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Alimentary > Nutrition and Ethics > Flashcards

Nutrition and Ethics Flashcards

1
Q

Define diet

A

The sum of all the foods ingested

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2
Q

Define nutrients

A

Chemical composition of all foods ingested

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3
Q

Define food

A

The individual foods ingested

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4
Q

What is the requirement for nutrients defined as ?

A

The amount of nutrients needed for sustain life and prevent a deficiency

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5
Q

What 3 things make up demand ?

A

Basal requirements
Mechanical work
Substrate turnover

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6
Q

What things change demand ?

A

Temperature
Exercise
Growth
Processing dietary intake

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7
Q

Define basal metabolic rate

A

Requirements needed to stay alive

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8
Q

How is basal metabolic rate measured ?

A

Can be measured directly by direct calorimetry but usually calculated.

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9
Q

Define nutritional failure

A

The failure to meet the nutritional requirements of the body

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10
Q

Define malnutiriton

A

A state of nutrition in which a deficiency causes measurable effects on the body

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11
Q

Which cancers is obesity linked to ? (2)

A

Breast and bowel cancer

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12
Q

BMI <20 ?

A

Underweight

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13
Q

BMI <18 ?

A

Causes physical impairment

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14
Q

Define over-nutrition

A

Intake of nutrients is over supplied

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15
Q

Define under-nutrition

A

Intake of nutrients is under supplied

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16
Q

Which scale is used to screen for malnutrition ?

A

MUST - Malnutrition Universal Screening Tool

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17
Q

Describe the 3 steps of MUST

A

Step 1
BMI
<20 score
<18 score 2

Step 2
Weight loss in the last 3-6 months
5% score 1
10% score 2

Step 3
Has the patient eaten in the last 5 days ?
No score 2

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18
Q

What score of the MUST screening tool suggests risk of malnutrition and in need or serious intervention ?

A

2 or more

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19
Q

What score of the MUST screening tool suggests concern and need of supplements ?

A

1

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20
Q

What score of the MUST screening tool suggests need for monitoring ?

A

0

21
Q

Why are those who are under nourished at risk in hospital ?

A

Impaired wound healing
Impaired immune system
Reduced muscle strength
Lower mood

22
Q

What are the 3 causes of undernutrition ?

A

Intestinal failure
Appetite failure
Access failure - stroke, teeth, obstruction

23
Q

Define short bowel syndrome

A

A group of disorders that are related to poor absorption of nutrients

24
Q

Define ethics

A

The study of moral standards and how they effect conduct

25
Q

What are the 4 medical ethical principles ?

A

Justice
Autonomy
Beneficence
Non-Maleasance

26
Q

Define justice

A

Treating everyone equally

27
Q

Define autonomy

A

Allowing the individual to decide what is best for them and what they want

28
Q

Define Non-maleficence

A

Do no harm

29
Q

Define beneficence

A

Doing good and what’s best always. Promoting patient wellbeing

30
Q

What is mental incapacity ?

A

Being unable to act, make decisions, understand or communicate decisions and remember which ones were made.

31
Q

What is basic care classed as ?

A

Food and fluids. Basic care is needed to make the individual comfortable.

32
Q

What is treatment classed as ?

A

In most basic forms anything un-natural e.g. feeding tubes

33
Q

What should you agree on when trialling treatment ?

A

What is the treatment ?
How long ?
What is the end point ?
What will help you make the decision/targets ?

34
Q

Define somatisation

A

The manifestation of psychological distress by the presentation of physical symptoms

35
Q

What may cause functional symptoms ?

A

Gut hormones
Gut microbiome
Change in diet
Psychological factors

36
Q

Which 4 groups of medications can cause GI symptoms ?

A

Opioids
Antidepressants
Anticholinergics
Cocaine

37
Q

What are the appropriate investigations for functional bowel symptoms ?

A

Coeliac blood tests/biopsy
H.pylori status
Endoscopy/colonoscopy
USS

38
Q

What is re-feeding syndrome ?

A

Reintroduction of carbohydrates into the diet when there is reduced insulin secretion. Main sources of energy are fat and proteins.

39
Q

How does re-feeding syndrome present ?

A

Sharp rise in insulin and lethargy is common.

Arrhythmias and seizures seen.

40
Q

How do you combat re-feeding syndrome ?

A

Start slowly and increase amount of carbohydrates given. Thiamine should be given 30 minutes beforehand and fluid depletion should be corrected. Potassium, magnesium and phosphate needed.

41
Q

What happens to phosphate levels in re-feeding syndrome ?

A

Rapidly taken up into cells and used so levels decrease.

42
Q

What is a binge eating disorder ?

A

A person binges, gains weight and fails to compensate

43
Q

What is Bulimia Nervosa ?

A

Binges, purges and then restricts. Normal or near normal weight.

44
Q

What is Anorexia Nervosa ?

A

Significant weight loss due to restriction. Over exercising is common and amenorrhoea seen in young females.

45
Q

Why is an MDT approach in a health care setting beneficial ?

A

Reduces delays
Integrates care
Improves outcomes

46
Q

Define precision medicine

A

Treatments tailored to the individual patient based on their predicted response or risk of disease.

47
Q

Define realistic medicine

A

Putting the patient at the centre of decisions about their care

48
Q

Which members of the health care team are present at MDT meetings ?

A 
Gastroenterologists
Oncologist
Pathologists
Surgeons
Clinical nurse specialists
Radiologists

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