Malnutrition Flashcards
What is Kwashiorkar malnutrition?
Predominantly protein malnutrition
What is marasmus malnutrition?
Calorie intake deficiency
What is cachexia?
Metabolic disorder where a person unintentionally loses weight
Symptoms: muscle atrophy, fatigue, weakness, loss of appetite
Normally cancer, AIDS, coeliac disease, COPD and TB
What is pellagra and what are the symptoms?
Vit B3 (niacin) deficiency
- Diarrhoea
- Dementia
- Dermatitis
- Death
What would vit K deficiency present as?
lack of production of coagulation factors II,VII, IXand X.
Presents as easy bruising
What are the ways to assess malnutrition in the hospital?
Quantified measurement calculated from BMI, mid-arm circumference indicating muscle mass and
the skin-fold thickness to measure body fat. The measurement score is called the Malnutrition
Universal Screening Tool and aims to be completed within 24 hours of hospital admission and also inlcludes unexplained weight loss experiences in past 3-6 months.
Management of malnutrition in the hospital:
1) general advice, social services
2) nausea: anti-emetics
4) dysphagia: find underlying cause, pureed food and high calorie drinks
5) enteral: oral supplements or via NG/NJ tube. Needs a functioning GI tract. Usually a nasogastric tube but enterostomy used if more than 4-6 weeks.
Contra-indication is any facial or nasal trauma
6) Parenteral feeding: IV nutrients -
Peripheral lines used for short-term and central line sif more than 2 weeks
Common clinical features of malabsorption
- Chronic diarrhoea
- Weight loss
- Steatorrhoea
- Vitmain and iron deficiencies
- Central and peripheral oedema
Why is their malabsorption with coeliac disease?
The inflammatory response results in shortening of the villi lining the small intestine;
villous atrophy. Therefore, absorption of vitamins and nutrients in the small bowel is markedly
impaired. Iron deficient anaemia is the most common blood disorder caused by coeliac disease.
Why is their malabsorption with crohn’s disease?
Damage to the terminal ileum lining
Cobblestone ulcers, muscular hypertrophy and formation of granulomas which affect absorption
Vitamin B12 malabsorption
Megaloblastic anaemia most common
What lipids are needed in the body?
- Triglycerides - most plentiful in body and provides twice as much energy as carb or protein. Can be saturated, mono/polyunsaturated
- Essential Fatty acids - body cant produce these
- Phospholipids - cell membranes due to amphipathic properties
- Steroids - cholesterol, bile salts, adrenal and sex hormones
- Eicosanoids - lipids from arachdonic acid - prostaglandins and leukotrienes
- Lipoprotein - carry cholesterol and triglycerides around the body
What is the difference between trace elements and minerals?
Trace elements present in small quantities (<5g) where minerals are >5g
Minerals: calcium, phosphorus, potassium, sulpher, Na, Cl, Mg, Fe, I
Trace elements: Cu, Co, Zn, Fluoride, manganese
Examples or water-soluble and fat-soluble vitamins:
What are Vitamins C E and beta-carotene?
Fat-soluble - Vit A D E K
Dependent on bile salts and absorbed in small intestine with lipids
Water soluble - Vit B1 B2 B6 B12 C. folate and niacin
Absorbed along with water in GI tract
Vitamins C, E and Beta-carotene act as antioxidants and inactivate oxygen free radicals that would damage DNA
Vit A deficiency causes:
Retinol deficiency causes Night blindness
Vit D (Cholecalciferol) deficiency causes:
Osteomalacia/ rickets
Proximal weakness of limbs
