Day 2- Nutrition and Obesity Flashcards
What is Marasmus?
What is Kwashiorkor?
Starvation associated malnutrition. Inadequate total intake(caloric and protein). Typical wasted appearance, normal visceral protein status, will respond to nutrition.
Starvation related, inadequate protein intake, protein stores deleted which lead to severe hypoalbuminemia and lead to edema(big belly), will respond to nutrition.
What is usual body weight?
What is IBW formulation?
What is Adjusted body weight formula?
Typical weight for a patient, used frequently when patients have fluid changes.
Male is 50 kg + (2.3 x inches over 5 ft) and Female is 45.5 kg + (2.3 x inches over 5 ft). For large or small frames is +/- 4.5 kg.
IBW + 0.4(ABW-IBW).
What is BMI calculation?
What are your lb to kg ratio and inches to cm ratio?
What is healthy BMI?
Weight(kg)/Height(m2).
- 2, 2.54.
- 5- 24.9 Obesity is >30.
When do you use the Mifflin-St.Jeor equation?
When do you use the ireton-jones equation?
How many kcals per day does someone need?
Most accurate in obese patients, not used in critically ill patients.
Calculates actual energy expenditure, best equation for critically ill patients.
Healthy: 20-25 per day. Illness or metabolic stress is BMI <30: 25-30. BMI > 30: 22-25. Major burn injury(>50% of total BSA) : >30 kcal per day.
What equation is used for basically normal patients?
How do you alter these equations based on certain states?
What are your macronutrient requirements?
Harris- Benedict.
Sepsis 1.2-1.4 for moderate, 1.3 for severe. Trauma, confined to bed 1.2, post operative 1-1.15, Burns up to 2.0.
Enteral fats: 9 kcal, parenteral is 10kcal/gram(1kcal from carb emulsifiers). Carbs is 3.4 kcal/gm, protein is 4kcal/gm.
What are your essential AA’s?
What is general protein requirement?
What are your essential fatty acids?
PVT TIM HALL.
0.8/kg/day. 1.5 for catabolism/critical illness, severe catabolism(major burn) 2.5 g. Chronic kidney or liver failure is 0.6.
Omega-3’s and Omega 6’s. Omega 3 is alpha lineolenic acid(plant oils and fish), Omega 6 is lineoleic acid(nuts, sunflower oil).
What are your daily lipid requirements?
What are your daily fluid requirements?
What is your daily carb range requirements?
2.5g/kg/day is enteral, 1g/kg/day is parenteral. No more than 10-35% of daily calories, If on propofol or clavidine consider these because of the fat.
30-35 ml/kg/day or 1mL/kCal/day
45-65%
What is dietary intake fat range requirements?
What’s the difference between magnesium and potassium deficiency?
What are your fat soluble vitamins?
20-35%
Potassium is muscle cramping, magnesium is twitching/weakness.
ADEK.
What are your B vitamins?
What are signs of Thiamine deficiency and when do you give glucose?
What are signs of Niacin deficiency vs too much?
The Romans Never Painted PYramids BeFore Caesar
Beriberi, Wernickes- Korsakoff Syndrome. GIVE THIAMINE BEFORE GLUCOSE! Get more from fortified grains, greens, meat, milk.
Pellagra(4 D’s–> diarrhea, dementia, death, dermatitis). Too much is liver failure, flushing. Those at risk for deficiency are high corn diets, dialysis, B6 (pyrixoidine) deficiency. Comes from meet, mushrooms, spelt.
What are signs of Riboflavin deficiency?
Where do you often see Pyridoxine deficiency vs toxicity and what does pyridoxine do?
What are signs of folic acid deficiency?
Mucositis, Cheilosis(corner mouth sores), Light sensitivity/eye burning.
Alcohol abuse and dialysis. Presents with microcytic anemia, neuropathy, seizure. Neuropathy is too much. Synthesizes niacin, neurotransmitters, hemoglobin.
400 mcg normal and 800 mcg for pregnant women is normal. Macrocytic anemia(megaloblastic), stomatitis, neural tube defects in infants.
What drugs can cause folate(vitamin B9) deficiency?
What is Cyanocobalamin(B12) deficiency?
What to know about Vitamin A(Retinol)?
Chronic, large doses of ASA or ibuprofen. Antiepileptics(phenytoin and phenobarb), sulfasalazine, methotrexate, trimethoprim. Toxicity is masking of B12 deficiency. Comes from grains, greens, broccoli, papayea, beans, lentils.
Macrocytic Anemia(pernicious), glossitis, peripheral neuropathy, depression. Comes from meat, fish, dairy.
Stored in liver and adipose tissue, toxicities are more common. Gingivitis and teratogenic effects are toxicity. Dry har and skin, blindness(particularly nighttime), pruritis is signs of deficiency.
What to know about Vitamin D?
What causes Drug induced Vitamin D defiency?
What does potassium and magnesium deficiency look like?
Signs of toxicity have kidney stones and high calcium and tissue calcification. Deficency is ricketts, osteomalacia, muscle weakness. Ergo is Vitamin D2, Chole is vitamin D3.
Antiepileptics, Chronic corticosteroids(>5 mg prednisone equivalent for >3 months), Chronic antacid use, orlistat.
Potassium gives you arrhthymias, Magnesium is palpitation and muscle weakness.
How does zinc help in the body and what happens if too much or too little?
What does copper hurt if you have too much?
What does calcium toxicity vs deficiency look like?
Catalyse for immune function, reactions, taste and smell. Toxicity leads to metallic taste and N/V. Deficiency leads to decreases sense of taste and smell, poor wound healing and growth, skin issues.
liver and kidney failure, muscle weakness and pigmentation decrease if too little.
Toxicity looks like kidney stones, bone pain, N/V. Deficiency looks like tetany/muscle spasms, fatigue, confusion and depression.
What happens with selenium in your body?
What to know about iron?
What to know about iodine?
Enzymatic reactions, T3 to T4. Brittle hair and nails and hair loss if too much, deficiency is cardiomyopathy, hypothyroidism, and immune dysfunction.
Poisoning is too much, anemia is too little.
Toxicity is mouth burning and hyperthyroidism, deficiency is brain damage and goiter or hypothyroidism.
What are the signs of refeeding syndrome?
What is waist circumference elevated risk?
What causes medication induced weight gain?
hypokalemia, magnesia, phosphatemia. Typically >7 days of inadequate nutrition puts you at risk. So does Chronic starvation or prolonged starvation, bariatric surgery, alcohol use, vomiting and diarrhea.
Men: >40 inches, Women : >35 inches.
Antihyperglycemics, Corticosteroids, Anti-epileptics, antipsychotics, Antidepressants, Anticholinergic.
