FSM Calculations > MNT 1 > Flashcards

MNT 1 Flashcards

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1
Q

What characteristics are needed to be diagnosed with Metabolic Syndrome (MetS)?

A

Must have 3 or more of the following: elevated BP, hyperglycemia, decreased HDL (below 40 in men, below 50 in women), elevated triglycerides (over 150), high waist circumference (over 40 in men, over 35 in women).

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2
Q

ranges for Normal, elevated, stage 1, and stage 2 HTN

A
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3
Q

What is a low sodium diet?

A

1500-2300 mg/day or 1.5-2.3 g Na diet.

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4
Q

What is atherosclerosis?

A

Hardening and narrowing of blood vessels due to HTN, obesity, smoking, hyperlipidemia, family history, high homocysteine.

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5
Q

What are normal lab ranges for LDL?

A

<100.

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6
Q

What is the normal range for total cholesterol (TC)?

A

<200.

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7
Q

What is the normal range for HDL?

A

> 40 in men, >50 in women.

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8
Q

What is the normal range for triglycerides?

A

<150.

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9
Q

What is the MNT for atherosclerosis (cHD)?

A

25-30g of fiber, 2-3 g of plant stanols/sterols, low sat fat .

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10
Q

What is CHF?

A

Thickening of the left ventricle from increased work of myocardium, leading to fluid retention in tissues instead of circulation, causing edema and shortness of breath.

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11
Q

What is the MNT for CHF?

A

LOW SODIUM AND LOW FLUID
PRO: 1.1-1.4 g/kg

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12
Q

What is cardiac cachexia?

A

Advanced heart failure - involuntary weight loss and muscle wasting

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13
Q

What is type 1 diabetes mellitus?

A

An autoimmune disease causing insulin deficiency that requires exogenous insulin. Risk: having GADA antibodies.

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14
Q

What is type 2 diabetes mellitus?

A

Insulin resistance is caused by obesity, inflammation, hypertension, smoking, etc. Common sign: acanthosis nigricans (insulin resistance).

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15
Q

What are the fasting plasma glucose (FPG) normal, impaired, and diabetes lab ranges?

A

Normal: 70-100, Impaired: 100-125, DM: >126.

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16
Q

What are the OGTT (2 hrs post prandial BS) normal, impaired, and diabetes lab ranges?

A

Normal: <140, Impaired: 140-199, DM: >200.

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17
Q

Hg A1C ranges?

A

Anyone: <5.7%, Over 65: <7%, Frail Elderly: <8%, At risk: 5.7-6.4%, DM: >6.5%, Goal: <7%.

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18
Q

Humulin R and Novolin R

A

Regular and Short Acting
BOLUS
Onset time - 30-45 min before eating
Lasts 3-6 hrs

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19
Q

Nonolog/Humalog

A

RAPID acting
take 5-15 min before eating
lasts 4 hrs
BOLUS

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20
Q

Lantus/Levemir

A

LONG acting
Onset 2-4 hrs
lasts 18-24 hrs
BASAL

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21
Q

Humlin N/Novolin N

A

Intermediate
Onset 2-4 hours
Lasts 10-16 hours
BASAL

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22
Q

What are Biguanides?

A

First line therapy, take with food.
Medication: Metformin (Glucophage).
Suppresses liver glucose production (gluconeogenesis).
Side effect: B12 deficiency (anemia, peripheral neuropathy).

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23
Q

What are SGLT2 Inhibitors?

A

For those with CKD and T2D or CAD and T2D. Medications: Jardiance, Invokana, Farxiga
Blocks renal glucose reabsorption (more glucose in urine)
leads to weight loss.

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24
Q

What are GLP-1 Receptor Agonists?

A

Medications: Byetta, Trulicity, Ozempic.
Slows gastric emptying, enhances insulin secretion post meals, suppresses glucagon, increases satiety,
leads to weight loss.

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25
What are DPP4 Inhibitors?
Often taken with metformin. Medications: Januvia, Onglyza. Allows endogenous GLP1 to stay active longer, reduces glucose from liver overnight and between meals, weight neutral.
26
What are Thiazolidinones?
Medication: Actos. Insulin sensitizer, improves insulin sensitivity - does not cause hypoglycemia leads to weight gain.
27
What are Sulfonylureas?
May cause hypoglycemia. Medications: Glimepiride (Amaryl), Glipizide (Glucotrol). Causes pancreas to release more insulin, leads to weight gain.
28
What DM meds can cause hypoglycemia?
Sulfonylureas Meglitinides Humlin R/Novolin R NovologHumalog Lantus/Levemir Humulin N/Novolin N
29
What is the MNT for gestational diabetes mellitus?
40-45% CHO (175g/day) with less CHO at breakfast (15-30g) since insulin resistance is highest in the morning. Sometimes need to take insulin.
30
What is the rule for hypoglycemia?
15:15:15 - 15 g of simple glucose, wait 15 min, if not above 70 give another 15g of simple glucose.
31
What vitamin do kidneys convert to the active form?
Vitamin D.
32
What hormones do the kidneys secrete?
Vasopressin, Renin, EPO.
33
What is the function of vasopressin?
Stimulates the kidneys to reabsorb water when BP is low.
34
What is the function of renin?
Stimulates the secretion of aldosterone, which stimulates the kidneys to reabsorb sodium when BP is low.
35
What is the function of EPO?
Stimulates red bone marrow to create new RBC.
36
What are the BUN lab ranges?
10-20.
37
What is urea?
Byproduct of protein metabolism - related to protein intake.
38
What are the normal creatinine ranges?
Males: 0.6-1.2, Females: 0.5-1.1.
39
What does elevated BUN and creatinine indicate?
Related to renal problems.
40
What are the sodium ranges?
135-145 mEq/L.
41
What are the potassium ranges?
3.5-5 mEq/L.
42
What are the phosphorus ranges?
3.0-4.5 mg/dL.
43
What BUN to creatinine ratio suggests AKI and also suggests for dialysis?
>20:1 AKI, <10:1 Dialysis.
44
As kidney function decreases, what happens to energy needs?
Increases.
45
What is AKI?
Oliguria (little urine production) and azotemia (increased blood urea (BUN) because kidneys can't get rid of it). Symptoms: fatigue, confusion, lethargy, nausea/vomiting/diarrhea, anorexia, rapid pulse, impaired serum levels of electrolytes (low sodium, high phosphorus and potassium).
46
What are the protein and calorie needs for AKI?
1-1.3 g/kg without dialysis 1.2-1.5 g/kg on dialysis 25-40 cals/kg low electrolytes depending on labs.
47
What are the CKD stages and GFR ranges?
Stage 1: >=90 Stage 2: 60-90 Stage 3: 30-59 Stage 4: 15-29 Stage 5: <15 (dialysis).
48
What are the calories and protein needs for CKD?
23-35 cals/kg Stage 1: 0.8-1.4 g/kg Stage 3,4: 0.6-0.8 g/kg.
49
What are the GFR, BUN, and creatinine levels during ESRD (CKD stage 5)?
GFR will be below 15, BUN will be above 100, creatinine will be between 10-12.
50
What is the MNT for hemodialysis?
HIGH PROTEIN: 1.2+ g/kg of HBV protein. <60 years: 35 kcal/kg, >60 years or obese: 30-35 kcal/kg. Supplements: vitamin C, B6, folate, B12, iron, zinc, vitamin D.
51
What is the MNT for peritoneal dialysis?
1.2-1.3 g/kg of HBV protein. Calories: <60 years: 35 kcal/kg, >60 years or obese: 30-35 kcal/kg. Same supplements as hemodialysis but ****include thiamin due to increased CHO absorption.****
52
What is transferrin?
>200. Iron transporter, increases when iron is low.
53
What is Mean Corpuscular Volume (MCV)?
80-95. Size of RBC.
54
What is Mean Corpuscular Hemoglobin (MCH)?
27-32. Amount of hemoglobin in a RBC (will affect the redness of the cell).
55
What are the hemoglobin ranges for males, females, and pregnant women?
Male: 14-18, Female: 12-16, Pregnant: 11 or higher, Infants: 10 or higher.
56
What is hematocrit?
Male: 42-52%, Female: 36-48%, Pregnant: 33%, Newborn: 44-64%. What percentage of your blood is made up of RBC.
57
What are the ferritin ranges?
Male: 10-150, Female: 12-300. Iron storage.
58
Deficiency in iron (Fe) causes what type of anemia?
Microcytic hypochromic anemia. Will also see low hemoglobin, MCV, MCH, iron, ferritin, high TIBC and transferrin.
59
Deficiency of B6 (pyridoxine) causes what type of anemia?
Microcytic anemia. Low hemoglobin, hematocrit, and B6.
60
Deficiency of B9 (folate) causes what type of anemia?
Macrocytic anemia. Low hemoglobin, hematocrit, and folate.
61
Deficiency of B12 (cyanocobalamin) causes what type of anemia?
Macrocytic anemia (also called pernicious anemia). Low hemoglobin, hematocrit, and B12, high MCV/MCH.
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