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Systems: Alimentary AB > Nutrition in Health and Disease > Flashcards

Nutrition in Health and Disease Flashcards

1
Q

Diet

A

Sum total of all foods ingested

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2
Q

Food

A

The individual items ingested

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3
Q

Nutrients

A

Chemically defined compounds required by the body

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4
Q

What influences our choice of food?

A
  • Likes/dislikes
  • Religious and ethical considerations
  • Social and psychological components
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5
Q

What is the required amount of nutrition equal to?

A

The amount required to sustain life and prevent a deficiency

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6
Q

What makes up the fixed component of demand?

A
  • Basal requirements
  • Mechanical work
  • Substrate turnover
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7
Q

What basal requirements are there?

A

Membrane function including pumps, transport and signalling

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8
Q

At what level can there be mechanical work?

A
  • Cellular level

- Tissue level

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9
Q

What makes up the variable component of demand?

A
  • Cost of processing the dietary intake
  • Cost of physical activity
  • Cost of maintaining body temperature
  • Cost of growth
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10
Q

How can basal metabolic rate be measured?

A

Direct colorimetry

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11
Q

What is basal metabolic rate dependent on?

A

Lean body mass

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12
Q

What equations can be used to calculate basal metabolic rate?

A
  • Schofield
  • Harris Benedict
  • Henry
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13
Q

What has to be taken into consideration when calculating basal metabolic rate?

A

Adjustments for factors such as activity and illness

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14
Q

What contributes to metabolic demand?

A

Many systems

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15
Q

What is responsible for supply?

A

The gut and its associated organs

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16
Q

Nutritional failure

A

Failure to meet the nutritional requirements of the individual and may include the development of deficiency (weight loss) or excess (obesity)

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17
Q

Give 3 examples of forms of malnutrition.

A
  • Marasmus
  • Kwashiokor
  • Obesity
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18
Q

Malnutrition

A

A state of nutrition in which an imbalance of energy, protein and other nutrients, causes measurable adverse effects on tissue/body form, (body size, shape, composition) body function and clinical outcome

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19
Q

What can malnutrition include?

A

Not only protein energy malnutrition but also malnutrition of other nutrients, such as micronutrients

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20
Q

What law are we bound by?

A

First law of thermodynamics: we cannot make or destroy energy

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21
Q

What does over-nutrition lead to?

A
  • Obesity which leads to longer term problems

- These are often hidden and only become apparent over time

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22
Q

What does under-nutrition lead to?

A
  • Weight loss and impaired function

- It strongly associates with illness

23
Q

What is often the cause of under nutrition?

A

Illness

24
Q

How do you calculate a BMI?

A

Weight (kg)
_________
Height^2 (m)

25
Q

How is over nutrition defined?

A
  • BMI>25 overweight

- BMI>30 obese

26
Q

What are 3 factors affecting obesity?

A
  • Environment
  • Exercise
  • Genes
27
Q

What metabolic syndromes can affect obesity?

A
  • Hypertension
  • CVD
  • Type II diabetes mellitus
  • Fatty liver
  • NASH
  • Cirrhosis
28
Q

What cancers are linked to obesity?

A
  • Breast

- Bowel

29
Q

What causes are linked to under nutrition?

A
  • Partly environmental

- Mostly disease related

30
Q

How is under nutrition defined?

A
  • BMI<20 underweight
  • BMI< 18 physical impairment
  • BMI<16 increasingly sever consequences
31
Q

What is a hallmark of under nutrition?

A

Weight loss

32
Q

What percentage loss of body mass is associated with increasing morbidity?

A

10%

33
Q

Why is BMI not a good indication if a patient is under nourished?

A

An obese patient who becomes ill can be under nourished but their BMI will not reveal that

34
Q

What screening is there for under nutrition?

A

Malnutrition universal screening tool (MUST)

35
Q

Who can carry out MUST assessments?

A

People without specialist training

36
Q

What does MUST identify?

A

Patients at risk of malnutrition

37
Q

What is step 1 in the MUST assessment?

A
  • Height
  • Weight
  • BMI (if <20 then score 1) (if <18 then score 2)
38
Q

What is step 2 in the MUST assessment?

A
  • Have you lost weight unintentionally in the last 3-6 months
  • Yes 10% score 2
  • Yes 5% score 1
39
Q

What is step 3 in the MUST assessment?

A
  • Has the patient eaten in the last 5 days?

- No score 2

40
Q

How are the results analysed of the MUST assessment?

A
  • A score over 2 suggests a risk of under nutrition
  • Score 1: supplements and watch
  • Score 0: monitor
41
Q

What is associated with malnutrition?

A
  • Illness
  • Social isolation
  • Age
  • Socially vulnerable groups
  • People affected by ‘food deserts’
42
Q

Explain the term ‘food deserts’

A

Limited choice of food due to inability to access wider ranges (limited access to shop, no internet, immobility)

43
Q

What are the clinical consequences of malnutrition?

A
  • Impaired immune response
  • Reduced muscle strength
  • Impaired wound healing
  • Impaired psycho-social function
  • Impaired recovery from illness and surgery
  • Poorer clinical outcomes
44
Q

What are the consequences for under nutrition?

A
  • More care at home
  • More hospital admissions
  • Longer length of stay
  • More GP visits, antibiotics etc.
45
Q

What is the first stage in treating someone with under nutrition?

A
  • Take a history
  • Examine the patient
  • Analyse what the problem is
  • Work out their requirements
46
Q

What is the easy method for treating a patient with under nutrition?

A

Refer the patient to a state registered dietitian

47
Q

What are possible causes of under nutrition?

A
  • Appetite failure
  • Access failure
  • Intestinal failure
48
Q

What can appetite failure be due to?

A
  • Anorexia nervosa

- Disease related

49
Q

What can access failure be due to?

A
  • Teeth
  • Stroke
  • Cancer of head and neck
  • Head injury
50
Q

Intestinal failure

A

Reduction in the function gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients.

51
Q

What can be the solution for people who require nutritional help?

A
  • Fine bore nasogastric tube

- PEG

52
Q

What is involved in percutaneous endoscopic gastrostomy?

A
  • Patient sedated
  • Endoscopy carried out
  • Needle and guide ire into stomach
  • Tube pulled back down and out of skin
  • Can be placed radiologically
53
Q

What are the advantages of PEG?

A
  • Can last 18 months without replacement

- Can be used at home

54
Q

What are the disadvantages of PEG?

A
  • Safe but carries definite risks
  • Still an operative procedure
  • Difficult ethical issues

Systems: Alimentary AB (37 decks)

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