Chapter 63 Malnutrition and Obesity

Question 1

Drugs to stimulate appetite

Answer 1

Periactin, Megace

Question 2

Overweight

Answer 2

10% over ideal body weight

Question 3

Obesity

Answer 3

20% over ideal body mass

Question 4

Morbid obesity

Answer 4

100% above ideal body weight

Question 5

Drugs for obesity

Answer 5

Meridia, Tenuate, Bontril, Xenical

Question 6

Hospital nutritional screening

Answer 6

height and weight, weight history, eating habits, ability to chew and swallow, and any recent changes in appetite or food intake

Question 7

Marasmus

Answer 7

calorie malnutrition where body fat and protein are wasted but serum proteins are often preserved

Question 8

Kwashiorkor

Answer 8

lack of protein quantity and quality in the presence of adequate calories. Body weight is more normal and serum proteins are low

Question 9

Marasmic-kwashiorkor

Answer 9

combined protein and energy malnutrition. Often presents clinically when metabolic stress is imposed on a chronically starved patient

Question 10

Where is protein synthesized?

Answer 10

the liver

Question 11

malabsorption

Answer 11

occurs with malnutrition due to atrophy of gastric mucosa and loss of intestinal villi

Question 12

H&H with malnutrition

Answer 12

May be low due to low albumin, anemia, infection, catabolism, or chronic disease
High values could indicate dehydration or hemoconcentration

Question 13

Serum albumin

Answer 13

reflects nutritional status a few weeks before testing and is not the most sensitive study (should be 3.5-5.0)

Question 14

Prealbumin

Answer 14

more sensitive indicator of protein deficiency because it has a short half life of 2 days. (normal is 15-36)

Question 15

Transferrin

Answer 15

an iron transport protein with a short half life of 8-10 days which is also a sensitive indicator of protein status

Question 16

Cholesterol levels

Answer 16

typically low with malabsorption, liver disease, pernicious anemia, end stage cancer, and sepsis (below 160 indicates malnutrition)

Question 17

Total lymphocyte count and malnutrition

Answer 17

malnutrition suppresses the immune system so this level is usually decreased below 1500

Question 18

Cyproheptadine (periactin)

Answer 18

an antihistamine to stimulate appetitie

Question 19

Refeeding syndrome

Answer 19

complication of enteral feeding
life threatening condition brought on when nutrition is restarted for someone in a starvation state
insulin production resumes and the cells take up glucose and electrolytes from the bloodstream thus depleting serum levels

Question 20

Refeeding syndrome sx

Answer 20

cardiovascular, respiratory, and neurological problems primarily caused by hypophosphatemia. Shallow respirations, weakness, acute confusion, seizures, and increased bleeding.

Question 21

Gastric pH

Answer 21

0-4

6 or more indicates the feeding tube is probably in the lungs

Question 22

Fat overload syndrome

Answer 22

Can occur with administration of Partial parenteral nutrition
Sx: fever, increased triglycerides, clotting issues, and multisystem organ failure

Question 23

Drugs that can cause weight gain with long term use

Answer 23

Corticosteroids, estrogens, NSAIDS, antihypertensives, antidepressants, antiepileptic, oral antibiotics, psychoactive drugs

Question 24

Post-op complications for gastric surgery

Answer 24

Anastomotic leaks are the most common serious complication and cause of death after gastric bypass surgery
Dumping syndrome

Question 25

Sx of Anastomotic leaks

Answer 25

increasing back, shoulder, or abdominal pain, restlessness, and unexplained tachycardia and oliguria

Question 26

Dumping syndrome sx

Answer 26

tachycardia, nausea, diarrhea, abdominal cramping