Met 2: Acute Malnutrition Flashcards
Severe acute malnutrition is the same as ______
protein energy malnutrition
What is the key feature of malnutrition?
Not meeting energy requirements
(not enough calories)
If you have a negative energy balance, what will your Nitrogen balance be?
If you have a negative energy balance, you will definitely have a negative Nitrogen balance
Define underweight
Low-weight for age
More than 2 SD below median
Define stunting
Low height/length for age
More than 2 SD below median
Define wasting
Decreased weight relative to height
Weighing less than 90% of your ideal body weight (a standard based on your height)
Define sarcopenia
Sarcopenia: low muscle mass
Is marasmus typically slow or fast onset?
How does that affect adaptation?
Marasmus is slow onset, so patients have better adaptation
Mild wasting is often called
“failure to thrive”
Kwashiorkor
- Definition
- Cause
- Onset
- Edematous malnutrition
- Due to protein deficiency
- Rapid onset
4 Signs of Kwashiorkor
- Edema
- Hepatomegaly
- Hyperpigmented, flaky rash
- Depigmented stripe of hair
Cachexia occurs with _______ or _______ conditions.
It ______ reversible with feeding
Cachexia occurs with inflammatory or cancerous conditions (chronic illness)
It is not reversible with feeding
Describe the Kwashiorkor mnemonic
Kwashiorkor results from protein-deficient MEALS
- Malnutrition
- Edema
- Anemia
- Liver is fatty
- Skin lesions (hyperkeratosis, hyperpigmentation)
Define cachexia
Malnutrition in the setting of chronic illness
Define marasmus
Severe malnutrition due to a calorie deficiency
Causes muscle and fat wasting
After using up all the glycogen, the body will utilize ________ as long as possible before ______________.
After using up all the glycogen, the body will utilize fat stores as long as possible before turning to muscle breakdown
What happens to basal metabolic rate with fasting?
Basal metabolic rate decreases
What are the signs of malnutrition in these systems?
- decreased metabolic rate (3)
- Endocrine (2)
- GI (1)
- Heart (1)
- Decreased metabolic rate: hypothermia, hypotension, bradycardia
- Endocrine: low insulin, increased epi and steroids
- GI: mucosal atrophy
- Heart: myocardial atrophy
What is the calorie intake in Kwashiorkor?
Calorie intake may or may not be adequate
It’s protein that’s specifically deficient
Why do kwashiorkor kids have edema?
Why do they have fatty liver?
Hypoalbuminemia -> edema
Hepatic fatty acid synthesis -> fatty, enlarged liver
Do psychological changes occur more in marasmus or kwashiorkor?
Kwashiorkor
When refeeding a malnourish patient,
- Food should be given ________
- Food is administered __________ b/c…
- Food should be given gradually
- Food is administered parenterally b/c gut function is severely compromised and will not be able to absorb nutrients
Refeeding syndrome has derangements in which 4 nutrients? Why
- hypokalemia
- Due to insulin release, which forces K+ into cells
- hypophosphatemia
- Due to insulin release and phosphorylation pathways being activated
- hypomagnesemia
- Due to increased requirement, since ATPase enzymes active again
- Thiamine deficiency
- Due to activation of energy breakdown pathways
Full feeding should only occur once ______ has resolved
Full feeding should only occur once edema has resolved
