Malnutrition / Infectious Diseases

Question 1

What is malnutrition?

Answer 1

Malnutrition refers to deficiencies, excesses or imbalances in a
person’s intake of energy and/or nutrients (WHO)

Under and over nutrition

Question 2

Who are most at risk of malnutrition?

Answer 2

• Under 2s
• Under 5s
• Pregnant Women
• Lactating Women
• Adolescent Girls
• Elderly
• People with HIV/AIDS and/or TB

Question 3

Describe CHRONIC malnutrition

Answer 3

• Over a long period
• Failure of linear growth
• Affects cognitive development

Question 4

Describe ACUTE malnutrition

Answer 4

• Short period of time
• Onset of a disease leading to a rapid weight loss
• Often accompany by acute infections

Question 5

Name the 2 types of actue malnutrition

Answer 5

• MAM = Moderate Acute Malnutrition (moderate wasting)

- SAM = Severe Acute Malnutrition (severe wasting and/or oedema)

Question 6

What are the 3 forms of Severe Acute Malnutrition (SAM)?

Answer 6

• Marasmus: extreme thinness or severe wasting
• Kwashiorkor: nutritional oedema or bilateral pitting oedema
• Marasmic-Kwashiorkor: a combination of both

Question 7

What are the definition and features of marasumus?

Answer 7

Weight for age <60% of the international standard
Gluconeogenesis
Ketosis
Infection

Question 8

What are the definition and features of kwashiorkor?

Answer 8

• Oedeme - fluid retention in the body.
• Weight for age 60-80% of international standard
• Low plasma albumin
• Abnormal plasma amino acid
• VLDL
• Fatty liver
• Liver protein depletion
• Nitrogen loss from infection

Question 9

What are the definition and features of marasumus / kwashiorkor?

Answer 9

• Weight for age <60% of the international standard

- Oedeme - fluid retention in the body.

Question 10

Name some of the clinical symptoms of marasmus?

Answer 10

• Wasting of subcutaneous fat and muscles
• Wrinkled face
• Inceased appetite
• Mild skin and hair changes
• Sunken eyeballs
• Irritable

Question 11

Name some of the clinical symptoms of kwashiorkor?

Answer 11

• Wasting of muscles and preservation of subcutaneous fat
• Moon face
• Loss of appetite
• Intense skin lesions and hair changes
• Growth faliure
• Pitting oedema
• Fatty liver
• Psychomotor retardation
• Lack of interest

Question 12

How can measurements be done?

Answer 12

• MUAC - indicator of whos suffering
• <5’s scale and basin/weighing pants - weight
• Board for height

Question 13

How do you assess nutritional oedema

Answer 13

Apply normal thumb pressure for about
3 seconds and then observe if the indentation persist after releasing
the pressure

Question 14

What are some of the treatment approaches to malnutrition?

Answer 14

• Community-Based Management of Acute Malnutrition - (CMAM)
• Infant and young children feeding in emergency - (IYCF-E)
• Management of acute malnutrition in infants - (MAMI)

Question 15

What is PEM and what does it mean?

Answer 15

Protein Energy Malnutrition.

Results when the body’s need for
protein, energy fuels or both cannot be satisfied by the diet

Question 16

What syndromes can PEM lead to

Answer 16

• Kwashiorkor - protein quality deficiency

- Marasmus - mainly energy deficiency!

Question 17

What percentage of body protein loss results in reduced:

• muscle strength for breathing,
• reduced immune function and
• reduced organ function that death results

Answer 17

30%

Question 18

Name some of the essential amino acids

Answer 18

Isoleucine
Leucine
Lysine
Methionine
Phenylalanine
Threonine
Tryptophan
Valine

Question 19

Name some of the conditionally indispensable amino acids

Answer 19

Arginine
Asparagine
Cystenine
Glutamine
Glycine
Proline
Serine
Tyrosine
Histidine

Question 20

Name some of the non-essential (dispensable) amino acids

Answer 20

Alanine
Aspartic acid
Glutamic acid

Question 21

What are the 3 types of diarrhoea?

Answer 21

• acute watery diarrhoea – lasts several hours or days, and includes cholera
• acute bloody diarrhoea – also called dysentery
• persistent diarrhoea – lasts 14 days or longer

Question 22

Whats is the the second leading cause

of death in children under five years old?

Answer 22

Diarrhoeal diseases

Question 23

Complete the last piece in the cycle for the summary malnutrition – infectious diseases

1. Malnutrition
2. Impaired child development
3. Compromised immunity
4. Infection
5. Disease
6. Energy loss
7. Reduced productivity
8. Poverty
9. Impaired development of education and health systems
10. _________________

Answer 23

Socioeconomic & political instability

Question 24

What vitamins and mineral deficiency are a concern to PHE?

Answer 24

Iodine
Vit. A
Iron
Zinc

Question 25

What are the risk factors for Zinc deficiency?

Answer 25

• Low protein diet
• High phytate, fibre or calcium in diet
• Zinc depleted soil
• Poor absorption
• Diarrhoea
• Parasitosis
• Hot humid climate (sweat loss)

Question 26

Who is most at risk from vitamin A deficiency?

Answer 26

Children and women are most affected by VAD - Infants who are not
breast fed are at increased risk

Question 27

What is xerophthalmia caused by?

Answer 27

Lack of vitamin A - can lead to blindness

Question 28

Lack of Thiamin (B1) can lead to….

Answer 28

Beriberi

Question 29

Lack of Vit B3 Niacin can lead to….

Answer 29

Pellagra

Question 30

Lack of vitamin C can lead to….

Answer 30

Scurvy

Question 31

Lack of vitamin D can lead to….

Answer 31

Rickets

Osteomalacia in women

Question 32

Lack of iodine can lead to….

Answer 32

Goiter