Nutrition in Health and Disease Flashcards
Where does our nutriotion demand come form?
Basal Requirements:
Membrane function:
- Pumps
- Transport
- Signalling
Mechanical Work:
- Cellular level
- Tissue level
Substrate turnover
Variable Component:
Cost of processing the dietary intake
Cost of Physical activity
Cost of maintaining body temperature
Cost of growth
What is meant by nutritional failure?
Failure to meet the nutritional requirements of the individual
Development of deficiencies
[Weight loss]
Or Excess
[Obesity]
What are two clincal examples if malnutrition?
Marasmus
Kwashiorkor
It can be distinguished from kwashiorkor in that kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein
Define malnutrition
When there is an imbalance of energy, protein or other nutrients that results in adverse effect on tissue / body form, body function and clinical outcome
How do you calculate BMI?
Weight divided by height squared
What BMI is defined as overqeight and obese?
BMI > 25 overweight
BMI > 30 obese.
What are the contributing factors to obesity?
Environment
Exercise
Genes
What is metabolic syndrome composed of?
(as a result of obesity)
- Hypertension.
- Cardiovascular disease.
- Type II diabetes mellitus.
- Fatty liver.
- NASH
- Cirrhosis
What types of cancer are obese people most likely to get?
Breast
Bowel
What are the aetiologies for indernutriotion?
Partly environmental
Mostly disease related
What are the BMI classifications for those who are malnourished?
BMI less < 20 underweight
BMI < 18 physical impairment
BMI < 16 increasingly severe consequences.
Why is BMI insufficient when determining undernutrition?
An obese patient who is experiencing weight loss would be indicative of undernutrition, however BMI would not be able to inform you of this
How do we screen for undernutrition?
Malnutrition Universal Screening Tool
Picks up patients at risk of malnutrition
What are the aspects of the Malnutrition screening tool?
BMI
If < 20 Score 1
If < 18 Score 2
Unintentional weight loss?
Yes - 10% score 2
Yes - 5% score 1
Patient eaten in the last 5 days or is expected to eat in the next 5 days? No - score 2
What do the scores indicate for the malnutrition universal screening tool?
A score over 2 suggests a risk of undernutrition
Score 1: supplements and watch
Score 0: Monitor
Which admission source is most likely to have malnourished patients?
Care homes
Other Hospitals
Which type of ward has the largest percentage of malnourished patients?
Care of the elderly / Stroke
What does malnutriotion associate with?
Illness
Social Isolation
Age
Socially Vulnerable groups
‘Food deserts’ - inability to reach food shops, reliance on conveniance stores
What are the clinical consequences of malnutrition?
- Impaired immune response
- Reduced muscle strength
- Impaired wound healing
- Impaired psycho-social function
- Impaired recovery from illness and surgery
- Poorer clinical outcomes
What are causes of undernutrition?
Appetite failure
Access failure
Intestinal Failure
What are the causes of appetite failure?
Anorexia nervosa
Disease related
What are the reasons for access failre?
Teeth
Stroke
Cancer of head and neck
Head injury
What is meant by intetinal failure?
Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients
For patients with access failure, what is the feeding method?
Sip feeding
Fine bore nadogastric tube
PEG - Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient’s stomach through the abdominal wall
What causes the fluid build up in Kwashiorkor?
Leaky capillaries, fluid retention.
(Probably as a result of loss of oncotic pressure)
Where would you be likely ot find marasmus?
Any Care of the Elderly Ward
General medical admissions
Oncology
Where would you be likely to find kwashiorkor?
ITU or HDU
