1. Nutrition for Elderly and Obese
By Alaina Darby
Nutrition for Elderly and Obese

2. Elderly

3. JO is a 75 yo WM. He is currently taking amitriptyline for sleep, pseudoephedrine for congestion, furosemide for CHF-related edema, and ibuprofen for arthritis. Which of the following would be the most likely to cause malnutrition because of decreased desire to eat?
Amitriptyline
Pseudoephedrine
Furosemide
Ibuprofen
More than one of the above b

4. JO is a 75 yo WM. He is currently taking amitriptyline for sleep, pseudoephedrine for congestion, furosemide for CHF-related edema, and ibuprofen for arthritis. Which of the following would be the most likely to cause malnutrition because of dysphagia?
Amitriptyline
Pseudoephedrine
Furosemide
Ibuprofen
More than one of the above d

5. JO is a 75 yo WM. He is currently taking amitriptyline for sleep, pseudoephedrine for congestion, furosemide for CHF-related edema, and ibuprofen for arthritis. Which of the following would be the most likely to cause malnutrition because of dry mouth?
Amitriptyline
Pseudoephedrine
Furosemide
Ibuprofen
More than one of the above
E (a and c)

6. JO is a 75 yo WM. He is currently taking amitriptyline for sleep, pseudoephedrine for congestion, furosemide for CHF-related edema, and ibuprofen for arthritis. Which of the following would be the most likely to cause malnutrition because of nausea and vomiting?
Amitriptyline
Pseudoephedrine
Furosemide
Ibuprofen
More than one of the above a

7. What is the most common etiology for malnutrition in the elderly?
Drug induced
Cardiovascular disease
Cancer
Gastrointestinal disease c

8. Which of the following is not a sign of frailty?
Weakness
Slow walking speed
Decreased cognition
Unintentional weight loss c

9. Which of the following is true of body composition in the elderly?
Increased body water, increased body cell mass, decreased body fat
Decreased body water, decreased body cell mass, increased body fat
Increased body water, decreased body cell mass, increased body fat
Decreased body water, decreased body cell mass, decreased body fat b

10. JD is a 68 yo WF. What is her optimal BMI?22 25 27 30 c

11. JD is a 68 yo WF. Which of the following factors would be used as part of the GNRI to calculate her nutritional risk?
Age and height
Age and albumin
Weight and height
Weight and albumin d

12. JD is a 68 yo WF. Higher measurements/levels of which of the following would not be more acceptable in this patient than a younger patient?
Cholesterol
Potassium
Glucose
Blood pressure b

13. JD is a 68 yo WF. Which of the following nutritional markers may not be accurate in this patient if she had ESRD and CHF?
Prealbumin
Transferrin
Skinfold
Albumin d

14. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be used to calculate calories if her BMI is calculated to be 29?
Ideal BW
Total BW
BEE
Adjusted BW c

15. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be used to calculate calories if her BMI is calculated to be 31?
Ideal BW
Total BW
BEE
Adjusted BW a

16. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be her goal for calories if her BMI is calculated to be 29?
1500
1750
2000
Can’t calculate b

17. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be her max goal for calories if her BMI is calculated to be 31?
1500
1750
2000
Can’t calculate d

18. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be closest to her goal for protein? 65 95
125
155 b

19. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be closest to her goal for protein if she was admitted to the ICU for pneumonia? 65 95
125
155
Probably d… but c is also a possibility

20. JD is a 68 yo WF. Her weight is 80 kg and BEE is 1400
JD is a 68 yo WF. Her weight is 80 kg and BEE is Which of the following would be closest to her goal for protein if her BMI is 31? 65 95
125
155 d

21. JD is a 68 yo WF. Which of the following would not increase the risk of hyperkalemia in this patient?
Decreased muscle mass
Decreased kidney function
Impaired aldosterone response
Diuretic administration d

22. JD is a 68 yo WF. Supplementation of which of the following would be least beneficial in this patient?
Calcium
Vitamin D
Vitamin A
Zinc c

23. Obesity

24. Which of the following is true of calculating energy expenditure in obesity?
IBW tends to overpredict
IBW is less accurate than TBW
TBW tends to underpredict
TBW is more accurate than REE b

25. Which of the following is not increased by obesity?
Metabolic complications
Hospital mortality
Complications in ventilator weaning
Heart failure complications b

26. Which of the following does not improve outcomes in obese patients?
Intensive insulin therapy
Increased CO2 production
Positive nitrogen balance
Decreased caloric intake b

27. Which of the following is not decreased with hypocaloric feeding?
Insulin use
Ventilator days
Mortality
Antibiotic use c

28. Which of the following is most improved with hypocaloric feeding?
Glucose metabolism
Fat metabolism
Protein metabolism
Insulin resistance b

29. Which of the following patients would likely require the most protein?
75 yo WF, BMI 35
45 yo WM, BMI 44
24 yo WF, BMI 44
64 yo WM, BMI 42 d

30. Administration of which of the following in a 66 yo WM (BMI 38) admitted to the ICU after a MVA is least important?
Lipids to prevent fatty acid deficiency
Glucose for wound healing
Protein for muscle maintenance
Non-protein calories for maintenance a

31. JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA
JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA. What should his glucose/protein intake be?
130 g/kg/day glucose, 2 g/kg/day protein
130 g/kg/day glucose, 2.5 g/kg/day protein
130 g/day glucose, 2 g/kg/day protein
130 g/day glucose, 2.5 g/kg/day protein c

32. JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA
JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA. When would 130 g/day glucose and 2 g/kg/day protein not be appropriate for this patient?
Existing hyperglycemia (BG 300)
Kidney disease (CKD stage 3)
Elevated triglycerides (>500)
Elevated LFTs (2x ULN) b

33. JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA
JR is a 66 yo WM (BMI 38) admitted to the ICU after a MVA. If the patient’s TG’s are 375, what would you do?
Decrease lipids
Decrease protein
Increase protein
Stop D5W
Stop lipids e