Nutrition Flashcards
List the daily calorie, carbohydrate, fat and protein requirement.
Women: 2000 Kcal
Men: 2500 Kcal
55% carbohydrate
30% fat
15% protein
Protein = 0.75g/Kg
What is the formula used to calculate someones daily nutritional requirements knowing their activity factor, level of stress and basal metabolic rate? Calculate the amount of each nutrient knowing their weight?
Protein 4kcal/g
Carbs 4kcal/g
Fat 9 kcal/g
Daily expenditure = BMR x stress factor x activity factor (PAL) (with weight and age factored in)
E.g: Stress factor, elective surgery = 1.2, burns= 2.0
List the water soluble and fat soluble vitamins?
Water soluble: BC
Fat Soluble: KAED
Kara ate everyones dinner
List the incidence and complications of under-nutrition?
Undernutrition due to malnutrition is not very common in developed countries but is much more common in developing countries.
Can also be due to malabsorption.
Undernutrition is most common in the elderly and alcoholic populations.
Severe malnutrition manifests as:
Marasmus: reduced energy intake of all macronutrients
Kwashikors (swollen abdomen): sufficient energy intake but an insufficient amount of protein.
List the complications of the following vitamin deficiencies:
A, Thiamin (B2), Niacin (B3), B12, Folate, C, D, E, K?
A: night blindness, xeropthalmia, leartomalacia
Thiamin: Werneckes Encepalopathy (common in alcoholics)
Niacin (B3): Pellagra (diahorrea, dermatitis, dementia)
B6: Polyneuropathy
B12: Megablastic anaemia
Folate: Megablastic Anaemia
C: Scurvy
D: Rickets
E: Neurological deficit
K: Coagulopathy
What is the difference between enteral and parenteral?
Enteral method of feeding that uses the gastrointestinal (GI) tract include oral intake and NG.
Paraenteral administered or occurring elsewhere in the body than the mouth and alimentary canal aka IV feeding.
What is the indication for parenteral feeding?
Advantage/Indication: considered for all patients who are malnourished or at risk of malnutrition and have a non-functioning or inaccessible gastrointestinal (GI) tract.
What are the complications of parenteral feeding?
Need a central line.
High risk of line infections.
There is a high risk of refeeding syndrome.
High risk of hyperglycaemia.
Which trace elements need replacing when someone is receiving total parenteral nutrition?
Vitamins including folic acid are infused with the solution.
Vitamin B12 must be prescribed separately.
Note: each individual bag is customised for each patient
What are the indications for insertion of an NG tube?
NG tubes can be used to:
Drain the stomach of contents in bowel obstruction
Feed patients that cannot swallow: Stroke + other neurological dysphagia, oesophageal/throat obstruction/surgery, patients with a high risk of aspiration.
What are the alternative methods of enteral feeding aka other than normal eating?
NG or NJ tubes should not be used as a long term method therefore if nutritional support is needed for more than 30 days and oral intake is not an option PEG should be used.
PEG = Percutaneous Enterogastrostomy (a tube which goes directly into the stomach
What are some of the potential complications of NG tube insertion?
Acute complications: (very rare but serious)
Pharyngeal or oesophageal perforation
Bronchial insertion (if not corrected will lead to a severe aspiration pneumonia)
Longer use complications:
May cause oesophagitis, oesophageal ulceration and stricture.
Describe how NG tube complications can be minimised?
All patients receiving an NG tube should have a CXR before an NG tube is classed as safe for use. (Check it very carefully)
Aspirate from the NG tube and check the pH before it is flushed. Should be less than 5.5.
If it is placed in the wrong place immediately remove it before any feed is given.
Define obesity and discuss the prevalence and risk factors social and medical for developing it?
BMI > 30 kg/m^2 Moderate 30-35 Severe 35-40 Morbid >40 Super obesity >50
Approximately 25% of UK adults are classified as obese.
Risk Factors: Increased energy intake/ decreased energy expenditure Sedentary Lifestyle Low Socioeconomic Group Learning difficulties
Medical: Hypothyroidism Cushings Corticosteroids Hypothalamic damage (controls satiety)
Discuss the complications of obesity? Think in systems!
Psychological: Low self esteem
Respiratory: Sleep Apnoea
Malignancy: Breast and ovarian (due to steroid conversion in peripheral adipose) and colorectal.
Metabolic: Atheroslcerotic disease, Type 2 DM, Hypertension
Abdo: NAFLD, GORD, Hiatus Hernia, Gall stones
Reproductive: Erectile dyfucntion/ammenorrhoea
Joints: Osteoarthiritis
Skin: Increased skin infections due to difficulty cleaning themselves (only in v.severe obesity)
Think obvious ones 1st: Metabolic, Abdo, Respiratory and Joints
