Nutrition

Question 1

What is the equation used to calculate the energy requirements

Answer 1

(BW(kg) x 30)+ 70
Can use the above for patients weighing 2-20kg

RER= 70 x (bodyweight in kg) to the power of 0.75

Question 2

Name 3 electrolyte abnormalities seen in refeeding syndrome

Answer 2

Hypophosphataemia
Hypokalaemia
Hypomagnesaemia

Question 3

Why does hypophosphatemia cause haemolytic anaemia?

Answer 3

Rbc need glycolysis for ATP generation

Decrease phosphate limits ATP production

May cause malfunction of Na K pump-> osmotic lysis and failure of membrane-associated actin and myosin fibres which help to maintain rbc shape, plasticity,membrane integrity,deformability

Question 4

What comprises TPN

Answer 4

Lipid
Carbohydrates (Dextrose)
amino acids

Usually 50:50 lipid: Dextrose

+/- Vitamins
+/- Electrolytes
+/-Minerals

Question 5

What are the suggested protein requirements for cats and dogs?

Answer 5

Dogs
Standard 4-5g/100kcal
Decreased 2-3g/100kcal
Increased 5-6g/100kcal

Cats
Standard 6g/100kcal
Decreased 4-5g/100kcal
Increased 6-8g/100kcal

Question 6

What are the categories of TPN complications and give examples

Answer 6

Mechanical-chewed lines or catheter complications

Metabolic- hyperammonium, hypoglycaemia, changes to K/phos/Na

Septic- from catheter infex or technically infex of TPN bag because of high lipid content