Disorders of the Nutritional Status Flashcards
Where are the hunger and satiety centers located in the brain?
in the hypothalamus
What is caloric use controlled by?
by metabolic rate which is regulated by thyroid hormones and by level of activity
What are the two types of fat that store calories?
White: predominant storage
Brown: more in early life and declines with age
Describe what BMI is
it is the ratio between your weight and height
weight/height
If you have a BMI under 18.5 what does that mean?
that you are underweight
If you have a BMI over 30 what does that mean?
that you are obese
What is the waist to hip ratio that marks obesity in men and women?
> 1 for men
>0.8 for women
List some of the complications of obesity.
systemic insulin resistance HTN Cardiovascular disease Diabetes Cancer (breast, endometrial) Gallbladder disease Osteoarthritis Menstrual irregularities Infertility Skeletal degradation
What are some disease processes which can cause malnutrition?
Crohn disease Malabsorption syndromes Ca Anorexia nervosa Severe injury/illness
Explain how malnutrition can occur from sever injury/illness
the body needs protein to fight and repair. If you can’t provide the E and nutrients to do it, the body will break down organs to do so
Common organs: liver, GI tract, kidneys, heart, resp muscles
How does marasmus present in children?
wasted appearance (no subcut fat)
protuberant abdomen
stunted growth
wrinkled skin
sparse, dry, dull hair
diarrhea
slow HR, low BP, low temp
frequent/concurrent infections
What is muscle hypotonia?
protuberant abdomen
What is the flag sign of marasmus?
sparse/dry/dull hair
What are the two general categories of protein-energy malnutrition?
Marasmus (protein and calorie def)
Kwashiorkor (protein def, but high carbs)
What can cause marasmus-like secondary protein energy malnutrition?
Chronic illnesses:
COPD
CHF
HIV
Ca
How does kwashiorkor present in children?
stunted growth, but presence of subcut fat
generalized edema
DISTENDED abd
Flaky lesions on skin, face, peri
Dec cardiac output and tachycardia
SANDY or RED hair
Anorexia, apathy
What causes the generalized edema in kwashiorkor?
Hypoalbuminemia (low albumin)
therefore dec osmotic gradient into the blood
What is the flag sign of kwashiorkor?
sandy or red hair
What can cause kwashiorkor-like secondary protein energy malnutrition?
HYPERMETABOLIC acute illnesses:
trauma
burns
sepsis
Describe anorexia nervosa. In what age group is it most common?
Determined dieting often with compulsive exercise and possible purging and binging.
Usually accompanied by inability to recognize problem, depression, OCD, and substance abuse
Usually in adolescence
How do eating disorders differ between men and women?
men are more likely to engage in binge-eating and compulsive exercise
What are some of the causes that contribute to anorexia nervosa?
Genetic
Personality
Anxiety disorders
Family hx depression, obesity
peer/family/cultural pressures regarding appearance
Describe the diagnostic criteria for anorexia nervosa.
1) refusal to maintain minimally normal weight for age and height (less than 85 percent)
2) intense fear of gaining weight
3) altered perception about own body size, weight, and shape
4) amenorrhea
What is amenorrhea?
cessation of menstruation and loss of secondary sex characteristics
