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KIN 334 > Body Composition III: Clinical Practice > Flashcards

Body Composition III: Clinical Practice Flashcards

1
Q

BMI is generally accepted as an overall predictor of _____ and _____.

A
  • morbidity

- mortality

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2
Q

Main limitation of BMI:

A

due to differences in body composition

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3
Q

The article “A requiem for BMI in the clinical setting” states that BMI is not appropriate to accurately differentiate between important ____ ____ _____ and therefore should not be used for…

A
  • body weight components

- making clinically important decisions at the individual patient level

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4
Q

BMI has a good correlation with ____ ____ ____ at the _____ level, but the predictive value at the _____ level is very limited.

A
  • % body fat
  • population
  • individual
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5
Q

BMI use in clinical practice may jeopardize the _____ _____, in particular of _____.

A
  • nutritional diagnosis

- malnutrition

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6
Q

BMI less than 30 kg/m^2 does not exclude the presence of ____ ____ associated with the _____ of _____.

A
  • metabolic risks
  • excess
  • adiposity
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7
Q

BMI at least 30 kg/m^2 does not exclude the presence of ____ ____ ____ (_____ _____), mainly in some clinical situations as in …..

A
  • low muscle mass (sarcopenic obesity)
  • elderly
  • cancer
  • chronic diseases
  • critically ill patients
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8
Q

Who is at risk for low muscle mass?

A
  • obesity
  • aging
  • HIV/AIDS
  • CV conditions
  • COPD
  • cancer
  • rheumatoid arthritis
  • hospitalized patients
  • diabetes
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9
Q

Muscle function:

A
  • strength and power
  • posture and balance
  • mobility
  • regulates blood glucose
  • stores proteins
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10
Q

10% muscle mass loss:

A
  • impaired immunity

- increase chance of infection

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11
Q

20% muscle mass loss:

A
  • weakness

- decreased healing

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12
Q

30% muscle mass loss:

A
  • physical impairment

- no wound healing

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13
Q

40% muscle mass loss:

A

death

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14
Q

Techniques to measure muscle strength:

A
  • handgrip strength
  • knee flexion/extension
  • peak expiratory flow
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15
Q

Techniques to measure muscle function:

A
  • gait speed
  • short physical performance battery
  • time up and go test
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16
Q

In grip strength, it is important that the _____ of the subject is _____:

A
  • position
  • standardized
  • sitting
  • shoulders relaxed
  • elbow at 90 degrees
  • upper arm not touching body
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17
Q

Calf circumference:

A
  • tape measure placed around calf without compressing the subcutaneous tissue
  • tape is moved along the length of the calf to obtain the maximal circumference
  • 4 times (2 times for each leg)
18
Q

Calf circumference should be ____ for males and females.

A

< 33

19
Q

Calf circumference is inversely correlated with ____.

A

mortality

20
Q

Low calf circumference is an indicator of _____ among elderly people.

A

malnutrition

21
Q

Calf circumference validity is lower for ____.

A

women

22
Q

Low muscle mass is a powerful and independent predictor of poor prognosis:

A
  • physical impairment disability
  • greater length of hospital stay
  • need for rehab
  • post op complications
  • disease progression
  • poorer quality of life
  • shorter survival
23
Q

Gaining muscle mass is ______, it is better to ____ the ____.

A
  • difficult

- prevent the loss

24
Q

Evidence shows it can take ____ to rebuild muscle mass lost over ____ days.

A
  • weeks

- 3-10 days

25
Q

What can lead to low muscle mass?

A
  • endocrine
  • neurological
  • inadequate nutrition
  • treatment/surgery
  • disuse
  • age related
26
Q

Endocrine factors that lead to low muscle mass:

A
  • corticosteroids
  • GH
  • IGF-1
  • IR
  • abnormal thyroid function
27
Q

Neurological factors that lead to low muscle mass:

A

motor neuron loss

28
Q

Disuse factors that lead to low muscle mass:

A
  • immobility

- lack of PA

29
Q

Age related factors that lead to low muscle mass:

A
  • sex hormones
  • apoptosis
  • mitochondrial
  • dysfunction
30
Q

Lean mass and ____ ____ are not strongly correlated.

A

body weight

31
Q

Screening –> ______ –> ______ –> ______ –> _______.

A
  • assessment
  • diagnosis
  • intervention
  • monitoring and evaluation
32
Q

Monitoring and intervening means utilizing tools:

A
  • MUST
  • SGA
  • MNA
33
Q

Monitoring and intervening means measuring:

A
  • BIA
  • DXA
  • muscle function/strength tests
34
Q

Monitoring and intervening means ____ support, ____ _____ supplements, ____.

A
  • nutritional support: adequate energy and high protein
  • oral nutritional supplements
  • exercise: resistance training, adaptation needed
35
Q

ICD:

A
  • International Statistical Classification of Diseases and Related Health Problems
  • medical classification list by the WHO
36
Q

ICD 10 code for….

A

sarcopenia

37
Q

ICD - 10 code for sarcopenia (low LM) lists that:

A
  • increase awareness and attention
  • acceptance as a condition: indication for treatment
  • enable storage and retrieval of diagnostic information
  • basis for reimbursement and resource allocation
  • potential to influence public health and health policy
38
Q

To progress the knowledge and recognition of sarcopenia, the task force recommends the following actions:

A

explore the impact of targeted nutritional approaches to countermeasure muscle loss alone and in a multimodal approach to maximize anabolic potential (eg. exercise and anabolic therapy)

39
Q

Body composition evaluation should be integrated into ____ ___ _____ for the initial ____ and sequential ___ ___ of ____ status.

A
  • routine clinical practice
  • assessment
  • follow up
  • nutritional
40
Q

Vision is to allow _____, _____, and ____ screening of malnutrition and promote the ____ and early initiation
of optimal _____ ______, thereby contributing to
reducing ….

A
  • objective, systematic, and early
  • rational
  • nutritional support
  • malnutrition-induced morbidity
  • mortality
  • worsening of the quality of life
  • global health care
    costs.
41
Q

Low muscle across the continuum of care:

A
  • primary care
  • acute setting
  • chronic disease
  • long term care
  • population health

KIN 334 (14 decks)

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