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Year 4 - OPIC > 6. Nutrition > Flashcards

6. Nutrition Flashcards

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1
Q

What does the body require energy for?

A
  • homeostasis
  • maintenance of ionic gradients
  • transport
  • biosynthesis
  • heat generation
  • locomotion
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2
Q

What are vitamins?

A

Organic compounds that are required in small amounts for maintenance of normal health and metabolic integrity.

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3
Q

What are the lipid soluble vitamins?

A

A, D, E and K

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4
Q

What are the sources of Vitamin A?

A
  • liver
  • carrots
  • kidney
  • egg yolk
  • butter
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5
Q

What are the signs of Vitamin A deficiency?

A
  • night blindness
  • xeropthalmia (dry eyes)
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6
Q

What are the consequences of Vitamin D deficiency?

A

Rickets (poor mineralisation of bone, affects children)

Osteomalacia (bone demineralisation, affects adults)

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7
Q

What are the sources of Vitamin E?

A
  • olive oil
  • meat
  • eggs
  • leafy vegetables
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8
Q

What are the consequences of Vitamin E deficiency?

A

Rare - serious neurological dysfunction.

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9
Q

What are the sources of Vitamin K?

A

Green vegetables:
- broccoli
- brussel sprouts
- kale
- spinach

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10
Q

What are the functions of Vitamin K?

A

Co-enzyme for FII, FVII, FIX and FX in the clotting cascade.

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11
Q

What are the consequences of Vitamin K deficiency?

A
  • impaired clotting
  • haemorrhagic disease
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12
Q

What are the sources of Vitamin B1 (thiamine)?

A
  • legumes
  • brown rice
  • cereals made from whole grains
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13
Q

What are the consequences of Vitamin B1 deficiency?

A
  • Wernicke-Korsakoff syndrome
  • peripheral neuritis
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14
Q

What are the sources of Vitamin B9 (folate)?

A
  • leafy vegetables
  • liver
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15
Q

What are the consequences of Vitamin B9 deficiency?

A
  • macrocytic anaemia
  • mouth ulcers
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16
Q

What is obesity?

A

Excess of body fat that is sufficient to affect health adversely (BMI >30kg/m2).

17
Q

What medical complications are associated with obesity?

A
  • T2DM
  • hypertension
  • coronary artery disease
  • cancers
  • osteoarthritis
18
Q

What are the goals of weight loss?

A

5-10% reduction in weight from is associated with clinically worthwhile reduction in comorbidities.

19
Q

What are some potential health benefits from the loss of 10kg from initial body weight in obese patients?

A
  • 25% fall in total mortality
  • 50% fall in obesity-related cancer deaths
  • 15% fall in HbA1c
20
Q

How can obesity be managed by diet?

A

Calculate deficit of 600kCal per day

8% of body weight can be lost within 12 months.

21
Q

What is the mechanism of action of Orlistat in obesity?

A

Inhibits pancreatic and gastric lipases, reducing absorption of dietary fat.

22
Q

What are the side effects of Orlistat?

A
  • liquid stools
  • faecal urgency
  • oily discharge
23
Q

What are the surgical options to treat obesity?

A
  • laparoscopic gastric banding
  • gastric bypass
24
Q

Approximately what proportion of adults aged >65years are undernourished?

A

10%

25
Q

What screening tool can be used to assess malnutrition risk in patients?

A

MUST score

26
Q

What are some causes of malnutrition?

A
  • vegans (lack iron or B12)
  • excessive alcohol
  • nausea
  • medication
  • social isolation
  • depression
  • poverty
27
Q

What are the clinical features of malnutrition?

A
  • muscle wasting
  • concave abdomen
  • loose rings on fingers
  • prominent cheek bones
28
Q

What are the indications of artificial nutritional support?

A

Indicated if oral intake is insufficient to maintain nutrition.

29
Q

What is enteral artificial nutrition support?

A

Nutrition support via the gut.

30
Q

What is parentral nutrition support?

A

Intravenous administration of nutrition.

31
Q

a) description

b) uses

c) advantages

d) disadvantages

of nasogastric access.

A

a) fine-boor tube giving pernasal access.

b) short-to-medium term intragastric feeding, due to inability to swallow.

c) bedside placement without sedation; well tolerated

d) risk of malposition; difficult to manage in confused patients

32
Q

a) description

b) uses

c) advantages

d) disadvantages

of nasojejunal access.

A

a) fine-bore tube passed into distal duodenum / proximal jejunum

b) inability to swallow complicated by GORD or gastroparesis; gastric outlet obstruction; acute severe pancreatitis

c) bedise placement; accurate delivery;

d) endoscopy or fluoroscopy for placement; easily displaced

33
Q

a) description

b) uses

c) advantages

d) disadvantages

of PEG access.

A

a) tube passed through abdominal wall into stomach, retained internally by a balloon.

b) long-term intragastric feeding;

c) difficult to displace; reliable in long-term;

d) requires endoscopic placement; peritonitis; bleeding; PEG site infection

34
Q

a) description

b) uses

c) advantages

d) disadvantages

of surgical jejunostomy access.

A

a) feeding tube placed surgically into jejunum

b) postoperative feeding

c) permits early enteral feeding in post-operative setting

d) not ideal for long-term use due to risk of displacement

35
Q

What are the options for parenteral nutritional support/

A
  • PICC line
  • midline catheter
  • Hickman catheter
36
Q

What is the role of artificial nutrition in palliative care?

A

Limited evidence to suggest length and quality of life is improved using artificial nutritional support in palliative care settings.

Patients can eat food naturally with accepted risk of aspiration.

37
Q

How can nutritional services be delivered in hospital?

A

MDT involving clinician, specialist nurse, dietitian and pharmacist within the hospital service.

Referral of patients to nutritional team.

Year 4 - OPIC (11 decks)

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