Nutritional deficiency PPT (Obesity lecture) - Josh Flashcards

1
Q

What are 5 types of nutritional Disorders

A
  1. Anorexia Nervosa
  2. Bulimia Nervosa
  3. Binge Eating
  4. Malnutrition
  5. Micronutrient
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2
Q

What are 3 Malabsorption Syndromes

A
  1. Caloria Deficieny
  2. Micronutrient Deficiencies
  3. Vitamin Deficiency
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3
Q

Nutritional Disorders:

using the categories below define Anorexia

  1. Weight
  2. Eating habits
  3. Body image
  4. Physical symptoms
  5. Emotional symptoms
  6. Relationships
A
  1. Underweight
  2. takes in fewcalories
  3. think they are fat
  4. weight loss, low bp, heart/kidney problems, LANUGO
  5. Depression, OCD, Anxiety
  6. withdrawn
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4
Q

Nutritional Disorders:

using the categories below define Bulimia

  1. Weight
  2. Eating habits
  3. Body image
  4. Physical symptoms
  5. Emotional symptoms
  6. Relationships
A
  1. normal or overweight
  2. Binge & Purge
  3. obsesed w/ weight
  4. Weight flunctuation, ulcers/sores in mouth, dehydration, dental problems
  5. Depression, guilt, anxiety
  6. withdrawn but able to be around others
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5
Q

Nutritional Disorders:

using the categories below define Binge eating

  1. Weight
  2. Eating habits
  3. Body image
  4. Physical symptoms
  5. Emotional symptoms
  6. Relationships
A
  1. Overweight
  2. Binges large amount of food in short period
  3. overy focused on weight and appearance
  4. excessive weight gain, High bp, DM,
  5. depression, guilt
  6. withdrawn overly sensitive
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6
Q

Nutritional Disorders: Anorexia

Is defines as the maintenance of body weight less than __% of that expected for age and height, or failure to make expected weight gain during period of growth!

A

85%

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7
Q

Nutritional Disorders: Anorexia

what are the 2 types

A
  1. Restrictive
  2. Binge /Purge
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8
Q

Nutritional Disorders: Anorexia

what is the restrictive type?

A

restriction of food intake on their own and does not engane in binge-eating or purging behavior

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9
Q

Nutritional Disorders: Anorexia

what is teh binge eating/purging type

A

The individual self-induces vomiting or misuses laxatives, diuretics, or enemas

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10
Q

Nutritional Disorders: Anorexia

CV s/s

A
  • Hypotension
  • bradycardia
  • MV prolapse
  • Decreased Myocardial contractility
  • Cardiomyopathy
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11
Q

Nutritional Disorders: Bulimia

Is defines as eating an amount of food that is significantly ______ than most people would eat under similar circumstances w/ inappropriate compensatory behaviors to prevent weight gain.

A

larger

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12
Q

Nutritional Disorders: Bulimia

they typical pattern of behavior is calorie restriction, binge eatin, and self induced vomiting occuring on average at least __ x’s a weeks for ____ months, and is commonly assosciated w/ depression

A
  • 2 times a week
  • 3 months
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13
Q

Nutritional Disorders: Binge eating

Binge eating resembles Bulimia, but in contrast binge patients do not what?

A

Purge

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14
Q

Nutritional Disorders: Binge eating

the principle medical complications w/ binge eating are what?

A
  • Morbid Obesity
  • HTN
  • NIDDM
  • high cholesterol
  • Joint disorders
    *
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15
Q

Nutritional Disorders: Anesthetic Implications

Preop:

What do you look for on PE

A
  • S/S of starvation
  • Medication abuse 9amphetamines, diuretics, laxatives)
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16
Q

Nutritional Disorders: Anesthetic Implications

Preop:

Are EKG and ECHOs warrented in these pt’s? why or why not?

A
  • EKG- Yes- to detect cardiovascular function
  • ECHO- only in severe instances
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17
Q

Nutritional Disorders: Anesthetic Implications

Preop:

What Labs do you want

A
  • Blood and Urine
  • especially Electrolytes
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18
Q

Nutritional Disorders: Anesthetic Implications

Preop:

Why is an airway assessment so important w/ these pt’s

A
  • Dental disease including periodontal disease are VERY likely
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19
Q

Nutritional Disorders: Anesthetic Implications

Preop:

What metabolic disorder is popular w these pt’s secondary to purging?

A

Metabolic Alkalosis (frequently present w/ increased bicarb concentrations)

(fun fact how I remeber alkolosis vs acidosis w/ pt how vomit and shit, if it comes out the ASS it is ASSidosis, if out the mouth its just he other)

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20
Q

Nutritional Disorders: Anesthetic Implications

Intraop:

what should you be vgalent for in these individuals

A
  • Abnormal ECGS
  • Prologed QT
  • multi organ failure
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21
Q

Nutritional Disorders: Anesthetic Implications

Intraop

what medicatio are these pt’s specifically sensitive to?

A

reversal for NMBD

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22
Q

Nutritional Disorders: Anesthetic Implications

Intraop:

What are 2 important task in these pt’s?

A
  • HYDRATE
  • NGT/OGT gastroporesis (may want to place prior to induction)
23
Q

Malabsorption Syndromes:

The ______ _______ does most the digesting of the foods we eat?

A

small intestines

24
Q

Malabsorption Syndromes:

if you have a malabsorption Syndrome your ____ _____ connot absorb nutrients from food

A

Small intestine

(cathing on to a theme here?)

25
Q

Malabsorption Syndromes:

What causes Malabsorption Syndromes?

A
  • Celiac disease
  • Lactose intolerance
  • Short Bowel
  • Whipple disease (rare bacteria infection0
  • Genetic diseases
  • Certain Medications
26
Q

Malabsorption Syndromes:

what are 3 classifications of malabsorption syndromes

A

Malnutrition

Micronutrient Deficiences

Vitamin deficiencies

27
Q

Malabsorption Syndromes:

Which subtype is defined as an altered metabolism due to an imbalance of intake and nutrient dense food resulting in loss of body mass or a deficiency in energy, protein, and other nutrients which cause measurable adverse effects

A

Malnutrition

28
Q

Malabsorption Syndromes: Malnutrition

Malnutrition is a meddically distinct syndrome that is responsive to caloric support provided by _____ or _____ nutrition

A

enternal

or

TPN

29
Q

Malabsorption Syndromes: Malnutrition

what are major causes of malnutrition in hospitals

A
  • N/V
  • Trauma
  • Inflammatory disease
  • Loss of appetite
  • Mechanical obstruction
30
Q

Malabsorption Syndromes: Malnutrition

what are the SE of malnutrition

A
  • reduced Muscle strength
  • Hypothermia
  • Loss of cardiac muscle
    • decreased CO, bradycardia, hypotension
  • Decreased GFR
  • Infection response weakened
  • Electrolyte inbalances
  • Higher concentrations of water
31
Q

Malabsorption Syndromes: Malnutrition

Malnurished pt’s are identifeied by what?

A
  • Serum albumin concentration < 3g/dL
  • Transferrin Levels below 200 mg/dL
32
Q

Malabsorption Syndromes: Malnutrition

malnutrition is associated w/ increased morbidity and mortality due to what mpaired symptoms?

A
  • Respiratoy
  • CV
  • Renal
  • Immune response
33
Q

Malabsorption Syndromes: Malnutrition

an average adult requires how many calories daly to mantain basal energy levels

A

1500-2000

34
Q

Malabsorption Syndromes: Malnutrition

What are 4 main events that can increase the caloric requirement? and for fun by how much?

A
  • Increase in Body temp (1 degree C=15% increase)
  • Multiple fractures (25% increase)
  • Major Burns (100% increase)
  • large tumor (100% increase)
35
Q

Malabsorption Syndromes: Malnutrition

Preop

it is reccomended that pt’s who have lost more than ____% of their body weight, they should be treated nutritionally before undergoing elective sx

A

20%

36
Q

Malabsorption Syndromes: Malnutrition

Preop

Provision of nutritional support for ___ days before sx decreases the postoperative complications, especially in pts w/ gastrointestinal Ca and elderly pt’s undergoing sx for hip fxs

A

7 days

37
Q

Malabsorption Syndromes: Malnutrition

Preop

why are antibiotics given prophylacticly in these pt’s

A

b/c changes in GI flora increases the susceptibility to infections

38
Q

Malabsorption Syndromes: Malnutrition

Intraop

what are some important interventions for these individuals?

A
  • Care positioning (loss of body mass)
  • Maintain Body temp (bair hugger)
  • Hydrate
  • Sympathomemetics (bp)
  • expect a bad response to hypoxia and hypercarbia (due to decreased Muscle mass of respiratory muscles)
39
Q

Malabsorption Syndromes: Malnutrition

Postop

why are they difficult to wean from vent?

A
  • decreased muscle mass and function
  • Prone to coughing
40
Q

Micronutrient Deficiencies: Vit B12

the most significant effects of B12 def are seen in what system?

A

Nervous system

41
Q

Micronutrient Deficiencies: Vit B12

treatment for B12 def

A
  • oral B12
  • increase foods high in B12
    *
42
Q

Micronutrient Deficiencies: Vit B12

what is recomended intake of Vit B12

A

10-15mcg/day

43
Q

Micronutrient Deficiencies: Vit B12

for food malabsorption induced Vit B12 deficiency what is the recomended replacement dose?

A

1,000 mcg/day

44
Q

Micronutrient Deficiencies: Vit D

A deficiency in Vit D has been associated w/what dysfunctions

A
  • muscle weakness
  • Functional impairment
  • Depression
  • Increased risk of fx
45
Q

Micronutrient Deficiencies: Vit D

pt’s w/ a vit D def may also present with _____calcemia and _____ serum parathyroid hormone (PTH)

A

hypocalcemia

High

46
Q

Micronutrient Deficiencies: Vit D

there has been studies that show a corrolation b/t low Vit D and increased prevalence of what other Health disorders

A

DM

HTN

Hyperlipidemia

PVD

47
Q

MENs

what does it stand for?

A

Multiple

Endocrine

Neoplasm

syndromes

48
Q

MENs:

what are the different classes

A

MEN 1

MEN 2A

MEN 2B

49
Q

MENs:

what is MENs?

A

rare autosomal dominat conditions that predispose affected individuals to benign and malignant tumors of the endocrine and non endocrine organs

50
Q

MENs:

How do these syndromes differ from other hereditary cancer syndroms?

A

most of these tumors occur in hormone-secreting glands

51
Q

MENs:

The fact that they occur in mostly hormone secreting glands, gives this syndrome 2 primary consequences of clinical importance. What are they?

A
  1. Excess hormone production-results in hormonal syndromes
  2. Excess hormone production serves as a sensitive tumor marker
52
Q

MENs:

where are the tumors located with each type?

A
  1. MEN 1 (PPP)
    • Pancrease
    • Parathyroid
    • Pituitary
  2. MEN II (PPM)
    • Phenochromocytoma
    • Parathyroid
    • Medullary thyroid Ca
  3. MEN III (IIB) (PMM)
    • Phenochromocytomas
    • Mucocutaneous Tumors
    • Medullary Thyroid Ca
53
Q

MENs:

Preop eval?

A
  • Thorough H&P
  • EKG
  • Labs
  • Attenuation of symptoms
54
Q

thats if for this shit

A

fucking gay and probally no good questions