Fiser Chapter 10 NUTRITION Flashcards Preview

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Flashcards in Fiser Chapter 10 NUTRITION Deck (57)
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1

Caloric need

20-25 calories/kg/day

2

Calories in different forms

Fat 9 calories/g
Protein 4 calories/g
Oral carbohydrates 4 calories/g
Dextrose 3.4 calories/g

3

Nutritional requirements

20% protein
30% fat
50% carbohydrates

4

Trauma, surgery, sepsis increase kcal requirement

20-40% increase

5

Caloric need equation if overweight

weight = [(actual weight - ideal body weight) x 0.25] + IBW

6

Colonocyte fuel

Short-chain fatty acids (butyric acid)

7

Small bowel enterocyte fuel

Glutamine
Releases NH4 in kidney, helping with nitrogen excretion
Can be used for gluconeogenesis

8

Neoplastic cells fuel

glutamine

9

Albumin half life

18 days

10

Transferrin half life

10 days

11

Prealbumin half life

2 days

12

Acute indicators of nutrition

Retinal binding protein
Prealbumin
Transferrin

13

IBW

Men: 106 lb + 6 lb for each inch over 5ft
Women = 100 lb + 5 lb for each inch over 5 ft

14

Preop signs of poor nutrition

Acute weight loss > 10% in 6 months
Weight
Albumin < 3.0 (strong risk factor for M&M after surgery)

15

RQ ratio

CO2 produced : O2 consumed

16

RQ > 1

Lipogenesis (overfeeding)

17

RQ < 0.7

ketosis and fat oxidation (starvation)

18

RQ 0.7 exactly

Pure fat utilization

19

RQ 0.8 exactly

Pure protein utilization

20

RQ 1 exactly

Pure carbohydrate utilization

21

Postoperative phases

0-3 catabolic (negative nitrogen balance)
2-5 diuresis
3-6 anabolic (positive nitrogen balance)

22

Glycogen stores

Muscle and liver
Depleted after 24-36 hours, then fat
Muscle lacks G6Pase

23

Gluconeogensis precursors

AAs (alanine)
Lactate
Pyruvate
Glycerol

24

Do protein conserving mechanisms occur after trauma or surgery?

No due to catecholamines and cortisol

25

Do protein conserving mechanisms occur with starvation?

yes

26

Main source of energy in starvation and trauma

Fat (ketones)

Trauma: more mixed (fat and protein) than starvation

27

T/F most patients can tolerate a 15% weight loss without major cx?

True

28

How long can patients tolerate without eating, after which should start tube feeds or TPN?

7 days

29

Why is enteral feeding important?

To avoid bacterial translocation (bacterial overgrowth, increased permeability due to starved enterocytes, bacteremia) and TPN complications

30

What does brain use for energy?

Normally glucose --> ketones during starvation