Mnt Exam 1

Front 1

The factor that has the greatest effect on basal energy expenditure is?

Back 1

Fat free mass

Front 2

A valuable technique for measuring total energy expenditure is...

Back 2

The double labeled water technique

Front 3

The thermic effect of food is the

Back 3

Increase in energy expenditure associated with digestion, absorption, and metabolism of food

Front 4

The effect of caffeine, nicotine, and metabolic rate is as

Back 4

stimulants

Front 5

What are the three components of total energy expenditure?

Back 5

Basal Energy Expenditure

Thermic Effect of Food

Activity thermogenesis

Front 6

What is BMR

Back 6

minimum amount of energy expenditure that is compatible with life

Front 7

What percentage does BMR have on total energy expenditure?

Back 7

60-70%

Front 8

What is the difference between resting metabolic rate and BMR

Back 8

More commonly used that BMR, basically the same thing, usually 10-20% higher than BMR

Front 9

What are some factors that affect RMR?

Back 9

Age

Body Composition (Fat free mass vs body mass index and high metabolic organs)

Hormonal status

Temperature

Caffeine, nictotine, and alcohol

Front 10

How does chronic fever effect RMR? specifically how much

Back 10

increases energy needs 7% each degree above 98.6

Front 11

What percentage of Total Energy Expenditure is the thermic effect of food?

Back 11

10%

Front 12

What are factors that effect the thermic effect of food?

Back 12

Increased after consumption of CHO and protein as opposed to fat

Spicy foods increase and prolong effect (33% for 3 hours)

Front 13

What does NEAT stand for?

Back 13

Non-exercise activity thermogenesis

(workday, shopping, fidgeting)

Front 14

What is direct calorimetry?

Back 14

Monitors the amount of heat produced by a person inside of a structure big enough for physical activity.

Provides no info on kind of fuel being oxidized

Seldom used

Front 15

What is indirect calorimetry?

Back 15

Estimates energy expenditure by measuring oxygen consumed and co2 produced.

The gold standard

Front 16

What is the best formula for estimating RMR?

Back 16

Mifflin St. Jeor

Front 17

What is a downfall of Mifflin St. Jeor's formula?

Back 17

underestimates obese

Front 18

What are the steps in the determining nutrition status?

Back 18

Nutrition screening--> nutrition assessment --> Nutrition status

Front 19

What is nutrition screening?

Back 19

the process used to identify nutritional problems or risk factors

Front 20

What is the goal of nutrition screening?

Back 20

Quickly identify individuals who warrant a more detailed assessment (5-10 minutes)

Front 21

Who performs nutrition screening?

Back 21

diet tech, nurse, physician or other qualified health professionals. Once completed those at nutritional risk are referred to the RD.

This is cost effective.

Front 22

Screening usually includes

Back 22

degree of weight loss, current need for nutrition support, skin breakdown, poor intake, chronic us of diets

Front 23

What is the first step in the Nutrition Care Process?

Back 23

Nutrition Assessment

Front 24

What is nutrition assessment?

Back 24

Comprehensiveevaluation carried out by a registereddietitian for defining nutrition statususing medical, social, nutrition, and medication histories; physicalexamination; anthropometric measurements; and laboratory data.

(RD interpretation of screening)

Front 25

What are three goals of nutrition assessment

Back 25

1. identify individuals who require aggressive nutrition support

2. Restore or maintain an individual's nutrition wellness

3. Identify appropriate MNT (Intervention)

(Provides the Basis for the Nutrition Diagnosis)

Front 26

Nutrient intake analysis; definition, advantages, and disadvantages

Back 26

72 calorie count hospital setting

Advantages: Actual observation

Disadvantages: doesn't reflect possible variation in portion sizes, or reflect intake of free living ind.

Front 27

Daily food record/diary; advantages, and disadvantages

Back 27

Advantages: Provides daily records or food intake. Can provide info on quantity of food, prep, and timing.

Disadvantages: Literacy of patient, ability to measure or judge portion sizes. Influenced by the recording process.

Front 28

Food frequency: advantages, and disadvantages

Back 28

Advantages: Easily standardized. Beneficial when considered in conjunction with usual intake.

Disadvantages: Literacy skill. Doesn't show meal patterns. Ability to measure portions.

Front 29

24 hour recall

Back 29

Advantages: quick and easy

Disadvantages: Relies on memory, ability to measure portions, doesn't reflect usual intake, interviewing skills necessary

Front 30

The purpose of nutrition screening is?

Back 30

quickly identify individuals who are malnourished or at a nutritional risk

Front 31

Retrospective methods for collecting dietary intake data include?

Back 31

food frequency questionaires

Front 32

What are laboratory test's used for in the nutrition care process?

Back 32

Diagnose disease

Support nutrition diagnoses

Monitor nutrition intervention

Front 33

What is the only objective data used in the nutrition care process?

Back 33

Lab data

Front 34

What are static testing procedures?

Back 34

Measuring actual level of nutrient in the specimen

Specimen nutrient concentrations do not reflect the amount of the substance stored in body pools that are not sampled

Influenced by recent dietary intake (requires fasting)

Front 35

What are functional testing procedures?

Back 35

Measures activity that depends on the nutrient of interest

Front 36

What is hypOvolemia

Back 36

Loss of water and electrolytes leading to ECF volume contraction

Front 37

What is hypERvolemia

Back 37

ECF volume expansion

Fluid overload in the intravascular compartment occurs to an increase in total body SODIUM content

NOT overhydration your body is retaining water not over consumption

Front 38

What happens to lab results during hypOvolemia?

Back 38

They all increase

Fluid is in a contracted state, everything is concentrated

Front 39

What happens to lab results during hypERvolemia?

Back 39

They all decrease

Retaining fluid, lab values are being diluted by excess fluid

Front 40

C-reactive protein is a ______ biomarker

Back 40

inflammatory; identifies when inflammatory response

Front 41

When C-reactive protein is high the body is ______

Back 41

catabolic

Front 42

What are some positive acute phase responders?

Back 42

C- Reactive Protein

Ferritin

Front 43

What are some negative acute phase responders?

Back 43

Albumin

Transferrin

Prealbumin

Retinol Binding Protein

Front 44

All negative acute phase responders _______ with inflammation

Back 44

Decline with inflammation and thus do not reflect current dietary intake or protein status

Front 45

Creatine is used along with _____ to assess kidney function, drawn from _______

Back 45

BUN

blood

Front 46

What does low albumin imply?

During inflammation?

Back 46

albumin low? Sometimes consideredmalnutrition.. Not a good assumption. If you have a liver disease its nevergoing to make albumin like it used to, because the liver makes albumin. If youare inflammatory, it will still be low.

Water in plasma moves to the interstitial compartment and promotes edema

Front 47

what is the major purpose of albumin?

Back 47

Maintains colloidal osmotic pressure of the plasma

Front 48

Retinol Binding Protein compared to albumin and prealbumin

Back 48

Not as effected by inflammatory stress

Front 49

Transferrin's role

Back 49

Transportsiron to the bone marrow for production of Hgb

Front 50

Plasma transferrin level controlled by

Back 50

size of iron storage pool

Front 51

Hematocrit

Back 51

Measure of the % of RBC's in total blood volume

Front 52

Total Iron Binding Capacity

Back 52

Measure of all protein available to bind mobile iron and depends on the number of free binding sites transferrin

Sinceiron moves through the blood attachedto transferrin,tells how well that protein can carry ironin the blood

Front 53

Transferrin saturation low/high and TIBC low/high with iron deficiency

Back 53

Transferrin low

TIBC high

Front 54

Hemoglobin

Back 54

¡Quantifiestotal Hgbin RBCs rather than a % of total blood volumeàmore direct measure of Fe than Hct

Front 55

Ferritin

Back 55

Storageprotein that contains theiron normally gathered in the liver, spleen and marrow.

Indicator of the size of body's iron storage pool

Front 56

As iron goes up/down ferritin goes up/down

Back 56

Iron stores increase ferritin increases

Front 57

Ferritin is an acute phase protein --> value increase/decrease in presence of inflammation

Back 57

increase

Thus not a reliable indicator of irons stores in acute inflammation

Front 58

Is the lab value of iron reliable?

Back 58

no large day to to day changes

Front 59

What are the three types of anemia?

Back 59

Microytic

Macroytic

Normoytic/Anemia of Chronic Disease

Front 60

Microytic Anemia

Back 60

Associated with iron deficiency

Small pale cells

Front 61

Macroytic Anemia

Back 61

Associated with folate and B12 deficiency

Few large cells, filled with Hgb

Front 62

Normocytic/Anemia of Chronic Disease

Back 62

Associated with rheumatic disease, CHF, chronic infection, and cancer

Front 63

Assessing folate and vitamin b12 metabolic function

Back 63

serum homocystein.. if either are low it will build up

Front 64

RBC folate reflects....

Back 64

tissue stores and most reliable indicator of folate status

Front 65

Serumproteins that decrease during the acute-phase response (negative acute-phaserespondents) include

Back 65

albumin,transferrin, and retinol-binding protein.

Front 66

Acutelyill patients experiencing inflammatory stress would be expected to have highserum levels of

Back 66

c reactive protein

Front 67

Anemiacaused by deficiencies of folate or vitamin B12 isusually

Back 67

macrocytic

Front 68

The Schilling test is used to

Back 68

detect defects in vitamin B12 absorption.

Front 69

Tetracycline

Back 69

Tetracycline will chelate with calcium from dairy foods and supplements, making both the drug and the calcium unavailable for absorption.

Front 70

Grapefruit

Back 70

increases/decreases intestinal metabolism of drugs

Fruit and juice inhibit the cytochrome enzyme which is responsible for the oxidative metabolism of many drugs can last for 72 hours

Front 71

Phenytoin

Back 71

Can increase the metabolism of a nutrient causing it to pass through the body faster

is an anticonvulsantonly free fraction drug is able to leave the serum and exert the drugs effect on the target organs, people with albumin levels <3 g/dL will need a lower dose of phenytoin

Front 72

Loop diuretics

Back 72

Increase the excretion of potassium, magnesium, sodium, chloride, and calcium

long term use need supp. Mg and Ca

Front 73

MAOI inhibitors

Back 73

Alter the intended pharmacologic action of a medication by enhancing the medication effects

Signifigant ingestion of high Tyramine foods while on MAOI can cause hypertension crisis

Front 74

Coumadin/Warfarin

Back 74

Inhibits action of drugs

Vitamin K opposes the action of warfarin and allows the production of more clotting factors

Front 75

creatine

Back 75

urine= muscle protein

blood= kidney function (filtration)

if kidney is not functioning right build up of creatine

Front 76

Prealbumin

Back 76

Transports thyroid hormone

has a half life of 2 days

Front 77

Retional Binding protein

Back 77

Best way to test..

Front 78

Transferrin

Back 78

controlled by iron stores

transports iron for Hmg production

Front 79

Hemotocrit vs Hemoglobin

Back 79

Hemo is % of Hmg in total blood volume Hmg is the total amount in body

Front 80

TIBC(Total Iron Binding Capacity)

Back 80

depends on transferrin

trans down TIBC up

Front 81

Ferrtin

Back 81

indicator of the body's iron storage pool

values increase during inflammation

Front 82

Serum homocysteine is a biomarker of.... but _____ is better for folate and ____ better for ....

Back 82

B12 or folate low it will build up

but RBC folate better

Shillings test better for b12

Front 83

Who credentials? DPD and RD's

Back 83

Acend during DPD

CDR once you are a RD

Front 84

what are the six criteria of malnutrition

Back 84

1. insufficient energy intake

2. weight loss

3. loss of muscle mass

4. Loss of subcutaneous fat

5. Localized or general fluid accumulation

6. Diminished functional state (hand grip)

Front 85

low levels of albumin effect on drugs (malnutrition)

Back 85

fewer binding sites for protein bound drugs , increased action of the drug

Front 86

Iron absorption goes up or down with food

Back 86

down 50 percent