Nutrition in medicine Flashcards

1
Q

Define malnutrition

A

Deficiences, excesses or imbalances in bodies macro and micronutrients

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2
Q

Define undernutrition

A

Form of malnutrition resulting from reduced supply of food or inability to digest, assimilate or utilise necessary nutrients

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3
Q

What % of the following types of patients are undernourished

a) on admission
b) in patients
c) out patients

A

a) 28-40%
b) 66%
c) 45-100%

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4
Q

Which groups are most vulnerable to under nutrition in the UK

A
Chronic diseases
Elderly
Recently discharged
Low income
Socially isolated
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5
Q

Name 4 consequences of under-nutrition in the community

A

Falls, depression, increased infection risk, dependency

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6
Q

Name 5 consequences of under-nutrition in the hospital

A
Increased morbitity
Increased length of stay
Increased dependency
Increased mortality
Increased costs of care
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7
Q

Name some causes of disease related under nutrition that relate to reduced nutritional intake

A
  • Anorexia
  • Side effects of treatment
  • Pain
  • Dysphagia
  • Physical disablity
  • Nil by mouth
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8
Q

Name some causes of disease related under nutrition that relates to increased nutritional losses

A

Malabsorption

Wound exudate/ burns

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9
Q

Name some causes of disease related under nutrition that relates to increased nutritional requirement

A

Inflammation/ infection
Pyrexia
Tissue healing
Metabolic effects

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10
Q

How long does it take undernourished catabolic patients to reach death

A

5 weeks

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11
Q

How long does it take undernourished patients in an otherwise normal metabolic state to reach death

A

10 weeks

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12
Q

Describe the changes that occur during undernutrition that lead to nitrogen death

A
  • Decreased muscle mass
  • Decreased visceral proteins
  • Impaired immune response
  • Impaired wound healing/ response to truama
  • Multiple organ failure
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13
Q

Describe the changes that occur during undernutrition that lead to energy death

A

-Lack of initiative
- Bedridden
- Apathy
- Depression
- Personality changes
- Total apathy
0 Complete exhaustion

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14
Q

At what % of original body weight does nitrogen death usually occur

A

60

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15
Q

What screening tool is used to detect malnutrition

A

MUST (malnutrition universal screening tool)

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16
Q

What 2 areas does subjective global assesment

A

History

Physical

17
Q

What needs to be examined when taking history as part of subjective glocal assesment

A
Weight changes
Appetite
Taste changes
Diet history
GI symptoms
18
Q

What needs to be physically examined as part of subjective global assessment

A

Muscle wasting
Fat
Ascites
Oedema

19
Q

What nutritional investigations can be done in the lab to assess nutrion

A

Anaemia
Plasma proteins
Vit. and mineral
Immune response

20
Q

What makes up total energy expenditure (TEE)

A

Basal metabolic rate
Thermic effect of food
Physical activity
Stress factors

21
Q

How is BMR measured

A

Subject lying down in comfortably heated room not digesting food

22
Q

What % of TEE does BMR account for

A

60-70

23
Q

Define basic metabolic rate

A

Energy used in involuntary msucle contraction and cellular action

24
Q

When is BMR high

A

Young people
Tall, thin people
Pregnant women
Stress

25
Q

What makes up nutriton support team

A

Dieticians
Doctor
Nurse
Pharmacist

26
Q

What are some indications for gastrostomy feeding

A

Reduced conciousness
Unsafe swallow
Pre head and neck cancer
Special situations liek cystic fibrosis

27
Q

What are some indications for parenteral nutritino

A
Prolonged postoperative ileus
Intestinal obstruction
Short bowel
Small bowel fistula
Acute pancreatitis
GI motility disorders