Nutrition Midterm Study Guide
Chapter 1
1. What are the consequences of inadequate nutrition?
a. Malnutrition or overweight/obesity
2. Is malnutrition an issue in the US?
a. Yes, just because they don’t appear like starving children doesn’t mean they aren’t
hungry or malnourished.
3. Who is especially at risk of malnutrition beyond children?
a. Elderly patients – living at home or in nursing homes
4. Define food insecurity.
a. Lack of access to food to fully meet basic needs at all times due to lack of financial
resources
5. What is obesity associated with?
a. ↑ Risk of diabetes, coronary heart disease, hyperlipidemia, HTN, Stroke, GB disease,
sleep apnea, osteoarthritis, respiratory problems, and certain cancers to name a few.
6. Define nutritional assessment.
a. The evaluation of an individual’s nutritional status based on the interpretation of clinical
information.
7. What is the importance of an accurate nutritional assessment?
a. Malnutrition and obesity are common the clinical setting. Therefore, a correct nutritional
assessment can lead to the correct diagnosis and treatment from which many patients
can benefit.
8. Under which portion of the history does the diet history fall?
a. Social
9. Define nutritional supplement.
a. Any product that can alter caloric, vitamin, or protein intake
10. Dietary preferences may be related to:
a. Religious or cultural beliefs
11. When evaluating smoking, alcohol, drug, and caffeine use, what components need to be
included?
a. Duration, frequency, amount
12. What do we need to recognize the need for as Pas relating to nutrition?
a. Need for RD referral and nutritional services
13. Who needs a consistent, detailed diet history?
a. Infants/children/adolescents, pregnancy women, older adults/elderly, patients with
PMH/FH of co-morbidities associated with obesity
14. Define diet history.
a. General or broad screening questions for all patients and more specific questioning
helpful for patients with certain disease states?
15. What question should you always ask?
a. Do you have a healthy balanced diet?
16. When asking specific diet history, what should you focus on for each of the following conditions:
hyperlipidemia, HTN, DM?
, a. Fats
b. Salts
c. Carbohydrates
17. Name the different questioning methods and tools available. Which as retrospective and which
are prospective?
a. Retrospective - 24-hour recall, unusual intake/diet history, food frequency questionnaire,
b. Prospective - 3-day food record
18. What are the cons of the 24-hour recall?
a. Patients may overestimate or underestimate if generalizing based on one day; relies on
patient recollection
19. What is the pro to the usual intake/diet history?
a. Approach provides more information about usual intake patterns, reflects longer term
habits with better accuracy
20. What is the con to the usual intake/diet history method?
a. Patients may only report what they know or think to be healthy
21. What is the food frequency questionnaire used for?
a. Determine trends in patients’ usual consumption of specific foods; geared toward
whatever condition the patient has; evaluates current intake of specific foods
22. Which method is the most accurate?
a. 3-day food record
23. What is the con to the 3-day food record?
a. Difficult for some patients to keep written logs
24. How do you calculate BMI?
a. Weight (kg)/height (m^2)
b. ((weight (lbs.))/(height (in^2)))*703
25. What is considered a normal BMI?
a. 18.5-24.9 kg/m^2
26. How is energy expressed?
a. Kilocalories
27. Based on 1 gram, how many kcals do you get from: protein, carbohydrate, fat, or alcohol?
a. Protein – 4
b. Carbohydrate – 4
c. Fat – 9
d. Alcohol – 7
28. What equation estimates energy requirements?
a. Mifflin-St. Jeor Equation
29. What is the Mifflin – St. Jeor Equation
a. (10*weight in kg)+(6.25*height in cm) – (5*age in years); +5 for males; -161 for females
30. When is waist circumference helpful?
a. In patients with a BMI <35
31. Why is waist circumference important?
a. Independent risk factor for diabetes, dyslipidemia, HTN, CV disease
32. What are the waist circumference values?
a. >102cm (40in) male
, b. >88cm (35in) female
33. How do you calculate percent weight change?
a. ((Usual weigh-current weight)/(usual weight))*100
34. Nutrition oriented aspects of the physical exam focus where?
a. Skin, hair, eyes, mouth, nails, extremities, abdomen, skeletal muscle, fat stores
35. What skin PE findings are associated with nutritional implications?
a. Rashes, dermatitis, bruising, petechia, purpura, changes in pigmentation, pressure
ulcers, paleness, pallor, thickening, dryness
36. What hair PE findings are associated with nutritional implications?
a. Dyspigmentation, easy pluckability, alopecia
37. What head PE findings are associated with nutritional implications?
a. Temporal muscle washing, delayed closure of fontanelle
38. What eye PE findings are associated with nutritional implications?
a. Night blindness, xerosis, bitot spots, corneal vascularization, keratomalacia,
photophobia, blurring, conjunctival inflammation, macular degeneration
39. What mouth PE findings are associated with nutritional implications?
a. Angular stomatitis, bleeding gums, cheilosis, fissuring, scarlet, raw tongue, nasolabial
seborrhea, dental caries, hypogeusia, glossitis, papillary atrophy/smooth tongue
40. What neck PE findings are associated with nutritional implications?
a. Goiter, parotid enlargement
41. What thoracic PE findings are associated with nutritional implications?
a. Rickets rosary, thoracic rachitic rosary
42. What abdominal PE findings are associated with nutritional implications?
a. Abdominal obesity, diarrhea, hepatomegaly/ascites
43. What cardiac PE findings are associated with nutritional implications?
a. Heart failure
44. What genital/urinary PE findings are associated with nutritional implications?
a. Delayed puberty, hypogonadism
45. What extremity/musculoskeletal PE findings are associated with nutritional implications?
a. Ataxia, bone ache, joint pain, bone tenderness, kyphosis, edema, hyporeflexia, growth
retardation, failure to thrive, muscle wasting and weakness, tenderness of long bones,
squaring of shoulders – loss of deltoid
46. What nail PE findings are associated with nutritional implications?
a. Transverse lines, spooning of nails
47. What neurological PE findings are associated with nutritional implications?
a. Dementia, delirium, disorientation, loss of reflexes, wrist drop, foot drop,
ophthalmoplegia, peripheral neuropathy, tetany, carpopedal spas
48. Why should a nutritional assessment always be included in the H&P?
a. Children – evaluate growth and development; children and adults – assess for nutrient
excess/deficiency
Chapter 2
1. What does RDA stand for?
a. Recommended daily allowance
Chapter 1
1. What are the consequences of inadequate nutrition?
a. Malnutrition or overweight/obesity
2. Is malnutrition an issue in the US?
a. Yes, just because they don’t appear like starving children doesn’t mean they aren’t
hungry or malnourished.
3. Who is especially at risk of malnutrition beyond children?
a. Elderly patients – living at home or in nursing homes
4. Define food insecurity.
a. Lack of access to food to fully meet basic needs at all times due to lack of financial
resources
5. What is obesity associated with?
a. ↑ Risk of diabetes, coronary heart disease, hyperlipidemia, HTN, Stroke, GB disease,
sleep apnea, osteoarthritis, respiratory problems, and certain cancers to name a few.
6. Define nutritional assessment.
a. The evaluation of an individual’s nutritional status based on the interpretation of clinical
information.
7. What is the importance of an accurate nutritional assessment?
a. Malnutrition and obesity are common the clinical setting. Therefore, a correct nutritional
assessment can lead to the correct diagnosis and treatment from which many patients
can benefit.
8. Under which portion of the history does the diet history fall?
a. Social
9. Define nutritional supplement.
a. Any product that can alter caloric, vitamin, or protein intake
10. Dietary preferences may be related to:
a. Religious or cultural beliefs
11. When evaluating smoking, alcohol, drug, and caffeine use, what components need to be
included?
a. Duration, frequency, amount
12. What do we need to recognize the need for as Pas relating to nutrition?
a. Need for RD referral and nutritional services
13. Who needs a consistent, detailed diet history?
a. Infants/children/adolescents, pregnancy women, older adults/elderly, patients with
PMH/FH of co-morbidities associated with obesity
14. Define diet history.
a. General or broad screening questions for all patients and more specific questioning
helpful for patients with certain disease states?
15. What question should you always ask?
a. Do you have a healthy balanced diet?
16. When asking specific diet history, what should you focus on for each of the following conditions:
hyperlipidemia, HTN, DM?
, a. Fats
b. Salts
c. Carbohydrates
17. Name the different questioning methods and tools available. Which as retrospective and which
are prospective?
a. Retrospective - 24-hour recall, unusual intake/diet history, food frequency questionnaire,
b. Prospective - 3-day food record
18. What are the cons of the 24-hour recall?
a. Patients may overestimate or underestimate if generalizing based on one day; relies on
patient recollection
19. What is the pro to the usual intake/diet history?
a. Approach provides more information about usual intake patterns, reflects longer term
habits with better accuracy
20. What is the con to the usual intake/diet history method?
a. Patients may only report what they know or think to be healthy
21. What is the food frequency questionnaire used for?
a. Determine trends in patients’ usual consumption of specific foods; geared toward
whatever condition the patient has; evaluates current intake of specific foods
22. Which method is the most accurate?
a. 3-day food record
23. What is the con to the 3-day food record?
a. Difficult for some patients to keep written logs
24. How do you calculate BMI?
a. Weight (kg)/height (m^2)
b. ((weight (lbs.))/(height (in^2)))*703
25. What is considered a normal BMI?
a. 18.5-24.9 kg/m^2
26. How is energy expressed?
a. Kilocalories
27. Based on 1 gram, how many kcals do you get from: protein, carbohydrate, fat, or alcohol?
a. Protein – 4
b. Carbohydrate – 4
c. Fat – 9
d. Alcohol – 7
28. What equation estimates energy requirements?
a. Mifflin-St. Jeor Equation
29. What is the Mifflin – St. Jeor Equation
a. (10*weight in kg)+(6.25*height in cm) – (5*age in years); +5 for males; -161 for females
30. When is waist circumference helpful?
a. In patients with a BMI <35
31. Why is waist circumference important?
a. Independent risk factor for diabetes, dyslipidemia, HTN, CV disease
32. What are the waist circumference values?
a. >102cm (40in) male
, b. >88cm (35in) female
33. How do you calculate percent weight change?
a. ((Usual weigh-current weight)/(usual weight))*100
34. Nutrition oriented aspects of the physical exam focus where?
a. Skin, hair, eyes, mouth, nails, extremities, abdomen, skeletal muscle, fat stores
35. What skin PE findings are associated with nutritional implications?
a. Rashes, dermatitis, bruising, petechia, purpura, changes in pigmentation, pressure
ulcers, paleness, pallor, thickening, dryness
36. What hair PE findings are associated with nutritional implications?
a. Dyspigmentation, easy pluckability, alopecia
37. What head PE findings are associated with nutritional implications?
a. Temporal muscle washing, delayed closure of fontanelle
38. What eye PE findings are associated with nutritional implications?
a. Night blindness, xerosis, bitot spots, corneal vascularization, keratomalacia,
photophobia, blurring, conjunctival inflammation, macular degeneration
39. What mouth PE findings are associated with nutritional implications?
a. Angular stomatitis, bleeding gums, cheilosis, fissuring, scarlet, raw tongue, nasolabial
seborrhea, dental caries, hypogeusia, glossitis, papillary atrophy/smooth tongue
40. What neck PE findings are associated with nutritional implications?
a. Goiter, parotid enlargement
41. What thoracic PE findings are associated with nutritional implications?
a. Rickets rosary, thoracic rachitic rosary
42. What abdominal PE findings are associated with nutritional implications?
a. Abdominal obesity, diarrhea, hepatomegaly/ascites
43. What cardiac PE findings are associated with nutritional implications?
a. Heart failure
44. What genital/urinary PE findings are associated with nutritional implications?
a. Delayed puberty, hypogonadism
45. What extremity/musculoskeletal PE findings are associated with nutritional implications?
a. Ataxia, bone ache, joint pain, bone tenderness, kyphosis, edema, hyporeflexia, growth
retardation, failure to thrive, muscle wasting and weakness, tenderness of long bones,
squaring of shoulders – loss of deltoid
46. What nail PE findings are associated with nutritional implications?
a. Transverse lines, spooning of nails
47. What neurological PE findings are associated with nutritional implications?
a. Dementia, delirium, disorientation, loss of reflexes, wrist drop, foot drop,
ophthalmoplegia, peripheral neuropathy, tetany, carpopedal spas
48. Why should a nutritional assessment always be included in the H&P?
a. Children – evaluate growth and development; children and adults – assess for nutrient
excess/deficiency
Chapter 2
1. What does RDA stand for?
a. Recommended daily allowance
