3 - Paeds - Gastro - Malnutrition

Question 1

what may malnutrition result from

Answer 1

anorexia, malabsorption, increased requirements

Question 2

What conditions increase the risk of a child having malnutrition

Answer 2

chronic illness eg pre-term, CHD, cancer - during chemo/BMT
chronic GI conditions - IBD
chronic renal failure, cerebral palsy

Question 3

What tool is used to ID adults who are malnourished/at risk/obese?
what is used in kids? what is it based on?

Answer 3

the MUST tool - 5 step tool

Paediatric Yorkhill Malnutrition score, based on:

• BMI
• wt loss
• red dietary intake
• risk of child’s nutrition being affected by admission

Question 4

nutritional status - expressed as …
weight for height - measure of what? severe malnutrition shown by what? MUAC < what indicates severe malnutrition?
what about height for age, indicator for what?

Answer 4

wt fro ht is measure for wasting
-severe malnutrition = wt for ht > -3SDs (<70%) below median

Mid upper arm circumference
-MUAC <115mm = severe mal

ht for age - an index of chronic mal and stunting

Question 5

Marasmus - cause? wt for ht?

Answer 5

caused by severe Protein energy malnutrition

wt for ht > -3SDs below median

Question 6

Marasmus - appearance? signs/Sx?

Answer 6

wasted, wizened appearance

no oedema, skinfold thickness and MUAC markedly reduced, withdrawn/apathetic

Question 7

Kwashiokor - cause? more common in what societies? often follows what?

Answer 7

severe Protein energy malnutrition

where infants not weaned until 12m -> high starch diet

often follows acute intercurrent infection eg measles/gastroenteritis

Question 8

Kwashiokor - Sx and Signs

Answer 8

generalised oedema and severe wasting
wt not as bad due to oedema

Also may be -> flaky paint rash, distended abdo, hepatomegaly, angular stomatitis, sparse hair, diarrhoea, hypothermia, bradycardia, hypotension, low albumin/K/Glucose/Mg