Malnutrition Flashcards
Malnutrition definition
Any deficiency, excess or imbalance in nutrients that impacts body function and clinical outcomes
What is wasting?
Acute malnutrition i.e. a low weight to height ratio or a low mid upper arm circumference (MUAC)
Kwashiokor
Odema secondary to malnutrition
What are some features of acute malnutrition?
Apathy, sparse hair, dermatosis, angular chelitis, hepatomegaly
Definition of moderate acute malnutrition and severe acute malnutrition
Moderate
Z score -2 to -3 or MUAC <12.5cm.
Severe
Z score < -3 or MUAC <11.5cm
Uncomplicated malnutrition - presentation and key interventions
Mild/moderate without acute complications. Can be managed as outpatient with nutritional counselling, dietary modification, regular follow up and education
Complicated malnutrition presentation and management (10 WHO steps)
Severe with complications like infection and Kwashiokor
- Treat or prevent hypoglycemia.
- Treat or prevent hypothermia.
- Treat or prevent dehydration.
- Correct electrolyte imbalance.
- Treat or prevent infection.
- Correct micronutrient deficiencies (without iron initially).
- Start cautious feeding.
- Achieve catch-up growth.
- Provide sensory stimulation and emotional support
- Prepare for follow-up after recovery
Wet beriberi - vitamin + presentation
Thiamine (B1). Odoema, heart failure
Dry beriberi - clinical presentation
Neuro - peripheral neuropathy, muscle weakness, difficulty walking. Wernicke’s with memory loss
Pellagra - Vitamin + presentation
Vitamin B3. Diarrhoea, dermatitis, dementia
Scurvy presentation
Bleeding gums, joint, pain, haemorrhagic folliculitis
Vitamin A deficiency
Poor vision at night, xerophthalmia (dry eyes, corneal ulceration)
Phases of treatment in malnutrition
Stabilisation (small, frequent low energy feed)
Transmition (gradual increase in volume)
Rehabilitation (nutrient dense feeds for weight recovery)
