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Nutrition > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What can cause malnutrition?

A

Poor intake
Poor absorption
Increased metabolic needs

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2
Q

What can cause poor absorption?

A

GI resection
Inflammatory disease

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3
Q

What can cause increased metabolic needs?

A

Cancer
Burns
Aids

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4
Q

What percent of households have low or very low food security?

A

10%

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5
Q

What type of population usually low food security?

A

Single mothers
Black patients
Low-income households

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6
Q

What percentage of adults do not get adequate amounts of nutrients?

A

85%

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7
Q

What are some screening tools for malnutrition?

A

Subjective global assessment(GBA):uses hx,ROS, PE
Malnutrition Universal screening tool(Must): uses BMI
Malnutrition screening tool(MST): 2 questions

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8
Q

How do we calculate percent usual weight?

A

(actual weight/usual weight) x 100

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9
Q

How do we screen for malnutrition in young children?

A

Checking body length and head circumfenrence

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10
Q

What types of cells does malnutrition especially affect?

A

Cells with rapid turnover or high metabolic activity such as…
Integumentary
Hematopoiesis
Neurologic

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11
Q

What is considered malnourished or over-nourished when using a skinfold thickness measurement?

A

Men <12.5mm malnutrition >20mm over nutrition
Women <16.5mm malnutrition >25mm over nutrition

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12
Q

What percentile is considering malnutrition in mid arm muscle circumference circumference?

A

<15th percentile

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13
Q

What BMI is considered underweight for adults?

A

<18.5

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14
Q

What is stunting? Wasting?

A

Stunting: Low height-for-age
Wasting: low weight-for-age

Underweight individuals may have both

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15
Q

How do we measure an underweight status in children?

A

It varies with age/development with a…
Growth chart

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16
Q

What types of imaging tools can you use for malnutrition?

A

Dual-energy x-ray absorptiometry (DXA, DEXA) (gold standard)
CT
MRI

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17
Q

What types of proteins do we access in malnutrition screening?

A

Somatic proteins
Visceral proteins

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18
Q

What does somatic proteins assess?

A

24hour urinary creatinine excretion
Measure state of skeletal muscle mass

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19
Q

What are examples of visceral proteins?

A

Albumin
Pre-albumin
Transferrin
Retinol-binding protein

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20
Q

Half life of albumin?

A

20 days

21
Q

Half life of pre albumin? decreased levels on what?

A

2 days
Decreased in acute stress states

22
Q

Half life of transferrin? When is it elevated?

A

8-10 days
Elevated in iron deficient states

23
Q

Define dietary reference intake(DRI).

A

Nutrient reference values developed by institute of medicine to quantify recommended levels of a given nutrient for optimal health

24
Q

Define recommended dietary allowance(RDA).

A

Average daily nutrient intake to meet the nutrient requirement of nearly all(97-98%) healthy individuals in a particular life stage/gender group

25
Q

Define adequate intake(AI). When is it used?

A

Recommended average daily dietary nutrient intake level sufficient by a group of apparently healthy people that assumed to be adequate.

When RDA cannot be determined

26
Q

Define estimated average requirement(EAR).

A

Average daily nutrient intake level estimated to meet the requirement of half (50%) the healthy individuals in a particular life stage and gender group

27
Q

Define estimated energy requirement(EER). What else does it include?

A

EAR specifically used for energy - average dietary intake predicted to maintain energy balance in healthy individuals of a given age, gender, weight, height, and physical activity 
level consistent with good health

Includes extrametbolic needs during pregnancy, lactation, or childhood

28
Q

Define tolerable upper intake level(UL)

A

Highest average daily nutrient intake level likely to pose no risk of adverse health effects to almost all individuals in the general population

29
Q

Define BMR. When is it determined?

A

Amount of energy needed just to live
Determined after a 12hr fast

30
Q

How is basal energy expenditure(BEE) different from BMR?

A

Its the same but after 24hr fast

31
Q

What is resting metabolic rate(RMR)

A

BMR and energy expended from food intake and complete physical activity

10-20% higher than BMR on average

32
Q

What is resting energy expenditure(REE)?

A

RMR but with a 24hr fast

33
Q

What are common mineral/nutrient deficiencies in underdeveloped countries?

A

Vitamin A
Iodine

34
Q

What are common mineral nutrient deficiencies?

A

Iron (worldwide)
Folate
Vit D
B vitamins
Vit A
Iodine

35
Q

How does marasmus present?

A

Large head with large eyes
Weak appearance
Thin dry skin, sparse hair
Shrunken limbs
Bradycardia, hypotension, hypothermia
Irritable

36
Q

How does kwashiorkor present?

A

Growth retardation
Changes in skin and hair pigmentation
Thin dry peeling skin
Rotund bellies
Bradycardia, hypotension, hypothermia
Lethargic
Low serum albumin
Classic edematous appearance

37
Q

What are features of a classic edematous appearance?

A

Begins in dependent areas, proceeds cranially
Involves presacral area, genitalia, periorbital area
Muscle atrophy with normal or even increased body fat

37
Q

What are features of a classic edematous appearance?

A

Begins in dependent areas, proceeds cranially
Involves presacral area, genitalia, periorbital area
Muscle atrophy with normal or even increased body fat

38
Q

Define cachexia.

A

Multifactorial wasting syndrome define by loss of muscle w or w/o loss of fat mass.

39
Q

What cachexia be reversed?

A

CANNOT be fully reversed by conventional nutritional support

40
Q

Cachexia is usually seen in who?

A

Cancer patients (50-80%)
Chronic illnesses such as AIDs

Accounts for up to 20% of cancer mortality

41
Q

What medical condition is thought to be associated with cachexia?

A

Mitochondrial dysfunction

42
Q

What are the types of nutritional replacement pathways?

A

Enteral: NG tubes and PEG tubes
Parenteral: TPN and PPN

43
Q

When do we use a parenteral feed over enteral?

A

When the gut is not working

Major bowel resection, lack of GI motility, Severe IBD, obstruction

44
Q

What are some issues with parenteral feeding?

A

Higher risk of bacteria, sepsis, poorer weight gain
Fat overload syndrome: Fever, hypersplenomegally, and coagulopathy
Bone metabolism disease in children (if long term use)

44
Q

What are some issues with parenteral feeding?

A

Higher risk of bacteria, sepsis, poorer weight gain
Fat overload syndrome: Fever, hypersplenomegally, and coagulopathy
Bone metabolism disease in children (if long term use)

45
Q

What is dumping syndrome? Where is it seen in”

A

Large amounts of foods moving rapidly from stomach into the bowel

Post-gastric surgery and tube feedings

46
Q

How do we prevent dumping syndrome?

A

Slow infusion rate and amount of feeding

47
Q

What are symptoms of dumping syndrome?

A

Sweating
Flushing
Dizziness
Tachycardia

Nutrition (7 decks)

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