Misc Flashcards
outline NICE management recommendations for obese patients by class
Overweight
Low waist circumference - general advice on healthy weight and lifestyle.
High or very high waist circumference - structured advice regarding diet and exercise.
Comorbidities - structured advice on diet and activity; consider drug treatment after evaluating the effect of lifestyle changes.
Obese (I)
No comorbidities - structured advice regarding diet and exercise.
Comorbidities - structured advice on diet and activity; consider drug treatment after evaluating the effect of lifestyle changes.
Obese (II)
No comorbidities - structured advice on diet and activity; consider drug treatment after evaluating the effect of lifestyle changes.
Comorbidities - structured advice on diet and activity; consider drug treatment after evaluating the effect of lifestyle changes. Consider referring for surgery.
Obese (III)
Structured advice on diet and activity. This may need to be via a specialised weight management programme.
Consider starting drug treatment after evaluation of lifestyle changes.
Consider referring for surgery.
define central obesity in men and women
> 94 cm wait circumference in men
>80 cm waist circumference in women
name some complications of obesity
sleep apnoea, stroke, cataracts, gallstones, NASH, PCOS, OA, gout, DM, dyslipidaemia, CVD, cancer
name and outline the tool used to screen for malnutrition in community and hospital
MUST malnutrition universal screening tool
2 or more points, refer to dietician
BMI: 1pt for 18.5 to 20, 2pt for <18.5
weight loss: 1pt for 5-10% loss, 2pt for 10%
acute disease effect: >5 days no food
what are the indications for enteral nutrition
dysphagia sedation unsafe swallow (post-stroke) high nutritional requirements NOT for dementia patients with low appetite
indications for parenteral nutrition
non-function gut (ileus, obstruction etc)
who is at risk of refeeding syndrome?
alcoholics, >5days not fed, oncology patients, IBD patients
what electrolyte disturbances seen in refeeding syndrome
hypokalaemia
hypomagnesaemia
hypophosphataemia
oedema
define pain
a subjective experience with both sensory and emotional components, arising from actual or potential tissue damage
what are the afferent pain fibres?
Ad fibres: myelinated, sharp pain, localized
C fibres: unmyelinated, dull pain, diffuse
name some non-pharmacological interventions for pain
physio acupuncture behavioural (CBT) neuromodulation botox nerve blocks ablation
what does the WHO recommend for moderate/severe pain?
regular analgesic not PRN
what is pellagra?
B3 vitamin deficiency
Sx: diarrhoea, dementia, dermatitis
what is polygenic disease?
common childhood onset polygenic disease?
common adult onset polygenic disease?
disease that arises from multiple gene inheritance and in combination with environmental factors
childhood: cleft palate, spina bifida, infantile autism, DM type 1, epilepsy, asthma
adult: CAN, HTN, stroke, DM2, schizophrenia, Alzheimers
