Lect 25 - Nutritional Disorders in Adolescence/Childhood

Question 1

What nutritional aspect does not increase appreciably over childhood/adolescence?

Answer 1

Fat intake

Question 2

What are the three types of nutritional challenges that are faced in childhood?

Answer 2

1) developmental/behavioral
2) socioeconomic
3) pathological

Question 3

What are the consequences of vitamin A and zinc deficiencies?

Answer 3

persistent diarrhea –> GI damage –> recurrent infections

Question 4

What is the difference between wasting, stunting, and underweight?

Answer 4

Wasting is low weight for height; stunting is low height for age; and underweight is low weight for age

Question 5

What is the presentation of acute malnutrition? Chronic malnutrition?

Answer 5

Acute: wasting
Chronic: stunting

Question 6

What is the definition of cachexia?

Answer 6

Hypercatabolic state and a chronic inflammatory response leading to an illness-induced weight loss that does not respond to caloric supplementation

Question 7

What is the difference between wasting and cachexia?

Answer 7

Wasting and malnutrition can be reversed with caloric supplementation

Question 8

What are some causes of cachexia?

Answer 8

1) cancer
2) infection
3) immunodeficiency
4) COPD
5) RA

Question 9

What are the two extremes of protein-energy malnutrition?

Answer 9

Protein, low energy - marasmus

Low protein, sufficient energy - kwashiorkor

Question 10

What is another name for marasmus? kwashiorkor?

Answer 10

Marasmus is wasting syndrome; kwasiorkor is edematous malnutrition

Question 11

What are some manifestations of marasmus?

Answer 11

low weight for height, decreased mid-upper arm circumference, fat store depletion, no edema

Question 12

What are three biochemical/physiological consequences of low protein-calorie intake?

Answer 12

1) muscle protein breakdown
2) increased plasma cortisol
3) decrease in insulin-like growth hormone

Question 13

How does the body adapt to marasmus?

Answer 13

decrease in physical activity, lethargy, decrease in basal energy metabolism

Question 14

What is the hallmark of kwashiorkor?

Answer 14

symmetrical peripheral pitting edema

Question 15

What are the first two steps in treating protein-energy malnutrition? What are you trying to prevent?

Answer 15

1) correct fluid and electrolyte abnormalities first
2) supply macronutrients by dietary therapy

Refeeding syndrome

Question 16

What is refeeding syndrome?

Answer 16

reintroduction of nutrition to severely malnourished individuals causing metabolic disturbances

Question 17

What are the electrolytes responsible for refeeding syndrome?

Answer 17

primarily phosphate, but also magnesium and potassium

Question 18

What are the consequences of refeeding syndrome?

Answer 18

1) reduction in stroke volume, thus cardiac output –> heart failure
2) arrhythmia
3) respiratory failure

Question 19

What are three criteria for anorexia nervosa?

Answer 19

1) BMI < 18.5
2) body dysmorphia
3) intense fear of gaining weight

Question 20

What are the two subtypes of anorexia nervosa?

Answer 20

1) restricting food intake/excessive exercise

2) binge eating and purging

Question 21

What is a serious cardiac complication of anorexia nervosa and why does it happen?

Answer 21

Mitral valve prolapse due to mitral valve not shrinking and becoming weak; leads to prolapse of valve