MNT 1 Exam 1

Practice vocabulary flashcards covering nutrition assessment concepts, clinical data interpretation, acute-phase reactants, hematologic patterns, and scope of practice from NFS 4260.

Biochemical Assessment Domain

The component of nutrition assessment that analyzes laboratory values, diagnostic tests, biomarkers, and trends over time.

Physical Assessment Domain

The component of nutrition assessment evaluating anthropometrics, body composition, visible or palpable physical findings, and nutrition-focused physical examination (NFPE) data.

Functional Assessment Domain

The component of nutrition assessment evaluating physical capabilities and organ function, including muscle strength, mobility, activities of daily living (ADLs), gastrointestinal function, appetite, and physical performance.

Nutrient Intake and Biologic Response Curve

A continuum illustrating biologic responses across nutrient concentrations, progressing from deficiency (death, overt symptoms, suboptimal metabolism) to normal metabolism, and advancing into toxicity (abnormal metabolism, overt symptoms, and death).

Basic Metabolic Panel (BMP)

A routine laboratory blood test evaluating blood glucose, fluid balance, electrolytes, and kidney function markers (such as BUN and creatinine).

Comprehensive Metabolic Panel (CMP)

A standard laboratory panel that includes all components of a BMP (glucose, electrolytes, and kidney function markers) along with liver-related diagnostic markers.

Complete Blood Count (CBC)

A routine hematologic laboratory panel measuring red blood cells (RBC), hemoglobin (Hgb), hematocrit (Hct), red cell indices including mean corpuscular volume (MCV), white blood cell count (WBC) with differential, and platelets.

Positive Acute-Phase Reactants

Inflammatory biomarkers whose serum concentrations increase in the presence of systemic inflammation, infection, or acute tissue injury; examples include C-reactive protein (CRP), ferritin, and fibrinogen.

Negative Acute-Phase Reactants

Circulating hepatic proteins whose serum concentrations decrease in response to systemic inflammation; examples include albumin, prealbumin, and transferrin.

Serum Albumin and Prealbumin

Negative acute-phase proteins that reflect inflammatory stress and illness severity, which makes them unreliable biomarkers of nutritional protein status or protein intake.

Ferritin

An iron storage biomarker and positive acute-phase reactant; low levels indicate depleted iron stores when inflammation is absent, but active inflammation can artificially increase its concentration and mask iron deficiency.

Mean Corpuscular Volume (MCV)

A red blood cell index from the complete blood count (CBC) measuring average erythrocyte volume, categorized into microcytic ($< 80\,\text{fL}$), normocytic ($80\text{--}100\,\text{fL}$), or macrocytic ($> 100\,\text{fL}$).

Microcytic Anemia Pattern

A pattern characterized by abnormally small red blood cells with an MCV of $< 80\,\text{fL}$, commonly signaling iron deficiency alongside other possible etiologies.

Normocytic Anemia Pattern

A pattern characterized by normal-sized red blood cells with an MCV of $80\text{--}100\,\text{fL}$, frequently associated with inflammation, chronic disease, or acute blood loss.

Macrocytic Anemia Pattern

A pattern characterized by abnormally large red blood cells with an MCV of $> 100\,\text{fL}$, commonly warranting evaluation for vitamin $B_{12}$ or folate deficiency.

Clinical Indicators of Dehydration

Signs including rapid weight loss, dry mucous membranes, decreased urine output, and elevations or changes in serum sodium, BUN, osmolality, and urine specific gravity.

Clinical Indicators of Overhydration

Signs including rapid weight gain, peripheral edema or ascites, fluid shifts, and apparent dilution of measured serum laboratory concentrations.

Targeted Micronutrient Testing

Specific laboratory diagnostic tests ordered to answer targeted clinical questions, such as $25(\text{OH})\text{D}$, vitamin $B_{12}$ with methylmalonic acid (MMA), folate, iron studies, magnesium, and vitamin $B_6$.

Specimen Type Considerations

The clinical principle that diagnostic utility depends on where a biomarker is analyzed, distinguishing whole blood, serum/plasma, urine, stool, breath, and hair/nails/saliva.

Nutrition-Focused Physical Exam (NFPE)

A systematic head-to-toe examination that evaluates nutrition-related signs and symptoms—such as muscle and subcutaneous fat stores, fluid accumulation, oral health, and skin/hair/nail integrity—using inspection, palpation, percussion, and auscultation.

Four Layers of RDN Scope of Practice

The concentric levels defining professional boundaries for registered dietitian nutritionists: (1) Professional scope, (2) Law and regulation, (3) Organization and privileges, and (4) Individual competence.

Integrative and Functional Testing Evaluation Criteria

A five-point clinical screening framework verifying if a non-routine test is analytically and clinically valid, supported by actionable evidence, superior to standard tests, reasonably low-risk regarding cost and restriction, and capable of meaningfully altering nutrition care.

8 nutrition intervention domains

1. goal planning

2. prescription planning

3. food and/or nutrient delivery

4. nutrition education

5. nutrition counseling

6. coordination of nutrition care

7. population based nutrition actions

8. intervention encounter context

Which phrase is Assess?

1. Reduced intake; early satiety; often 2 meals/day; 18-lb (9.5%) unintentional loss; fatigue; caregiving demands.

2. Inadequate oral intake related to reduced appetite/early satiety and competing caregiving demands as evidenced by decreased intake, often 2 meals/day, and 18-lb unintentional loss over ~6 months.

3. Prioritize adequate intake; individualized eating pattern; easy energy/protein-dense options; address barriers; coordinate appetite/medication concerns as appropriate.

4. Weight trajectory; eating frequency/intake adequacy; appetite/early satiety; energy/function; progress toward agreed goals; follow-up timeframe

which phrase is Diagnose?

Reduced intake; early satiety; often 2 meals/day; 18-lb (9.5%) unintentional loss; fatigue; caregiving demands.

Inadequate oral intake related to reduced appetite/early satiety and competing caregiving demands as evidenced by decreased intake, often 2 meals/day, and 18-lb unintentional loss over ~6 months.

Prioritize adequate intake; individualized eating pattern; easy energy/protein-dense options; address barriers; coordinate appetite/medication concerns as appropriate.

Weight trajectory; eating frequency/intake adequacy; appetite/early satiety; energy/function; progress toward agreed goals; follow-up timeframe

Which phrase is Intervention

Reduced intake; early satiety; often 2 meals/day; 18-lb (9.5%) unintentional loss; fatigue; caregiving demands.

Inadequate oral intake related to reduced appetite/early satiety and competing caregiving demands as evidenced by decreased intake, often 2 meals/day, and 18-lb unintentional loss over ~6 months.

Prioritize adequate intake; individualized eating pattern; easy energy/protein-dense options; address barriers; coordinate appetite/medication concerns as appropriate.

Weight trajectory; eating frequency/intake adequacy; appetite/early satiety; energy/function; progress toward agreed goals; follow-up timeframe

Which phrase is M&E?

Reduced intake; early satiety; often 2 meals/day; 18-lb (9.5%) unintentional loss; fatigue; caregiving demands.

Inadequate oral intake related to reduced appetite/early satiety and competing caregiving demands as evidenced by decreased intake, often 2 meals/day, and 18-lb unintentional loss over ~6 months.

Prioritize adequate intake; individualized eating pattern; easy energy/protein-dense options; address barriers; coordinate appetite/medication concerns as appropriate.

Weight trajectory; eating frequency/intake adequacy; appetite/early satiety; energy/function; progress toward agreed goals; follow-up timeframe

White adipose tissue

stores triglycerides, cushions organs, and insulates the body

Brown AT

thermogenic tissue, contributes to temp regulation

visceral AT

central/internal AT associated with cardiometabolic risk

How AT expands: hypertrophy

increase in adipocyte size, common in adults

How AT expands: Hyperplasia

increase in adipocyte number, occurs normally during growth and when existing cells reach capacity

How AT expands: Lipogenesis

synthesis/storage of fatty acids and triglycerides influenced by energy balance and substrate availability

Indirect calorimetry

used oxygen consumption and carbon dioxide production to estimate resting energy expenditure

REE/RMR (resting energy expenditure/ resting metabolic rate)

resting needs

TEE (total energy expenditure)

total daily expenditure

EER (estimated energy requirement)

predicted intake to maintain energy balance

TEF (thermic effect of food)

Energy used to digest, absorb, transport, metabolize, and store

nutrients, part of TEE and not separately calculated

BP is

cardiac output x systemic vascular resistance

systolic BP

pressure during ventricular contraction

diastolic BP

pressure during ventricular relaxation

hypertension

persistently elevated arterial BP

Normal BP

< 120 AND < 80

elevated BP

120-129 AND <80

stage 1 hypertension BP

130-139 OR 80-89

Stage 2 hypertension BP

>140 OR > 90

what does RAAS do

regulates blood pressure, blood volume, and sodium-potassium balance.

how does RAAS raise BP?

1. kidneys release renin

2. angiotensin 1—> angiotensin 2

3. angiotensin 2 raises BP by

   1. vasoconstriction

   2. signals aldosterone release

4. aldosterone tells kidneys to save sodium

5. yay! Your body holds on to more water, and your blood vessels are more constricted. Blood pressure and blood flow to the kidneys improve, so the body reduces the RAAS response.

why might dash diet lower blood pressure?

lower sodium and fatty foods

general target of sodium

<2300 mg/day

sodium levels with hypertensoin?

reducing towards 1500/day

meaningful change of sodium

1000 mg/day

benefits of potassium with BP

• promotes sodium excretion

• helps regulate fluid balance

• helps blood vessels relax

***assess medications and conditions like hyperkalemia and chronic kidney disease

atherosclerosis

when plaque builds up inside arteries, reduced oxygen rich blood flow

how does atherosclerosis develop?

lipid retention and inflammation interact with the arterial wall over time

steps of atherosclerosis

1. fatty streak

2. fibrous plaque

   1. advanced plaque

thrombosis

ruptured plaque that causes a blood clot

chylomicron

carries dietary triglycerides from intestine, remnants can be atherogenic

VLDL

carries liver derived triglycerides

IDL

Intermediate particle formed as VLDL loses triglycerides, transitional

LDL

Delivers cholesterol to cells and other tissues, can be atherogenic when retained in arterial wall

HDL

Picks up excess cholesterol from tissues and helps transport it back to the liver, “good cholesterol”

LDL-C

how much cholesterol is carried within LDL particles

ApoB

approx. number of circulating atherogenic particles

non HDL-C

total cholesterol — HDL-C

total cholesterol ranges

<200 desirable | 200–239 borderline high | ≥240 high

LDL-C ranges

<100 optimal | 100–129 near/above optimal | 130–159 borderline high | 160–189 high | ≥190 very high

HDL-C ranges

low <40 men / <50 women; ≥60 historically considered favorable—but higher is not always better

triglycerides

<150 normal | 150–199 borderline high | 200–499 high | ≥500 severe

Lp(a)

genetically influenced atherogenic lipoprotein; risk enhancer

familial hypercholesterolemia

a common, inherited genetic disorder present from birth that causes very high levels of low-density lipoprotein (LDL, or "bad") cholesterol in the blood

unsaturated fats

MUFA/PUFA-rich foods are useful replacement choicessa

saturated fats

fat whoes carbon chains are saturated with hydrogen atoms

industrial trans fats

raises LDL-C and can lower HDL-C

common cholesterol lowerin meds

statins, EZETIMIBE (Zetia), PCSK9 INHIBITORS