HNF 471 EXAM ONE AND ANSWERS WITH WELL DEFINED
SOLUTIONS GRADED A++
Somatic Protein
- skeletal
-creatinine height index
-nitrogen balance
Creatinine Height Index
-lower the number, more severe malnutrition
- normal is considered 1
-formed by creatinine phosphate during PA
- amount correlates with muscle mass
Nitrogen Balance
Dietary protein intake / 6.25 - UUN - 4g
- negative N2 balance indicates malnutrition, protein deficiency, or muscle wasting
Visceral Protein
*non skeletal proteins
- albumin (-)
- pre albumin/transthyretin (-)
- RBP Retinol Binding Protein (-)
- transferrin (-)
-fibronectin (FN) (-)
,- c-reactive protein (CRP) (+)
- insulin like growth hormone (IGF) (-)
Albumin
- norm 3.5 -5
function: blood transport protein
most abundant serum protein
larger half life
***albumin loss occurs with burn injuries, nephrotic syndrome, protein losing
enteropathy, cirrhosis. ALSO by inflammation, multiple myeloma, trauma,
hypoalbuminemia
-typically reflects illness and not necessarily nutrition status
Transferrin
-synthesized by the LIVER
-transports iron throughout the body****
-affected by iron status *
-serves an as indicator of protein status due to its short half life, also makes it sensitive
to acute changes in protein intake or requirements
-limitation: its concentration is directly affected by iron status, disease like states such
as hepatic and renal disease, inflammation, and congestive heart failure all affect serum
levels
Prealbumin/Transthyretin
- transport of thyroxine and its associated retinol binding protein
- affected by: illness, inflammation, stress, trauma, liver disease, malabsorption,
, hyperthyroidism , renal disease, hepatitis, Hodgkins*, cirrhosis
short half life
- acute phase protein synthesized by liver
- expensive
- serum levels may decrease due to inflammation but not necessarily due to malnutrition
Retinol Binding Protein (RBP)
- synthesized by the liver
- acute phase respondent and serves as the transport molecule for vitamin A
- hast he smallest body pool and shortest half life of the serum proteins
- levels effected by renal disease, liver failure, hyperthyroidism, vitamin A deficiency,
Zinc deficiency, and metabolic stress, cystic fibrosis
Fibronectin and C-Reactive (+) protein are made when:
body is in severe state
BOTH ACUTE PHASE PROTEIN
Immunocompetence
Total Lymphocyte Count (TLC)
TLC = WBC x % lymphocytes / 100
- protein defiance routinely results in increased risk of infection as well as altered
immune and inflammatory responses
- affected by infection, trauma, stress, Ca, HIV, and medication that influences immune
system like chemo and corticosteroids
Hematological Assessment (Hematology) determines:
SOLUTIONS GRADED A++
Somatic Protein
- skeletal
-creatinine height index
-nitrogen balance
Creatinine Height Index
-lower the number, more severe malnutrition
- normal is considered 1
-formed by creatinine phosphate during PA
- amount correlates with muscle mass
Nitrogen Balance
Dietary protein intake / 6.25 - UUN - 4g
- negative N2 balance indicates malnutrition, protein deficiency, or muscle wasting
Visceral Protein
*non skeletal proteins
- albumin (-)
- pre albumin/transthyretin (-)
- RBP Retinol Binding Protein (-)
- transferrin (-)
-fibronectin (FN) (-)
,- c-reactive protein (CRP) (+)
- insulin like growth hormone (IGF) (-)
Albumin
- norm 3.5 -5
function: blood transport protein
most abundant serum protein
larger half life
***albumin loss occurs with burn injuries, nephrotic syndrome, protein losing
enteropathy, cirrhosis. ALSO by inflammation, multiple myeloma, trauma,
hypoalbuminemia
-typically reflects illness and not necessarily nutrition status
Transferrin
-synthesized by the LIVER
-transports iron throughout the body****
-affected by iron status *
-serves an as indicator of protein status due to its short half life, also makes it sensitive
to acute changes in protein intake or requirements
-limitation: its concentration is directly affected by iron status, disease like states such
as hepatic and renal disease, inflammation, and congestive heart failure all affect serum
levels
Prealbumin/Transthyretin
- transport of thyroxine and its associated retinol binding protein
- affected by: illness, inflammation, stress, trauma, liver disease, malabsorption,
, hyperthyroidism , renal disease, hepatitis, Hodgkins*, cirrhosis
short half life
- acute phase protein synthesized by liver
- expensive
- serum levels may decrease due to inflammation but not necessarily due to malnutrition
Retinol Binding Protein (RBP)
- synthesized by the liver
- acute phase respondent and serves as the transport molecule for vitamin A
- hast he smallest body pool and shortest half life of the serum proteins
- levels effected by renal disease, liver failure, hyperthyroidism, vitamin A deficiency,
Zinc deficiency, and metabolic stress, cystic fibrosis
Fibronectin and C-Reactive (+) protein are made when:
body is in severe state
BOTH ACUTE PHASE PROTEIN
Immunocompetence
Total Lymphocyte Count (TLC)
TLC = WBC x % lymphocytes / 100
- protein defiance routinely results in increased risk of infection as well as altered
immune and inflammatory responses
- affected by infection, trauma, stress, Ca, HIV, and medication that influences immune
system like chemo and corticosteroids
Hematological Assessment (Hematology) determines:
