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Daily caloric needs
25 kcal/kg/day
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calories in each gram of protein
4
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calories in each gram of fat
9
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calories in each gram of oral carbohydrate
4
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calories in each gram of dextrose
3.4
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daily protein needs
1g/kg/day
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increase in caloric requirements in times of trauma or stress
20-40%
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inc kcal requirement in pregnancy
300kcal/day
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inc kcal requirement in lactation
500 kcal/day
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equation to determine caloric needs in burn patients
25 kcal/kg/day + (30 kcal/kg/day X % burn)
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equation to determine protein needs in burn patients
1-1.5g/day + (3g X % burn)
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increase in basal metabolic rate for each body temp degree >38
10%
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equation calculating basal energy expenditure
Harris Benedict equation
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Adjusted body weight
= [(actual weight- ideal weight) X 0.25] + IBW
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fuel for colonocytes
short chain fatty acids
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fuel for small bowel enterocytes
glutamine
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primary fuel for neoplastic cells
glutamine
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half-life of albumin
20 days
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half-life of transferrin
10 days
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half-life of prealbumin
2 days
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ratio of CO2 produced to O2 consumed
respiratory quotient
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RQ demonstrating lipogenesis (overfeeding)
RQ>1
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RQ demonstrating ketosis and fat oxygenation (starvation)
RQ<0.7
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RQ of pure fat metabolism
0.7
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RQ of pure protein metabolism
0.8
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RQ of pure carbohydrate metabolism
1.0
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organ that contains glucose-6-phosphatase
liver
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main source of energy in trauma and starvation
fats
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bacterial overgrowth with increased intestinal permeability to bacteria due to starved enterocytes
bacterial translocation
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fuel for brain during starvation
ketones
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obligate glucose users in the body (4)
peripheral nerves, adrenal medulla, RBCs, WBCs
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cytokine mediating cachexia
TNF alpha
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Severe protein deficiency
Kwashiorkor
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Severe starvation
Marasmus
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Adrenal response to injury/trauma
Inc cortisol, inc catecholamine
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Cardiac response to trauma/injury
Inc stroke vol, inc HR
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Pancreatic response to trauma/injury
Inc glucagon, dec insulin
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Pituitary response to trauma/injury
Release of ACTH, ADH, GH
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Amount of protein that contains 1g nitrogen
6.25 g
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nitrogen balance equation
= (Nin-Nout) = ([protein/6.25] � [24 hr urine N + 4g])
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total protein synthesis in a healthy normal 70kg male
250g/day
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amino acids preferentially generated from skeletal muscle breakdown
alanine, glutamine
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aggregates of bile salts, long chain free-fatty acids, and monoacylglycerides
micelles
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factor that increases absorption area for fats, helping to form micelles
bile salts
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factor used to synthesize bile salts
cholesterol
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fat types that enter enterocytes by simple diffusion
medium and short chain fatty acids
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enzyme that clears chylomicrons from the blood
lipoprotein lipase
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structure formed when micelles and other fatty acids enter enterocytes
chylomicrons
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fats that enter the portal system
medium and short chain fatty acids
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fats that enter lymphatics
long chain fatty acids
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most important route of entry for dietary cholesterol; synthesized in liver
VLDL
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Fats used for fuel by cardiac and skeletal muscles
Saturated fatty acids
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Preferred energy source for liver, heart, and skeletal muscle
Fatty acids (ketones acetoacetate, beta-hydroxybutyrate)
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Enzyme that breaks down TAGs to fatty acids and glycerol
Hormone sensitive lipase
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Essential fatty acids (2)
Linoleic, linolenic
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Omega 3 fatty acids (3)
PGI3, TXA3, LTB5 (all odd)
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Omega 6 fatty acids (3)
PGE2, TXA2, LTB4 (all even)
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First enzyme of carbohydrate digestion
Salivary amylase
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Carbohydrates absorbed by secondary active transport into portal vein
Glucose, galactose
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Carbohydrates absorbed by facilitated diffusion into portal vein
Fructose
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Fructose + glucose
Sucrose
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Galactose + glucose
Lactose
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Glucose + glucose
Maltose
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First enzyme for protein digestion
Pepsin (stomach)
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Nonessential amino acids
Those beginning with A and G, and proline and serine
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Branched chain amino acids
Leucine, isoleucine, valine
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Vitamin deficiency causing hyperglycemia, encephalopathy, neuropathy
Chromium
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Vitamin deficiency causing cardiomyopathy, weakness and hairloss
Selenium
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Vitamin deficiency causing pancytopenia
Copper
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Vitamin deficiency causing poor wound healing, hair loss, rash
Zinc
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Vitamin deficiency causing weakness, encephalopathy, decreased phagocytosis
Phosphate
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Vitamin deficiency causing wernicke�s encephalopathy, cardiomyopathy, peripheral neuropathy
B1 (thiamine)
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Vitamin deficiency causing sideroblastic anemia, glossitis, peripheral neuropathy
B6 (pyridoxine)
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Vitamin deficiency causing megaloblastic anemia, peripheral neuropathy, beefy tongue
B12 (cyanocobalmin)
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Vitamin deficiency causing megaloblastic anemia and glossitis
Folate
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Vitamin deficiency causing pellagra (diarrhea, dermatitis, dementia)
Niacin
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Vitamin deficiency causing night blindness
Vit A
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Vitamin deficiency causing coagulopathy
Vit K
-
Vitamin deficiency causing rickets, osteomalacia
Vit D
-
Vitamin deficiency causing neuropathy
Vit E
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