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RB Y1 GI > IF and malnutrition > Flashcards

IF and malnutrition Flashcards

1
Q

what is ulna length an estimate of

A

height

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2
Q

what does hand grip dyamometry assess

A

upper muscle strength

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3
Q

what does mid upper arm circumference reflect

A

muscle mass and subcutaneous fat

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4
Q

what does tricep skin fold thickness provide

A

estimate of total body fat

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5
Q

what does waist circumference tell you

A

predictor of CV risk

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6
Q

what does IF result from

A

inability to maintain adequate nutrition or fluid status via the intestines

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7
Q

type I

A

Self-limiting short term postoperative or paralytic ileus

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8
Q

type II

A

Prolonged, associated with sepsis and metabolic complications. Often related to abdominal surgery with complications

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9
Q

type III

A

Long term but stable – home parenteral nutrition often indicated

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10
Q

where is type III taken care of

A

wards to home

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11
Q

what will investigations show

A

dec albumin, ADEK and zinc

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12
Q

treatment of type I

A

self limiting - replace fluid and electrolytes

PPIs

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13
Q

in type I IF what do you do if they cant tolerate food or fluid

A

parenteral nutrition

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14
Q

what do u give to preserve Mg in type I IF

A

alpha hydroxycholecalciferol

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15
Q

enteral nutrition

A

Delivery of nutrition into the stomach, duodenum, or jejunum via a tube.

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16
Q

what do you feed patients with in perioperative period

A

enteral nutrition

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17
Q

enteral nutrition contraindications

A
  • Lower G.I. obstruction
  • Prolonged ileus
  • Severe vomiting/diarrhoea
  • Fistulae
  • Intestinal ischaemia
18
Q

enteral nutrition complications

A

incorrect insertion
rupture and perforation - bleeding
reflux
GI intolerance or irritation

19
Q

what is the first choice for enteral nutrition short term feeding

A

nasogastric

20
Q

when is Parenteral Nutrition used

A

when patients cant be fed enterally

21
Q

what is the tunnelled catheter in parenteral nutrition insertion guided by

A

US

22
Q

when is parenteral nutrition used over ET feeding

A

SBS
non functioning GI tract
motility disorder
IBD with severe malabsorption

23
Q

dangers of parenteral nutrition

A

sepsis
SVC thrombosis
line fracture
liver disease

24
Q

what feeding is given in type II IF

A

parenteral and possible enteral

25
Q

how is type III IF treated

A

HPN
bowel lengthening
intestinal transplantation

26
Q

what is the long term survival of intestinal transplantation like compared to HPN

A

lower

27
Q

SBS

A

small bowel <200cm

28
Q

what is SBS an indication for

A

HPN

29
Q

what is a small bowel transplantation usually combined with

A

liver transplantation

30
Q

what are the indications for small bowel transplantation

A

last resort - loss of venous access and liver disease

31
Q

step 1 MUST score

A

BMI

>20=0, 18.5-20=1, <18.5=2

32
Q

MUST score step 2

A

Weight Loss

<5%=0, 5-10%=1, >10%=2

33
Q

MUST score step 3

A

Disease

If pt acutely ill and no (or no likely) nutrition >5 days=2

34
Q

MUST score step 4

A

risk

0=Low, 1=Medium, ≥2=High

35
Q

MUST score step 5

A

management

  • Low risk Routine clinical care, repeat screening
  • Medium risk Observe, document dietary intake for 3 days
  • High risk Treat: refer to dietician, set goals, monitor
36
Q

Alpha-beta-lipoproteinaemia inheritance

A

Au R

37
Q

Alpha-beta-lipoproteinaemia

A

inability to synthesis chylomicrons - affect the absorption of fat, cholesterol and fat soluble vitamins

38
Q

Alpha-beta-lipoproteinaemia

treatment

A

vitamin E

39
Q

refeeding syndrome

A

As the body turns to fat and protein metabolism in the starved state, there is a drop in the circulating level of insulin.

The catabolic state also depletes intracellular stores of phosphate, although serum levels remain normal.

When refeeding begins, the insulin levels rise and there is an inc cellular uptake of phosphate.

40
Q

what develops within 4 days in refeeding syndrome

A

hypophosphateaemic state

- red and white cell dysfunction, respiratory insufficiency, arrhythmias, cardiogenic shock and sudden death

41
Q

malnutrition effects - water and electrolyte disturbances

A

dec ability to excrete Na and water

42
Q

malnutrition effects - menstrual irregularities and amenorhroea

A

infertility and osteoperosis

RB Y1 GI (54 decks)

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