NUTR 650 Study Guide
NUTR 650 Study Guide NUTR 650
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This 5 page Study Guide was uploaded by Valerie Nesom on Sunday February 21, 2016. The Study Guide belongs to NUTR 650 at University of New Hampshire taught by Dr. Rielly in Spring 2016. Since its upload, it has received 57 views. For similar materials see Lifecycle Nutrition in Nutrition and Food Sciences at University of New Hampshire.
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Date Created: 02/21/16
Questions 1. Pre-Eclampsia (Include the following in your essay) 21 points a. Define pre-eclampsia. b. Describe three risk factors involved in the development of this condition? c. What are the three classic symptoms of this condition? d. Describe the biochemical changes that occur in pre-eclampsia? e. What is the treatment for pre-eclampsia? f. What is the only known cure for pre-eclampsia? g. What is the HELLP Syndrome? Pre-eclampsia is a complication from pregnancy due to a sudden rise in blood pressure and is diagnosed 20-weeks+ pregnancy. Three risk factors involved in its development are if the pregnant mother is over 35, if she is obese or overweight and the third risk factor is if she has a poor diet specifically a diet low of vitamin D and C. Three classical symptoms of this condition are protein found in urine, HTN and weight gain. Biochemical changes that occur include a decrease in serum albumin, increase protein in the urine, decrease of platelet count, increase in hemoglobin and an increase in serum creatinine. In order to treat it you need bedrest, monitor BP and maintain a healthy diet. In order to cure pre-eclampsia the fetus must be delivered, which is the only known cure for it. HELLP Syndrome is a very dangerous complication of pre-eclampsia. HELLP stands for: hemolysis (H), elevated liver enzymes (EL) and low platelet count (LP). 2. List and describe four distinct (different) functions of the placenta. 12 points Four functions of the placenta include: it serves as a protective wall of most harmful and toxic substances, it cleans and gets rid of any waste products, such as carbon dioxide, and transports it into the maternal blood, the placenta is a place of gas exchange and nutrient exchange and lastly it produces different hormones and enzymes for the growing fetus. 3. Menstrual Cycle. (Include the following in your essay) 15 points a. What are the two phases of the menstrual cycle called? What is the timing of these two phases and what occurs in these two phases? b. What are the major organs involved in the menstrual cycle? c. Describe each stage of follicular development. (Include timing). d. What hormones are involved in the menstrual cycle and how does each of them function during each phase of the menstrual cycle? e. How does the endometrium change during the two phases and how do these changes benefit the developing fetus. 1 Two phases of the menstrual cycle are follicular and luteal phase. The follicular phase begins from day one, where blood flow starts, until day 14 of ovulation. The endometrium is developing lots of blood vessels in preparation of the woman becoming pregnant. The luteal phase begins on day 14, when ovulation occurs, and ends on day 28. During this phase the endometrium is preparing the uterus for a fetus with the help of progesterone. The major organs involved in the menstrual cycle are the brain, ovary, and uterus of the mother. There are many stages in follicular development. The first stage is the primordial stage, which occurs on day one, where 6-20 immature follicles are produced. The primary stage is the second stage, which happens between days 2-3, where the primordial follicles are maturing slightly. The third stage is the secondary stage, which happens between days 4-6, is where the follicles have developed more space around them and more estrogen is being produced. The fourth stage is the tertiary stage. There are two eggs left that the follicles encapsulate in this stage, which occurs around day seven. They are much larger than they were before. The last stage is called the graffian where the most mature egg will ovulate at day 14 and move into the fallopian tube leaving the follicle behind. The follicle, which was left behind, becomes the corpus luteum. The corpus luteum continues to produce the hormone progesterone for three months if the egg becomes fertilized. If the egg never becomes fertilized, ten days later the corpus luteum goes through atresia and is now called the white body. The hormones involved are estrogen, progesterone, gonadotropin-releasing hormone (GnHR), luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Estrogen, in the follicular phase, is produced by the follicles and is in charge of stimulating the GnRH during the follicular phase of menstruation. The release of GnRH occurs due to low levels of estrogen at the end of the menstrual cycle. The low levels are signaled to the hypothalamus in the brain to release the GnRH by the negative feedback mechanism. Estrogen also stops the luteal phase. GnRH functions by stimulating the release of LH and FSH by the anterior pituitary gland. These are two very important hormones because they control what happens during the menstrual cycle. LH functions by signaling ovulation to happen during the second half of the menstrual cycle. This happens during the end of the follicular phase but mostly during the second half of the cycle. FSH functions by stimulating follicular growth and maturation in the follicular phase (day 1-14). Lastly, progesterone, which is produced by the corpus luteum in the luteal phase, functions by preparing the uterus for the fertilized egg. This hormone also stimulates the build up of the uterine lining in order to help support the fertilized egg. FSH and LH also help the endometrium prepare for the fertilized egg through the two phases. During the follicular phase (vascular phase) there is a very large buildup of blood vessels to increase the blood supply to the area due to 2 high levels of estrogen. During the luteal phase (glandular phase), blood vessels are continuing to develop and nutrients, primarily glycogen, are coming in due to high levels of progesterone. The nutrients, blood vessels and thickening of the endometrium will all help with supporting the growth of the placenta and fetus. 4. CASE STUDY #1: To receive full credit you must show your math. 10 points Maria is a 28-year-old woman who is 29 weeks pregnant. Maria is 5’3” tall and her pregravid weight 148#. Prior to pregnancy Maria consumed ~2134 kcal/day. a. What is Maria’s pregravid BMI? 1 kg= 2.2 lbs Kg=148 lbs x (1 kg)/(2.2 lbs)= 67.3kg 1 m = 39.37 in 5(12)+3=63in m= (63in)/(39.37)=1.6 BMI=(kg)/(m^2) BMI=(67.3kg)/(1.6m^2)=26.2 b. According to the IOM classifications, in what category does this BMI place Maria’s weight? Maria is in the overweight category (BMI 25.0-29.9). c. How much weight would you suggest that Maria gain during her entire pregnancy? She should gain between 15-25 pounds throughout her entire pregnancy. Since Maria is overweight she should gain less weight as opposed to a normal weight woman who should gain between 25-35 pounds. How many calories does she need at this point in her pregnancy? Maria was consuming about 2,134kcal/day and an additional 452kcal/day is needed in the third trimester. 2,134 kcal + 452 kcal = 2,583kcal/day d. How many grams of protein does she need at this point of her pregnancy? Since Maria is in her third trimester, she requires 1.10kg of protein per day. Pregravid pregnancy she weighed 67.3kg. Protein requirement: (67.3kg) (1.10kg)=74.03kg of protein per day is needed for Maria. 5. CASE STUDY #2: To receive full credit you must show your math. 9 points Charlotte is 16 years old and is pregnant for the first time. She does not drink much milk because she says, “it is fattening”. However she adds a little bit of milk to her coffee. She asks you if she is getting enough calcium in her diet now that she is pregnant. You conduct a 24- 3 hour recall to help answer her question. Each day Charlotte consumes ½ cup milk, 1 cup of yogurt and 1½ oz. of cheese. a. Using the Rule of 300’s, calculate how many mg of calcium Charlotte is consuming each day? ½ cup milk=150mg 1 cup yogurt=300mg 1 ½ oz cheese=300mg 150mg+300mg+300mg+300mg (non calcium foods)=1,050mg of calcium b. Is Charlotte meeting the DRI for a pregnant 16-year old? Why or why not? Charlotte is not meeting the DRI. The DRI for a pregnant female under the age of 19 is 1300mg of calcium per day. Charlotte is only consuming 750mg of calcium per day, which is below the recommended 1300mg. c. What are two practical suggestions that you could make to Charlotte to help her increase her daily calcium intake? Since Charlotte finds milk products to be fattening, she could add in 1 cup of almond or soymilk in her diet per day in maybe a homemade smoothie for example. This will help to increase her calcium intake while consuming a low-fat and calorie food product. She could also consume 1 cup of low-fat frozen yogurt as an after dinner snack to increase her daily calcium intake. 6. DEFINITIONS: In one or two sentences please define the following terms (Please make sure your answers apply to Module 1) 3 points each a. Anencephaly is a type of neural tube defect where there is a complication of the central nervous system. The brain and/or spinal column are either partially or totally not formed, which can result in neonatal death. b. Atresia is natural cell death, which specifically refers to the eggs produced prenatally that never develop. Prenatally, you have around 7 million eggs and only about 400-500 will develop causing the rest to go through atresia. c. α-feto protein is a protein made in the liver and high levels found in amniotic fluid and fetal and maternal blood could possibly imply a neural tube defect in the fetus. An α-feto protein test is given to the mother during 16 to 18 weeks of pregnancy as a precaution for a possible neural tube defect in the fetus. d. Villous chorion is the fetal side of placenta development where trophoblasts go inside of the uterine lining. More villi also develop to increase the surface area for allow for gas and nutrient exchange. 4 e. Fetal origins hypothesis describes the risk of a chronic disease, which possibly initiates in the uterus. Nutrition of the mother and birth weight of the baby may have an influence over future disease risk of the baby. f. AI is a type of dietary intake standard that stands for adequate intake. Types of foods/nutrients that fall under this standard are ones that don’t have enough research yet in order to determine its DRI (daily reference intakes). g. Hyperemesis gravidarum is an ucommon complaint during pregnancy that involves severe nausea and vomiting all throughout the pregnancy. The high frequency of vomiting can cause weight loss, electrolyte imbalances and dehydration, which should all be carefully monitored. h. Abruptio placenta is a pregnancy complication where the placenta rips away from the wall of the uterus. This happens more commonly in pregnant women 35 years and older i. Prostaglandins are fats produced by the uterus. Its function is to contract the uterus causing the output of blood and nutrients from the endometrium. j. Anabolic Stage of Pregnancy occurs in the first half of pregnancy where the mother is building stores of nutrients. This is important in order to prepare for the second half of pregnancy where the fetus is utilizing nutrient stores at a rapid rate. k. Active transport is a type of placental transport that requires a carrier and energy source, such as ATP. Amino acids, calcium, water-soluble vitamins, iron, and potassium all require active transport. 5
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