CNSC Exam 2023 Already Passed!!

CNSC Exam 2023 Already Passed!! Microcytic hypochromic anemia is a result of a deficiency in... - Answer Iron or Copper Macrocytic anemia results from a deficiency of... - Answer B12 or Folate Consequences of long-term parenteral nutrition - Answer Anemia Leukopenia Neutropenia Skeletal abnormalities Symptoms of copper deficiency - Answer Sensory ataxia Lower extremity spasticity Parathesis in extremities Leukopenia Neutropenia Hypercholesterolemia Increased erythrocyte turnover Decreased ceruloplasmin and erythrocyte copper/zinc superoxide dismutase (SOD) Abnormal EKG patterns Myeloneuropathy What change should be made to the PN for a patient with high ileostomy output? - Answer Increase sodium and increase fluid volume (high output leads to water and Na loss) Acute disease-associated malnutrition symptoms - Answer Hypalbuminemia Edema Anasarca % body weight loss to meet malnutrition criteria - Answer 5% or more in 1 month 7.5% or more in 3 months 10% or more in 6 months Stress vs Starvation related malnutrition - Answer Stress: hypermetabolism, hypergylcemia, lipolysis Starvation: ketosis, hypoglycemia, lipolysis Subjective Global Assessment includes - Answer Historical: Weight history Dietary intake GI symptoms Functional status Metabolic demand Physical Exam Parameters: Subcutaneous fat Muscle wasting Edema Ascites CNSC Exam 2023 Already Passed!! What lab value is a significant predictor of morbidity and mortality in critically ill patients? - Answer Albumin What can compromise the reliability of urinary urea nitrogen to calculate nitrogen balance? - Answer Creatinine clearance 50 mL/min What can reduce plasma homocysteine concentrations? - Answer Folic acid B6 B12 Fluid requirements for healthy adults - Answer 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 - Answer Duodenum and Jejunum (in ferrous state) Which amino acid is essential for small intestinal structure and function? - Answer Glutamine PKU is caused by a... - Answer deficiency of phenylalanine hydroxylase (PAH) Conditionally indispensable amino acids - Answer 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 - Answer Scaly dermatitis Alopecia Thrombocytopenia Anemia Impaired wound healing What IV fluid most closely resembles jejunal and ileal electrolyte content? - Answer Lactated Ringer's (LR) Supplementation of Vitamin A should be given for a maximum of - Answer 14 days DKA puts a patient at high risk for low... - Answer phosphate (hypophosphatemia) The risk of metastatic calcification in soft tissues begins to increase when the product of calcium x phosphorus exceeds... - Answer 55 What is the most common cause of zinc deficiency? - Answer Diarrhea Liver disease can lead to toxicity of what mineral? - Answer Copper (80% of copper is excreted in the bile, liver patients should be monitored) What trace element may improve hepatic encephalopathy? - Answer Zinc What is the benefit of aluminum in the PN? - Answer 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? - Answer 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 - Answer 0.71 primarily fat oxidation 0.82 primarily protein oxidation 0.85 mixed substrate utilization 1.0 carbohydrate oxidation Cheilosis is associated with... - Answer Cheilosis: cracking of corners of mouth Deficiency of: Riboflavin Niacin Iron Pyridoxine Ascites treatment includes - Answer Fluid and sodium restriction What is the normal length of small intestine in adults? - Answer 300 to 600 cm Where is fat absorbed in the GI tract? - Answer Duodenum and proximal jejunum Gastrectomy patients are at risk for deficiency of... - Answer B12 Which part of the GI tract has the least impact on nutrient absorption and intestinal adaptation following significant intestinal resection? - Answer 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? - Answer Carnitine Methotrexate (chemo drug) interferes with the normal intracellular metabolism of what nutrient? - Answer Folate Which trace element accumulation is associated with Wilson's disease? - Answer Copper.