Calculations/Equations Flashcards

(40 cards)

1
Q

Nitrogen content of protein

A

Nitrogen content = g protein x .16
AKA 16% of protein is nitrogen

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2
Q

Holliday Segar Method

A

First 10kg = 100ml/kg
Second 10kg = 50ml/kg
>20kg = 20ml/kg
If over 50, 15ml/kg
Cant use in those <14 days

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3
Q

Free Water Deficit

A

TBW x 1-(140/measured Na)

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4
Q

Total Body Water

A

Weight in kg x .6

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5
Q

Fluid Distribution

A

ICF = 66% of TBW
ECF = 33% of TBW
-Intravascular = 25% of ECF
-Interstitial = 75% of ECF

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6
Q

Respiratory Quotient

A

.7 = lipid oxidation
.82 = amino acid
.85 = mixed substrate
1 = carb breakdown

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7
Q

Corrected Calcium

A

Measured Calcium + .8 x (4-alb)

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8
Q

Corrected Sodium

A

Measured Na + [.016 x (BG-100)]

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9
Q

Nutrients Absorbed in the Stomach

A

Fluoride
Iodine

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10
Q

Nutrients Absorbed in the Duodenum

A

Fat soluble ADEK
Water soluble B vits (thia, ribo, nia, bio, fol) , except B12/B5/B6
Minerals Fe,Ca, Phos, Mg, Cu, Se, Io
All except choline, Zn, Mang, Chrom, Moly

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11
Q

Nutrients Absorbed in the Jejunum

A

AA
Monosaccharides
Lipids - glycerol, FFA

Fat soluble ADEK
Water soluble B vits (thia, ribo, nia, panto, bio, fol, pyrid, Vit C
MInerals Ca, Phos, Mg, Fe, Zn, Chro , Mang

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12
Q

Nutrients Absorbed in the Ileum

A

Bile salts and acids

Fat soluble - Vit D, Vit K
Vit C, Folate, B12
Mg

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13
Q

Nutrients Excreted by Bile/Stool

A

Fat soluble vits
Fe
Zn
Cu
Mang
Se

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14
Q

Nutrients Excreted in Urine

A

Water soluble except B12/folic acid
Choline
Cu (very little)
Se
Chrom
Iodine
Fluoride
Moly

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15
Q

Nutrients recycled by enterohepatic circulation

A

B12
Folic acid/B9

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16
Q

Vit A deficiency/toxicity

A

Deficiency - night blindness, follicular hyperkaratosis, impaired wound healing
Cause - fat malabsorption
Nutrient interactions: low ZN reduces Vit A

Toxicity - Alopecia, Ataxia, Prutitus

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17
Q

Vitamin D Deficiency/Toxicity

A

Deficiency - Tetany, Osteomalacia, hypoCa
Cause - fat malabsorption, renal disease,** LT PN support,** meds (steroids, isonizid, phenytoin)
Nutrient interactions: Excess vit D = excretion of vit K

Toxicity - Soft tissue calcification, confusion, tremor

18
Q

Vitamin E Deficiency/Toxicity

A

Deficiency - Age spots, ataxia, hemolytic anemia
Causes - Fat malabsorption,** LT PN without supplementation**
Nutrient interactions: Excess supp interferes with Vit K and warfarin

Toxicity - Bruising, thrombocytopenia, cerebral hemorrhage

19
Q

Vitamin K Deficiency/Toxicity

A

Deficiency - Bruising, prolonged bleeding, decreased bone density
Causes - Fat malabsorption, ABX, LT PN without ILE
Nutrient interactions: Excess vit A/E decreased Vit K absorption, excess vit D increases excretion

Toxicity - no toxicity

20
Q

Vitamin C Deficiency/Toxicity

A

Deficiency - Capillary rupture, delated wound healing, corkscrew hairs
Causes - Older adults, cancer, alcohol/tobacco, hyper BG = less transport
Nutrient interactions: Vit C increases iron absorption

Toxicity - N/V/D, renal stone

21
Q

Vitamin B1 Deficiency/Toxicity

A

Thiamine
Dry beriberi - muscle weakness
Wet beriberi - reduced cardiac output, encephalopathy, nystagmus
Causes - alcoholism, **LT PN **or HD, refeding, hyperemesis
Nutrient interactions: repletion only possible if Mg WNL, needed to activate

Toxicity - no toxicity

22
Q

Vitamin B2 Deficiency/Toxicity

A

Riboflavin
Deficiency - dermatitis, cheilosis, normochromic normocytic anemia
Causes - critically ill
Nutrient interactions: Alcohol, Cu, Zn, Fe and mang can form chelates and prevent absorption

Toxicity - no toxicity

23
Q

Vitamin B3 Deficiency/Toxicity

A

Niacin
Deficiency - Pellagra: dermatitis, diarrhea, dementia
Causes - older adult, alcohol, isonizaid/mercaptopurine
Nutrient interactions: needed for activation of folate

Toxicity - flushing, heat, GI upset, glucose intolerance

24
Q

Vitamin B6 Deficiency/Toxicity

A

Pyridoxine
Deficiency - Microcytic anemia, seborrheic dermatitis, cheilosis
Causes - AUD, HD, older adults
Nutrient interactions: leads to alterations in AA

Toxicity - derm lesions, ataxia, sensory neuropathy

25
Vitamin B12 Deficiency/Toxicity
Cyanocobalamin Deficiency - Cognitive decline, **megaloblastic anemia,** thrombocytopenia, bone marrow Causes - vegetarian diet, low HCl secretion Nutrient interactions: excess vit C can temporarily impair/destroy B12 Toxicity - no toxicity
26
Vitamin B9 Deficiency/Toxicity
Folic acid Deficiency - Cheilosis, **megaloblastic or macrocytic anemia,** diarrhea Causes - AUD, pregnancy, phenytoin/chlostyramine/sulfasalazine Nutrient interactions: Zn can impair absorption Toxicity - seizures
27
Vitamin B7 Deficiency/Toxicity
Biotin Deficiency - elevated cholesterol, leythargy, dementia, hypotonia Causes - AUD**, LT PN**, partial gastrectomy Toxicity - no toxicity
28
Vitamin B5 Deficiency/Toxicity
Pantothenic Acid Deficiency - poor wound healing, N/V/D, NM disturbances Causes - in conjunction with other nutrient deficiencies, DM, ID, ethanol intake Toxicicity - no toxicity
29
Choline Deficiency/Toxicity
Deficiency - visual/verbal impairment, hepatic steatosis Causes - pregnancy/lactation, hyper metabolic state, LT PN Nutrient Interactions: Choline can replace B12 to form homocystein Toxicity - sweating, salivation, hypotension, anorexia, fishy body odor, hepatotoxicity
30
Iron Deficiency/Toxicity
Deficiency - pallor, **hypochromic anemia**, nausea Causes - blood loss, decreased gastric acid, roux-en-y Nutrient interactions: non-heme reduced by phytic acid, oxalic acid, polyphenols, Ca, Zn, mang. Chrom toxicity contributes to iron anemia Toxicity - skin pigmentation, organ damage Cause - hemochromatosis
31
Zinc Deficiency/Toxicity
Deficiency - rash, smell/taste alterations, immune/wound, alopecia Causes - older adults, postop, AUD, burns, renal disease Nutrient interactions: Zn deficiency can cause vit A deficiency. High levels of Ca/Fe comepete. HIgh Zn completes with Cu Toxicity - GI distress, N/V, decreased HDL
32
Copper Deficiency/Toxicity
Deficiency - Hypopigmentation, **hypochromic microcytic anemia,** parasthesia Causes - Undernutrition with chronic diarrhea Nutrient Interactions: phytates, dietary fiber, large dose Zn, inron, large dose Ca gluc, excess moly = urindary loss, large dose Vit C andcopepr deficiency can reduce absorption Toxicity - Kayser-Fleisher rings, metallic taste, blood in urine Causes - Wilson's disease, liver disease
33
Manganese Deficiency/Toxicity
Deficiency - Rare - Ataxia, Growth retardation, defects in lipid/carb metabolism Causes - hepatobiliary disease**, LT PN with biliary duct obstruction** Nutrient Interaction: competes with iron Toxicity - hyperirritability, Parkinson-like, immune/reproductive dysfunction
34
Selenium Deficiency/Toxicity
Deficiency - N/V, cardiomyopathy/Keshan's, altered thyroid Causes - **LT PN support without supplementation,** thermal injury, statin Nutrient Interaction: selenium deficiency reduces iodine function Toxicity - skin lesions, hair/nail loss, peripheral neuropathy
35
Iodine Deficiency/Toxicity
Deficiency - Decreased TSH, goiter, weight loss, tachy Causes - low sodium diet, low levels in soil Nutrient interactions: selenium deficiency reduces iodine function Toxicity - Elevated TSH
36
Chromium Deficiency/Toxicity
Deficiency - peripheral neuropathy, weight loss, increased BG, glycosuria, elevated FFA Causes -** LT PN without supplementation,** T2DM/pregnancy Nutrient interactions: Fe competes with binding Toxicity - rhabdo, liver dysfunction, renal failure
37
Fluoride Deficiency/Toxicity
Deficiency - increased risk of dental caries Causes - Unfloridated water Nutrient interactions: Ca and Mg form insoluble complexes when combined with fluoride Toxicity - Lacrimation, excess salivation, fluorosis, arrythmias
38
Molybdenum Deficiency/Toxicity
Deficiency - AMS, Tachy, N/V, altered vision Causes - **LT PN** Nutrient interactions: moderate doses associated with copper wasting in urine Toxicity - hyperuricemia, gout-like symptoms
39
Deficiencies that cause anemia
Vit E - Hemolytic anemia (infants) Riboflavin/B2 - Normochromic normocytic anemia Pyridoxine/B6 - Microcytic anemia Cyanocobalamin/B12 - Megaloblastic anemia Folic acid/B9 - Macrocytic anemia Iron - Hypochromic anemia Copper - Hypochromic microcytic anemia
40
Osmolarity of TPN/PPN
Amino acid 1g = 10 mOsm Dextrose 1g = 5 mOsm Add these together and divide by total volume. In our case: Amino acid 75g = 750 mOsm Dextrose 210g = 1050 mOsm 750 mOsm + 1050 mOsm = 1800 mOsm/3000mL = 600 mOsm/L