Nutrition + Diet

Question 1

Consequences of malnutrition

Answer 1

Decrease resp function
Decrease cardiac function
Decrease mobility
Increase risk of pressure sores
Increase risk of infection
Decrease wound healing
Increase risk malabsorption

Question 2

Anthropometrics

Answer 2

Weight
Height
BMI
Weight History

Question 3

Surrogate height measures

Answer 3

Knee height
Demispan
Ulna length

Question 4

Surrougate weight measure

Answer 4

Mid Upper Arm Circumference (MUAC)

Question 5

MUAC

Answer 5

<23.5, BMI likely to be <20

>32, BMI likely to be >30

Question 6

Ascites weight increase

Answer 6

tense- 14kg
moderate- 6kg
minimal- 2.2kg

Question 7

Peripheral oedema weight increase

Answer 7

severe- 10kg (up to sacrum)
moderate- 5kg (up to knee)
mild- 1kg (ankle)

Question 8

Fat Mass

Answer 8

Skin folds

Usually triceps

Question 9

Fat free mass

Answer 9

i.e. protein status
Arm muscle circumference
Dervive from MUAC + skin folds

Question 10

Hand grip dynamometry

Answer 10

Measures muscle strength + endurance

Predictor of mortality

Question 11

Albumin

Answer 11

Large protein
Synthesised in liver
Found in plasma
35-50g/
Maintains oncotic pressure

Question 12

Hypoalbuminaemia

Answer 12

Inflammation + sepsis with infection
Increased C reactive protein, WC, pyrexia
Capillary walls become more porous + albumin drifts out –> low plasma albumin

Question 13

Albumin + nutrition

Answer 13

Good prognostic indicator of mortality risk

Question 14

Albumin + nutritional status

Answer 14

Low albumin is not caused by poor intake

Question 15

Refeeding syndrome

Answer 15

A potentially fatal condition characterised by severe fluid + electrolyte shifts and related metabolic implications in malnourished patients undergoing refeeding

Question 16

In Starvation

Answer 16

Glucagon levels rise
Insulin falls
Glycogen used up first 24-72 hours
Shifts to protein for energy
FAs metabolised to produce ketone bodies –> become main source of energy
Loss of fat + lean body mass, water + minerals
Intracellular stores of K+, PO4- and Mg2+ depleted

Question 17

In Refeeding

Answer 17

Metabolism changes from FAs –> carbohydrates
Raised insulin secretion
Insulin stimulate K+, PO4- and Mg2+ to return to cells
Intracellular stores are replenished but at expense of plasma concentrations

Question 18

Refeeding Syndrome consequences

Answer 18

Hypophosphataemia
Hypomagnesaemia
Hypokalaemia

Question 19

Hypophosphataemia

Answer 19

Seizures
Rhabdomyolysis
Impaired respiratory muscle function
Cardiac failure
Fluid + salt retention

Question 20

Hypomagnesia

Answer 20

Tetany
Seizures
Arrhythmias
Anorexia
Abdo pain

Question 21

Hypokalaemia

Answer 21

Paralysis
Rhabdomyolysis
Resp. depression
Arrhythmias
Constipation

Question 22

Parenteral nutrition

Answer 22

GIT unable to digest or absorb

GIT can’t be accessed