191 Starvation Flashcards
What were the major findings from the Minnesota Starvation Experiment?
starvation lead to increased BMR, energy expenditure, body temperature, red cell mass, HR, BP and also changes in body composition and function
also lead to psychological changes like obsession with food, depression, irritability, etc.
What is the difference in basal metabolic rate change between starvation-associated malnutrition and disease-associated malnutrition?
decreased in starvation, increased in disease (due to fever, inflammation, etc.)
What is the mechanism of Marasmus?
a starvation disorder with a primary deficit of calories
What are the symptoms of marasmus?
low body weight, significant wasting of lean body mass
What is the mechanism of Kwashiorkor?
starvation with a primary protein deficiency (diet rich in carbohydrates, low in protein)
What are the symptoms of kwashiorkor?
adequate carbohydrate intake stimulates insulin release, which decreases protein catabolism and increases hepatic lipogenesis
leads to edema, ascites, fatty infiltration of the liver, skin rash, hair depigmentation
Who is given enteral or parenteral nutrition?
individuals who can’t or won’t eat
What are complications of parenteral nutrition?
central line associated bloodstream, hyperglycemia, refeeding syndrome
What is refeeding syndrome?
a life-threatening condition that can occur in severly malnourished patients within the first day of nutritional support –> causes low electrolyte levels, weakness, impaired contractility, cardiac arrhythmias
Which of the following is most likely to be seen in a previously healthy teenager who has consumed a restrictive diet containing only lean chicken, low-fat milk and yogurt, fruit and nonstarchy vegetables (600 calories per day) for ten months?
a) decreased cardiac mass, heart rate, blood pressure, and body temperature
b) fatty infiltration of the liver, low blood albumin concentration, and lower extremity edema
c) increased intestinal dissacharidase activity and increased GI motility
d) decreased blood concentration of insulin and blood sugar and increased blood concentrations of leptin and ketone bodies
e) markedly decreased adipose tissue stores with normal skeletal muscle mass
a) decreased cardiac mass, heart rate, blood pressure, and body temperature
What adaptive metabolic or hormonal changes occur during starvation AND during therapeutic weight loss in obesity?
reduction in energy expenditure
reduction in leptin level
reduction in thyroid hormone levels
increase in ghrelin level
Identify the ways in which the clinical manifestations of marasmus and kwashiorkor differ.
body weight (very low in marasmus)
presence/severity of hypoalbuminemia (kwashiorkor)
presence of liver dysfunction (kwashiorkor)
presence of edema and ascites (kwashiorkor)
presence of desquamative skin rash (kwashiorkor)
presence of hair depigmentation (kwashiorkor)
