L_8 Vulnerable Groups Flashcards
1
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Calories ??
A
1,600
2
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Calories ??
A
2,140
3
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Protein (gm) ??
A
54
4
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Protein (gm) ??
A
43
5
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Vitamin A (mcg) ??
A
400
6
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Vitamin C (mg) ??
A
35
7
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Vitamin C (mg) ??
A
45
8
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Iron (mg) ??
A
11
9
Q
Energy and nutrients’ needs of the school-age child
((7-9 Yrs))
Iodine (mcg) ??
A
120
10
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Vitamin A (mcg) ??
A
400
11
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Vitamin C (mg) ??
A
45
12
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Calcium (mg) ??
A
1,000
13
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Iron (mg) ??
A
13
14
Q
Energy and nutrients’ needs of the school-age child
((10-12 Yrs))
Iodine (mg) ??
A
120
15
Q
How we use our energy?
Digesting Food=
Physical Activity=
Basal Metabolic Rate (BMR)=
A
Digesting Food= 5-10%
Physical Activity=25-35%
Basal Metabolic Rate (BMR)= 55-65%
16
Q
a condition due to lack of food, or excess food, or wrong type of food, or inability to use nutrients properly to maintain health
A
Malnutrition “bad nourishment”
17
Q
the cellular imbalance between supply of nutrients & energy and the body’s demand for them to ensure growth, maintenance and specific functions.
A
WHO defines malnutrition
18
Q
The WHO cites malnutrition as the greatest single threat to the world’s public health with:??
A
↑ risk of disease & early death.
19
Q
lack of one or more nutrients
A
undernutrition
20
Q
(excess of one or more nutrients)
A
overnutrition
21
Q
Classification of malnutrition
كم عددهم ومين هم
A
1-Type of deficient nutrients
2-Degree
3-Cause
4-Rapidity of onset and duration
5-Timing of onset / age group affected
22
Q
**Classification of malnutrition
Type of deficient nutrients
A
–Macronutrient (‘Protein-Energy’) vs Micronutrient
23
Q
**Classification of malnutrition
Degree
A
–Mild/Moderate/Severe
How far anthropometric measures deviate from normal
24
Q
**Classification of malnutrition
Cause
A
–Primary (no underlying disease /inadequate food intake)
–Secondary (due to underlying disease)
25
**Classification of malnutrition
Rapidity of onset and duration
سرعة البدء والمدة
– Acute (wasting +/– oedema)
– Chronic (stunting)
26
**Classification of malnutrition
Timing of onset / age group affected
– In-utero
– Childhood
– Adult (life-long)
27
**Recognizing Malnutrition in Mothers and Babies
Mothers: ??
• Low BMI < 18.5 kg/m2
•Mid-Upper Arm Circumference (MUAC) < 20 cm
• Short height < 145 cm
• Chronic undernutrition
28
**Recognizing Malnutrition in Mothers and Babies
Babies ??
LBW < 2.5 kg
Preterm + SGA
IUGR + others
29
is defined as babies born alive before 37 weeks of pregnancy are completed
Preterm
30
…………….may be proportionately small (equally small all over) or they may be of normal length and size but have lower weight and body mass.a
SGA babies
31
…….stands for intrauterine growth retardation. This means that your baby is growing slowly and doesn't weigh as much as your doctor expected for this stage of pregnancy.
IUGR
32
is a severe form of acute malnutrition. It is characterized by clinical signs including oedema (swelling due to water retention) beginning in the lower legs and feet and which can spread to other parts of the body. Other signs include cracked and peeling skin, changes in hair colour (lightening) and texture, lethargy and misery.
Kwashiorkor
33
is a severe form of acute malnutrition. individuals have the clinical signs of extreme thinness, often with flaccid skin, hanging in loose folds to give an 'old man's appearance'. individuals may be alert but irritable.
Marasmus
34
is a form of acute malnutrition. Wasted individuals are too light for their height (very thin)
Wasting
35
is a form of chronic malnutrition that arises when an individual is too short for their age and occurs in the first 2 to 3 years of life.
Stunting
36
Levels of stunting are likely to increase in chronic emergencies.
صح ولا خطا
صح
37
Underweight individuals are too light for their age (maybe short or thin or both
Underweight
38
Acute malnutrition:
Chronic malnutrition:
Acute malnutrition: Kwashiorkor, Marasmus, Wasting
Chronic malnutrition: stunting, underweight
39
PEM
Protein Energy Malnutrition
40
In children, ……………………. measurements that fall below 2 SD under the normal weight for age (underweight), height for age (stunting) and weight for height (wasting)
Protein Energy Malnutrition (PEM)
41
In children, PEM is defined by “measurements that fall below 2 SD under the normal weight for age (underweight), height for age (stunting) and weight for height (wasting)”.
below 2 SD ايش المقصود بيها ؟؟؟
below 2 standard deviations
أي أن القياسات التي تكون أدنى من هذه القيم القياسية بمقدار انحرافين معياريين تحت المتوسط المتوقع تشير إلى وجود حالة تقزم النمو ونقص الوزن لدى الطفل
42
PEM may occur early in children (6 mo – 2 yrs) & associated with early weaning, delayed introduction of complementary foods, a low-protein diet and repeated or severe infections.
ترجم المكتوب
قد يحدث PEM في وقت مبكر عند الأطفال (6 أشهر - 2 سنة) ويرتبط بالفطام المبكر، وتأخر إدخال الأطعمة التكميلية، واتباع نظام غذائي منخفض البروتين والالتهابات المتكررة أو الشديدة.
43
inadequate intake of energy or protein or both
Protein Energy Malnutrition (PEM)
44
PEM has 3 forms:
Underweight (thin for age),
Stunting (short for age),
Wasting (thin for height)
45
PEM may result in poor mental & physical development, high risk to infections, poor school performance, low productivity in adulthood.
صح
46
Calorie deficiency
Marasmus:
Kwashiorkor:
Calorie deficiency
Marasmus: Severe
Kwashiorkor: Normal, Mild
47
Protein deficiency
Marasmus:
Kwashiorkor:
Protein deficiency
Marasmus: Severe
Kwashiorkor: Severe
48
Weight loss
Marasmus:
Kwashiorkor:
Weight loss
Marasmus: Severe
Kwashiorkor: Normal, Mild
49
Under-stature
Marasmus:
Kwashiorkor:
Under-stature
Marasmus: Mild, Moderate
Kwashiorkor: Normal, Mild
50
Apathy
Marasmus:
Kwashiorkor:
Apathy
Marasmus: Mild
Kwashiorkor: Severe
51
Anorexia
Marasmus:
Kwashiorkor:
Anorexia
Marasmus: Mild, Moderate
Kwashiorkor: Severe
52
Edema
Marasmus:
Kwashiorkor:
Edema
Marasmus:—————————————
Kwashiorkor: Severe
53
Hypo-proteinemia
Marasmus:
Kwashiorkor:
Hypo-proteinemia
Marasmus:—————————————
Kwashiorkor: Moderate
54
Muscle wasting
Marasmus:
Kwashiorkor:
Muscle wasting
Marasmus: Severe
Kwashiorkor: Severe
55
Subcutaneous fat
Marasmus:
Kwashiorkor:
Subcutaneous fat
Marasmus: Decreased
Kwashiorkor: Normal
56
Face
Marasmus:
Kwashiorkor:
Face
Marasmus: Old Man Face
Kwashiorkor: Moon Face
57
Skin changes
Marasmus:
Kwashiorkor:
Skin changes
Marasmus: Normal, Mild
Kwashiorkor: Severe
58
Hair changes
Marasmus:
Kwashiorkor:
Hair changes
Marasmus: Normal, Mild
Kwashiorkor: Severe
59
It is pathological state resulting from consumption of excessive amount of food over an extended period of time”.
Overnutrition
60
are very common conditions in developed society and are becoming more common in developing societies and those in transition.
Overweight and obesity
61
It is characterized by excess weight and body fat
Overnutrition
62
Overnutrition results in:
serious heart problems & diabetes at young age.
health, economic & social implications in adulthood.
low self-esteem.
السؤال ذا الدكتور قال جي في الاختبار
63
Consequences of Malnutrition
(Individual)
Death, infections → +/- death / disability, growth failure, adult health outcomes and disabilities.
64
Consequences of Malnutrition
Families / generations
Poor reproductive health, maternal complications and death, small size at birth, disability outcomes, ↓ opportunities in educational & economic development.
65
Consequences of Malnutrition
Societal
Economic burden of treatment, loss of productivity.
العبء الاقتصادي للعلاج، وفقدان الإنتاجية.
66
Consequences of Malnutrition
Disability adjusted life years (DALYs)
1 DALY = loss of 1 year of healthy life due to health problem
67
1 DALY = ?
(((1 Disability adjusted life year = 1 DALY)))
1 DALY = loss of 1 year of healthy life due to health problem
68
Prevention requires a coordinated approach of many disciplines at various levels:
صح ولا خطا
صح
69
Prevention of Malnutrition
Prevention requires a coordinated approach of many disciplines at various levels:
Proper antenatal care
Promotion of breastfeeding & proper weaning
Supplementary nutrition (age-appropriate)
Immunization
Regular health check-up
Referral services
Programs for micronutrient supplementation
Nutrition and health education
Improve hygiene and sanitation to reduce infections.
رعاية ما قبل الولادة المناسبة
الترويج للرضاعة الطبيعية والفطام المناسب
التغذية التكميلية (مناسبة للعمر)
التحصين الخاص بالطها
فحص صحي منتظم للفحص الصحي
خدمات الإحالة.
برامج مكملات المغذيات الدقيقة.
التغذية والتثقيف الصحي للتغذية
تحسين النظافة والصرف الصحي للحد من العدوى.
70
Fighting Malnutrition At Family Level
Nutrition education for the family on :
Selection of right kind of local foods.
Planning of nutritionally adequate diets withinlimits of their purchasing power.
Identification and correction “of harmful food taboos & dietary prejudice.
Promote breastfeeding and adequate infant & child feeding
Consider nutritional needs of expectant & nursing mothers and children in the family.
Planning a kitchen garden or keeping poultry.
اختيار النوع المناسب من الأطعمة المحلية.
التخطيط للأنظمة الغذائية الكافية من الناحية التغذوية ضمن حدود قوتها الشرائية.
تحديد وتصحيح "المحرمات الغذائية الضارة والتحيز الغذائي.
تشجيع الرضاعة الطبيعية والتغذية الكافية للرضع والأطفال
النظر في الاحتياجات الغذائية للأمهات الحوامل والمرضعات والأطفال في الأسرة.
التخطيط لحديقة المطبخ أو حفظ الدواجن.
71
It is a syndrome affecting mothers due to repeated non- spaced pregnancies (> 5) & characterized by PEM, iron deficiency anemia, osteomalacia, goiter and dental caries.
Micronutrients Depletion
72
Micronutrients Depletion
General factors:
poverty, large family size, low educational level, cultural nutritional beliefs and practices.
73
Micronutrients Depletion
Specific factors:
a. PEM: due to lack of proteins of high biological values.
b. Iron deficiency anemia: due to ↓intake, ↓ absorption, increased demand of iron, or increased blood loss.
c. Osteomalacia: due to decrease intake of calcium.
d. Goiter: due to decrease intake of iodine.
e. Dental caries: due to decrease intake of fluorine.
74
Dental caries
لماذا يحدث
due to decrease intake of fluorine.
75
Goiter
لماذا يحدث
due to decrease intake of iodine.
76
Osteomalacia
لماذا يحدث
due to decrease intake of calcium.
77
It occurs when the body doesn't have enough iron to produce hemoglobin which carries oxygen from the lungs to different tissues of the body.
Iron Deficiency Anemia
78
People at risk for iron deficiency include:
• Heavy menstruating, pregnant and postpartum women.
• Babies with poor weaning.
• Adolescents (rapid growth rate, eating habit & body image concern).
• People with bleeding lesions, frequent don ation and absorption problems.
• Strict vegetarians.
• النساء اللائي يعانين من ثقل من الحيض والحوامل وبعد الولادة.
• الأطفال الذين يعانون من ضعف الفطام.
• المراهقون (معدل النمو السريع، عادة الأكل والقلق بشأن صورة الجسم).
• الأشخاص الذين يعانون من آفات نزيف ومشاكل متكررة في الامتصاص.
• نباتيون صارمون.
79
Iron Deficiency Anemia
Clinical Picture, Symptoms :
General weakness & fatigue, easy fatigability
Headache, dizziness, irritability, lack of concentration
Pallor, shortness of breath, palpitation
Sore tongue, brittle nails, decreased appetite
80
Iron Deficiency Anemia
Complications during pregnancy:
Mother:
Fetus:
Later: child
Mother: ↑ morbidity & mortality during pregnancy & labor as: morning sickness, postpartum depression,..ect
Fetus: premature, LBW, fetal anemia, neonatal death
Later: child with developmental delay, learning disabilities & increased susceptibility to anemia in childhood.
81
Prevention of Anemia
1 Screening to early detect high risk groups.
2 Food supplementation: with iron, calcium & vitamin D.
*Eat well-balanced diet rich in iron such as:
•red meat, poultry, fish and eggs
•green leafy vegetables (as spinach, broccoli)
•iron-enriched cereals and grains
•beans, lentils, nuts and seeds
* Eat foods rich in vitamin C to help your body absorb more iron such as: citrus fruits and juices, strawberries, kiwis, tomatoes and peppers.
3- Health and nutrition education.
4- Community & social support.
82
Treatment for Anemia
• The cause of the deficiency must be identified
•Iron supplement, folic acid supplement, vitamins.
• Diet rich in iron and folic acid.
83
To absorb more iron:
Take iron pills on an empty stomach.
With vitamin C as orange juice.
Not with milk (Calcium interferes with iron absorption).
Not with coffee and tea (interfere).
84
Side effects from taking iron supplements
GIT upsets: constipation, nausea, vomiting, heartburn, abdominal discomfort & dark stools when start taking iron.
