Nutrition and vitamin deficiency

Question 1

Parenteral nutrition

Answer 1

nutrients given via central or peripheral vein

Question 2

Parenteral nutrition: SPN (supplementary parenteral)

Answer 2

In addition to oral or enteral feeds

Question 3

Parenteral nutrition: TPN (total parenteral)

Answer 3

Sole source of nutrition

Question 4

Parenteral nutrition: important notes

Answer 4

• 10% glucose is infused via central vein to avoid thrombosis
• Give enough phosphate to allow the phosphorylation of glucose
• Add fructose, sorbitol to avoid hyperosmolar hyperglycaemic non-ketotic acidosis
• Do not add additives to fat emulsions unless compatibility known

Question 5

Enteral nutrition

Answer 5

nutrients given via tube to stomach or small intestine

Can’t eat enough to meet nutritional needs
- Monitor: fluid + electrolytes, haematological + biochem parameters

Liquid feeds prepared for adults are unsuitable for children

Question 6

Vitamin deficiency: A

Answer 6

Retinol
o Teratogenic
o Night blindness
o RTI infections

Benefits:
o Night vision
o Immune system
o Healthy skin

Source:
o Liver (organ meats)
o Fish liver oil
o Eggs
o Dairy
o Leafy greens

Question 7

Vitamin deficiency: C

Answer 7

Ascorbic acid
o Bleeding gums
o Bruising
o Slow healing
o Scurvy

Benefits:
o Immunity
o Wound healing
o Antioxidants (forms collagen)
o Aids absorption of iron

Source:
o Oranges
o Peppers
o Kale

Question 8

Vitamin deficiency: D

Answer 8

→ D2 = ergocalciferol
→ D3 = cholecalciferol
→ Severe RI: alfacalcidol + calcitriol

Vitamin D
o Rickets
o Ostomalacia

Benefits:
o Healthy bones
o Aids dietary absorption of calcium

Source:
o Sun exposure

Question 9

Vitamin deficiency: E

Answer 9

Tocopherol
o Interacts w warfarin

Benefits:
o Powerful antioxidant
o Healthy skin

Source:
o Plant oils (olive oil, nuts + seeds)
o Wheat germ

Question 10

Vitamin deficiency: K1

Answer 10

Phytomenadione + menadiol
o Bleeding
o Interacts w warfarin

Benefits:
o Blood clotting
o Given to new born babies to prevent neonatal haemorrhage

Source:
o Green leafy veg

Question 11

Vitamin deficiency: B1

Answer 11

Thiamine
o Chronic alcoholics
o Anaphylaxis w injections

Benefits:
o Release energy from food
o Healthy CNS

Source:
o Fortified cereals
o Wholegrain

Question 12

Vitamin deficiency: B2

Answer 12

Riboflavin

Benefits:
o Healthy skin, nerves + eyes

Source:
o Milk
o Eggs
o Fortified cereals
o Rice

Question 13

Vitamin deficiency: B3

Answer 13

Niacin
o Nicotinamide + nicotinic acid (vasodilation)

Benefits:
o Healthy skin + yes

Source:
o Meat
o Fish
o Wheat flour
o Eggs
o Milk

Question 14

Vitamin deficiency: B6

Answer 14

Pyridoxine
o Prevents peripheral neuropathy w isoniazid
o Risk of sensory neuropathy w prolonged use of doses >200mg, treats PMS

Benefits:
o Makes neurotransmitters
o Haemoglobin

Source:
o Fortified cereals
o Chicken
o Veg

Question 15

Vitamin deficiency: B7

Answer 15

Biotin
o Strengthens hair + nails

Benefits:
o Essential for fat metabolism

Source:
o Veg
o Whole cereals

Question 16

Vitamin deficiency: B12

Answer 16

Cobalamin
o Deficients in vegans
o Treats megaloblastic anaemia

Benefits:
o Healthy CNS
o Makes RBC
o Processing folic acid

Source:
o Salmon
o Meat
o Fortified cereals

Question 17

Neural tube defects: dose

Answer 17

400mcg daily
- Before conception + until week 12 of pregnancy

High risk: 5mg daily
- Anti-epileptic med
- Diabetes
- Previous infant
- Sickle cell disease (whole pregnancy)