American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the treatment approach for an RQ greater than 1?

1. Increase protein intake

2. Decrease carbohydrates and calories

3. Increase carbohydrates and calories

4. No treatment required

The correct answer is: Increase carbohydrates and calories

When the respiratory quotient (RQ) is greater than 1, it indicates that the body is in a state where it is producing more carbon dioxide than oxygen it consumes. This situation typically occurs when the metabolism is primarily utilizing carbohydrates for energy, leading to greater CO2 production compared to O2 consumption. Thus, the treatment approach under these circumstances revolves around managing the macronutrient intake. Increasing carbohydrates and calories would provide the necessary energy while ensuring that the metabolic process is balanced. Since carbohydrates are preferentially utilized during states where RQ is elevated, increasing their availability can help normalize the RQ by promoting aerobic metabolism and efficiently utilizing oxygen. This could also potentially stabilize the ratio of gas exchange, as a well-maintained carbohydrate intake can lead to improved metabolic efficiency and gas exchange in tissues. In contrast, increasing protein intake or decreasing carbohydrates and calories would not directly address the underlying metabolic condition and could exacerbate the situation with further imbalances in energy utilization and gas production. Not requiring treatment could lead to persistent abnormalities in metabolism that could impact overall health, making active intervention more appropriate for managing an elevated RQ.