Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

nutrition > malnutrition and cachexia > Flashcards

malnutrition and cachexia Flashcards

1
Q

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

A

Malnutrition

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

3 causes of malnutrition

A
  1. Poor intake - imbalanced diet, anorexia, sensory issues, poor dentition, diminished thirst/hunger
  2. Poor absorption - intestinal bacterial overgrowth, inflammatory disease, GI tract resection or scarring
  3. Increased metabolic needs - cancer, burns, AIDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how to calculate % usual weight

A

(actual weight ➗ usual weight) x 100

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

how to screen children for malnutrition

A

body length and head circumference

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

skin, hair, nails, mucosal membranes is what type of system

A

Integumentary

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

immunosuppression, anemia, bleeding or bruising
is what type of system

A

Hematopoiesis

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

paresthesias, weakness, cognitive delay or impairment is what type of system

A

Neurologic

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

which malnutrition screen uses calipers

A

skinfold thickness

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

which malnutrition screening uses tape measure

A

Midarm muscle circumference

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

the BMI for underweight is

A

<18.5

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

what is used to assess child’s growth relative to peers
Failure to thrive

A

growth charts

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

low height-for-age
Associated with chronic or recurrent undernutrition

A

stunting

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

low weight-for-age
Associated with recent/severe weight loss as well as chronic undernutrition

A

wasting

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

dual-energy x-ray absorptiometry (DXA or DEXA)
considered the gold standard and is most accessible

A

imaging

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

what labs are ordered to screen malnutrition

A
  1. Somatic proteins - 24 hour urinary creatinine excretion
    - Assesses relative state of skeletal muscle mass
  2. Visceral proteins - albumin, transferrin, prealbumin, retinol-binding protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what protein is most commonly used; t ½ 20 days
Can be decreased in acute septic states, even without malnutrition

A

Albumin

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

what protein has t ½ of 2 days
More useful in very acute malnourishment
Also depressed in acute stress states

A

Prealbumin

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

what protein has t ½ of 8-10 days
Elevated in iron deficiency states

A

transferrin

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

what is Dietary Reference Intake (DRI)

A

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 (e.g. height, gender, activity level)

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

the DRI includes ?

A

RDA, AI, EAR, EER, UL

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

what is Recommended Dietary Allowance (RDA)

A

average daily dietary nutrient intake level sufficient to meet the nutrient requirement of nearly all (97-98%) healthy individuals in a particular life stage and gender group

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

what is Adequate Intake (AI)

A

recommended average daily intake level based on approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people that are assumed to be adequate

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

what is used when an RDA cannot be determined

A

Adequate Intake (AI)

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

what is 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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is Estimated Energy Requirement (EER)
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
26
____ includes extra metabolic needs during pregnancy, lactation or childhood
EER
27
what is Tolerable Upper Intake Level (UL)
highest average daily nutrient intake level likely to pose no risk of adverse health effects to almost all individuals in the general population
28
what is Basal Metabolic Rate (BMR)
energy expenditure needed to sustain the metabolic activities of cells and tissues, blood circulation, respiration, GI and renal processing, and staying awake - Determined with subject reclining after a 12 hour fast
29
what is Basal energy expenditure (BEE)
BMR extrapolated to 24 hours
30
what is Resting Metabolic Rate (RMR)
Similar to BMR; accounts for energy expenditure increases caused by recent food intake or effect of recently completed physical activity 10-20% higher than BMR on average
31
what is Resting energy expenditure (REE)
RMR extrapolated to 24 hours
32
what is the Harris-Benedict Equation
original equation used to determine an individual’s BMR - published in early 20th century and later revised in 1984.
33
BMR is used to estimate the kilocalories needed to maintain current weight (EER) based on someone’s activity level, as follows:
1. Little to no exercise - kcal/d needed = BMR x 1.2 2. Light exercise (1–3 d/wk) - kcal/d needed = BMR x 1.375 3. Moderate exercise (3–5 d/wk) - kcal/d needed = BMR x 1.55 4. Heavy exercise (6–7 d/wk) - kcal/d needed = BMR x 1.725 5. Very heavy exercise (2x/d, extra heavy workouts) - kcal/d needed = BMR x 1.9
34
what is the most common deficiency worldwide
iron deficiency
35
state of protein and total energy malnutrition
1. Marasmus (Starvation) - Severe tissue wasting and weight loss - Excessive loss of lean body mass and subcutaneous fat
36
PE findings of marasmus (starvation)
1. Relatively large head with large, staring eyes 2. Emaciated, weak appearance 3. Thin, dry skin with thin, sparse hair that is easily plucked 4. Shrunken arms, thighs, and buttocks with redundant skin folds 5. Bradycardia, hypotension, hypothermia 6. Irritable, fretful demeanor
37
- protein malnutrition in the presence of caloric intake - Classically seen in babies weaned from the breast in low-income countries
Kwashiorkor (Protein Deficit)
38
PE findings of kwashiorkor (protein deficit)
1. Growth retardation 2. Changes in skin and hair pigmentation, and thin, dry, peeling skin 3. *Low serum albumin* 4. Bradycardia, hypotension, and hypothermia 5. Distended abdomen with dilated intestinal loops - May see hepatomegaly from fatty liver infiltrates 6. Lethargic, apathetic, irritable 7. *edematous appearance* - Begins in dependent areas, proceeds cranially - May involve presacral area, genitalia, periorbital area - Muscle atrophy with normal or even increased body fat
39
multifactorial wasting syndrome defined by continuous loss of skeletal muscle mass, with or without loss of fat mass
Cachexia
40
what cannot be fully reversed by conventional nutritional support
cachexia
41
what affects 50-80% of cancer patients May account for up to 20% of cancer mortality
cachexia
42
1. what is thought to be tied to mitochondrial dysfunction - Decreased ATP and protein synthesis - Increased oxidative stress in the body - Elevated inflammatory markers
cachexia
43
what are the types of nutrition replacement
1. Enteral - via the GI tract - Includes oral and feeding tubes - NG tubes - Nasogastric tubes - short-term feeding - PEG tubes - percutaneous endoscopic gastrostomy tubes - long-term feeding 2. Parenteral - via the bloodstream - Typically delivered via a central line - TPN - total parenteral nutrition - PPN - peripheral parenteral nutrition
44
where would a tube be placed with pts with higher aspiration risk
jejunum
45
parental is only indicated if ?
the gut is not working for some reason! - Major bowel resection, lack of GI motility, severe IBD, obstruction
46
Where possible, nutrition should always be delivered ____ why?
1. enterally - Parenteral carries higher risk of bacteremia and sepsis, poorer weight gain - Fat overload syndrome - fever, HSM, and coagulopathy due to fat sludging - Associated with bone metabolism disease in children with long-term use
47
General Principles for Low-Appetite (Anorexia) Patients
1. Frequent spacing of small meals 2. Prioritize energy-dense foods 3. Powdered or liquid nutritional supplementation - Pediasure, Ensure, protein powders 4. Adding calories and nutrition to preferred foods
48
what is included for patients on Tube Feedings
1. Formulas specially designed to contain oligosaccharides, protein, and triglycerides, +/- fiber supplementation 2. Can get specially made formulas focusing on a few key nutrients to add to tube feedings or to feed alone if full supplementation is not needed
49
what is Dumping Syndrome
1. sweating, flushing, dizziness, and tachycardia caused by large amounts of foods (especially high intake of simple sugars) moving rapidly from the stomach into the bowel 2. Seen in post-gastric surgery, tube feedings 3. Slow infusion rate and amount of feeding given at one time
50
Megestrol acetate (Megace)
Appetite Stimulants
51
Cyproheptadine (Periactin)
Appetite Stimulants
52
Dronabinol (Marinol)
Appetite Stimulants
53
Synthetic progestin which has been found to promote appetite Anorexia or cachexia associated with AIDS
Megestrol acetate (Megace)
54
SE of Megestrol acetate (Megace)
GI upset, headache, insomnia, rash
55
what is the off-label use for Megestrol acetate (Megace)
Cancer-related cachexia
56
1st generation Antihistamine Can be used as an appetite stimulant
Cyproheptadine (Periactin)
57
SE of Cyproheptadine (Periactin)
dizziness, drowsiness, anticholinergic
58
CI of Cyproheptadine (Periactin)
1. Allergy to medication 2. MAOI therapy 3. urinary or gastric obstruction (BPH, stenosis, etc.) 4. acute angle-closure glaucoma 5. gastric ulcer
59
Cyproheptadine (Periactin) should not be given to ?
1. premature infants 2. neonates 3. pregnant/breastfeeding women 4. elderly 5. debilitated patients
60
Cannabinoid-derived agent (THC); can suppress N/V and promote appetite Used mostly in patients AIDS and patients on chemotherapy Controlled - Schedule III
Dronabinol (Marinol)
61
SE of Dronabinol (Marinol)
euphoria, GI upset, dizziness, drowsiness, AMS
62
CI of Dronabinol (Marinol)
1. Allergy to medication 2. use of disulfiram or metronidazole in last 14 d 3. allergy to alcohol or sesame oil

nutrition (12 decks)

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