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Clinical Nutrition 1 > Nutritional Assessment - Anthropometrics, Malnutrition > Flashcards

Nutritional Assessment - Anthropometrics, Malnutrition Flashcards

1
Q

What are the 3 elements of malnutrition screening?

A

Current condition
Stable condition
Deteriorating condition

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2
Q

When assessing current condition, BMI of 18.5-20?

A

at risk of malnutrition

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3
Q

When assessing current condition, BMI less than 18.5?

A

Decreased lean mass

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4
Q

How can we assess if the patients condition is stable?

A

Assess involuntary weight loss

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5
Q

Patient has >5% involuntary loss in one month or >10-15% loss in 6 months, their risk of malnutrition is __

A

SEVERE

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6
Q

Patient has >5% involuntary loss in one month, their risk of malnutrition is ____

A

MODERATE

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7
Q

What question can we ask to determine if patients condition is deteriorating?

A

Ask if their appetite has decreased in the past few dyas

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8
Q

Compromised intake/loss of BM —> ____ –> Starvation related malnutrition

A

NO Inflammation

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9
Q

Inflammation —> Mild/Moderate —> _____

A

Chronic disease related malnutrition

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10
Q

Inflammation —> Marked/Inflammatory Response —> _____

A

Acute disease/injury related malnutrition

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11
Q

Define Nutritional Screening

A

the process of rapidly identifying individuals who may be at risk for nutritional deficiencies or problems, and would benefit from seeing a dietitian

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12
Q

Define Nutritional Assessment

A

the assessment of body compartments and the analysis of the structure and function of organ systems and their effect on metabolism

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13
Q

What are the two main goals of nutritional assessment?

A

To identify the patients needs

To establish a baseline for monitoring and evaluation of the nutritional assessment plan

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14
Q

What are the 3 additional goals of nutritional assessment?

A
  • Disease prevention
  • Identification of micro and macronutrient deficiencies
  • Assessing/preventing overall malnutrition
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15
Q

What is malnutrition associated with?

A
  • Increased morbidity (malnutrition has lots of co-morbidities)
  • Increased mortality
  • Increased hospital stay and costs
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16
Q

What are the components of nutritional screening?

A
  • Pre-existing condition causing nutrient loss
  • Condition causing increased nutrient requirement
  • Dietary intake (simple)
  • Weight-loss (any involuntary weight-loss is NOT healthy)
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17
Q

What are the components of nutritional assessment?

A

ABCDF

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18
Q

What is clinical assessment?

A

Patients medical, social and psychological history, includes the PHYSICAL signs that we can see from the development of a nutritional deficiency (muscle wasting, brittle hair, nails, eye function etc)

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19
Q

Diet inadequacy - what method?

A

dietary

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20
Q

Decreased tissue levels - what method?

A

Biochemical, not commonly used

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21
Q

Decreased bodily fluid levels - what method?

A

Biochemical, such as decreased serum ferritin

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22
Q

Decreased function within tissue - what method?

A

Anthropometric/Biochemical

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23
Q

Decreased enzymatic activity - what method?

A

Biochemical

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24
Q

Functional change - what method?

A

Behavioural/Psychological (functional assessment such as handgrip strength, walking test)

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25
Q

Clinical Symptoms/Anatomical signs - what method?

A

Clinical (final stage of nutrient deficiency)

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26
Q

Anthropometrics =

A

measurements are done through body size, shape, circumferences, weight and proportions

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27
Q

Body composition =

A

measurement of body compartments (i.e. fat-free, fat and bone mass)

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28
Q

Put the following in order of increasing % compostion in a normal, 70 kg man:

  • Viscera
  • Plasma proteins
  • Fat
  • Skeleton,skin
  • Skeletal muscle
  • Exrtacellular
A
  • Fat
  • Skeletal Muscle
  • Extracellular
  • Viscera
  • Skeleton, skin
  • Plasma proteins
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29
Q

Name two ways skeletal muscle can be assessed

A
  • Arm muscle circumferences

- CHI (Creatinine height index)

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30
Q

How many kg of protein found in a 70 kg man?

A

12 kg

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31
Q

How many kcal of fat in a 70 kg man?

A

160,000 kcal

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32
Q

How is standing height measured?

A

Standiometer, shoulders and heels against wall. Patient should be barefoot and Frankfurt plan parallel to the wall

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33
Q

How is knee height measured?

A

Knee at 90 degree angle on bed, use calliper to measure top of knee to heel

34
Q

Who is armspan not recommended for?

A

Usually not accurate in most, but especially asians, african americans and those with spinal deformities

35
Q

How is wrist circumference measured? what does it determine?

A

height(cm)/wrist circumference (cm)

measures FRAME size

36
Q

What is weight?

A

sum of all components at each level of body composition

37
Q

Equation to adjust for amputation calculation, will it increase or decrease?

A

current weight / (100 - %loss) x 100

Will INCREASE

38
Q

head ?

A

7%

39
Q

arm?

A

6.5%

40
Q

forearm?

A

2.3%

41
Q

hand?

A

0.8%

42
Q

calf?

A

7.1%

43
Q

leg?

A

18.6%

44
Q

foot?

A

1.8%

45
Q

BMI of <18.5

A

underweight

46
Q

BMI of 18.6-24.9

A

normal

47
Q

BMI of 25-29.9 - what classification and HBW?

A

Overweight

BMI of 25 for HBW

48
Q

BMI of 30-34.9 - what classification and HBW?

A

Obese Class I

BMI of 25-28 for HBW

49
Q

BMI of 35-40 - what classification and HBW?

A

Obese Class II

BMI of 25-28 for HBW

50
Q

BMI of >40 - what classification and HBW?

A

Obese Class III

BMI of 30 for HBW

51
Q

Name some limitations of BMI

A
  • does not determine body composition

- not accurate in athletes

52
Q

BMI 21 for person over 65

A

May be associated with some health risks (<24)

53
Q

BMI of 26 for person over 65

A

Healthy for elderly (24-29)

54
Q

BMI of 29 for person over 65

A

Healthy for elderly (24-29)

55
Q

BMI of 32 for person over 65

A

May be associated with some health problems (>29)

56
Q

What does MAC measure?

A

Mid-upper arm circumference: Bone, muscle and sub fat

57
Q

What does MAMC measure?

A

Mid-upper arm muscle circumference: Muscle and bone

58
Q

How is MAMC calculated?

A

MAC(mm) - (pi x TSF)

59
Q

What is TSF?

A

Tricep skinfold thickness

60
Q

What is the preferred/more accurate way to measure muscle and bone?

A

MAMA

61
Q

What does MAMA measure?

A

Mid-upper arm muscle area: Muscle and bone (more sensitive to changes than MAMC)

62
Q

How is MAMA calculated?

A

MAMC^2/4pi

63
Q

What is cMAMA?

A

Corrected mid-upper arm muscle area: Muscle only

64
Q

Is cMAMA valid in elderly/obese?

A

NO

65
Q

How is cMAMA calculated in MEN?

A

MAMA - 10

66
Q

How is cMAMA calculated in WOMEN?

A

MAMA - 6.5

67
Q

What is MAFA?

A

Mid-upper arm fat area: reflects subcutaneous adipose stores, more accurate than skinfold thickness

68
Q

(T/F) Tricep skinfold thickness is more accurate than measuring the mid-upper arm fat area

A

False, MAFA is more accurate

69
Q

MAMA is in the <5th percentile?

A

Muscle deficit

70
Q

MAFA is between 5-15th percentile?

A

Below average

71
Q

MAMA is between 15-85th percentile?

A

Average

72
Q

MAFA is >85th percentile?

A

Excess fat

73
Q

What tool estimates fat-mass, fat-free mass and body water?

A

Bioelectrical impedence

74
Q

How does BIA work?

A

Measures the impedence (electrical current resistance) throughout the body, and then the resistance is plugged into a regression equation

75
Q

What are some limitations of BIA?

A
  • influenced by hydration status
  • less precise in atypical bodies
  • little reference data
76
Q

Which tool measures bone and soft tissue mass?

A

DXA

77
Q

How does DXA work?

A

Machine that measures the density of each body tissue

78
Q

What tissues are the most dense?

A

Bone –> Lean mass –> fat-free mass

79
Q

What are limitations of DXA?

A

Expensive, some exposure to radiation, must assume normal hydration status

80
Q

What tool measures lean and fat body mass?

A

BOD POD

81
Q

How does BOD POD work?

A

Measures the displacement of air once the individual enters the machine, based off the principle that pressure is inversely related to volume

Clinical Nutrition 1 (30 decks)

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