Nutritional deficiency PPT (Obesity lecture) - Josh Flashcards
What are 5 types of nutritional Disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Malnutrition
- Micronutrient
What are 3 Malabsorption Syndromes
- Caloria Deficieny
- Micronutrient Deficiencies
- Vitamin Deficiency
Nutritional Disorders:
using the categories below define Anorexia
- Weight
- Eating habits
- Body image
- Physical symptoms
- Emotional symptoms
- Relationships
- Underweight
- takes in fewcalories
- think they are fat
- weight loss, low bp, heart/kidney problems, LANUGO
- Depression, OCD, Anxiety
- withdrawn
Nutritional Disorders:
using the categories below define Bulimia
- Weight
- Eating habits
- Body image
- Physical symptoms
- Emotional symptoms
- Relationships
- normal or overweight
- Binge & Purge
- obsesed w/ weight
- Weight flunctuation, ulcers/sores in mouth, dehydration, dental problems
- Depression, guilt, anxiety
- withdrawn but able to be around others
Nutritional Disorders:
using the categories below define Binge eating
- Weight
- Eating habits
- Body image
- Physical symptoms
- Emotional symptoms
- Relationships
- Overweight
- Binges large amount of food in short period
- overy focused on weight and appearance
- excessive weight gain, High bp, DM,
- depression, guilt
- withdrawn overly sensitive
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!
85%
Nutritional Disorders: Anorexia
what are the 2 types
- Restrictive
- Binge /Purge
Nutritional Disorders: Anorexia
what is the restrictive type?
restriction of food intake on their own and does not engane in binge-eating or purging behavior
Nutritional Disorders: Anorexia
what is teh binge eating/purging type
The individual self-induces vomiting or misuses laxatives, diuretics, or enemas
Nutritional Disorders: Anorexia
CV s/s
- Hypotension
- bradycardia
- MV prolapse
- Decreased Myocardial contractility
- Cardiomyopathy
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.
larger
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
- 2 times a week
- 3 months
Nutritional Disorders: Binge eating
Binge eating resembles Bulimia, but in contrast binge patients do not what?
Purge
Nutritional Disorders: Binge eating
the principle medical complications w/ binge eating are what?
- Morbid Obesity
- HTN
- NIDDM
- high cholesterol
- Joint disorders
*
Nutritional Disorders: Anesthetic Implications
Preop:
What do you look for on PE
- S/S of starvation
- Medication abuse 9amphetamines, diuretics, laxatives)
Nutritional Disorders: Anesthetic Implications
Preop:
Are EKG and ECHOs warrented in these pt’s? why or why not?
- EKG- Yes- to detect cardiovascular function
- ECHO- only in severe instances
Nutritional Disorders: Anesthetic Implications
Preop:
What Labs do you want
- Blood and Urine
- especially Electrolytes
Nutritional Disorders: Anesthetic Implications
Preop:
Why is an airway assessment so important w/ these pt’s
- Dental disease including periodontal disease are VERY likely
Nutritional Disorders: Anesthetic Implications
Preop:
What metabolic disorder is popular w these pt’s secondary to purging?
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)
Nutritional Disorders: Anesthetic Implications
Intraop:
what should you be vgalent for in these individuals
- Abnormal ECGS
- Prologed QT
- multi organ failure
Nutritional Disorders: Anesthetic Implications
Intraop
what medicatio are these pt’s specifically sensitive to?
reversal for NMBD
Nutritional Disorders: Anesthetic Implications
Intraop:
What are 2 important task in these pt’s?
- HYDRATE
- NGT/OGT gastroporesis (may want to place prior to induction)
Malabsorption Syndromes:
The ______ _______ does most the digesting of the foods we eat?
small intestines
Malabsorption Syndromes:
if you have a malabsorption Syndrome your ____ _____ connot absorb nutrients from food
Small intestine
(cathing on to a theme here?)
Malabsorption Syndromes:
What causes Malabsorption Syndromes?
- Celiac disease
- Lactose intolerance
- Short Bowel
- Whipple disease (rare bacteria infection0
- Genetic diseases
- Certain Medications
Malabsorption Syndromes:
what are 3 classifications of malabsorption syndromes
Malnutrition
Micronutrient Deficiences
Vitamin deficiencies
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
Malnutrition
Malabsorption Syndromes: Malnutrition
Malnutrition is a meddically distinct syndrome that is responsive to caloric support provided by _____ or _____ nutrition
enternal
or
TPN
Malabsorption Syndromes: Malnutrition
what are major causes of malnutrition in hospitals
- N/V
- Trauma
- Inflammatory disease
- Loss of appetite
- Mechanical obstruction
Malabsorption Syndromes: Malnutrition
what are the SE of malnutrition
- reduced Muscle strength
- Hypothermia
- Loss of cardiac muscle
- decreased CO, bradycardia, hypotension
- Decreased GFR
- Infection response weakened
- Electrolyte inbalances
- Higher concentrations of water
Malabsorption Syndromes: Malnutrition
Malnurished pt’s are identifeied by what?
- Serum albumin concentration < 3g/dL
- Transferrin Levels below 200 mg/dL
Malabsorption Syndromes: Malnutrition
malnutrition is associated w/ increased morbidity and mortality due to what mpaired symptoms?
- Respiratoy
- CV
- Renal
- Immune response
Malabsorption Syndromes: Malnutrition
an average adult requires how many calories daly to mantain basal energy levels
1500-2000
Malabsorption Syndromes: Malnutrition
What are 4 main events that can increase the caloric requirement? and for fun by how much?
- Increase in Body temp (1 degree C=15% increase)
- Multiple fractures (25% increase)
- Major Burns (100% increase)
- large tumor (100% increase)
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
20%
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
7 days
Malabsorption Syndromes: Malnutrition
Preop
why are antibiotics given prophylacticly in these pt’s
b/c changes in GI flora increases the susceptibility to infections
Malabsorption Syndromes: Malnutrition
Intraop
what are some important interventions for these individuals?
- 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)
Malabsorption Syndromes: Malnutrition
Postop
why are they difficult to wean from vent?
- decreased muscle mass and function
- Prone to coughing
Micronutrient Deficiencies: Vit B12
the most significant effects of B12 def are seen in what system?
Nervous system
Micronutrient Deficiencies: Vit B12
treatment for B12 def
- oral B12
- increase foods high in B12
*
Micronutrient Deficiencies: Vit B12
what is recomended intake of Vit B12
10-15mcg/day
Micronutrient Deficiencies: Vit B12
for food malabsorption induced Vit B12 deficiency what is the recomended replacement dose?
1,000 mcg/day
Micronutrient Deficiencies: Vit D
A deficiency in Vit D has been associated w/what dysfunctions
- muscle weakness
- Functional impairment
- Depression
- Increased risk of fx
Micronutrient Deficiencies: Vit D
pt’s w/ a vit D def may also present with _____calcemia and _____ serum parathyroid hormone (PTH)
hypocalcemia
High
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
DM
HTN
Hyperlipidemia
PVD
MENs
what does it stand for?
Multiple
Endocrine
Neoplasm
syndromes
MENs:
what are the different classes
MEN 1
MEN 2A
MEN 2B
MENs:
what is MENs?
rare autosomal dominat conditions that predispose affected individuals to benign and malignant tumors of the endocrine and non endocrine organs
MENs:
How do these syndromes differ from other hereditary cancer syndroms?
most of these tumors occur in hormone-secreting glands
MENs:
The fact that they occur in mostly hormone secreting glands, gives this syndrome 2 primary consequences of clinical importance. What are they?
- Excess hormone production-results in hormonal syndromes
- Excess hormone production serves as a sensitive tumor marker
MENs:
where are the tumors located with each type?
- MEN 1 (PPP)
- Pancrease
- Parathyroid
- Pituitary
- MEN II (PPM)
- Phenochromocytoma
- Parathyroid
- Medullary thyroid Ca
- MEN III (IIB) (PMM)
- Phenochromocytomas
- Mucocutaneous Tumors
- Medullary Thyroid Ca
MENs:
Preop eval?
- Thorough H&P
- EKG
- Labs
- Attenuation of symptoms
thats if for this shit
fucking gay and probally no good questions
