CNSC STUDY GUIDE EXAMS ALL QUESTIONS AND
ANSWERS SURE A+
✔✔What lab value is a significant predictor of morbidity and mortality in critically ill
patients? - ✔✔Albumin
✔✔What can compromise the reliability of urinary urea nitrogen to calculate nitrogen
balance? - ✔✔Creatinine clearance < 50 mL/min
✔✔What can reduce plasma homocysteine concentrations? - ✔✔Folic acid
B6
B12
✔✔Fluid requirements for healthy adults - ✔✔35 mL/kg for 18-55 yo
30 mL/kg for 55-75 yo
25 mL/kg for >75 yo
<25 mL/kg when fluid restriction indicated
✔✔Iron is primarily absorbed in the - ✔✔Duodenum and Jejunum (in ferrous state)
✔✔Which amino acid is essential for small intestinal structure and function? -
✔✔Glutamine
,✔✔PKU is caused by a... - ✔✔deficiency of phenylalanine hydroxylase (PAH)
✔✔Conditionally indispensable amino acids - ✔✔Require a dietary source in order to
meet increased needs caused by metabolic stress.
Arginine (wound healing)
Cysteine
Glutamine
Glycine
Proline
Tyrosine
✔✔Symptoms of Essential Fatty Acid Deficiency - ✔✔Scaly dermatitis
Alopecia
Thrombocytopenia
Anemia
Impaired wound healing
✔✔What IV fluid most closely resembles jejunal and ileal electrolyte content? -
✔✔Lactated Ringer's (LR)
✔✔Supplementation of Vitamin A should be given for a maximum of - ✔✔14 days
✔✔DKA puts a patient at high risk for low... - ✔✔phosphate (hypophosphatemia)
✔✔The risk of metastatic calcification in soft tissues begins to increase when the
product of calcium x phosphorus exceeds... - ✔✔55
✔✔What is the most common cause of zinc deficiency? - ✔✔Diarrhea
✔✔Liver disease can lead to toxicity of what mineral? - ✔✔Copper (80% of copper is
excreted in the bile, liver patients should be monitored)
✔✔What trace element may improve hepatic encephalopathy? - ✔✔Zinc
✔✔What is the benefit of aluminum in the PN? - ✔✔None, no biologic function
Often a contaminant in PN or in medic such as antacids or sucralfate
✔✔What can cause an invalid indirect calorimetry measurement? - ✔✔Air leaks (leaking
chest tube, bronchopleural fistula)
High mechanical vent settings (FiO2 >60% or PEEP > 12 cm H20)
Hemodialysis (loss of CO2)
, ✔✔Respiratory Quotient values - ✔✔0.71 primarily fat oxidation
0.82 primarily protein oxidation
0.85 mixed substrate utilization
1.0 carbohydrate oxidation
✔✔Cheilosis is associated with... - ✔✔Cheilosis: cracking of corners of mouth
Deficiency of:
Riboflavin
Niacin
Iron
Pyridoxine
✔✔Ascites treatment includes - ✔✔Fluid and sodium restriction
✔✔What is the normal length of small intestine in adults? - ✔✔300 to 600 cm
✔✔Where is fat absorbed in the GI tract? - ✔✔Duodenum and proximal jejunum
✔✔Gastrectomy patients are at risk for deficiency of... - ✔✔B12
✔✔Which part of the GI tract has the least impact on nutrient absorption and intestinal
adaptation following significant intestinal resection? - ✔✔Jejunum (ileum can adapt well,
if you lose ileum D&J can't adapt; colon loss leads to fluid loss)
✔✔Valproic acid (epileptic drug) can cause what deficiency? - ✔✔Carnitine
✔✔Methotrexate (chemo drug) interferes with the normal intracellular metabolism of
what nutrient? - ✔✔Folate
✔✔Which trace element accumulation is associated with Wilson's disease? -
✔✔Copper
✔✔The acute phase response has what effect on serum iron and ferritin levels? -
✔✔Decreases serum iron levels
Increases serum ferritin levels
✔✔The majority of dietary folate is reabsorbed via... - ✔✔Enterohepatic circulation
✔✔Which tests can be used to assess vitamin A status? - ✔✔1. Serum retinol
concentration
2. Plasma transthyretin-retinol binding protein (TTR-RBP) concentration
3. Serum retinol binding protein level
ANSWERS SURE A+
✔✔What lab value is a significant predictor of morbidity and mortality in critically ill
patients? - ✔✔Albumin
✔✔What can compromise the reliability of urinary urea nitrogen to calculate nitrogen
balance? - ✔✔Creatinine clearance < 50 mL/min
✔✔What can reduce plasma homocysteine concentrations? - ✔✔Folic acid
B6
B12
✔✔Fluid requirements for healthy adults - ✔✔35 mL/kg for 18-55 yo
30 mL/kg for 55-75 yo
25 mL/kg for >75 yo
<25 mL/kg when fluid restriction indicated
✔✔Iron is primarily absorbed in the - ✔✔Duodenum and Jejunum (in ferrous state)
✔✔Which amino acid is essential for small intestinal structure and function? -
✔✔Glutamine
,✔✔PKU is caused by a... - ✔✔deficiency of phenylalanine hydroxylase (PAH)
✔✔Conditionally indispensable amino acids - ✔✔Require a dietary source in order to
meet increased needs caused by metabolic stress.
Arginine (wound healing)
Cysteine
Glutamine
Glycine
Proline
Tyrosine
✔✔Symptoms of Essential Fatty Acid Deficiency - ✔✔Scaly dermatitis
Alopecia
Thrombocytopenia
Anemia
Impaired wound healing
✔✔What IV fluid most closely resembles jejunal and ileal electrolyte content? -
✔✔Lactated Ringer's (LR)
✔✔Supplementation of Vitamin A should be given for a maximum of - ✔✔14 days
✔✔DKA puts a patient at high risk for low... - ✔✔phosphate (hypophosphatemia)
✔✔The risk of metastatic calcification in soft tissues begins to increase when the
product of calcium x phosphorus exceeds... - ✔✔55
✔✔What is the most common cause of zinc deficiency? - ✔✔Diarrhea
✔✔Liver disease can lead to toxicity of what mineral? - ✔✔Copper (80% of copper is
excreted in the bile, liver patients should be monitored)
✔✔What trace element may improve hepatic encephalopathy? - ✔✔Zinc
✔✔What is the benefit of aluminum in the PN? - ✔✔None, no biologic function
Often a contaminant in PN or in medic such as antacids or sucralfate
✔✔What can cause an invalid indirect calorimetry measurement? - ✔✔Air leaks (leaking
chest tube, bronchopleural fistula)
High mechanical vent settings (FiO2 >60% or PEEP > 12 cm H20)
Hemodialysis (loss of CO2)
, ✔✔Respiratory Quotient values - ✔✔0.71 primarily fat oxidation
0.82 primarily protein oxidation
0.85 mixed substrate utilization
1.0 carbohydrate oxidation
✔✔Cheilosis is associated with... - ✔✔Cheilosis: cracking of corners of mouth
Deficiency of:
Riboflavin
Niacin
Iron
Pyridoxine
✔✔Ascites treatment includes - ✔✔Fluid and sodium restriction
✔✔What is the normal length of small intestine in adults? - ✔✔300 to 600 cm
✔✔Where is fat absorbed in the GI tract? - ✔✔Duodenum and proximal jejunum
✔✔Gastrectomy patients are at risk for deficiency of... - ✔✔B12
✔✔Which part of the GI tract has the least impact on nutrient absorption and intestinal
adaptation following significant intestinal resection? - ✔✔Jejunum (ileum can adapt well,
if you lose ileum D&J can't adapt; colon loss leads to fluid loss)
✔✔Valproic acid (epileptic drug) can cause what deficiency? - ✔✔Carnitine
✔✔Methotrexate (chemo drug) interferes with the normal intracellular metabolism of
what nutrient? - ✔✔Folate
✔✔Which trace element accumulation is associated with Wilson's disease? -
✔✔Copper
✔✔The acute phase response has what effect on serum iron and ferritin levels? -
✔✔Decreases serum iron levels
Increases serum ferritin levels
✔✔The majority of dietary folate is reabsorbed via... - ✔✔Enterohepatic circulation
✔✔Which tests can be used to assess vitamin A status? - ✔✔1. Serum retinol
concentration
2. Plasma transthyretin-retinol binding protein (TTR-RBP) concentration
3. Serum retinol binding protein level
