ACBN Clinical Nutrition & Medical Nutrition Therapy Flashcards

Which indirect calorimetry measurement is considered the gold standard for determining resting energy expenditure (REE) in clinical settings?

Answer: Metabolic cart (respiratory gas analysis)

Metabolic cart calorimetry measures actual oxygen consumption and CO2 production to calculate REE, and is far more accurate than predictive equations.

In MNT for celiac disease, which protein must be eliminated from the diet?

Answer: Gluten (gliadin and glutenin)

Gluten, composed of gliadin and glutenin found in wheat, barley, and rye, triggers the autoimmune intestinal damage characteristic of celiac disease.

A patient with a nasogastric tube feeding who develops diarrhea should first be evaluated for:

Answer: Formula osmolality, rate, temperature, and medication side effects

Enteral feeding-related diarrhea is commonly caused by hyperosmolar formulas, rapid infusion rates, cold formula, or concurrent antibiotic/sorbitol-containing medications.

The nutrition-focused physical exam (NFPE) assesses which of the following to diagnose malnutrition?

Answer: Muscle and fat loss, fluid accumulation, and grip strength

NFPE evaluates muscle wasting (temples, clavicles, scapulae), subcutaneous fat loss, edema, and functional measures like handgrip strength to characterize malnutrition.

For patients receiving total parenteral nutrition (TPN), which electrolyte is added to prevent Wernicke's encephalopathy?

Answer: Thiamine (vitamin B1)

Thiamine must be added to TPN or given IV before initiating TPN with dextrose to prevent Wernicke's encephalopathy in malnourished or alcoholic patients.

In managing phenylketonuria (PKU), the primary dietary treatment involves:

Answer: Restricting phenylalanine intake while supplementing tyrosine

PKU management requires limiting phenylalanine (found in high-protein foods) while supplementing tyrosine, which becomes essential since the conversion enzyme is absent.