Chapter 3: Clinical Assessment

Question 1

the methodology used during the advanced stages of nutritional deficiency

should not be used as the only method of assessment

Answer 1

clinical assessment

Question 2

should be used as adjunct to clinical assessment

Answer 2

biochemical or lab results

Question 3

useful for identifying the severity of the problem and measuring progress toward long-range goals to eradicate nutrient deficiencies

Answer 3

clinical measurements

Question 4

components of physical assessment (2)

Answer 4

medical history and physical examination

Question 5

components of physical assessment

defined as changes, believed to be related to inadequate nutrition, can be seen or felt in superficial epithelial tissue, esp. the skin, eyes, hair, and buccal mucosa, or in organs near the surface of the body

Answer 5

physical examination

Question 6

components of physical assessment

may reveal evidence of certain nutritional deficiencies which will not be detected by dietary or lab methods

Answer 6

physical examination

Question 7

corroborated or validates the findings obtained by medical history

Answer 7

physical examination

Question 8

components of physical assessment

obtained thru interview of patient or from records or both

includes a description of the patient and relevant environmental, social, and family factors

Answer 8

medical history

Question 9

types of medical records

consists of patient identification data, admission notes, physician’s orders, lab reports, medication records, consent, consultations, operating room records, progress notes, flow sheets

Answer 9

source-oriented medical record (SOMR)

Question 10

types of medical records

consists of a defined database, a complete problem, the initial care plan, progress notes, flow sheets, and discharge summary

Answer 10

problem-oriented medical record (POMR)

Question 11

nasolabeal seborrhea deficiency (3)

Answer 11

prydoxine, riboflavin, niacin

Question 12

cheilosis and angular stomatitis (5)

Answer 12

riboflavin, niacin, biotin, vitamin b6, iron

Question 13

glossitis of the tongue (4)

Answer 13

riboflavin, niacin, folic acid, vitamin b12

Question 14

who classification of physical signs most often associated with malnutrition

signs that are considered to be of value in nut assessment

often associated with nutritional deficiency status

signs of malnutrition may often be mixed and may be due to the deficiency of 2 or more micronutrients

Answer 14

group 1

Question 15

who classification of physical signs most often associated with malnutrition

sings that need further investigation

may be related to malnutrition, perhaps of a chronic type, but are often found in populations of developing countries where other health and environmental problems (poverty and illiteracy), coexist

Answer 15

group 2

Question 16

who classification of physical signs most often associated with malnutrition

signs that have no relation to malnutrition

may be similar to physical signs found in persons with malnutrition and must be carefully delineated from them

usually takes the particular expertise of a physician or other health worker expertly trained in nutritional diagnosis

Answer 16

group 3

Question 17

are assessment of clinical vitamin a deficiency in individuals and populations (2)

Answer 17

xerophthalmia and night blindness

Question 18

include growth retardation and decreased immune function in lowering effects of measles and diarrhea episodes

Answer 18

vitamin a deficiency - non-ocular signs

Question 19

allow diagnosis on clinical grounds, esp. when the condition is moderately advanced

Answer 19

ocular signs

Question 20

classification of xerophthalmia

is often the first evidence of vitamin a deficiency

the individual has a reduced ability to see in dim light

parents may notice that their young child is clumsy in the dark or fails to recognize people in a poorly lit room

Answer 20

night blindness (XN)

Question 21

night blindness occurs because vitamin a deficiency reduced the _____ in the rods of the retina

Answer 21

rhodopsin

Question 22

classification of xerophthalmia

dying if the conjunctiva

patches of xerosis give the appearance of sandbanks at receding tide

the conjunstiva loses its shiny lustre and often becomes thickened, wrinkled, and sometimes pigmented

Answer 22

conjunctival xerosis (X1A)

Question 23

classification of xerophthalmia

sometimes accompanying the conjunctival xerosis

usually triangular-shaped, raised whitish plaques that occur in both eyes

Answer 23

bitot’s spots (X1B)

Question 24

classification of xerophthalmia

when examined closely they look like a fine foam with many tiny bubbles

this foamy, sticky material can be wiped away

Answer 24

bitot’s spots (X1B)

Question 25

classification of xerophthalmia

the next stage, drying of the corneal surface, which first appears hazy and then granular on simple eye examination

drying is followed by a softening of the cornea, often with ulceration and areas of necrosis

Answer 25

corneal xerosis (X2)

Question 26

prevalence criteria for determining the public health significance of xerophthalmia and vitamin a deficiency in children aged 6 months to 6 years

night blindness (XN)

Answer 26

minimum prevalence %
>1%

Question 27

prevalence criteria for determining the public health significance of xerophthalmia and vitamin a deficiency in children aged 6 months to 6 years

bitot’s spots (X1B)

Answer 27

minimum prevalence %
>0.5

Question 28

prevalence criteria for determining the public health significance of xerophthalmia and vitamin a deficiency in children aged 6 months to 6 years

corneal xerosis/corneal ulceration/keratomalacia (X2/X3A/X3B)

Answer 28

minimum prevalence %
>0.01

Question 29

prevalence criteria for determining the public health significance of xerophthalmia and vitamin a deficiency in children aged 6 months to 6 years

corneal scar (XS)

Answer 29

minimum prevalence %
>0.05

Question 30

prevalence of night blindness to define a public health problem and its level of importance among children aged 24-71 months

prevalence of night blindness - mild

Answer 30

0.01-0.99%

Question 31

prevalence of night blindness to define a public health problem and its level of importance among children aged 24-71 months

prevalence of night blindness - moderate

Answer 31

1.0-4.9%

Question 32

prevalence of night blindness to define a public health problem and its level of importance among children aged 24-71 months

prevalence of night blindness - severe

Answer 32

5.0% or more

Question 33

a trace element in the human body and is absorbed through the gut as iodide, the chemically bound form of this element

Answer 33

iodine

Question 34

the most common cause of goiter, a condition defined when each of the lateral lobes of the thyroid gland is larger than the terminal phalanges of the thumb of the person examined

Answer 34

iodine deficiency

Question 35

increase in _____ is usually the first clinical sign of impaired iodine nutrition and indicates an adaptation to the reduction of thyroid hormone available

Answer 35

thryoid

Question 36

enlargement of the thyroid results from increased _____ of TSH or lymphocyte production of TSH-like immunoglobulins

Answer 36

pituitary secretion

Question 37

a reflection of chronic iodine deficiency and can be used as a baseline assessment of a region’s iodine status and as a sensitive long-term indicator for the success of an iodine program

Answer 37

goiter