Inman RD Prep
Vitamin A 1)Stored in the 2)Function 3)Sources 4)Deficiencies cause 5) Precursor
1) liver 2) skin, vision 3) yellow, orange fruits, dark leafy greens, fortified skim milk 4) Nyctalopia (night blindness) Xeropthalmia (cornea damage, not reversible) Bitot's spots on conjunctiva Dry, scaly skin 5) carotene (converted in intestinal mucosal cells)
how does acid affect angel food cake?
1) maintains the white color by preventing the Maillard rxn 2) stabilizes the egg white to increase volume 3) makes the crumb tender
Patient has pH 6.94; HCO3: 15, pCO2: 40 1) condition 2) compensatory response
1) metabolic acidosis 2) hyperventilation
Patient has pH 7.48, HCO3: 30, pCO2: 40 1) condition 2) compensatory response
1) metabolic alkalosis 2) hypoventilation to lower pH
SBS MNT
1) parenteral nutrition initially to restore & maintain nutrient status 2) start enteral feeding early to stimulate growth & increase over time; continuous drip 3) may take weeks or months to transition to food
Patient has pH 7.32; HCO3: 25; and pCO2: 56 1) Condition 2) compensatory response
1) respiratory acidosis 2) kidneys hang on to HCO3 (base)
Patient has pH 7.5, HCO3: 25, pCO2 27 1) condition 2) compensatory response
1) respiratory alkalosis 2) the kidneys dump HCO3
4 Functions of liver
1) store & release blood 2) filter toxic elements 3) metabolize & store nutrients 4) regulate fluid & electrolyte balance
3 types of written specifications for orders
1) technical--objective quality e.g: graded food items 2) approved brand specifications 3) performance e.g: pH level for detergents
1) Protein Bound Iodine measures 2) When PBI is elevated __ is higher
1) the activity of the thyroid 2) BMR
Weakest positive correlation 0.89 0.65 -0.99
0.65
Insensible water loss is ___/day
0.8-1L
Strongest positive correlation
1
Ratio of gelatin to liquid
1 T gelatin: 1 pint liquid
Recipe for buttermilk
1 T vinegar or lemon juice or 1.75 tsp cream of tartar & add enough milk to make 1 cup
Respiratory Quotient for intakes of: 1) CHO alone 2) PRO alone 3) fat alone 4) mixed intake How can you lower the respiratory quotient?
1) 1 2) 0.82 3) 0.7 4) 0.85 increase fat
1) #3 can has how many cans/case? 2) How much does it weigh? 3) How many cups fit? 4) How many servings?
1) 12 cans/case 2) 46 oz 3) 5.75 cups 4) 12-15 servings/can
AW of & # of Valence e- 1) Na 2) K 3) Ca
1) 23;1 2) 39;1 3) 40;2
1) #2.5 can has how many cans/case? 2) How much does it weigh? 3) How many cups fit? 4) How many servings?
1) 24 cans/case 2) 1 lb 13 oz 3) 3.5 cups 4) 6-8 servings/can
1) #2 can has how many cans/case? 2) How much does it weigh? 3) How many cups fit? 4) How many servings?
1) 24 cans/case 2) 1 lb 4 oz. 3) 2.5 cups 4) 4-6 servings/can
1) #300 can has how many cans/case? 2) How much does it weigh? 3) How many cups fit? 4) How many servings?
1) 24 cans/case 2) 14-16 oz 3) 1.75 cups 4) 3-4 servings/can
1) #10 can has how many cans/case? 2) How much does it weigh? 3) How many cups fit? 4) How many servings?
1) 6 cans/case 2) 6 lbs 9 oz 3) 13 cups 4) 20-25 servings/can
Vitamins affected by Bill Roth I and II
1) B12 (lack of intrinsic factor and bacterial overgrowth) 2) folate (needs B12 for transport inside cell; also from poor iron levels)
1) what is sorbitol? 2) How is it absorbed? 3) what is it converted to? 4) May cause
1) EToH from glucose absorbed more slowly than glucose 2) PASSIVE diffusion 3) fructose. 4) diarrhea
1) If linoleic acid replaces CHO 2) If linoleic acid replaces saturated fat
1) LDL goes down & HDL goes UP 2) total cholesterol goes down including HDL
What are the 5 federal block grant areas?
1) Maternal and child health 2) Community Services 3) Social Services 4) Preventive Health Service 5) Primary Care
6 Steps in program planning
1) Mission statement- needs/problem statement 2) set goals-broad/gen purpose 3) set objectives (SMART) 4) develop plan 5) budget development-controls/coordinates activities 6) implementation
1) Epilepsy meds 2) What supp do they need 3) Interfere with absorption of 4) How to take if eating/ if TF
1) Phenobarnital & phenytoin (Dilantin) 2) 1 mg folate daily (may need vitamin D, Ca, thiamin) 3) Calcium 4) away from meals and other supplements/ if TF hold feeds for at least 2 hrs
Describe dumping syndrome
1) Simple carbs enter jejunum 2) water is drawn in for osmotic balance, which quickly empties vascular fluid compartment & reduces peripheral vascular resistance 3) Blood pressure goes down and cardiac insufficiency signs pop up 4) 2 hrs later, CHO is digested & absorbed rapidly 5) Blood sugar goes up 6) insulin is overproduced to compensate 7) blood sugar drops (reactive/alimentary hypoglycemia)
1) Chronic GI disease, intestinal lesions; may also affect stomach. Caused by bacteria, virus, or parasitic infection 2) can cause 3) treatment includes
1) Tropical Sprue 2) Diarrhea, malnutrition, deficiencies of B12 and folate due to low HCL & intrinsic factor 3) Abx, high cal, high PRO, intramuscular B12, oral folate
hyperbilirubinemia in newborns 1) causes 2) MNT
1) a result of increased breakdown of RBC 2) encourage 9-12 feedings/day to promote hydration & intestinal motility
Payback period
1) add up cost of service 2) add up cost saved by new service cost of service ÷ dollars saved
CKD stages 1-3 kcals Stage 4,5 kcals
1) based on EER 2) 30-35 kcals/kg
What is reliability?
1) consistency or reproducibility
Budget projections
1) determine actual cost for this year (n) 2) multiply (n) by expected increase for next year= (b) 3) b+n 4) total all costs sales 1,500,000 labor this year=35% projected increase=7% 1) 1,500,000 (.35)=525,000 2) 525,000 (.07)= 36,750 3) 525,000+36,750=561,750
Candy preparation method for small crystals.
1) dissolve all sugar, allow NO dust to settle during cooling 2) cool until viscous 3) agitate continuously
1) What organ produces secretin and pancreozymin. 2) After what surgery are they reduced?
1) duodenum 2) Bill Roth II
food cost per month (2 equations)
1) food cost purchases + foods removed from inventory 2) (beginning inventory - ending inventory)+ foods purchases
hemodialysis happens
a few times a week and is more restrictive
Prime cost Mark-up FACTOR formula
a) add desired food cost % + labor cost % = z b) 100 ÷ z
What percentage of butter & margarine is fat?
80%
80/20 rule
80% of output is result of 20% input
DBPCFC
Double Blind Placebo Controlled Food Challenges--gold standard for food intolerance diagnosis
Developed to explain why people, esp high risk, fail to participate in programs designed to detect or prevent disease. A person must perceive the severity and their susceptibility to the threat for the threat to be a behavior-motivating factor
Health Belief Model
A survey categorizing a population's general health status (used in work sites, government agencies as a health education or screening tool)
Health Risk Appraisal
USDAs overall measure of diet quality
Healthy Eating Index
Reduce infant mortality and improve health of low income women, infants, children, and families
Healthy Start by DHHS
provides foods to help meet nutritional needs of children and adults and strengthens agricultural market for products produced by American farmers. The food is given to School Lunch, elderly feeding, and supplemental food programs
USDA Commodity Food Donation/Distribution Program
1) Properties: Most abundant mineral. Regulated by the parathyroid hormone. Vitamin D, acid, lactose aid absorption. Calcitonin lowers serum ___ by inhibiting bone resorption. 2) Function: blood clotting, cardiac function, nerve transmission, smooth muscle contractility 3) Sources: dairy, leafy veggies, legumes 4) Deficiencies cause: tetany
calcium
If teeth are missing, loose, or missing enamel, you've probably got a___ deficiency
calcium
the elderly often lack__ and ___ due to decreased absorption as a result of decreased HCL
calcium & iron
Mineral absorption affected by Bill Roth II
calcium (bc absorbed fastest in duodenum) & iron (bc requires an acid as a reducing agent)
Thermic effect of foods
calories burned by digesting, absorbing, & assimilating nutrients
causes abdominal pain and bloody diarrhea found in raw/undercooked meat or poultry, raw milk, raw veg
campylobacter jejuni
judiciary branch
can discard a law if in violation of basic rights
Executive Branch
can veto legislation & sign a law
The most unsaturated fatty acid is
canola oil
Hyperkalemia causes
cardiac irregularities
regulations
carry the force of a law, but easier to change
What does a gallbladder infection lead to
causes excess water to be absorbed causing cholesterol to precipitate out leading to gallstones- cholelithiasis
PN Long term central access
cephalic, subclavian, or internal jugular into superior vena cava
hedonic scale is great for
children and people who speak another language
HDL (alpha)
cholesterol from cells to liver and excretion
Prader-Willi syndrome
chromosome 15 deletion low LBM high body fat ghrelin levels are elevated obesity at 2-3 years of age, try to control intake
Signs of Ulcerative Colitis
chronic bloody diarrhea, wt loss, anorexia, electrolyte (Na, K) imbalance, dehydration, anemia, fever, negative nitrogen balance
Diverticulitis MNT
clear liquids, low residue or elemental, gradual return to high fiber
Gastritis MNT
clears; advance as tolerated, avoid gastric irritants
What happens to a baked product with too much sugar?
coarse cells thick walls shiny crust crumbly product
Gout meds
colchicine
Job analysis
collects info & studies all aspects of a job for job description
__ and __ may cause liver failure or liver disease. Also avoid __ with liver disease
comfrey (liver dz) Kava (liver failure) Valerian Root
commercial versus non-commercial
commercial: only purpose is to sell food non-commercial- sells food as secondary thing (hospitals, schools)
cost effectiveness analysis
compares cost of ALTERNATIVE STRATEGIES & analyzes outcome assumes goal of project is worthwhile
benchmarking
comparing satisfaction levels to those of other facilities that are considered "best in class"
integrative problem solving does what?
conflict is converted into a joint problem solving situation
What stage of the Transtheoretical Model for Behavior Change is this? Thinking about making a change "I was looking at the salt content of the foods I have at home"
contemplation
Fiedler management approach
contingency/situational management. What works sometimes may not work others
What does Cholecystokinin (CCK) do?
contracts gallbladder to release bile & stimulate pancreas
These are all examples of which function of management? measure present performance against standard, document both process & evaluation
controlling/evaluating
Cooling steps
cool from 135-70 F in 2 hrs cool from 70 to 41 F in 4 hrs
what oils can be winterized? Which is not?
corn, soy & cottonseed olive oil is NOT
cost of sales
cost of raw food & beverages SOLD
Inventory turnover rate
cost of sales aka food cost ÷ average inventory cost
injunction
court order to prevent someone from doing something
How to prevent a film from forming on heated milk?
cover or beat it (produces foam)
stomatitis
cracks in skin at corners of mouth; riboflavin (B2) deficiency avoid extreme temperature foods (hot/cold), spices, sour rinse with lukewarm water after meals
List 3 baking acids
cream of tartar, molasses, sour milk
Seat turnover formula
customers served from 1 seat--> (hours of operation x # of times seats turnover)÷ total # of seats
This menu type is non-selective, serves people who are unable to or do not wish to choose, permits more accurate forecasting, & greater control
cycle or single use
mobile equipment and storage cabinets are usually made of
aluminum because strong and lightweight
differential costs
amount increase/decrease when you compare alternative choices
mini max stock
amount ordered is the same every time. You establish a minimum and maximum amount to have on hand
Retrogradation is more likely in foods that are high in___.
amylose
Dextrin is
an intermediate of starch breakdown
clostridium botulinum
anaerobic, deadly, found in honey (do not give to infants) and improperly canned/sealed goods
triangle test
analytical three samples; 2 same, one different; determine which are the same. test differences between new and old product
paired comparison
analytical two different samples side by side; compare to each other
A serum transferrin greater than 200 mg/dL means
anemia
Manifestations of Renal Dz
anemia (low EPO), blood pressure upset, low vitamin D (bc kidney produces active form)
methyphenidate (Ritalin) can cause
anorexia, weight loss, nausea
What is sodium stearate used for?
anti-caking
BHA and BHT
antioxidants used for fatty products
numerical continuous
any data that is numerical and continues to be measured as it changes(e.g. blood pressure)
Delaney Clause
anything causing cancer in animals or humans must be removed from market
What are some symptoms of ESLD?
apathy, drowsiness, confusion, coma (PSE--Portal Systemic Encephalopathy)
Marinol is an
appetite stimulant
Megestrol acetate is an
appetite stimulant
dextroamphetamine is an
appetite suppressant, causes anorexia, nausea, weight loss
2 amino acids needed during times of stress
arginine & glutamine
When blood can't leave the liver
ascites
net worth ratios
assess ability to meet LONG term debt
liquidity ratios
assess ability to meet SHORT term debt
profit center
assigned both expense and revenue responsibility (like a cafeteria in hospital)
Bacteria found in rice, cereals, starches Forms SPORES
bacillus cereus
this microorganism needs abundant moisture and neutral foods
bacteria
Food cost %
daily food cost ÷ daily income
6 Sigma
data driven approach for quality improvement hoping to get little variation 6 sigma=6 standard deviations from the mean (very few)
numerical discrete
data with numbers (e.g number of clinic visit)
Atrophic gastritis
decreased HCL production in elderly
check off
deduction of union dues from pay
Nephrotic Syndrome
defect in capillary basement membrane of glomerulus which permits escape of large amounts of protein into the filtrate moving through the tubules
Glycogen storage disease 1) what is it? 2) diet
deficiency of glucose-6-phosphatase in liver impairs gluconeogenesis and glycogenolysis leading to hypoglycemia diet: provide consistent exogenous glucose with raw cornstarch at regular intervals high CHO low FAT diet
What does albumin over 5 g/dL indicate?
dehydration
high serum sodium
dehydration
nausea, dizziness, sunken eyes, fever, hyperventilation, increased sweating, concentrated urine, high BUN, tachycardia, weight loss, low appetite all signs of
dehydration
acid as a preservatives does what?
denatures bacteria protein
Economic Order Quantity
determines most economical order size 2(Demand)(order cost)÷(holding cost)(purchase price per unit) & take square root of whole equation (see photo)
fixed order quantity inventory system
determines the order point
Managerial attributes that distinguish successful organizations from others
fix it, do it, solve it bias for action autonomy-be a risk taker treat people with dignity management is hands on & value driven
Break even point in sales volume (amt of money you have to make)
fixed cost ÷ 1-(variable cost/sales)
Break even point in # of units sold
fixed cost ÷ selling price-variable cost
What is asterisix?
flapping, involuntary jerking motions in ESLD, sign of impending coma treatment
What are the basic ingredients of quickbreads?
flour, eggs
Serum sodium is the best parameter for
fluid status
Path-Goal Theory Evans, House
focuses on leader's effect on motivation levels
methotrexate decreases
folate
Methotrexate affects
folate (B9)
phenobarbital decreases
folate, B6, B12, and Vitamins D & K
flow phase
follows fluid resuscitation & return of oxygen transport
food cost per meal
food cost per month ÷ # of meals per month
These programs collect excess wholesome foods that would otherwise be thrown away for delivery to hungry people.
food recovery & gleaning programs
ready prepared/cook-chill/cook-freeze
foods prepped on site then chilled or frozen for later use pros: lower need for skilled labor, less stress, lower labor cost cons: expensive freezers, storage space
Strong Heart Diet Study
for CVD and DM; Native Americans; trying to determine causative factors of obesity (must be something other than intake bc they eat fewer calories than avg US population)
4 dominance-suppression conflict resolution strategies
forcing-repress conflict rather than settle it smoothing-diplomatic; manager tries to talk one side into giving in avoidance-manager pretends it didn't happen resolve conflict by majority vote
operating budget
forecast of revenue, expenses, profit for specific period of time
standing order
forever order eliminates need to call in daily/weekly orders
audit
formal study that prospectively monitors performance
MNT for gastrectomy
frequent, small, dry feedings fluid before and after meals (not during) restrict hypertonic concentrated sweets 50-60% CHO, pro at each meal, moderate fat lactose may be poorly tolerated during rapid transport B12 injections may be needed
What is the sweetest CHO? least sweet?
fructose lactose
Upper part of stomach
fundus
Cholecystitis
gallbladder inflammation
may lower cholesterol and blood pressure, but reduces clotting time so should be avoided with warfarin
garlic
What are the natural remedies that should be avoided with anticoagulants (warfarin)
garlic, ginger, ginkgo biloba also avoid high doses of Vitamins A and E
Avoid use of ___, ___, and ___ with warfarin
garlic, ginseng, ginkgo biloba
Surgery, DM, viral infections, obstructions may cause
gastroparesis
Atopy
genetic predisposition to produce excessive IgE antibodies in response to allergen
Vitamin E in grains is found mostly in the___.
germ
an anti-emetic, but should be avoided with drugs that affect bleeding
ginger
vasodilator, but should be avoided with warfarin
ginkgo biloba
enhances immunity and endurance; may cause high blood pressure, avoid with warfarin
ginseng
blind check method for receiving procedures
give clerk blind invoice or purchase order requires more labor & time
forecasting usage: exponential smoothing
gives more weight to recent values; does NOT uniformly weight past observations
poor heat conductors
glass & stainless steel
wall requirements
glazed tiles, 5'8" high, washable, impervious to moisture
hormones that raise BG
glucagon, glucocorticoids, epinephrine, growth hormone
What process makes glucose from glycerols and amino acids?
gluconeogenesis
in the presence of magnesium, Phosphorous and glucose are converted to
glucose-6-phosphate
10% of fat is ____ which can be converted to glucose
glycerol
positive discipline practices
goal is to correct behavior & salvage emlpoyee
public relations
good press, newsworthiness, lobbying
An award of financial or direct assistance: anyone can apply, usually lasts over a few years
grant
If wash temp is low, what happens?
greasy dishes
How to detect PKU
guthrie blood test
If using Sweet and Low use __as much.
half
pilot study
has every step of the intended larger study, but on a small scale
EAR is used for
healthy people
diuretics are used for
heart failure
convection
heat moved with fan
Direct calorimetry measures
heat produced in a respiration chamber & has limited usefulness
Adding bran to muffins makes them___. How do you fix it?
heavy increase flour & liquid
Alcoholic liver disease can lead to
hepatic steatosis, alcoholic hepatitis, cirrhosis
High LDH, AST, SGOT
hepatitis
concerned with the lack of uniformity in the performance of people
heterogenicity
MNT for cirrhosis
high PRO, high kcal, mod/low fat, MCT if needed, decrease LCTs if steatorrhea develops, B complex, vitamins C, K, Zn, Mg & monitor need for A & D
If IBD (Crohn's/colitis) is in remission, what might stimulate peristalsis?
high fiber diet
MNT for constipation
high fluid, high fiber, exercise
Steatorrhea MNT
high pro high complex cho fat as tolerated ADEK, mineral supps MCT oil (rapidly hydrolyzed in GI)
In custards, the ___the % sag, the more tender the gel.
higher
luster of metals
higher number, higher polish
Steam cookers higher PSI means
higher temperatures
Range
highest # minus lowest #
Diffusion of innovation
how an idea or behavior spreads innovators-adopt it readily, with no input from others early adopters- opinion leaders early majority- cautious in adopting new idea late majority- skeptical, adopt idea bc peer pressure laggards- last to adopt
positioning statement
how you want your company to be viewed by others
What is glycerol monostearate?
humectant
Refeeding syndrome can result in
hypokalemia, hypophsphatemia, hypomagnesemia
SIADH-Syndrome of Inappropriate Anti-Diuretic Hormone is___ caused by ____ and treated with___
hyponatremia caused by hemodilution treated with fluid restriction
this acts as satiety & feeding center has glucoreceptors regulates body temperature
hypothalamus gland
ebb phase
hypovolemia, shock, tissue hypoxia
Functions of organization
identify tasks & divide them into positions
Chronic Pancreatitis vitamin concerns
if malabsorbing ADEK, give water soluble forms Parenteral B12 (pancreatic protease splits off vitamin from carrier & is deficient now)
Gastrostomy or Jejunostomy feedings
if needed for more than 3-4 weeks DO NOT use blue dye to check tube placement. X-ray confirmation only
Hawthorne Effect Western Electric- Elton Mayo
if people are involved in process they're more productive special attention results in better performance
If jejunum is resected, what happens?
ileum adapts to take over jejunal functions
Right to work Laws
illegal to fire an employee who refuses to join the union
causes of FTT
illness, restrictive diet, poor appetite. a secondary cause might be lack of fiber
imitation versus substitute foods
imitation=nutritionally inferior substitute=nutritionally equal
concentric model of organization
improves representation of dynamics bc eliminates above and below positions. Functions centered on individuals. Present organization without loose ends
Maple Syrup Urine Disease
inability to break down BCAA (Valine, isoleucine, leucine) avoid meat, eggs, nuts, dairy May use MSUD powder, gelatin may be used, allow small amount of milk to support growth
examples of vegetable blends
incaparina: maize, sorghum, cottonseed flour CSM: corn, soy, milk (fat free, solids), vitamins, minerals
NNMRRP--National Nutrition Monitoring and Related Research Program
includes all data collection and analysis activities of the federal government jointly run by DHHS (Dept of health & Human Services) and USDA
When using buttermilk in place of regular milk, what do you do?
increase baking soda to neutralize acid
Acute Viral Hepatitis MNT
increase fluids care varies on symptoms 50-55% CHO to replenish liver glycogen & spare protein 1-1.2g pro provide lipotropic agents to convert fat into lipoproteins for removal from liver mod/lib fat if tolerated unless steatorrhea small, frequent feeds encourage coffee (antioxidant), multivitamin with B complex, C, K, Zn
What is overrun? What is normal? How do you measure it?
increase in ice cream volume from freezing & whipping/agitating 70-80% By weight
hyperventilation ___ pH
increases; more alkaline
What are some ETOH abuse concerns?
inflamed GI, B12, Vitamin C, & folate absorption issues, increased Mg needs, Folate and PRO deficiencies (most responsible for malabsorption) B1 deficiencies (dry beri beri-Wernicke Korsakoff Syndrome)
Describe pancreatitis
inflammation with edema, cellular exudate, and fat necrosis may be due to blockage or reflux of the ductal system; premature activation of enzymes within pancreas leads to autodigestion
Managerial roles
informational, decision maker, conflict resolution
These keep food warm, have less moisture loss over conventional units
infrared tubules
Services are mostly produced and consumed at the same time so they are __ and ___
inseparable and perishable
hormone that lowers BG
insulin
service marketing consists of
intangibility perishability heterogenicity inseparability
most services are
intangible
_____ _____ tests whether the difference between two groups is real
internal validity
Transitional Feedings
introduce a minimal amt of FULL STRENGTH enteral feed at low rate to establish GI tolerance decrease PN as you increase EN by 25-30 mL/hr increments every 8-24 hrs to maintain prescribed nutrient levels
value analysis
investigating w/ goal of eliminating unnecessary costs
Total Quality Management (TQM)
involves quality management customers, culture, counting
Add solids from 4-6 months. Start with ____ then____
iron fortified cereals; strained f/v
If nails are brittle, thin, or spoon shaped, it indicates a ___ or ___ deficiency
iron or protein
If skin is pale, dry, and scaly, it means you have a ____, ____, or ____ deficiency
iron, folate, or zinc
BUN: Cr of 10:1
irreversible damage, dialysis is needed
Lead poisoning symptoms in children
irritability, lethargy, V/D, anorexia, anemia
Imitation milk
is made from casein derivatives or soybean protein and has no milk fat, only vegetable oil
acid does what to veggies?
it removes the magnesium for chlorophyll and turns it into pheophytin
invoices are checked against
items received & purchase order
loss leaders
itmes priced low to draw customers in
Weighted average purchase price
its time consuming its the average price paid for products over time
commissary-satellite
kitchen and, service areas are separate pros: low cost, uniform quality, no duplicate equipment/personnel cons: delivery safety; 9 CCP
prime costs
labor & food
What are the components of whey?
lactalbumin, lactose, lactoglobulin, water soluble vitamins, minerals.
Pyruvate can become
lactic acid (anaerobic conditions) acetyl CoA (with B1,2,3,5, magnesium, lipoic acid)
glucose+ galactose=
lactose
Casein Hydrosylate is recommended for
lactose intolerant babies bc it contains NO LACTOSE
Standard treatment for ESLD
lactulose--a hyperosmotic laxative that removes nitrogen neomycin- abx that destroys bacterial flora that produce ammonia
FIFO method for determining inventory value
last price paid X # of units in inventory PRICES INVENTORY HIGH
most phopholipids are ___ which contain ___
lecithins; choline
The more the muscle is used the ____ tender the meat.
less
Osmosis
less concentrated to more concentrated
significant figure p=
less than or equal to 0.05 so 0.06= NOT SIGNIFICANT
Normal Hgb for pregnant women
less than or equal to 11
fresh fish should arrive at what temp?
less than or equal to 41 F
Vitamin B6 and Protein both decrease the effects of ___, which is used to treat parkinson's. It should be taken in the morning, with limited protein.
levodopa
used to treat ulcers, but should be avoided with Spironolactone, thiazide and loop diuretics, and hypertensive meds
licorice root
ileal resection
limit fat, use MCT oil, supplement ADEK, Ca, Mg, Zn, parenteral B12 followed by IM B12
This menu type lets clients choose *some* items
limited choice
What happens if the ileum can't recycle bile salts?
lipids are not emulsified, which leads to ADEK malabsorption malabsorbed fats combine with Ca, Zn, Mg, leading to formation of "soaps" colonic absorption of oxalate increases, which leads to renal oxalate stones increased fluid and electrolyte secretion, increased colonic motility
choline is a ___ ___ which prevents fat accumulation in the liver & functions in transport & use of FA & cholesterol via enzyme LCAT (lecithin cholesterol acyltransferase)
lipotropic factor
job description
lists duties
job specifications
lists qualifications
Organ synthesizes fat, but doesn't store it
liver
In ESLD, what function in the liver has decreased?
liver can't convert ammonia (NH3) to urea- ammonia accumulates
High iron foods
liver, kidney, beef, dried fruit, peas, beans, nuts, fortified whole grains, leafy greens
glycogen can be released from ___ but NOT __ to bring BG back up
liver; NOT MUSCLES
Ischemia
localized deficiency of blood due to obstruction
strategic marketing
long term view of marketing in the organization where resources are allocated and objectives set AFTER defining the market; creation and maintenance of an appropriate marketing mix
Critical Path Method
longest pathway through that shows order/relationships among phases of project dotted lines mean those phases have same predecessor and can be done at the same time
What are the 3 most concerning losses in SBS?
loss of distal 1/3 of ileum loss of illeocecal valve loss of colon
Adrenal hormones (Addison's dz) & what happens when they're low
low cortisol: glycogen depletion, hypos low aldosterone: Na loss, K retention, dehydration low androgenic: tissue wasting, wt loss
gallbladder dz treatment
low fat diet acute: 30-45g chronic: 25-30% fat kcals cholecystectomy--bile is then secreted from liver directly into intestine
CIrrhosis with varices MNT
low fiber
PedNSS is a surveillance system for
low income, high risk children, birth-17 years, emphasis on kids birth-5 years
PNSS- Pregnancy Nutrition Surveillance System
low income, high risk pregnant women, meant to ID and reduce pregnancy-related health risks
When canning acidic foods: When canning basic foods:
low pH/acid: boil high pH/basic: pressure
Gout diet
low purine (may not be enough) may need wt reduction mod protein liberal CHO low/mod fat decrease ETOH liberal fluid avoid high purine foods- broth, anchovies, sardines, organ meats, sweetbreads, herring, mackerel
Cirrhosis with edema or ascites
low sodium
Esophagitis
lower esophageal sphincter disorder causes dysphagia start with puree/moist-thick foods & progress to thick liquids
hypoventilation ___pH
lowers; more acidic
Acute Respiratory Distress Syndrome
lungs no longer able to exchange gases, hypermetabolism, severely underwt provide enteral feeds containing EPA & GLA (gamma-linoleic acids), and enhanced levels of antioxidant vitamins
Treatment for Ulcerative Colitis & Crohn's (IBD)
maintain fluid status antidiarrheal agent (sulfasalazine) energy needs according to current BMI limit fat ONLY is steatorrhea water soluble vitamins & ADEK; Fe, folate; assess Ca, Mg, Zn May need MCT oil watch lactose high fat may help improve energy balance
sugar and salt as preservatives do what?
make water unavailable
Chemo can cause
malabsorption
Celiac disease can lead to
malabsorption of ADEK, macrocytic anemia, iron deficiency anemia, weight loss, diarrhea, steatorrhea
Likert
management of conflict Autocratic, exploitative Autocratic, benevolent Consultative Participative (most desired/team work) Peter Principle-promote to level of incompetence
organizational change
managers serve as catalysts for change within organization rallies employees to effect change by showing need for change & appealing to values/goals of employees
cost center
manages expenses, but doesn't generate revenue (patients in hospital)
Selling price using mark-up factor
markup factor * raw food cost **May include hidden 10% of raw food cost added
meQ equation
meQ= (mg/atomic weight) valence
3 measures of central tendency
mean, median, mode
continuous scores
measured on a continuous scale
Indicators
measurement tool that monitors & evaluates important aspects of patient care
specific gravity
measures consistency use for batter
line spread test
measures viscosity use for sauces
examples of using conduction and radiation
meat on a grill or meat braising in a steam jacketed kettle
Digitalis
med that strengthens heart contraction
Biguanide
metformin- enhances insulin action; suppresses hepatic glucose production
Limiting amino acid in soy
methionine
cysteine can be synthesized from
methionine
limiting amino acids in legumes
methionine, cystine, tryptophan
Gelatin is low in (which amino acids) ___ and ___ , and has no____
methionine, lysine, NO TRYPTOPHAN
Most digestion occurs in the
mid- jejunum
Trans fatty acids are found in
milk fat margarines shortenings/frying fats
may help protect the liver; no known interaction
milk thistle
What is filled milk?
milk with fat in it replaced with vegetable oil
Surimi
minced fish used for analogs
diagonal communication
minimizes time and effort expended in organization (eliminates a middle man)
How much staff should you plan to have during a disaster?
minimum
galactosemia & diet for it
missing enzyme that would have converted galactose-1 PO4 into glucose-1-PO4 diet: galactose & lactose free NO organ meats MSG extenders, milk, lactose, galactose, whey casein, dry milk solids, curds, Ca, Na, caseinate, dates, bell peppers
ESLD MNT
moderate to high levels of protein (1-1.5 g/kg) 30-35 kcals/kg 30-35% fat with MCT if needed low Na if ascites
This microorganism likes warm, damp conditions, is used in curing cheese & making soy sauce, doesn't produce harmful substances
mold
Describe these 3 informational roles: monitor disseminator spokesman
monitor role-searches for info to use disseminator-transmits info to underlings spokesman-transmits info to inside & outside
More sugar in cakes creates ___volume
more
The more collagen a meat has the ___you cook it.
more
Old baking powder is ____ _____ and causes ___ ___.
more alkaline; thiamine loss.
Diffusion
more concentrated to less
isotonic formula
osmolarity is close to blood's
low serum sodium
overhydration
NHANES II
oversampling of adults 65+ with no upper age limit
Four modifiable factors in primary prevention & tx of heart dz
overweight, high Na intake, ETOH consumption, physical inactivity
Butter turns rancid as it take up __ and releases __.
oxygen; hydrogen
What are the things that affect enzymes
pH and temperature
Odyniphagia
painful swallowing
Two separate but similar forms of the same test at the same time. Reliability is determined by the degree to which the sets of scores coincide.
parallel forms
3rd party reimbursement
payment by a 3rd party for service rendered (Blue Cross, Medicare, etc.)
centralized purchasing
personnel in one office does all purchasing for all units in that organization. It's cost effective & time saving
EFAD sign
petechiae (little red spots)
PKU formulas
phenex 1,2 Phenyl -Free 1,2
tyrosine can be synthesized from
phenylalanine
What happens when albumin is below 2.8?
physical signs of fluid retention
Maslow's basic needs
physiological-food, clothing, shelter, pay, benefits, working conditions, schedule security & safety-insurance, retirement plans, job security
Functions of management
plan, organize, direct/control, evaluate
These are all examples of what function of management? objectives, policies, procedures, time span,disaster prep, security, production, procurement
planning
prospectus
planning guide
capital budget is used for
plant facilities, equipment, cost of improvement and repairs
HIGH popularity LOW profitability the menu item is called a ____ and you should consider ______
plow horse; price increase
When blood can't leave the portal vein it leads to
portal HTN
direct benefits in cost/benefit analysis
positive change in patient's health status
describe 3 behavior modification techniques
positive reinforcement-must be specific & immediate avoidance learning-learn to escape unpleasant consequences by improving performance extinction-completely ignore behavior
thiazide diuretics decrease __ and __ and absorb ___
potassium, magnesium; calcium
Most effective thickener
potato starch
What stage of the Transtheoretical Model for Behavior Change is this? Unaware or not interested in changing "I did not know salt had an affect on my BP"
pre-contemplation
What stage of the Transtheoretical Model for Behavior Change is this? decides to change and plans it "I bought a cookbook on low salt cooking"
preparation
fixed budget
prepared at one level of sales/revenue, does not anticipate major changes in patient/customer count
Propionate is a ___ and a ___.
preservative & mold inhibitor
Civil Rights Act
prevents discrimination based on race, color, national origin; prohibits SEXUAL HARRASSMENT--overseen by EEOC
Equal Employment Opportunity Act
prevents discrimination in employment based on race, color, religion, sex, national origin, POLITICS--overseen by EEOC
cost of profit pricing
price the product to ensure a certain amt of profit
Early screening for risk factors is an example of ____ prevention
primary
Pareto Charts
prioritize problems by importance using bar graph; big bars=big problems
Describe Non-Governmental agencies
private, non-profit organizations, chartered and licensed by a government agency, funded by contributions from citizens or organizations (like AHA)
iatrogenic malnutrition
pro-kcal malnutrition brought on by treatment, hospital, meds
3 types of descriptive research
qualitative (often precedes other research) case study surveys
promotions price
sale-- low price for a short time
net profit
sales - X X=ALL COSTS
gross profit
sales-cost of sales
What are MCTs
saturated fatty acids between 6-12 carbons that are naturally found in milk fat, coconut oil, and palm kernel oil
indirect benefit in cost/benefit analysis
saving physician's time & other resources not used because patient is healthy
pathway chart of flow diagram
scale drawing showing path of a worker during a process
Frederick Taylor management theory
scientific- try to find best, most efficient way to do job, focus on physical aspects
Recruiting those with elevated risk factors into treatment program is an example of ____ prevention
secondary
this hormone stimulates the flow of pancreatic juice and water into the duodenum, inhibits gastric acid secretion
secretin (duodenum)
Prime cost method for selling price
selling price=prime cost x markup factor
hollow square/free flow/scramble service system
separate counters for hot foods/salads/etc. fastest if too slow, add more stations
group/co-op purchasing
separate units come together to purchase a large order to get a lower price & divide product purchased
Functional position
serves as both line and staff
HBV (Hepatitis B) is transmitted
sexually
PPN
short term therapy, usually post-surgery (when enteral is resumed in 5-7 days) mild/moderate malnutrition, or as a supplement to enteral
forecasting usage: time series method
short term, moving average, uniformly weighs past observations; take average of most recent 3 months
To prevent stringy, curdled-looking cheese products, cook for a ___time at ___temperatures.
short; moderate
Dyspnea
shortness of breath
organizational chart
shows how employees fit into organization authority lines-bold advisory/staff positions-dotted line
flow chart
shows steps the work must take, their sequence, and the relation of working units to each other. typically has little cross traffic and no back tracking
How do fresh eggs behave in water?
sink to the bottom of a pan in cold water
MNT for gastroparesis
small, frequent meals, pureed food, AVOID HIGH FIBER/HIGH FAT (liquid fat may be better tolerated)
Work simplification procedures look at
smallest parts of a job to eliminate unnecessary parts of a job.
YRBS- Youth Risk Behavior Survey
smoking, ETOH, exercise, & eating habits of 9-12th graders by HHS
solid in liquid is a ____
sol gravy is a sol
Fiber that binds bile acids, converting more cholesterol into bile
soluble
Renal Solute Load measures
solutes excreted in 1 L of urine; daily fixed load of 600 mOsm mainly measures nitrogen (60%) and electrolytes (Na)
what is slightly less sweet than glucose?
sorbitol
irradiation is approved by the FDA for
spices, beef, lamb, pork, poultry, wheat, potatoes
3 foam cakes
spongecake chiffon cake angel cake
Carrageenan, pectin, cellulose, gelatin, vegetable proteins
stabilizers
HIGH popularity HIGH profitability this menu item is a _____ and you should consider____
star; promoting it
Endosperm is ___ and rich in___.
starchy; protein
This menu is the same every day, but clients change
static
benefits
statutory-payment required by law in event of unemployment, injury, or death compensatory-PTO supplementary-life & health insurance
This equipment uses conduction and radiation heating. It's very energy efficient. Two sections of stainless steel with air space between for circulation of steam
steam jacketed kettle
process charts
steps involved in work process using symbols
originates in intestines of humans and animals found in milk, eggs, potato salad, food help at room temp for too long
streptococcus
nominal group technique
structured & controlled brainstorming group. strong leader, leader writes down ideas & group ranks them & votes on final decision
PN is delivered to ____ vein to reduce risk of___
subclavian; phlebitis
formal; competitive bid buying
submit written specifications & quantities needed to vendors who submit a price. All bids are opened together & order is placed with lowest price
What do histograms measure?
summarizes data from a process that has been collected over time
Gelatinization
swelling that occurs when starch is heated in water close to the boiling point
Urea cycle defects, diet
unable to synthesize urea from ammonia resulting in ammonia accumulation diet: PRO restriction based on tolerance example: OTC--Ornithine Trans-Carbamylase deficiency
Low SGOT
uncontrolled DM with acidosis
disciplining a union versus non-union employee
union-formal, written non-union-settled by employee & supervisor
Oliguria
urine <500mL
induction heating
use of electrical magnetic vibrations to excite molecules of metal cooking surfaces (pan) burner doesn't get hot, just the pan faster heat, no wasted heat, iron-based
orangoleptic
use of sense organs
Gantt Chart
used for scheduling [start---complete] V=current time
traditional/incremental budget
uses existing budget as a base and projects changes for the ensuing year in relation to the current budget
lean
using less human effort, space, etc. to get work done e.g. use cameras to observe work being done instead of staff
social marketing
using marketing to advance a social cause, idea, or behavior change
prime vending
using one vendor for most purchases
BCAA are
valine leucine isoleucine
direct cost
varies directly with change in sales e.g.: china, silver, food, uniforms, repairs, benefit
Renin
vasoconstrictor 1) secreted by glomerulus when blood volume decreases 2) stimulates aldosterone to increase sodium absorption & return BP to normal
Renal Hormones
vasopressin (ADH) Renin Erythropoeitin (EPO)
found in raw/undercooked seafood. causes fever, vomiting, cramps, diarrhea
vibrio parahaemolyctis, vibrio vulnificus
Abx decrease ___ because they kill the beneficial bacteria that produce it.
vitamin K
If your tongue is smooth, slick, purple, or has a white coating, you may have ___ or ___ deficiencies.
vitamin or iron
Underwriter's Laboratories
voluntary inspection of electrical equipment
French serving style
waiter plates at table & makes dressing or sauce tableside
mechanical wash temp rinse temp
wash temp: 140-160 F rinse temp: 170-180 F
3 compartment sink temps wash rinse sanitize
wash: 110-120 F rinse: warm sanitize: 170 F for at least 30 seconds or use chemical solution for 1 minute in lukewarm water
informal/grapevine communication
water cooler talk. meets social needs
Large intestine absorbs
water, salts, & vitamins produced by bacteria (B1, B2, B12, vitamin K)
Loop of Henle controls
water/Na balance
compromise is a ___method for conflict resolution
weak because doesn't usually lead to solution that best serves organization
constipation may be caused by
weakened muscles (atonic colon from chronic laxative abuse)
Elavil is an antidepressant that can cause __, ___, and has a ___ effect.
weight gain, increased appetite, sedative effect
rate based indicator
what happens with BEST care 95% high risk patients are assessed in 24 hrs
variable of interest
what researchers are observing
informal;open market purchasing
when a small amount is needed quickly, buyer requests quotes on specific items
How do you use eggs as leavening?
when an egg foam is heated, air expands, egg white stretches & protein coagulates
marketplace
where service will be offered
When milk is heated ___precipitates out.
whey
Populations at higher risk of osteoporosis
white & Asian
legislative branch
who introduces & enacts laws & can override a veto
Type 1 osteoporosis
within 15-20 years of menopause
Leadership Grid Blake, Moulton, McCanse
x=concern for people, y=concern for production 1,9 Country Club Management example: Micheal Scott from "The Office" 1,1 Impoverished Management minimum effort to get work done 9,9 Team Management 9,1 Authority/Obedience
This microorganism grows in water, energy, and is an acid medium in oxygen
yeast
Does ETOH affect BP?
yes
ABC inventory classification system
you rank inventory by expense A=expensive C=cheap
triglycerides are made up of:
3 Fatty acids+ 1 glycerol
eggs will last
3-5 weeks
How many feet between tables
4-5'
Medium fat meat fat g
4-7
kcals in etoh=
(0.8)(proof)(oz.)
Lacto/Ovo vegetarian, no caffeine, no etoh
7th Day Adventists
high fat meat fat g
8+
Yellowing cake is caused by
alkaline batter (excess soda)
The longer eggs are stored the more ___they become due to loss of___.
alkaline; CO2
Medicaid is for
all eligible needy
lactation kcals for 1) 1-6 months 2) 6-12 months
1) +330 kcals 2) +400 kcals
PN protein % means?
# of % is g/100 mL so, 3% AA solution has 3g/100mL
Meals per labor hour
# of meals produced ÷ # of hrs worked
Formula for meals/labor hour
# of meals produced/# of hrs worked
incidence
# of new cases of a disease
Span of control
# of people supervisor is in charge of (narrow=few, wide=many)
EtoH proof=
% etoh x 2
Labor turnover rate formula
(# of employees terminated ÷ total # of positions in dept) *100
What vitamins are grains enriched with?
(B1, B2, B3, B9, Iron) Thiamine, Riboflavin, Niacin, Folate, Iron
sulfonylureas, meglitinides
(Glucotrol) promotes insulin secretion
Cis fatty acids are found in
(all H's on the same side of the double bond) found in most natural fats and oils
Order Point Formula
(average daily use)(lead time)+safety stock lead time=how long it takes to deliver
cause and effect fish diagram
(causes point towards this word w/arrows)Cause-->thing-->effect (arrows pointing to effects)
Depreciation Equation
(cost of equipment-salvage value) ÷ # of years of useful life
Math to figure out how many kcals in Dex for parenteral
(mL)(% decimal)(3.4)
Edible portion
(portion size)(#of servings)
Weakest negative correlation -1 -0.85 -0.72
-0.72
Strongest negative correlation -1 -0.85 -0.72
-1
frozen food should be stored at what temperature?
-10 to 0 F
Lean meat fat g
0-3
normal HCO3
24-28
small for gestational age %ile?
10%
Normal BUN:Cr
10-15:1
What percentage of lard is fat?
100%
Mark-Up Factor
100÷ food cost %
Hepatic Failure (ELSD) means liver function is at __% or ___.
25% or less
Normal wt pregnancy weight gain
25-35 lbs
normal weight for newborns?
2500-4000gms
Dried whole milk is ___% fat. Does it keep well?
26% No
If pregnant: Min Hgb? Min Hct?
11 g/dL Hgb 33% Hct
Obese pregnancy weight gain
11-20 lbs
Normal Hgb in women
12-15 mg/dL
Normal Hgb in men
14-17 mg/dL
Safe min temp for pork, beef, lamb, steaks, roast fish
145F
2 Pasteurization time & temps
145F for 30 mins 160F for 15 secs
Sweetened condensed milk adds ___% sucrose/glucose.
15-18%
overweight pregnancy weight gain
15-25 lbs
Entire Leg
16%
Safe min temp for ground meats
160F
JDA Food Code temp for transporting hot food
165-170 F
Safe min temp for poultry
165F
DRI for CHO during GDM
175g/day 15-30g at breakfast, rest divided evenly
How many inches between chairs?
18"
Health & Diet Survey
18+ phone interview that tracks knowledge
Temperature for brewing coffee
185-203F
Straight dough versus sponge method
2 methods for mixing yeast dough Sponge method lowers proofing time sponge: liquid + yeast + part of flour & ferment then add sugar, salt, fat, other flour & knead straight: all ingredients added before dough rises
egg yolks and whites will last
2-4 days
Underweight pregnancy weight gain
28-40 lbs
Hand + forearm
2.3%
Hands should be washed using soap and friction for ___ seconds
20 seconds
low acid canned vegetables have to reach what temperature when canning
212 F
Age to introduce eggs? nuts/fish?
24 months 36 months
SCOOP formula
32 ÷ scoop #= ounces
Normal Hct in pregnant women
33%
how many more kcals do you add for the 2nd trimester?
340 kcals
Nephrotic Syndrome MNT Kcals Pro Na Pho Ca
35 kcals/kg .8-1 g pro/day 2-3g Na/day depending on edema phosphorous <12 mg/day calcium 1.5g/day
normal pCO2
35-45
Normal Hct in women
35-47%
dextrose infusion should not exceed ____ mg/kg/min to prevent _____
4-5 mg/kg/min; hyperglycemia
How much Vitamin D is added to milk per quart
400 USP
Temperature to which fat can be heated before smoke occurs?
400F
Temperature Danger Zone
41-135 F
Normal Hct in men
42-52%
How many more kcals do you add for the 3rd trimester?
452 kcals
winterized oil is chilled to
45F
2010 Guidelines for Americans are revised every
5 years
Entire arm
5%
Tropical climate can increase metabolism by
5-20%
low birth weight
5.5 lbs
Lower Leg + Foot
6%
how many g of N : 1g Protein
6.25g
Most state and local codes require immersion in chemical solutions for at least ___ using water temperature____
60 seconds; above 75 F
Kitchen main traffic lane should have how much space?
60"
Evaporated Milk has __% of water removed Has __% milk fat And is brown due to ___ during canning
60% no less than 7.9% caramelization
coffee, EtoH, and cigarettes can increase metabolism by
7-15%
ideal temp range for pathogens
70-125 F
fresh fruits and vegetable humidity
85-90%
label regulation for low cholesterol
<20 mg/ serving
How are canned f/v graded?
A (deserts, salads--Fancy), B (processed--Choice), C (puddings, pies--Standard)
What happens if you overmix quickbreads?
Loss of CO2 & overdeveloped gluten cause tunnels & tough/heavy product
Tool used to evaluate the validity of your test
ANOVA--Analysis of Variance
USDA provides healthy snacks. Schools receive cash subsidies for each snack served. Same eligibility bases as NSLP
ASP After School Snack Program
end products of catabolism
ATP, CO2, H2O
-Administered by state health agencies -Monthly commodity canned or packaged foods -low income women (pregnant, breast-feeding, postpartum), infants and children up to 6 years, some elderly; at nutritional risk
CSFP- Community Supplemental Food Program
High fiber diet may increase need for
Ca, Mg, P, Cu, Se, Zn, Fe and water
What ethnicity does this cuisine belong to? Yin foods: raw, cold--fish, veggies, fruit Yang foods: bright, hot--soup rice is neutral
Chinese
Name 3 pigments
Chlorophyll, carotenoids, flavonoids
Sous vide
ANAEROBIC & extends storage life of meat Vacuum packing meat in O2 impermeable packaging & stored at 0C
McClelland's Achievement
Achieve, Power, Affiliation Achieve: make things better (sales/management) Power: competition Affiliation: being liked
Name 3 crystal inhibitors
Acid-cream of tartar,vinegar Fat-chocolate, milk Protein-milk, egg whites, gelatin
How do you stiffen an egg white foam?
Add acid (such as cream of tartar) to tenderize the protein.
How do you prevent crystallization in non-crystalline candies?
Add interfering substances (fat, milk) or increasing concentration of sugar
BRFSS- Behavioral Risk Factor Surveillance System
Adults 18+ telephonic nutrition assessment by HHS
Retrogradation
After a starch paste cools, it may become less soluble and recrystallizes to form a solid/rigid gel. The H+ bonds break and reform in an orderly way, causing gritty texture
When using a translator, who do you speak to?
Always speak directly to client
What is starch made up of?
Amylose & amylopectin
2 flavonoids
Anthocyanin & Anthoxanthins
Thiazide diuretics (name 5) may cause
Chlorothiazide (Diuril) Chlorthalidone. Hydrochlorothiazide (Microzide) Indapamide. Metolazone. Low Potassium (Hypokalemia)
LDL (beta)
Cholesterol from diet & liver to all cells
1) Properties: Component of lecithin 2) Function: transports lipids as acetylcholine 3) Sources: fat in eggs, milk, liver, soybeans
Choline
1) Properties: absorption enhanced by Vitamin C, niacin, Ultra trace mineral 2) Function: Aids insulin action & glucose metabolism 3) Sources: yeast, oysters, potatoes, liver 4) Deficiencies cause: insulin resistance
Chromium
Bran has what vitamins?
B1, B2, Phosphorous
1) Properties: contains cobalt & is bound by intrinsic factor in gastric juice 2) Function: coenzyme in protein synthesis & forms RBC 3) Sources: liver, meat, milk, kidney, eggs, fish, cheese 4) Deficiencies cause: macrocytic, megaloblastic anemia, pernicious anemia--after gastrectomy or removal of ileum due to lack of intrinsic factor
B12
What is affected if distal ileum is resected?
B12 absoprtion, intrinsic factor, bile salts
1) Properties: Lost in UV light 2) Function: energy release from protein, needed for RBC production 3) Sources: liver, kidney, meats, milk 4) Deficiencies cause growth failure, cheilosis (cracked lips), angular stomatitis (mouth corner cracks, sore throat, magenta tongue)
B2- Riboflavin milk is packaged in opaque containers because B2 is lost in UV light
Atrophic gastritis supplemetation
B6 & B12
Oral contraceptives decrease what vitamins?
B6, folate, Vitamin C
1) Properties: Isoniazid interferes with this vitamin 2) Function: coenzyme in amino acid metabolism: Deamination & transamination 3) Sources: meat, wheat, corn, yeast, pork, RTE cereals, 4) Deficiencies cause: seizures, anemia, dermatitis, glossitis, peripheral neuropathy
B6- Pyridoxine
ESLD altered neurotransmitter theory
BCAA are decreased bc the muscles use them for energy. Aromatic AA are high bc the damaged liver can't clear them out adding BCAA adds kcals and PRO; may not reduce symptoms & its used when standard therapy doesn't work
Dawn Phenomenon
BG goes up at dawn (no low required)
Pyruvate --> Oxaloacetate requires
BIOTIN
What is baking powder made of?
Baking soda dry acid cornstarch
Why do frozen vegetable have a shorter cook time?
Because blanching and freezing have made them tender.
1) Properties: Synthesized by intestinal bacteria, inactivated by avidin (protein in raw egg white) 2) Function: coenzyme in fatty acid synthesis, converts pyruvate to oxaloacetate in gluconeogenesis 3) Sources: liver, kidney, egg yolk, yeast 4) Deficiencies cause: muscle pain, dermatitis, glossitis
Biotin
____ from federal government are given to states or local communities in distributing funds.
Block Grants
Nitrites inhibit___.
Botulism
Anatomy of a whole grain
Bran Endosperm Scutellum Germ
gas is measured in
British Thermal Units
loop diuretics (name 4) may cause loss of ___
Bumetanide (Bumex) Ethacrynic acid (Edecrin) Furosemide (Lasix) Torsemide (Demadex) thiamin
Supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential day care centers. Reimburses operators for meal costs, provides commodity foods and nutrition education materials Must serve foods that meet guidelines; must offer free or reduced price to eligible Eligibility standards same as NSLP
CACFP Child and Adult Care Food Program (run by USDA)
this hormone is released from the duodenum when fat enters, contracts the gallbladder, releasing bile, and stimulates the pancreas
CCK- cholesystokinin
This is a major federal level grant; steps to a healthier US focused on community based health initiatives related to obesity. Directs funds to address asthma, obesity, and DM prevention
CDC Steps Grant
Parts of stomach
CF BAP Cardiac Sphincter Fundus, Body, Antrum Pyloric Sphincter
Under Social Security Act, partnership between federal and state governments Expands health coverage to uninsured children whose families earn too much to qualify for medicaid but who can't afford private insurance
CHIP
___ is protein sparing and allows PRO to be used for muscle building
CHO
the thermic effect after consumption is higher for __ and __ than it is for___
CHO, PRO; FAT
during prolonged exercise, ___ is needed to provide ___ for lipid oxidation.
CHO; pyruvate
AKI with edema Na needs
Low Na (oliguric phase)
Milk is 80%___.
Casein
When an acid is added to milk,___precipitates out.
Casein
If baby can't tolerate cow's milk OR soy based formula, what do you feed?
Casein hydrosylate formula (Pregestimil)
Acrolein
Causes bitter taste in burned fat
Damaged liver tissue is replaced by bands of connective tissue, which divides liver into clumps and reroutes many of the veins & capillaries
Cirrhosis
fire with ordinary, combustible materials, wood, paper cloth
Class A fire (triangle)
fire with flammable liquids, gases, greases
Class B (square)-- most kitchen fires
Live electrical fires
Class C (circle)
Extinguishers used in most kitchens
Class K
1) Properties: exists with B12; stored in liver 2) Function: maturation of RBC 3) Deficiencies: related to B12 deficiency
Cobalt
soothes nerves & may cause irreversible liver disease
Comfrey
How many Critical Control Points do each of these have? Commissary Ready Prepared Conventional Assembly Serve
Commissary: 9 Ready Prepared: 8 Conventional: 5 Assembly Serve: 4
horizontal communication
Communication between departments
Development of sustainable, community based strategies to ensure all have access to culturally acceptable, nutritionally adequate food at all times
Community Food Security Initiative
CAM and AIDS
Complimentary Alternative Medicine is discouraged. Use of Vitamin C or St. John's Wort could result in drug resistance
1) Properties: Trace mineral; attached to protein; ceruloplasmin 2) Function: hemoglobin synthesis, aids in iron absorption 3) Sources: liver, kidney, shellfish 4) Deficiencies cause: (rare) microcytic anemia, neutropenia. Wilson's Disease: low serum __, genetic absence of liver enzyme
Copper
Sulfur containing amino acids?
Cysteine Cystine Methionine
Why are room temperature eggs better for whipping?
Lower surface tension
During this metabolic pathway, lactate is released from tissue, transported to liver, and converted back to pyruvate
Cori Cycle
_____ _____ retards crystallization and increases viscosity and chewiness.
Corn Syrup
High homocysteine levels are an independent risk factor for
Coronary Heart Disease
DTERMINE
Disease Tooth loss Economic hardship Reduced social contact Multiple meds Involuntary wt loss/gain Needs help with self care Elder years above 80
Regional enteritis aka
Crohn's disease
2 main types of candies
Crystalline and noncrystalline
Herbals, botanicals, & supplements are regulated by
DSHEA: Dietary Supplement Health and Education Act 1994
When baking at high altitudes __ baking powder and __liquid.
Decrease baking powder ;increase liquid
What kind of variable is an outcome?
Dependent
Prospective Payment System
Diagnostic related groupings; part of TEFRA (Tax Equity and Fiscal Responsibility Act), means payment is known in advance based on diagnosis
What might happen after a gastrectomy?
Dumping Syndrome
found in rare or raw ground beef, uncooked fruit/veg, raw milk, unpasteurized apple juice can survive high acidity, freezing, & can grow at refrigerator temps
E. Coli
1) Provides grants to universities that assist in community development. 2) trains nutrition aides to educate the public 3) improve food practices of low income homemakers with young children 4) Works with small groups; teaches skills needed to obtain a healthy diet (how to budget, meal planning, shop, cook)
EFNEP- Expanded Food and Nutrition Education Program run by USDA
Giovanetti Diet may be used for
ESRD; 20g pro (HBV) increase kcals; control edema, prevent deficiencies
This organization establishes and monitors water quality standards & determine safety and tolerance levels for pesticides
Environmental Protection Agency
Egg cuticle
Shell
2 International agencies
FAO- Food and Agriculture Organization- raising worldwide levels of nutrition by increasing efficiency of production & distribution of foods WHO-World Health Organization-developed RDAs for developing countries
Licenses radio and TV
FCC- Federal Communications Commission
Standards of identity, quality and of fill of containers are formulated by
FDA
Who controls additives?
FDA
Ensures safety of some domestic & imported food production
FDA- Food & Drug Administration
Monitors truth in labeling & regulates content of food ads
FTC- Federal Trade Commission
This organization monitors internet, TV, radio
FTC-Federal Trade Commission
How is fresh produce graded?
Fancy, Extra #1, #1, Combination, #2
Wet Beri Beri
Fast heart rate, Shortness of Breath, Edema (legs)
Tricep Skinfold measures
Fat
supplements for pregnancy?
Fe and folate
What bacteria can cause ulcers
H. Pylori
1) Properties: trace mineral 2) Function: teeth, bones 3) Sources: soil, water 4) Deficiencies cause: dental caries
Fluoride
1) Properties: water soluble, PABA (Para Mino Benzoic Acid) is a precursor 2) Function: DNA synthesis forms RBC in bone marrow, prevents neural tube defects 3) Sources: fortified dry cereal, liver, kidney, green/leafy veg, citrus, lentils, beans 4) Deficiencies cause: megaloblastic, macrocytic anemia, diarrhea, fatigue
Folate
What accelerates retrogradation?
Freezing
Introduce children to fresh f/v free to children nationwide in selected schools
Fresh Fruit and Vegetables Program
In the presence of glucose and fat, these hormones are released from the intestine to stimulate production & release of insulin
GLP-1 and GIP GLP-1: Glucagon-like Peptide 1 GIP: Glucose-dependent Insulinotropic Peptide
Disorder of purine metabolism
Gout
two standard deviations from the mean
Green
Atherosclerosis risks
HTN, obesity, smoking, elevated blood lipids, heredity
elevated T3 and T4 means
HYPERthyroidism
low T3 and T4 indicate
HYPOthyroidism
2 Lactose intolerance tests
Hydrogen Breath test- H2 is produced by colonic bacteria digesting lactose & exhaled within 60-90 minutes Lactose tolerance test- oral lactose (up to 50g) after a fast. If BG goes up less than 25 mg/dL, indicates lactose intolerance
High TG and low HDL is called
Hyperlipidemia
cyclosprine is an immunosuppressant that can cause the Hyper 4, which are
Hyperlipidemia hyperglycemia hyperkalemia hypertension
1) Properties: trace mineral 2) Function: central nervous system 3) Sources: whole grains, legumes, nuts 4) Deficiencies: are unlikely
Manganese
Under Title V of the social security act fosters public health nutrition programs at the state and local levels provides training, consultation, funding women of child-bearing age, infants, children;state eligibility requirements
Maternal & Child Health Block Grant from DHHS
AKI MNT
IV glucose, lipids, PRO then, if no dialysis needed .6-.75g pro/kg & increase to 1.2g/kg if non-catabolic as GFR returns to normal catabolic= 1.2-1.5g/kg low Na replace potassium fluid output+500 mL
High ALP, ALT, SGPT
Liver disease
What kind of variable is the kind you manipulate in your experiment?
Independent
Crystalline Sugar Candies
Large Crystal- rock candy Small Crystal- fondant, fudge
Why might ice cream be grainy?
Large crystals due to too little fat
fiber that binds water & adds bulk
Insoluble
___ softens gluten & prevents its development by absorbing some of the water gluten needs.
Sugar
1) Properties: Trace mineral; part of thyroxine 3) Sources: Seafoods, iodized salt 4) Deficiencies cause: Goiter (in adults) & cretinism in children
Iodine
1) Properties: Trace mineral, part of hemoglobin, 2) Function: Oxygen transport 3) Sources: animal: meat, fish, poultry non-animal: cereals, vegetables 4) Deficiencies cause: 1) Food name: 2) Absorbable form: 3)Stored form: 4) animal sources contain____ 5) non-animal sources contain___and require a reducing agent (vitamin C) Oxaloacetates DO NOT aid absorption because if they are present, they bind to this mineral unless calcium is present, then the oxaloacetate will bind to calcium instead.
Iron 1) Ferric 3+ 2) Ferrous 2+ 3) Ferritin 4) Heme iron 5) non-heme
How do we get green eggs?
Iron in the yolk combines with sulfur to make ferrous sulfide. Happens when eggs are over cooked or cooled slowly.
Intracellular electrolytes
K+, Mg++, P Potassium, Magnesium, Phosphorous
relieves anxiety; may cause liver failure and is very likely hazardous
Kava
IDL (Intermediate Density Lipoprotein aka pre-beta to beta)
LDL precursor; found in circulation prior to catabolism of other lipoproteins
This fat does not require bile salts & needs less intestinal surface area
MCT oil
1) Properties: abundant in food because it's part of chlorophyll. 50% in bone, 50% in cells 2) Function: protein and fatty acid synthesis, stabilizes structure of ATP, high protein, calcium, and vitamin intakes increase need 3) Sources: most foods, milk, bread 4) Deficiencies cause: (rare) tremors
Magnesium
What stage of the Transtheoretical Model for Behavior Change is this? sustains the change for 6 months or longer "I found a website that helps me plan family low sodium meals"
Maintenance
Drucker MBO
Management by objectives participative, democratic, establish performance goals with employees
Meat inspection is ____ by _____and assures____
Mandatory by USDA and assesses wholesomeness at time of slaughter
Health insurance program for 65+ or of any age with ESRD; employees and employers pay
Medicare by DHHS
B12 deficiency leads to
Megaloblastic anemia
Vitelline Membrane
Membrane that surrounds the yolk
Median
Middle number after putting them in order
Evaluates independence, medication therapy, number of full meals consumed/day, protein intake, fruits, veggies, fluid, mode of feeding
Mini Nutritional Assessment
What is MAP cooking?
Modified Atmosphere Packaging: remove O2 & replace with CO2 or N
4 emulsifiers
Monoglycerides, diglycerides, lecithin, disodium phosphate
Serum Creatinine is related to
Muscle mass
Marasmus
NO EDEMA
Staphylococcus Aureus
NO FEVER resists drying & freezing n/v/d avoid--wash hands cool food quickly in shallow pans
Run by Administration on Aging Developed Services to foster independent living; cash and commodities to state agencies
NSIP Nutrition Services Incentive Program
Extracellular electrolytes
Na+, Ca++, Cl-, HCO3- sodium, calcium, chlorine, bicarbonate
NCEP 1) Assessment risk factors? a) HDL, LDL, Total Cholest 2) Diet Recs a) fat kcals %, sat fat %, PUFA %, MUFA %, max cholest b) fiber recs c) how to inhibit cholest absorption d) PA recs/#kcals to expend
National Cholesterol Education Program 1) LDL <100 optimal Total Cholest <200 desirable HDL<40 low for males; <50 low for F 2) Therapeutic Lifestyle Change from Adult Treatment Program III a) up to 35% kcals from fat <7% sat fat 5-10% PUFA max 20% MUFA <200mg cholest b) 25-30 g fiber (half soluble) c) stanols and sterols inhibit cholest absorption (2-3g/day) d) increase PA to at least 30 mins most days (expend 200 kcals)
A private nonprofit, voluntary health agency that focused upon health misinformation, fraud, and quackery as public health problems.
National Council Against Health Care Fraud
Entitlement program to improve nutrition of children, esp. from low income families, utilize surplus production of foods cash grants and food donations; dollars reimburse schools on the basis of number of meals served National guidelines require it meets 1/3 of DRI
National School Lunch Program
1) Properties: precursor is tryptophan & it is essential in all cells for energy production 2) Function: metabolism of CHO, PRO, & FAT 3) Sources: protein, peanuts, RTE cereals, chicken, rice, yeast, milk 4) Deficiencies cause: Pellagra, 3Ds-Dementia, Dermatitis, Diarrhea, Beefy, bright red tongue, pigmented rash in sunlight
Niacin- B3
___competes with starch for the water needed for gelatinization
Sugar
Lignin
Non-CHO substance softened by cooking. AMT in veggies increases as they age
Assessment for the elderly
Nutrition Screening Initiative DETERMINE checklist (increase awareness of factors that affect nutritional health) Level I- Level II
Helps ID nutritional problems of the elderly
Nutrition Screening Initiative DTERMINE checklist (Dz, Tooth loss, Economic hardship, Reduced social contact, Multiple meds, Involuntary wt change, Needs assistance w/self care, Elder yrs above 80 Level 1 Level 2
BMR mesasures
O2 consumed
Indirect calorimetry measures
O2in & CO2 out and which nutrients are being used
Determines minimum safety standards record keeping of accidents inspection of facilities
OSHA-Occupational Safety and Health Act
1 hot meal/day, 5 days/wk, provides 1/3 DRI eligibility: all aged 60+ and spouse, regardless of income Congregate meals (if ambulatory, transportation essential for rural elderly) Home Delivered Meals- Meals on Wheels- must be homebound Counseling, nutrition education, referrals, social interaction
Older Americans Nutrition Program by DHHS
Non-profit programs that link sources of unused, cooked, and fresh foods with social service agencies that serve the hungry.
PPFPs (prepared and perishable food programs)
1) Function: Coenzyme A- energy synthesis of fatty acids 2) Sources: animal foods, grains, legumes 3) Deficiencies cause: Rare deficiency, paresthesia in feet
Pantothenic acid
When you use flour as a thickener, sauces are ___.
Opaque
Motivational Interviewing Foundation Skills
Open-ended questions Affirmations Reflective listening Summaries
When high CRP goes down, ___ goes up & it indicates
PAB; nutrition therapy would be beneficial
Chronic pancreatitis MNT
PERT w/ meals & snacks MCT oil (do not require pancreatic lipase) add to mixed dishes, jams, jellies to increase wt, give max tolerated fat without steatorrhea or pain Pancreatic bicarb may be deficient, many need antacids for PERT may need TPN/PPN if severe/prolonged avoid large meals with fatty foods, avoid etoh
Cystic fibrosis MNT
PERT w/ meals & snacks high Kcal, High pro high salt (additional 2-4g/day in hot weather) liberal fat supplement water soluble vitamin A & E
Medicare Hospiral insurance
Part A
Medicare optional insurance for supplementary benefits
Part B
Protopectin becomes...
Pectin-->Peptic Acid
MACROcytic Anemia RBC Hgb Hct MCV MCH MCHC
RBC: low Hgb: low Hct: low MCV: high MCH: high MCHC: normal
Microcytic & Hypochromic Anemia RBC Hgb Hct MCV MCH MCHC
RBC: may be normal Hgb: low Hct: low MCV: low <80 MCH: low MCHC: low
DRI now replaces
RDA
Components of Health Belief Model
Perceived susceptibility- obesity puts me at risk for heart dz Perceived impact- heart dz will impede my ability to work Perceived advantage of change- greater mobility appraisal of barriers- i hate exercise self efficacy- conviction that you can successfully do the thing that produces outcomes "i can join the gym close to work"
1) Properties: Second most abundant mineral. part of DNA, RNA, and ATP 2) Function: phospholipids transport fat through lymph and blood, bone, teeth 3) Sources: meat, milk,poultry, eggs, fish, cheese. best sources are animal sources 4) Deficiencies are rare
Phosphorous
What are the 2 branches in Maslow's hierarchy of needs
Physiological (Basic) & higher human needs
PDCA cycle
Plan, Do, Check, Act: a problem solving technique for TQM
When R=+1
Positive correlation line goes up and right
Aldosterone increases excretion of___
Potassium
Steam is measured in
Pounds per Square Inch
Taft Harley Labor Act
Pro Management- outlawed closed shop, limited union shop to one year
What is elastin? What happens to it in heat?
Protein found in ligaments, yellow color. Little change during cooking.
What is a hiatal hernia & what MNT does it require?
Protrusion of stomach into above the diaphragm into the chest; small, bland feedings, avoid late night snacks, caffeine, chili powder, and black pepper
Criteria should___
RUMBA! Relevant Understandable Measurable Behavioral Achievable
The 3 possible products of glucose-6-phosphate are:
Pyruvate (aerobic conditions, with glucose-6-phosphatase) Ribose (NADPH is released) Glycogen (reversible reaction)
How does heat affect color of meat?
Red-->pink-->brown--> gray because heat denatures globin and iron is oxidized
Entitlement program, purpose is to initiate, maintain, or expand food service programs to children when school is not in session Objective is to provide meals and snacks to children at participating institutions in poor areas
SFSP- Summer Food Service Program
Largest food assistance program; ENTITLEMENT assist low income needy with monthly benefits; net income must be at or below a certain % of poverty level Least costly of USDA four food plans
SNAP: Supplemental Nutrition Assistance Program
used to relive symptoms of enlarged prostate; may also have diuretic effects
Saw palmetto
How is pernicious anemia diagnosed?
Schilling Test
Entitlement program, meal must provide 1/4 of DRI for protein, calcium, iron, vitamin A and C
School Breakfast Program
SAP stands for
Screen Assessment Plan
Low ALP
Scurvy, malnutrition
What part of the grain has most of the thiamin?
Scutellum (the layer around the germ)
1) Properties: Cooperate with vitamin E; trace mineral 2) Function: antioxidant; tissue respiration 3) Sources: soil, grains, meat, fish, poultry, dairy 4) Deficiencies cause: myalgia, cardiac myopathy
Selenium
Grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmers markets, roadside stands, community supported agriculture programs (CSA) fresh, nutritious, unprepared fruits and vegetables, honey may be limited to certain locally grown foods nutrition education provided
Senior Farmer's Market Nutrition Program
Proportion of people who test positive for a particular condition during screening for it.
Sensitivity
found in cold mixed salads, raw veg, watermelon, causes bloody diarrhea
Shigella
The colon transforms malabsorbed CHO and fibers into
Short Chain Fatty Acids (acetate, butyrate, propionate, lactate), which provide substrates for energy production gases: H2, CO2, N, CH4 (methane)
When preparing candies, you want __crystals for a smooth, creamy mouthfeel.
Small
Maslow Higher Human Needs
Social-organized activities Self Esteem-job title, praise, rewards, promotion Self Realization/Self Actualization-realizing your potential (job enrichment)
1) Properties: Part of amino acids: Cysteine, Cystine, Methionine 2) Function: components of organic molecules 3) Sources: meat, fish, eggs, poultry
Sulfur
What are thiols?
Sulfur containing phytochemicals in cruciferous veggies
_______ is an example of a thick, white sauce
Souffle
Pork; few dairy products
Southeast Asian
Non-athetoid CP
Spastic; low kcal, hig fluid, high fiber
Purpose is to encourage consumption of milk by children. Objective is to provide subsidy for milk served to children in participating schools, child care centers, summer camps not participating in other subsidized meal programs, and free milk to the needy
Special Milk Program
Proportion of non afflicted people during screening for it.
Specificity
What kind of test is it if you divide the test in half & determine reliability by the degree of similarity in results.
Split halves reliability test
antidepressive, but may compromise meds for heart disease, cancer, seizures, and birth control
St. John's Wort
Modified starch
Starch with chemical modification by acids/enzymes to change gelling ability physical modification: pre-gelled dehydrated starches (like instant pudding)
Dextrinization
Starches heated and broken down into dextrins (toasting)
TANF- Temporary Assistance for Needy Families
States determine the eligibility of needy families and the benefits and services those families will receive
3 leavening agents
Steam (used in popovers and cream puffs) Air (beat, sift, fold, cream) CO2 (yeast + sugar OR acid + baking soda or adding baking powder)
Describe Bill Roth II
Stomach to Jejunum (more serious!)
Describe Bill Roth I
Stomach to duodenum
What is collagen? What happens to it in heat?
Structural part of tendon that surrounds muscle. In heat, it hydrolyzes to gelatin & becomes tender.
History, intake, GI symptoms, functional capacity, physical appearance, edema, weight change
Subjective Global Assessment
Systems approach
System is an organized whole based on interdependent parts
Quarterly distributions of commodity foods by local, public, or private nonprofit agencies, food banks,soup kitchens, homeless shelters Supplements diets of low income households
TEFAP- The Emergency Food Assistance Program
1) Motivate child to make healthy choices; helps schools meet Guidelines 2) provides recipes, training, support
Team Nutrition Implements School Meals Initiatives for Healthy Children
How is syneresis induced?
Temp too high Temp too low and cooked too long
MacGregor
Theory X: people hate work Theory Y: work is natural
How do vinegar and salt improve shape of eggs?
They hasten coagulation
How do acids change proteins?
They increase water holding capacity
Non-Crystalline Sugar Candies are/look like
They're amorphous, glass-like
1) Properties: water soluble, lost as temp or pH rises. It's heat stable in acid 2) Function: Important in oxidation of CHO 3) Sources: Grains, wheat germ, pork, liver 4) Deficiencies: Beri beri, muscle weakness, foot drop, tachycardia, low erythrocyte transketolase and high plasma pyruvate
Thiamin/ B1
What vitamins are coenzymes?
Thiamine, Riboflavin, Niacin, Pantothenic Acid (B 1,2,3,5)
What hormone regulates metabolism and rate of oxidation? -influences physical and mental growth -stimulates liver glycogenolysis, gluconeogenesis--raises blood sugar
Thyroxine
Why are nitrites added to meats?
To inhibit botulism
Poor volume in cakes is caused by
Too little baking powder, improper level of sugar or fat
Solanine
Toxicant produced in potatoes exposed to sunlight
Who grades f/v?
USDA
When you use cornstarch as a thickener, sauces are___.
Translucent
TV TILL PMH= Essential AA
Tryptophan Valine Threonine (309) Isoleucine Leucine Lysine Phenylalanine Methionine Histidine
This menu type offers upscale items for clients willing to pay more
Two tier
This organization inspects and certifies fishing vessels, seafood processing plants, retail facilities for federal sanitation standards
US Department of Commerce
Name 2 uses for Disodium phosphate.
Used as a cheese emulsifier (Velveeta) Added to quick-cooking cereals to make them more alkaline so the granules swell faster
How can we prevent retrogradation?
Using waxy corn, sorghum, or rice as thickener
RQ= what /what
VCO2 (CO2 expired)/VO2 (O2 consumed)
calmes nerves, but should be avoided with liver disease
Valerian Root
If eyes are pale, dry, and you have poor vision, you maybe deficient in
Vitamin A, Zinc, Riboflavin
1) Properties: Most easily destroyed, structure similar to glucose, it's an antioxidant, needs and acidic pH, is destroyed by heat, alkalinity, and oxidation 2) Function: changes proline-->hydroxyproline-->collagen, which strengthens intercellular substances, wound healing, and aids in iron absorption 3) Sources: citrus fruits, potatoes, papaya, dark green & yellow veggies 4) Deficiencies cause: scurvy, poor wound healing, bleeding gums, petechiae
Vitamin C
If hair is thin, sparse, dull, dry, and brittle, you may be deficient in
Vitamin C & Protein
1) Cholesterol is a precursor 2) Function: Calcium and Phosphorous metabolism 3) Sources: 3) Sunlight, egg yolks, 4) Deficiencies cause Rickets in children (soft bones) and Osteomalacia (same condition, but for adults)
Vitamin D
1) Least toxic vitamin 2) Function: antioxidant. resists hemolysis of RBC 3) Sources: veg oils, whole grains, green veg, almonds 4) Decifiencies cause: hemolytic anemia
Vitamin E.
1) Synthesized by bacteria in lower intestinal tract 2) Function: forming prothrombin in liver. It is given before surgeries & helps with calcium metabolism 3) Sources: Dark, leafy greens 4) Deficiencies cause: hemorrhage
Vitamin K
Meat grading is ____by ____ and assures____
Voluntary by Agricultural Marketing Service of USDA and assures quality
NOT an entitlement program for at risk, low income pregnant, postpartum women and children UP TO 5 YEARS OLD
WIC
conventional system
all prep done where meals are served pros: flexible, low distribution cost, less freezer storage cons: stressful, low productivity, high labor cost
Syneresis
Weeping liquid from a coagulated food, creating a tough, watery product
Least effective thickener
Wheat
What are the prolamins (storage PRO 'gluten' refers to) in Wheat Rye Barley Oats
Wheat: gliadin Rye: secalin Barley: hordein Oats: avenin
What is convenience or accidental sampling?
When you use whoever is willing/shows up for research instead of trying to eliminate bias in your population.
When do we use waxy starches?
When you're making a gel that you plan to freeze (like gravy)
Chalaza
White strands that anchor the yolk
Where is glutamic acid found?
Young vegetables. Used to make MSG.
1) Properties: trace mineral, excess leads to copper or iron deficiency 2) Function: increases taste acuity, enhances insulin action, stabilizes DNA, RNA, and cell division. Important in glucose metabolism 3) Sources: Meat liver, eggs; phytates and copper decrease absorption 4) Deficiencies cause: reduced immune function, alopecia, poor wound healing, hypoguesia
Zinc
budget gives management
a basis for control-estimate for future needs
Determining needs equation
a) EP; convert to pounds b) amt to purchase=EP ÷ % yield
phenylalanine-->
tyrosene
most glucogenic amino acid
alanine
Catabolism of amino acids
aa-->NH2-->NH3 --> Urea --> Purine --> ketoacid is transaminated to create new amino acid
Drug therapy for ulcers
abx (for H. Pylori) and antacids Cimetidine Ranitidine They are H2 blockers that prevent binding of histamine to receptor & decrease acid secretion
alcohol is converted into ____, which does what?
acetaldehyde and H+; disrupts liver metabolism
Distal tubule controls
acid/base balance
ceiling requirements
acoustically treated, lighter in color than walls, 14-18' high
What stage of the Transtheoretical Model for Behavior Change is this? Tries to make the change "I removed the salt shaker from the kitchen table"
action
Coagulation
action/process of a liquid turning into a solid or semi solid PRO coagulates at 62-70C This is how custards are set
physical inventory
actual count of all goods on hand at the end of accounting period
How can you prevent browning of f/v low in Vitamin C?
add acid, add sugar before freezing, or heat to boiling
flexible budget
adjusted to various levels of operation with varying levels of sales throughout year (e.g. closing a floor for renovation)
Addison's Dz & MNT
adrenal cortex insufficiency MNT: high PRO, frequent feeds, high Na
Staff
advisory; specialist advise & support the line but not involved in day to day e.g. Personal Director, Consultant
paired preference test
affective compares two samples for preference of a specific attribute
If making a gel/custard that requires acid, when do you add it & why?
after cooking/gelatinization is complete because if you add it too early, acid will break down starch and product will be runny.
Do you evaluate vendor performance after several orders have been filled, or after the first order especially if there are errors?
after several orders
Type II osteoporosis
age related >70 yrs
How can you make ice crystals small in ice cream?
agitation; fat
foam cake leavener
air
pound cake leavener
air and steam
Americans w/Disabilities aisles doors alarms for deaf
aisles-36" doors-32" flashing light alarms
nominal variables
aka non-ordered no- rank variables (e.g. gender, race, marital status, present or absent)
exercise releases____ from muscle protein & takes to liver to deaminate it and convert it to glucose
alanine
Mean
average
IBS basic food recs
avoid large meals, caffeine, alcohol, and sugar
MNT for Ulcers Omit:?
avoid late night snacks, diet as tolerated Omit: cayenne pepper, black pepper, large amts of chili powder, excess caffeine, and ETOH
Layer cake leavener
baking powder
Self rising flour has
baking powder, flour, salt
queue theory
balance of cost of making people wait in line longer versus cost of preventing lines by increasing service/staff
collective bargaining steps
bargain -verbal between union steward and management mediate- neutral person helps settle differences (not legally binding) arbitrate-hearing to dissolve dispute (legally binding)
zero based budget/planning programming budget system
begin at 0, must justify each expense, planning oriented; past dollar allocations are NOT basis of projections
Adult diarrhea: what to do when it stops.
begin with low fiber foods followed by pro, fat need not be limited avoid lactose foods/supplements that contain prebiotics (oats, banana, pectin, fructose bc favor friendly bacteria) Probiotics
Where does ulcerative colitis begin and what does it affect?
begins in rectum; affects the COLON
___ formation may occur in people with gastroparesis due to____. tx includes enzyme or endoscopic therapy
bezoar; undigested food/meds
Landrum Griffin Act 1959 Labor Management Reporting and Disclosure Act
bill of rights for union members;regulates internal union affairs
good heat conductors
black cast iron, copper, aluminum
Eases menopause symptoms & may cause blood clotting
black cohosh
Heparin is used to treat
blood clots
azotemia
blood in urine
Why might a Crohn's patient suffer from iron deficiency anemia?
blood loss, decreased absorption
CAP-FEIA
blood test specific for identifying children with milk, egg, fish, peanut allergies
HCV (Hepatitis C) is transmitted by
blood to blood
steroids decrease ___ growth and can cause __ intolerance.
bone; CHO
semi variable cost
both fixed and variable e.g: labor, maintenance, utilities (electricity)
Acute Crohn's flare-up may require:
bowel rest, parenteral nutrition OR minimal residue
Par stock method & formula
bring stock up to par level every time you order if par is 10 and you have 8, order 2
AKI is caused by
burns, accident, obstruction, severe dehydration
Name 3 fermented milks
buttermilk sweet acidophilus milk kefir
mineral oil/cholestyramine decreases aborption of __ and ___ soluble vitamins.
fat;fat soluble
methionine-->
cysteine
Orlistat decreases___ absorption by binding ____
fat;lipase
WWEIA- What We Eat In America
dietary intake component of NHANES conducted by USDA
These are examples of which branch of management? delegating, communicating, motivation, leadership, management approaches
directing/coordinating
market segmentation
divide market into categories (like age, social class,etc.)
Nonparametric test
does not depend on normal distribution
food broker
does not own products, but connects buyers with sellers
LOW popularity LOW profitability this menu item is a _____ and you should consider____
dog; eliminate
What are Baker's Special Eggs?
dried eggs with sugar added to improve foaming ability.
prevents & moderates cold symptoms, but you should avoid taking it for more than 2 months
echinacea
lack of linoleic acid causes
eczema, poor growth rate, petechiae (red/purple skin spots)
What does albumin under 3.5 g/dL indicate?
edema
Low serum protein leads to
edema and ascites
cross charts
efficiency of equipment placement; shows # of movements between equipment
Baby Friendly Hospital Initiative
effort to increase breastfeeding time. hospital must show ten steps to successful breastfeeding
Acute UC flare-up may require
elemental diet to minimize fecal volume
Vasopressin (ADH)
elevates BP (pressor effect) increases water resorption from distal & collecting tubules
fan system purpose
eliminates odors
continuous quality improvement
emphasis on organization & systems rather than individuals
humanistic approach
employee participation, Ouchi Theory Z: high value placed on group & group decision making
How does hard water affect dish washing?
encourages formation of soap scum makes it harder to form a lather, use more soap
If CF child grows normally, how many kcals? If they don't?
enough to cover RDA; if not, may need 110-200% Energy needs
Requires payment of benefits to all eligible people as established by law; for a specific population who meet certain income or other eligibility requirements, usually for a finite amount of time (1 year) 5 EXAMPLES
entitlement program 1) SNAP 2) Medicare 3) NSLP 4) SFSP (summer food service program) 5)SBP
Sometimes ___are added to grains so they cook faster. It works by splitting the proteins.
enzymes
promotes weight loss; but causes rapid heart rate, headaches, and is likely very hazardous
ephedra
During times of catabolic stress, BG raises because
epinephrine suppresses insulin secretion
HAV (Hepatitis A) is transmitted via
fecal oral contact
Quasi governmental agencies, like the red cross, receive funds from
federal and state sources
business marketing
filling customer needs & desires
4 renal functions
filtration --keeps RBC & PRO in blood, filters all else absorption--100% glucose, Amino acids, 85% water, Na, Potassium excretion- wastes, urea, excess ketones secretion- BP balance & blood component controlling hormones, acid/base ions,
balance sheet
financial condition at a particular time
When blood can't enter the liver it leads to
esophageal varices and the esophageal, abdominal, and collateral veins enlarge
Fair Labor Standards Act 1938
established minimum wage & overtime Minimum Wage or Wage Hour Law
leniency of error
evaluating everyone higher than they ought to be
peritoneal dialysis happens
every day; less restrictive
agency shop
everybody pays membership not required
marketing channel
exchange of ownership; producer, processor, distributor, customer, supplier
Analytical research
experimental model (basic research) quasi experimental-test before & after something is implemented cohort studies-follow a specific population/group to see if they develop same illness (incidence studies) case control studies-people with a disease compared to those without cross sectional aka prevalence study--all cases of a specific disease among a group of people in a specific time
___ ___ tests whether or not a generalization can be made from the study to a larger population.
external validity
Anasarca
extreme localized edema associated with cardiac, liver, & renal failure and extreme protein/kcal malnutrition
Russian servinf style
family style
What are 3 strategies to strengthen local food systems?
farmer's markets, food recovery & gleaning programs, PPFPs (prepared and perishable food programs)
At rest, ____ is the primary energy source
fat
during low/mod intensity exercise ___ is a significant energy source
fat
What is finish?
fat cover on carcass
chronic nonspecific infantile diarrhea, what to consider?
fat: CHO ratio volume of ingested fluids give 40% kcals as fat, balanced with limited fluids, restrict or dilute fluids with high osmolar loads, like juice
To prevent lumps in custard, mix starch + ___, ___ liquid/sugar.
fat; cold
Pregnancy Induced HTN (PIH)
more frequently found in women with poor diets w/ lack of prenatal care do not use Low Na diet Na is needed
More sugar in cakes means it takes __time to reach the ___coagulation temperature
more; elevated
mode
most repeated # in a set
Describe ascitic fluid
mostly plasma with a high osmolar load. It pulls in more fluid to dilute it, which may cause low serum albumin
Herzberg's 2 Factor Theory
motivation/maintenance approach maintenance-hygiene factors (fair wage, insurance, retirement, etc) if present-satisfiers If not-dissatisfiers: interfere with work they don't provide motivation, but they can prevent it from occurring motivation-achievement, accomplishment, job enrichment
operation charts
movement of hands; reduces transportation and re-plans work areas
____ is depleted in 2-3 hours of continuous exercise
muscle glycogen
Arm Muscle Area measures ____ & is useful in finding ___
muscle; pro-energy malnutrition in children
closed shop
must be member of union before hiring (Taft Harley Labor Act outlawed this)
union shop
must join post-hire
1) Properties: In plants as phytic acid related to sugar. Contains phosphorous vitamin-like factor 2) Function: binds calcium, zinc, iron membrane structure 3) Sources: outer husks of cereal grains, leafy green veg
myo-inositol
market niche
need you are filling
appropriations bill
needs to be passed for funding
When R=-1
negative correlation line goes up and left
profit margin
net profit ÷ sales dollars
tryptophan --->
niacin OR serotonin
Do union stewards get paid more?
no
label regulations for low calorie
no more than 40 kcals/ serving
Null hypothesis
no relationship in population of data. Often has "equal to" expressed
Maillard reaction
non-enzymatic browning that happens when a reducing sugar (all except sucrose) & amino acid combine. faster browning-increase pH to 6+, increase temp, decrease water content
Athetoid Cerebral Palsy
non-spastic; wormlike movements; needs high cal, high pro finger foods
jejunal resection MNT
normal balance of CHO, PRO, FAT, avoid lactose, oxalates, large amt of concentrated sweets, need vitamin & mineral supps
indirect costs
not affected by sales volume e.g.: rent, taxes, interest on debt, insurance, depretiation
Dry Beri Beri
numb hands/feet confusion pain aka Wernicke Korsakoff
diuretics may cause what other symptoms
nutrient loss, glucose intolerance, high serum uric acid
Nutrition Education Training Program (NET)
nutrition education for educators and food service staff
work sampling
observe random samples to determine amt of time working/idle
LIFO method for determining inventory value
oldest price paid X # of units in inventory UNDERESTIMATES THE VALUE OF OF CURRENT INVENTORY
a-linoleNic is aka and comes mainly from
omega 3; fish oils, walnuts, flax seeds, canola
linoleic acid is also known as ___ and the best source is ___
omega 6; safflower
What does Maslow believe in regarding needs/motivation?
once basic needs are met, higher needs serve as motivators
NHANES-National Health and Nutrition Examination Survey
ongoing repeated survey used to obtain info on health of American people
What are waxy starches made up of? What are some examples?
only amylopectin waxy corn, rice, sorghum
dichotomous scores
only two results are possible
3 types of budget
operating budget cash flow budget capital budget
open shop
optional membership to union
These are examples of which function of management? provide organizational structure, determining staffing needs, work simplification, productivity management, work schedules, labor/turnover rate
organization
Delphi technique
probes expert minds via written interviews, people never meet
Erythropoeitin (EPO)
produced by kidney; stimulates bone marrow to produce RBC
Food Additive Amendment
producer of an additive must prove safety
marketing mix consists of
product place price promotion
marketing mix
product-good, service, idea place-where it's sold promotion-advertising price-cost
types of control
production, quality, quantity
Free on board
products are delivered with all transport paid
cash budget
projects revenue & expenses, showing input & output of cash purpose is to determine if funds will be available when needed
erythromycin and metoclopramide are examples of
prokinetics--increase gastric motility
Low energy washer pros and cons
pros: no booster heater, water temp is 140 F cons: increase use of detergents, rinse aids, water, higher labor costs because longer wash/rinse times
Egg Bloom
protective bacteria layer from chicken butt that Americans wash off
Formula and cow's milk both have more____ than breast milk
protein
If hair is easily plucked, you may be deficient in
protein
Transthyretin and PAB pick up changes in ___ status quickly because of the short half life.
protein
What leads to ascites, fatty liver, and impaired blood clotting in cirrhosis?
protein deficiency
glucocorticoids and Abx can cause ___
protein deficiency
BUN is related to
protein intake renal disease
descriptive research
provides baseline info and monitors changes over time
when can a nutritionist present views about a potential law
public hearings where testimony is taken from bill's sponsors
future contracts
purchase goods at specific price to be shipped later
Just in time purchasing
purchase products as needed for production & immediate consumption by customer
Acute pancreatitis MNT
put pancreas at rest, withhold all feedings, maintain hydration (IV) 1) progress as tolerated to easily digested foods with low fat 2) elemental enteral nutrition into jejunum may be tolerated
LOW popularity HIGH profitability this menu item is a _____ and you should consider____
puzzle; whether or not it should stay
Most digestion in the stomach occurs in the
pyloric region
Is needed for the transport of amino acids
pyridoxine
This vitamin is involved in catabolism
pyridoxine
gluconeogenesis requires
pyridoxine (B6)
Isoniazid treats TB, but it depletes___ and can cause peripheral ___. You should take it with ___ because it interferes with vitamin ___, __, and ___.
pyridoxine; neuropathy, food; D; calcium, phosphorous
without thiamin, what happens?
pyruvate can't be converted into acetyl Coa for energy & heart muscle is deprived
What kinds of cereals should people on low Na diets avoid?
quick-cooking
observations compared from best to worst. (maybe on a scale of 1-4)
rank order aka ordinal scale variable
prime cost formula
raw food cost + direct labor costs
Somogyi Effect
reactive hyperglycemia (low BG stimulates hormones that made BG rise)
cash accounting
recognizes a transaction when cash is taken in/out
accrual accounting
recognizes revenues when earned/expenses when incurred regardless of when actual cash is released
general ledger
records/reports transactions categorized by acct number
When meat changes colors, what's the progression? Why?
red-->brown-->green caused by Myoglobin breakdown/oxidation
Motion economy
reduce motions & time required
What does detergent do to soil?
reduces surface tension
Osteoblasts
reform bone
Barriers to effective delegation
reluctance to delegate feel they can do it better, feel a loss of power, may be too disorganized to plan ahead, lack of confidence in subordinates
Adults diarrhea MNT
remove cause bowel rest (NPO) replace lost fluid & electrolytes
Acute infant/child diarrhea MNT
replace fluids & electrolytes lost FAST (WHO recommends glucose electrolyte solution bc cheaper/easier to obtain/just as effective as parenteral rehydration) reintroduce oral intake within 24 hrs
AKI in diuretic phase Na needs
replace losses
Osteoclasts
resorb/remove bone
a-linoleic acid is important for ___ __ and __ __. Deficiency results in :
retinal functions and brain development. Deficiency= neurological changes- blurred vision, numbness reduces hepatic production of VLDL
BUN:Cr of 20:1
reversible renal dmg; no dialiysis
Expectancy Theory Beer, Vroom
rewards are motivators they must be attractive to employee and employee must feel work leads to reward
If lips are swollen, red, dry, and cracked, you may be deficient in
riboflavin, Pyridoxine, or niacin
Food least likely to cause allergy
rice
Wagner National Labor Relations Act
right to organize & join labor union--Pro Labor
In this oven, food is in motion while inside, good for large volume baking
rotary, reel, revolving tray
perpetual inventory
running record of balance on hand; updated each time an item is placed in or removed from storage
Too much sugar in starch thickened pie recipe means ___ filling.
runny
To prevent curdling, add acids ___ to milk.
s l o w l y
most polyunsaturated fatty acid
safflower
This menu offers a complete meal at a set price.
table d'hote
Traditional/classical management
task focused, scalar principle (authority goes from highest to lowest echelons), mechanical, doesn't see group interactions
inferential statistics
techniques that allow you to assume conclusions beyond the group tested (may be applied to a larger group)
Carry over cooking
temps rise 15-25F within 10 mins or removing from cooking heat source
What organ does Crohn's affect
terminal ileum. (May lead to B12 deficiency)
As dz progresses, intervention to reduce severity is an example of ____ prevention
tertiary
chi square
tests whether or not there is a real difference between categories
Calcium binds
tetracycline
How does alcohol disrupts liver metabolism?
the hydrogen replaces fat as fuel in the Kreb's Cycle & fat accumulates in liver and blood, which increases TG
Loop diuretics deplete
thiamin, potassium, magnesium, calcium, sodium
As energy expenditure (calorie needs) increase, the need for these vitamins also increases
thiamin, riboflavin, niacin, Pantothenic acid B1, B2, B3, B5
Very versatile piece of equipment. Serves as oven, fry pan, braising pan, kettle, steamer, food warmer
tilting skillet
NFCS- National Food Consumption Survey
to obtain info on food intake of individuals and total households from entire US- evaluates 7 nutrients: protein, calcium, iron, thiamin,riboflavin, Vitamins C & A
Why do we use the acid/alkaline diet?
to prevent acidic/alkaline kidney stones
Why do you need a drying agent for rinse cycle in mechanical wash?
to reduce water spots
Coarse texture in cakes is caused by
too much baking powder, too much sugar, inadequate mixing too low oven temp
Tough/dry crumb in cakes is caused by
too much flour, egg, too much mixing, overbaking too little fat or sugar
Fallen center in cakes is caused by
too much sugar, fat, baking powder Inadequate mixing too low temperature, oven door opened early in cooking process
Formula for # of relief workers needed
total # of employees * 0.55
Formula for total # of workers needed including relief staff
total # of employees * 1.55
prevalence
total # of people with a disease during a period of time
assembly-serve
total convenience kitchen-less kitchen pros: low labor time, low equipment & space needs cons: limited menu, quality, acceptability
Cost of profit pricing
total food cost ÷ desired food cost % (as decimal)
What happens to an angel food cake with no acid?
tough, yellow, small
transactional vs transformational
transactional-clarifies roles/responsibilities, uses rewards/punishment transformational-agents of change--inspires followers to become leaders
PN concerns
translocation of bacteria (may cause sepsis) GALT-gut associated lymphoid tissue- is compromised by bowel rest or PN. Provides 50% of total body immunity
Sugar increases ____ and reduces ___ and ____ strength.
translucency viscosity gel strength
VLDL (pre-beta)
transports TG from liver to adipose cells
Chylomicron
transports dietary TG from gut to adipose cells synthesized in intestine from dietary fat lowest density due to smallest amt of PRO
homosystinurias
treatable inherited disorder of amino acid metabolism characterized by severe elevations of methionine and homocysteine
a-linoleNic acid will reduce ___ but have little effect on___
triglycerides; total cholesterol levels
60 mg ____= 1 mg niacin
tryptophan
What does gelatin do?
turns a liquid into an elastic solid
Reward, coercive, position, expert, referent
types of power referent (likeability)
If taken with MAOI, this can cause HTN
tyramine
