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Nutrition > Malnutrition and Cachexia > Flashcards

Malnutrition and Cachexia Flashcards

1
Q

What is malnutrition?

A

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

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2
Q

What are causes of malnutrition?

A

Poor intake
Poor absorption
Increased metabolic needs

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3
Q

What is the gold standard for malnutrition screening?

A

Duel-energy x-ray absorptiometry (DEXA)

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4
Q

What do labs screening for malnutrition look for?

A

Somatic and visceral proteins
Somatic = urinary creatinine
Visceral = albumin and transferrin

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5
Q

What is the half life of albumin?

A

20 days

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6
Q

What is the half life of prealbumin?

A

2 days

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7
Q

What is the half life of transferrin?

A

8-10 days

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8
Q

What is the DRI?

A

Dietary Reference Index
Made by institute of medicine to recommend levels of a nutrient necessary for optimal health

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9
Q

What is RDA?

A

Recommended dietary allowance
Average daily dietary nutrient intake level sufficient for nearly all healthy individuals

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10
Q

What is AI?

A

Adequate intake
Recommended intake based on approximations of nutrient intake by healthy people

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11
Q

What is EAR?

A

Estimated average requirement
Average need that meets the requirement of half the healthy individuals

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12
Q

What is the EER?

A

Estimated energy requirement
average dietary intake predicted to maintain energy balance

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13
Q

What is UL?

A

Tolerable upper intake level
Highest average daily nutrient intake level

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14
Q

What is BMR?

A

Energy expenditure needed to sustain the metabolic activities, reclining after a 12 hour fast

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15
Q

What is BEE?

A

Basal energy expenditure
BRM extrapolated to 24 hours

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16
Q

What is RMR?

A

Resting metabolic rate?
BMR but accounts for energy expenditure increases caused by recent food intake or effect of recently completed physical activity. 10-20% higher than BMR on average

17
Q

What is REE?

A

Resting energy expenditure
RMR extrapolated to 24 hours

18
Q

What is the most common worldwide deficiency?

A

iron deficiency

19
Q

What is marasmus?

A

starvation, the state of protein and total energy malnutrition due to lack of intake

20
Q

What is kwashiorkor?

A

protein deficit, protein malnutrition in the presence

21
Q

What does kwashiorkor look like on a PEx?

A

Classic edematous appearance
Skin/hair changes, dryness
bradycardia, hypotension, hypothermia
Distended abdomen with dilated bowel loops
Lethargic, apathetic, irritable

22
Q

What is cachexia?

A

Multifactorial wasting syndrome defined by continuous loss of skeletal muscle mass, with or without loss of fat mass

23
Q

Is cachexia reversible?

A

Not fully reversible by conventional nutritional support

24
Q

How many cancer patients are affected by cachexia?

A

50-80%

25
Q

What is cachexia thought to be caused by?

A

Thought to be tied to mitochondrial dysfunction

26
Q

What are the risks of parenteral nutrition?

A

Bacteremia, sepsis, poor weight gain
Fat overload syndrome - fever, HSM, coagulopathy
Bone metabolism disease in children

27
Q

What are the general principals for low-appetite patients?

A

-frequent small meals
-energy dense foods
-powdered supplements
-add calories and nutrition to preferred foods

28
Q

What is dumping syndrome?

A

Sx: sweating, flushing, dizziness, tachycardia
Caused by large amounts of foods (esp sugar) moving rapidly from the stomach to the bowel

29
Q

What is megestrol acetate (Megace)?

A

Synthetic progestin that has been found to promote appetite
Often in AIDS and cancer patients

30
Q

What are the SE of Megace?

A

GI upset, HA, insomnia, rash

31
Q

What is cyproheptadine (Periactin)

A

1st generation antihistamine that can be used as an appetite stimulant

32
Q

What are the SE of cyproheptadine (Periactin)?

A

Dizziness, drowsiness, anticholinergic

33
Q

What are the CI of cyproheptadine (Periactin)?

A

Allergy, MAOI, urine/gastric obstruction, acute angle closure glaucoma, gastric ulcer

34
Q

What is dronabinol (Marinol)?

A

Cannabinoid-derived agent (THC); can suppress N/V and promote appetite. Is schedule III

35
Q

What is the SE of dronabinol (Marinol)?

A

Euphoria, GI upset, dizziness, drowsiness, AMS

36
Q

What is the CI to dronabinol (Marinol)?

A

allergy, disulfiram or flagyl in 14 days, allergy to alcohol or sesame oil

Nutrition (5 decks)

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