroid at a concentration of 10-40 mg/100 g wet weight tissue.
10-30
____ and _____ are molybdenum antagonists
Copper and tungsten
Molybdenum is required as a cofactor for the oxidase enzymes- _____ _____, _____ ______ and ______ _____.
xanthine oxidase, sulfite oxidase, and aldehyde oxidase
The metabolism of methionine and cysteine are dependent on sulfite oxidase to transform _____ to _______.
sulfite to sulfate
____ (Low or High) protein intake and high dietary consumption of copper, tungsten, and inorganic sulfate are antagonists to molybdenum bioavailability.
Low
Molybdenum is present in the body in low concentrations with the largest amount being in the _____ (2.5-5 microg/g dry weight tissue), followed by the kidneys, spleen, lung, brain and muscles.
liver
In man, the consumption of diets high in molybdenum (10-15 mg/day) has been associated with an unusually high incidence of _____ _____, accompanied by increased blood concentrations of molybdenum, uric acid and xanthine oxidase.
hyperuricemic gout
If deficiency or toxicity is suspected, purine and sulfur metabolic profiles and _____ statues should be obtained.
copper
Even though selenomethionine results in a faster repletion of deficient patients, ____ ____ is currently being used for most patient care.
selenious acid
______ ______ protects cells against peroxide-induced damage.
Glutathione peroxidase
Glutathione peroxidase is a major intracellular antioxidant that utilizes _____ as a proton donor to catalyze the reduction of hydrogen peroxide and organic hydroperoxides to nontoxic products.
glutathione
Selenium is primarily ingested as selenomethionine from ____ and as selenocysteine from _______.
plants; animals
Total body content of selenium varies according to the relative amount present in the _____.
soil
The highest concentrations of selenium are found in the _____, followed by the liver, muscle, skin.
kidney
Muscle contains almost ___% of the total body selenium content.
50
____ selenium reflects short term selenium status better than whole blood selenium.
Plasma
Selenium is incorporated as ____, the biologically active form of selenium, into glutathione peroxidase and selenoprotein P.
selenocysteine
Selenium is primarily eliminated in the _____, but significant losses through ____ also occur.
urine, feces
Less than ____% is eliminated by the lungs and skin.
5
Biologically active selenium can be estimated by measuring ____ _____.
glutathione peroxidase
Plasma glutathione peroxidase increases within __-___ days after initiating selenium supplememntation, whereas red blood cell activity does not increase for 2-4 weeks.
1-2
Similar to Keshan's disaease, potentially fatal ____ can occur in long-term TPN patients unsupplemented with selenium.
cardiomyopathy
Selenium toxicity is characterized by chronic dermatitis, loss of hair and nails, excessive fatigue, dizziness, headaches, nausea, vomiting, pulmonary edema, circulatory collapse and _____ odor on the breath.
garlic
The breath odor in selenium toxicity is due to the presence of ______.
dimethylselenide
Burn patients may require as much as ____ microg/g selenium /day for as long as two weeks.
200