Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

(C) Nutrition > Lecture 5: Malnutrition & Cachexia > Flashcards

Lecture 5: Malnutrition & Cachexia Flashcards

1
Q

What is malnutrition?

A

The general state of inadequate nutrient and/or energy intake and absorption to meet metabolic demands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 main causes of malnutrition?

A

Poor intake

Poor absorption

Increased metabolic needs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much of US adults do not consume adequate amounts of nutrients on a regular basis?

A

85%!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many households in the US were considered low or very low in terms of food security?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What tools can we use to screen for malnutrition?

A

Subjective Global Assessment (SGA)

Malnutrition Universal Screening Tool (MUST)

Malnutrition Screening Tool (MST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the SGA?

A

Combines hs, ROS, and PE findings.

It is mainly to categorize pts by their nourishment status.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MUST?

A

Utilizes BMI, unintentional weight loss, and effect sof acute disease to measure RISK OF MALNUTRITION.

Offers recommendations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MST?

A

2-question screen, also helps determine RISK OF MALNUTRITION.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we check nutritional status in adults vs children?

A

Adults: generally weight

Children: Body length and head circumference.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What specific organs would show nutrient malnutrition and how?

A

Integumentary: skin, hair, nails, mucosal membranes.
Hematopoiesis: immunosuppression, anemia, bleeding or bruising.
Neurologic: Paresthesia, weakness, cognitive delay or impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where do we measure skinfold thickness? How?

A

Triceps
Using calipers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What skinfold thickness are men usually at? Women?

A

Men: 12.5-20mm
Women: 16.5-25mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What midarm muscle circumference % is suggestive of malnutrition?

A

< 15th percentile.

Measured with a tape measure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is underweight for adults?

A

BMI <18.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is underweight for children?

A

Depends on growth charts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the difference between stunting and wasting?

A

Stunting has to do with low HEIGHT for age.

Wasting has to do with low WEIGHT for age.

Note:
Stunted trees are SHORT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is an underweight patient malnourished?

A

Not always!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the gold standard to screen for malnutrition?

A

DEXA scan (Dual-energy XRAY absorptiometry)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What proteins do we measure for malnutrition?

A

Somatic and visceral proteins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we assess somatic proteins?

A

24 hour urinary creatinine excretion.

This assesses the relative state of skeletal muscle mass.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the visceral proteins?

A

Albumin, transferrin, prealbumin, and retinol-binding protein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which visceral protein do we commonly measure? Why?

A

Albumin. It has the longest half-life at 20 days.
However, it can be decreased in any septic state

Normal range is about 3.5-5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When do we measure prealbumin?

A

Acute malnourishment (t1/2 is 2d)

Depressed in acute stress states as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When do we measure transferrin?

A

Iron deficiency elevates it.

T1/2 is 8-10d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is dietary reference intake?
Nutrient reference values developed by the institute of medicine to quantify recommended levels of a given nutrient necessary for optimal health based on a patient's individual characteristics. Includes: RDA AI EAR EER UL
26
What are all the things included in a DRI?
RDA: Recommended dietary allowance AI: Adequate intake EAR: Estimated Average Requirement EER: Estimated Energy Requirement UL: Tolerable upper level intake
27
What is RDA/recommended dietary allowance?
The average amount of nutrient sufficient to meet the requirements of 97-98% of health individuals.
28
What is AI/adequate intake?
Recommended average daily intake level based on health individuals. Used when RDA cannot be determined!!
29
What is EAR/estimated average requirement?
Average nutrient level needed to meet 50% of individuals. Often known as the threshold/minimum.
30
What is EER/estimated energy requirement?
Average dietary intake predicted to maintain energy balance. It includes extra needs such as pregnancy, lactation, or childhood. It is only the minimum, no upper level.
31
What is UL/tolerable upper intake level?
Highest average daily nutrient intake level that won't cause adverse effects. AKA the most you can consume in nutrients without consequences.
32
What is BMR and how do we determine it?
Basal Metabolic Rate Energy spent to maintain basic metabolic processes. Determined by subject reclining after a 12 hour fast.
33
What is Basal energy expenditure/BEE?
BMR extrapolated to 24 hours.
34
What is RMR and how do we determine it?
Resting Metabolic Rate Includes BMR + recent eating or exercise. 10-20% higher than BMR on avg.
35
What is Resting energy expenditure/REE?
RMR extrapolated to 24 hours.
36
What equation is used to estimate energy requirements for an individual?
Harris-benedict equation
37
What information does the Harris-Benedict Equation need?
Weight in kg Height in cm Age
38
How is EER calculated from BMR?
BMR is multipled to adjust for a person's physical activity level.
39
What equation is the most current one to calculate EER now?
Institute of Medicine equation.
40
What is the most common nutrition deficiency in the world?
Iron Deficiency.
41
What are two common nutrient deficiencies in underdeveloped countries?
Vitamin A Iodine deficiency
42
What is marasmus?
A state of BOTH protein and total energy malnutrition. Results in massive wasting and weight loss.
43
How does someone with maramus appear?
Relatively large head with large, staring eyes. Emaciated, weak appearance. Thin skin and hair that is easily plucked. Bradycardia, hypotensive, hypothermic Like gollum
44
What is kwashiorkor?
A state of PROTEIN malnutrition with normal caloric intake.
45
What demographic often presents with kawshiorkor?
Babies weaned from the breast in low-income countries.
46
What are some PE findings in someone with kwashiorkor?
Growth retardation Distended abdomen with dilated intestinal loops. Classic edematous appearance with pitting edema.
47
Why does kwashiorkor present with pitting edema?
Hypoalbumenia leads to low osmotic colloid pressure. Lack of protein = lower production of albumin.
48
What is cachexia?
Multifactorial wasting syndrome with continuous loss of skeletal muscle mass, with or w/o loss of fat.
49
What is significant about cachexia?
Not fully reversible by nutritional support. Progressive functional impairment.
50
What kind of pts are most commonly cachetic?
50-80% of cancer patients. Accounts for up to 20% of cancer mortality. Also appears in pts with AIDS.
51
What is the suspected cause of cachexia?
Mitochondrial dysfunction. Leading to... Decreased ATP and protein synthesis Increased oxidative stress in the body Elevated inflammatory markers
52
What are the two general ways we can provide nutrients to a patient?
Enteral Parenteral
53
What are the enteral nutritional options?
Oral and feeding tubes: Nasogastric/NG tubes for short-term. Percutaneous endoscopic gastrostomy tube/PEG for long-term feeding. Jejunal tubes as well for high aspiration risk patients.
54
What are the parenteral nutritional options?
Central line delivery TPN: Total parenteral nutrition PPN: Partial parenteral nutrition. PPN is only used in situations where the gut is not working properly.
55
What are the concerns with parenteral nutrition treatment?
Higher risks of bacteremia and sepsis, poor weight gain. Fat overload syndrome: fever, HSM, and coagulopathy Bone metabolism disease in children with long-term use.
56
What is fat overload syndrome specifically a complication of?
Intravenous lipid emulsion therapy (ILE)
57
What are the general treatment principles for an anorexic patient?
Frequent spacing of small meals. Prioritize energy-dense foods. Powdered/liquid supplementation Adding calories/nutrients to preferred foods.
58
What is dumping syndrome?
Sweating, flushing, dizziness, and tachycardia caused by large amounts of food moving rapidly from the stomach to the bowel.
59
When is dumping syndrome commonly seen? What do we do to treat it?
Tube feeding and post-gastric surgery. Slowing infusion rate and amount of feeding given at one time.
60
What is megestrol acetate/megace? Indications?
A synthetic progestin used as an appetite stimulant. Indicated for: Anorexia or cachexia associated with AIDS. Off-label: Cancer-related cachexia
61
What are the SEs and CI of megace?
SE: GI upset, HA, insomnia, rash CI: Allergy
62
What is cyproheptadine/periactin?
1st gen antihistamine used as appetite stimulant. Can be given to adults or peds.
63
What are the SEs and CIs of periactin?
SE: dizziness, drowsiness, anticholinergic. CIs: Allergy, MAOI use, gastric or urinary obstructions, acute angle-closure glaucoma, and gastric ulcer. NOT FOR USE IN: preemies neonates Pregnant or breastfeeding elderly or debilitated
64
What is dronabinol/marinol? Indications?
Cannabinoid-derived agent (THC). Schedule 3 drug. Indicated for anorexia/cachexia associated with AIDS
65
What are the SEs and CIs of marinol?
SE: euphoria, GI upset, dizziness, drowsiness, AMS CI: allergy, use of disulfiram or metronidazole in past 2 weeks, allergy to alcohol or SESAME OIL

(C) Nutrition (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions