Module 7

A woman consumed 48 grams of protein in a 24 hour period. What is her nitrogen intake?

8 - Nitrogen intake = grams of protein consumed in 24 hours divided by 6.25

A patient has a transferrin level of 420 mg/dl. What might this indicate?

A transferrin level of 420 mg/dl indicates elevated levels; elevated in iron deficiency, lowered in chronic disease, fluid overload; normal ranges are 200-400 mg/dl.

A woman is taking the antineoplastic medication Flurouracil. All of the following are side effects she may experience except:

Antineoplastic medication side effects may include decreased appetite, nausea/vomiting, altered taste sensitivity and diarrhea.

As intensity of exercise increases, which fuel is primarily used?

As exercise intensity increases carbohydrate is used for energy.

A patient's labs reveal: serum calcium 11.2 mg/dl, sodium 140 mg/dl, albumin 4.1 g/dl, and phosphorous 2.0 mg/dl. Which disorder best describes these labs? a. hyperparathyroidism b. overhydration c. renal disease d. hypothyroidism

Calcium - normal levels 8.8-10 mg/dl; increased with hyperparathyroidism, hyperthyroidism, cancer; Phosphorous - normal levels 2.7-4.5 mg/dl; decreased with hyperparathyroidism, hemodialysis, alcoholism. Albumin and sodium levels are within normal ranges.

Creatinine Height Index is an indicator of lean body mass when:

Creatinine height index is an index of lean body mass; indicator when renal function is normal, fluid intake is adequate, and there is no presence of rapid muscle breakdown.

Which of the following is true of negative nitrogen balance? a. pregnant women always have a greater output of nitrogen when compared to nitrogen intake b. children experience negative nitrogen balance c. a man gaining weight would never experience a positive nitrogen balance d. a patient with severe burns is experiencing negative nitrogen balance as nitrogen output exceeds nitrogen intake

D. Positive nitrogen balance occurs when nitrogen intake is greater than nitrogen output, during growth pregnancy, childhood, etc. Negative nitrogen balance occurs when nitrogen intake is less than nitrogen output, such as trauma and burns.

woman has a mean corpuscular volume (MCV) of 107. What might this indicate?

Elevated levels of MCV may indicate folate or B12 deficiency.

A patient's fasting glucose reveals 110 mg/dl on 1 day and 123 mg/dl on a different day. This indicates:

Fasting Glucose - pre-diabetes (impaired glucose tolerance) indicated by 100-125 mg/dl; diabetes indicated by 126 mg/dl or greater - diabetes should be confirmed by testing again on a different day

A patient's fecal fat test reveals 15 g/24 hours. This indicates:

Fecal Fat - normal levels <7 g/24 hours; elevated levels indicate fat malabsorption.

A patient is on a MAO inhibitor medication. Which of the following should be avoided?

Foods containing tyramine should be avoided when taking MAO inhibitor medication. Foods high in tyramine include aged cheese, dried, pickled or smoked meats, processed meats, fermented soybean products, overripened fruits, and sauerkraut.

A patient taking Lovastatin is referred to you to learn more about food medication interactions. Which of the following food modification recommendations do you make based on his 24 hour recall? a. choose iceberg lettuce instead of spinach leaves b. low sodium tomato sauce instead of regular tomato sauce c. choose poached salmon filet instead of smoked salmon d. choose mixed berries instead of grapefruit sections

Grapefruit - when taking any of the following: Amidoarone, Buspirone, Cisapride, Cyclosporine, Lovastatin, Nifedipine, Simvastatin, Sirolimus, Tacrolimus, grapefruit should be avoided as it affects how the medication works.

Which of the following body fat testing methods tends to be the most accurate? a. skinfold testing b. bioelectric impedance analysis c. hydrostatic weighing d. waist to hip ratio

Hydrostatic weighing is the gold standard for body fat testing, involves measurement of displaced water.

A healthy adult male visits you to improve his diet. He is interested in reducing his body fat as well. Normal body fat percentages in males are:

Recommended values of normal body fat are 12-20% total body weight (males) and 20-30% total body weight (females).

A patient has an albumin of 6.0 g/dl, a sodium of 155 mEq/L and a hemoglobin of 19 g/dl. You suspect:

Serum albumin - elevated in dehydration, normal level = 3.5-5 g/dl. Hemoglobin (HB) - elevated levels indicate dehydration, normal levels = 14-17 g/dl (males) 12-15 g/dl (women). Sodium - normal levels 135-145 mEq/L; increased with dehydration, renal disease.

A patient taking phenytoin may experience which of the following?

Serum calcium and folate levels can be decreased due to central nervous system medications including Phenytoin and Phenobarbital.

In a simultaneous multiple analysis or a SMA, what does the number following indicate (ie: SMA12)?

The number following SMA indicates the number of tests taken from the same sample.

A woman walks for an hour 5 times per week. When exercising at a low intensity which of the following is your fuel source?

Use of glucose increases as intensity increases, as intensity lowers, glucose and fats are used for energy.

Which of the following is an indicator of short term protein stores? a. transferrin b. thyroxine-binding prealbumin c. albumin d. none of these

Thyroxine-binding prealbumin is an indicator of short term protein stores; 1/2 life of 2 days.

A patient taking Parnate is referred to you to learn more about food medication interactions. Which of the following food modification recommendations do you make based on her food frequency questionnaire? a. choose mixed berries instead of grapefruit sections b. choose poached salmon filet instead of smoked salmon c. choose iceberg lettuce instead of spinach leaves d. choose low sodium tomato sauce instead of regular tomato sauce

Tyramine - MAO inhibitors require limiting tyramine in the diet; foods to limit include aged and mature cheeses, smoked, processed or dried meats, fermented soy products, sauerkraut, caffeine, and some alcoholic beverages including beer and wine.

A woman has pale conjunctiva and dry, scaly skin. What nutrient deficiency might this be an indicator of?

Vitamin A deficiency characteristics include pale conjunctiva and dry scaly skin.

A female is taking oral contraceptives. Which nutrients might she be deficient in?

Vitamin B6 (Pyridoxine) - deficiency can be due to drugs including to oral contraceptives; Folate - levels can be decreased due to drugs/medications including anti-neoplastic medication Methotrexate, alcohol, and oral contraceptives.

An elderly woman in a long term care facility has a decubitis ulcer. Which of the following may she be deficient in?

Vitamin C deficiency may be indicated in decubitis ulcer.

A patient is taking Lithium and Coumadin. Which of these is true of the patient's medications?

Vitamin K - anticoagulants such as Warfarin (Coumadin) require consistent amounts of vitamin K in the diet; Sodium - Lithium requires consistent amounts of sodium in the diet.

A cardiac patient is taking Quinidine. Labs reveal total cholesterol 197 mg/dl, HDL-C 55 mg/dl, LDL-C 137 mg/dl, TG 207 mg/dl and fasting blood sugar 137 mg/dl. Based on this information, you are concerned with:

elevated LDL-C, TG, and possible diabetes LDL-cholesterol - optimal level <100 mg/dl, Triglycerides - desirable level <150 mg/dl, diabetes indicated by 126 mg/dl or greater - diabetes should be confirmed by testing again on a different day.