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GI > General Nutrition > Flashcards

General Nutrition Flashcards

1
Q

How much unintentional weight loss is a red flag?

A

5-10% in 6 months

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2
Q

Someone with decreased ABW, normal lean body mass, and decreased total body water is considered what?

A

dehydrated

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3
Q

What is the estimated average requirement?

A

meets vitamin and trace element needs of 50% of persons

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4
Q

What is the caloric recommended daily intake for carbohydrates?

A

4kcal/g

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5
Q

What is the caloric recommended daily intake for protein?

A

4 kcal/g

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6
Q

What is the caloric recommended daily intake for fat?

A

9 kcal/g

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7
Q

What affects albumin/ protein assessment?

A
  1. dehydration
  2. decreased hepatic function
  3. abnormal renal function loss
  4. abnormal GI function loss
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8
Q

What would cause increased levels of albumin?

A
  1. dehydration
  2. anabolic steroid use
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9
Q

What would cause a decrease in albumin?

A
  1. fluid overload
  2. malnutrition
  3. burns
  4. nephrotic syndrome
  5. cirrhosis
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10
Q

How often do albumin levels need to be checked? Why?

A

every 2-3 weeks;
half-life= 2-3 weeks, chronic marker

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11
Q

How often do pre-albumin levels need to be checked? Why?

A

every 2-3 days;
half-life= 2-3 days, acute marker

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12
Q

Is a baseline value more important for albumin or pre-albumin?

A

albumin

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13
Q

What types of underlying pathologies can contribute to nutritional problems?

A
  1. neoplastic diseases
  2. digestive/ absorptive diseases
  3. COPD
  4. cirrhosis
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14
Q

What is marasmus?

A

severe malnutrition where the body digests its organs leads to kwashiorkor

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15
Q

What is kwashiorkor?

A

acities due to severe protein/ albumin depletion

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16
Q

What are early signs of malnutrition?

A
  1. dermatitis
  2. glossitis
  3. cheilosis (crust around lips from fat deficiency)
  4. jaundice
17
Q

What are the consequences of underfeeding?

A

metabolic abnormalities and nutrient deficiency –> infection, wound healing, arrhythmias

18
Q

What are the consequences of starvation?

A

changes in metabolic process –> digestion of organs/ muscle –> inability to clear fluids around the heart and lungs –> pneumonia –> death

19
Q

What medications are recommended for underweight/malnourished and able to tolerate oral intake safely?

A
  1. Mirtazapine
  2. Testosterone
  3. Megestrol Acetate
  4. Dronabinol
20
Q

What patients would Mirtazapine (Remeron) work best in?

A

weight loss due to depression

21
Q

What patients would Megestrol acetate (MEGACE) work best in?

A
  1. cancer
  2. AIDS
  3. end of life
  4. palliative care
22
Q

What is the MOA of Megestrol acetate?

A

synthetic progestin; anti-estrogenic properties

23
Q

What are SEs with Megestrol acetate (MEGACE)?

A
  1. Thromboembolic events
  2. diabetes
24
Q

What patients would Dronabinol (MARINOL) work best in?

A

AIDS patients

25
Q

What are SEs with Dronabinol (MARINOL) ?

A
  1. CNS depression
  2. exacerbation of mental illness
26
Q

How is Dronabinol (MARINOL) administered?

A

1 hour before lunch and dinner

27
Q

What patients would Testosterone work best in?

A

malnourished males with low testosterone

28
Q

Why is testosterone rarely used?

A

SE profile, fluid retention

29
Q

What happens during initial onset of starvation?

A

Decreased insulin and glucose utilization
Increased catecholamines and gluconeogenesis
(fight/flight response)

30
Q

What happens as starvation progresses?

A

Fatty acid utilization becomes main source of energy –> vital organs (heart/respiratory muscles) used as caloric source

31
Q

What is hypermetabolism?

A

Neuroendocrine (sympathetic) response to maintain homeostasis due to injury

32
Q

What is acute hypermetabolism?

A

lasts 24-36 hours after injury; promotion of hyperglycemia and protein catabolism

33
Q

How should acute hypermetabolism be managed?

A

increase calories 1.5-2 times BEE

34
Q

Why is nutritional support vital during adaptive hypermetabolism?

A

increased metabolic rate, protein consumption, glucose flow, and hyperthermia

35
Q

What are indications to recieve chronic nutritional support?

A
  1. inability to absorb nutrients using GI tract (small bowel resection, small intestine diseases, radiation)
  2. inadequate nutritional intake (inability to swallow due to aspiration risk, lack of appetite)
36
Q

When should acute nutritional support be given?

A

nutrition cannot be provided for 5-7 days

GI (23 decks)

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