nutrition in med Flashcards
where is food absorbed
vast majority is in the first 1/3 of the digestive tract
jej quite leaky- can get net exit of water
ileum is good at absorbing the water again.
energy expenditure requirements
+ stress factors- e.g infections or burns or recoverng from #
30-35 mils per kg of fluid per day also.
causes of disease related malnutrition
increace requirement
invol mvt. infection, inflam, pyrexia, tissue healing, metabolic effects.
dec nutritional intake
anorexia, side effects of Rx, pain, dysphagia, physical disability.
response to starvation
response to catabolic insult
metabloic rate decreaces to 20-25kcal/kg/day. protein storage protected.
no adaptive responses activated, increaced met rate to 35-40kcl/kg/day. inc gluc prod in excess of need. increaced use of protein for fuel. inefficient fat energy use.
discuss consequences of malnutrition
how to decide which additional food to give
is the gut working?
is it accessable?
how long will starvation last
is feeding in the patients interest?
enteral (delivered using the gut)
parenteral- not using the gut
what is elemental feeding, what is it good for
all components have been broken down, so AAs instead of prots,
good for people with big inflammatory bowel diseases, etc
what is re-feeding syndrome
body uses glucose- glycogen- fatty acids- protein. gradual reduction of insulin as less glucose utilised
then when you get food, insulin rises quickly, pushing nutrients into the cells from the blood, causing dangerous lowering of blood contents
what are the two types of malnutrition
Kwashiorkor - enough carbs, but not enough protein, sufficient total intake, bilateral pitting pedal edema and ascites (enlarged liver)- affects children mostly post wean.
Marasmus - inadequate caloric intake, including protein. overt loss of adipose tissue and muscle may also develop pitting oedema due to protein deficiency.
