Malnutrition Flashcards
1
Q
malnutrition=
A
insufficient dietary intake to meet metabolic requirements
2
Q
malabsorption
A
digestive tract disorder inability to utilise an appropriate dietary intake
3
Q
2 types of malnutrition
A
- protein energy malnutrition
- specific nutrient malnutrition
4
Q
kwashiorkor=
A
protein lack
5
Q
marasmus=
A
total dietary lack
6
Q
dysphagia=
A
inability to swallow
7
Q
iron deficiency anaemia=
A
microcytic
hypo chromic
8
Q
vitamin A deficiency=
A
night blindness
9
Q
who often has vitamin B deficiency
A
alcoholics
10
Q
B1 deficiency= (2)
A
cardiomyopathy
encephalopathy
11
Q
B3 niacin deficiency=
A
pellagra
12
Q
pellagra symptoms= (4)
A
diarrhoea
dermatitis
dementia
death
13
Q
B12 deficiency= (5)
A
- megaloblastic anaemia
- neuropathy
- SACD
- ataxia
- dementia
14
Q
B2 deficiency=
A
stomatitis
15
Q
B6 deficinecy=
A
neuropathy
16
Q
folic acid anaemia=
A
megaloblastic
17
Q
vitamin D deficiency =
A
osteomalacia / rickets in children
18
Q
vitamin C deficiency =
A
- scurvy
- impaired wound healing
19
Q
scurvy characterised by (3)
A
- red-blue spots on skin
- fatigue
- limb pain (legs)
20
Q
vitamin K deficiency leads to lack of which clotting factors
A
II
VII
IX
X
21
Q
measurement scale for malnutrition in hospital
A
malnutrition universal screening tool (MUST)
22
Q
enteral=
A
delivery of nutritionally complete food directly into stomach duodenum or jejunum
23
Q
who can enteral feeding be given (2)
A
oral feeding or tube feeding
24
Q
what does nasogastric tube bypass
A
mouth and oesophagus if patient has dysphagia or can’t coordinate swallowing
25
if enteral feeding is going to last >4-6 weeks what is used
enterostomy feeding -percutaneous
26
parenteral feeding=
intravenous administration of nutrients
27
when is a peripheral line used for parenteral feeding
<2 weeks of feeding
28
longer than 2 weeks of parenteral feeding requires
central access - central catheters tunnelled subclavian vein central lines
29
when makes tolerance to peripheral line feeding better
low osmolarity
neutral pH
soft paediatric cannulas
30
clinical features of malabsorption
```
chronic diarrhoea
weight loss
steatorrhea
vitamin and iron deficiencies
central and peripheral oedema
```
31
most iron is absorbed in the
duodenum
32
most common nutritional anaemia=
iron
33
B12 absorbed mainly in the
ileum
34
most common inflammatory disorder of the small bowel=
coeliac disease
35
what is coeliac disease an exaggerated autoimmune response to
gliadin
36
3 main food groups containing gluten
wheat
barley
rye
37
what happens to the small intestine in coeliac
shortening of the villi lining the small intestine + villous atrophy
38
most common blood disorder of coeliac
iron deficiency anaemia
39
treatment for coeliac
life-long gluten free diet
40
coeliac symptoms after eating gluten (4)
- chronic diarrhoea
- abdominal discomfort
- malabsorption
- loss of appetite
41
blood test in coeliac
TTG
42
blood condition of Crohn's
megaloblastic anaemia -as Crohn's mainly affects terminal ileum
43
diverticulosis symptoms (4)
- pain in epigastrium
- muscle guarding
- change in bowel habit
- palpable mass and tenderness on left side
44
most common place for diverticular
sigmoid colon
45
what can diverticular disease be related to
a low fibre diet and constipation
46
possible consequences of diverticulitis (4)
- bowel perforation
- abscess formation
- fistula formation
- general peritonitis
47
symptoms of haemorrhoids
perianal discomfort
pruritus ani
rectal bleeding
mucus stool
48
are haemorrhoid cushions normally present
yes
49
what are haemorrhoids made off (3)
sinusoids
connective tissue
smooth muscle
50
what are haemorrhoid cushions important for (2)
- continence -provide anal closure at rest
| - protect internal/external anal sphincters
51
2 types of haemorrhoids
internal
| external
52
where are internal haemorrhoids found
above the dentate /pectinate line
53
what covers internal haemorrhoids
columnar epithelium
54
are internal haemorrhoids painful
no -unless strangulated blood supply
55
where do external haemorrhoids occur
below the dentate line
56
are external haemorrhoids normally painful
yes
57
anal fissures symptoms (4)
- sharp, stinging pain during defection
- pain lasting after passing stool
- pruritus ani
- rectal bleeding
58
what is an anal fissure
tear in lower part of rectum
59
what can cause anal fissures (7)
```
trauma
chronic diarrhoea
large stool
constipation
childbirth
anal intercourse
Crohn's
```
60
what does calprotectin in stool indicate
Crohn's disease
61
right colon cancer symptoms (5)
- malaise
- weight loss
- vague abdo pain
- palpable mass
- iron deficiency anaemia
62
left colon cancer symptoms (4)
- obstructive symptoms
- colicky abdo pain
- change in bowel habit
- passage of mucus
63
rectal tumours symptoms
rectal bleeding
mucus discharge
tenesmus
64
anal cancer is what type of cancer
squamous cell carcinoma
65
biggest risk factor for anal cancer=
HPV
66
first line treatment for anal cancer =
chemotherapy
67
2 inherited conditions for bowel cancer
FAP
| HNPCC
68
what mutations occurs in FAP
APC
69
what is APC
a tumour suppressor gene
70
what does APC regulate
beta catenin -which coordinates DNA replication
71
sequence of mutation in FAP
```
APC
APC -Beta catenin
K-RAS
TP53
Telomerase
```
72
other name for HNPCC
lynch syndrome
73
what part of the colon does HNPCC mainly affect
right colon
74
what is the defect in HNPCC
DNA mismatch repair causing
| microsatellite instability
75
2 types of sporadic colon cancer
chromosome instability pathway (85%)
| CpG island methylater phenotype (15%)
76
when are investigations of rectal bleeding indicated (3)
- strong family history/ anxiety about colorectal cancer
- persistent rectal bleeding
- history of pelvic radiotherapy
77
>40 urgent referral if
rectal bleeding+ change in bowel habit >6 weeks
78
>60 urgent referral if
rectal bleeding >6 weeks without change in bowel habit
79
what investigation not to use for colorectal cancer
barium enema
80
suspect colorectal cancer -->
urgent 2 week referral
81
best treatment for haemorrhoid
rubber band ligation
82
when is a haemorrhoidectomy indicated
bleeding or prolapsing haemorrhoids not responding to treatment
83
treatment options for haemorrhoids (4)
- lifestyle changes
- topical corticosteroids
- rubber band ligation
- sclerotherapy
84
treatment for anal fissures
glyceryl trinitrate ointment
85
what does glyceryl trinitrate due
relaxes the muscle in the back passage
86
in secondary care what is anal fissure treatment
diltiazem ointment
87
diverticular disease treatment
- high fibre diet
- adequate fluid intake
- bulk-forming laxatives
88
2 bulk-forming laxatives
ispaghula
| methylcellulose
89
avoid what drugs in diverticulosis
avoid NSAID or opioid analgescis
