Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med 3 > Nutritional Disorders > Flashcards

Nutritional Disorders Flashcards

1
Q

where does the body get its energy source from?

A
  • Carbohydrate
  • Indigestible carbohydrate (fiber)
  • Nitrogen
  • Water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RDA (Recommended Dietary Allowances) is the most recognizable what?

A

Most recognizable way nutritional requirements have been expressed in past

-Initially designed to meet the nutritional needs of healthy individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RDAs (Recommended Dietary Allowances) initially designed to meet what?

A

the nutritional needs of healthy individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what has replaced RDAs (Recommended Dietary Allowances)?

A

DRI’s (Dietary Reference Intakes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do the DRI’s do?

A

Broader approach to defining nutritional adequacy

Attempt to include nutritional information as it relates to long term health and reduction of chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does energy support?

A

normal functions and activity, growth and repair of damaged tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how is energy provided to the body?

A

by the oxidation of dietary protein, fat, carbohydrate and alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 3 factors of energy expenditure?

A
  • Basal energy expenditure (BEE)
  • Thermic effect of food (TEF)
  • Physical activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is Basal energy expenditure (BEE)?

A

amount of energy required to maintain basic physiologic functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is the Basal energy expenditure (BEE) measured?

A

in a warm room, not having eaten for 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what equation can you use to estimate Basal energy expenditure (BEE)?

A

Harris-Benedict equation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is thermic effect of food (TEF)?

A

amount of energy expended during and following the ingestion of food
-averages approx. 10% of the BEE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is protein required for?

A

growth and maintenance of body structure and function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the RDA (Recommended Dietary Allowances) for protein? (in men and women)

A

56g/day for men

45g/day for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how many carbs does an American diet contain?

A

approx 45% carbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are dietary carbs?

A
  • Simple sugars
  • Complex carbohydrates (starches)
  • Indigestible carbohydrates (dietary fiber)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the most concentrated course of food energy?

A

fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Average American diet contains how much fat and recommendations to limit it to what?

A

Average American diet contains 35-40% of calories as fat

Current recommendations are to limit this to 20-35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is fat primarily composed of?

A

fatty acids and dietary cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

cholesterol is the major constitute of what?

A

cell membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cholesterol is synthesized by what?

A

the body - not essential nutrient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

the assessment of nutritional status is important to what patient populations?

A

patient populations who are at risk for nutritional deficiencies

  • Elderly
  • Adolescent
  • Pregnant or lactating women
  • Low socioeconomic status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what historical information must be obtained when trying to identify high risk patients who are at risk for nutritional deficiencies?

A
  • Regularity and availability of meals
  • Grocery shopping and food preparation
  • Changes in appetite
  • Weight loss or gain
  • Food allergies
  • Use of drugs, alcohol, medications
  • Presence of co-morbidities affecting nutritional needs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

physical examination when assessing nutritional status?

A
  • Body weight
  • Muscle wasting
  • Fat stores
  • Volume status
  • Signs of nutritional deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is BMI?

A

body weight in relation to height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is more of a reliable predictor of nutritional status over BMI?

A

a recent unintentional change in body weight reported by a patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does protein-energy malnutrition result from?

A

from relative or absolute deficiency of energy or protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the 2 syndromes of protein-energy malnutrition?

A

Kwashiorkor

Marasmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is Kwashiorkor?

A

Syndrome of protein-energy malnutrition

-deficiency of protein in presence of adequate energy (sufficient caloric intake, insufficient protein deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Kwashiorkor is sufficient in what and insufficient in what?

A

sufficient caloric intake, insufficient protein consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is Marasmus?

A

Syndrome of protein-energy malnutrition

combined protein and energy deficiency (severe malnutrition, emaciated appearance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Marasmus is severe what?

A

severe malnutrition (combined protein and energy deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what type of appearance do Marasmus pts have?

A

emaciated appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

where does primary protein-energy malnutrition pose a health problem?

A

in developing nations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

in developing nations, in what areas does Kwashiorkor occur?

A

in areas where foods containing protein are insufficient

  • occurs in areas of famine or poor food supply
  • occurs in developing countries in children after women stop breast feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

in who does Kwashiorkor occur in, in developing countries?

A

children after women stop breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

in developing nations, where is Marasmus seen?

A

where adequate quantities of food are not available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

protein-energy malnutrition is often what in industrialized societies?

A

secondary to other disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

in industrialized societies, Kwashiorkor-like deficiency syndrome occurs in?

A

associated with illnesses where the body is in a hypermetabolic state (ex: trauma, sepsis, burns)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

in industrialized societies, Marasmus-like deficiency syndromes result from what?

A

chronic disease like heart failure, cancer, COPD, AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what organ system doe protein-energy malnutrition affect?

A

every organ system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

how much loss of body weight d/t protein-energy malnutrition results in death?

A

losses of 35-40% of body weight usually results in death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

how much loss of protein can be tolerated without compromise?

A

5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

protein losses begin with what and progress to what?

A

begin with skeletal muscle and progress to internal organs (liver, GIT, kidneys, heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when does organ dysfunction develop in protein-energy malnutrition?

A

with progressive muscle loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what liver dysfunction occurs from protein malnutrition?

A

hepatic synthesis slows, circulating proteins decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what heart dysfunction occurs from protein malnutrition?

A

decreased cardiac output and contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what respiratory dysfunction occurs from protein malnutrition?

A

functionality is affected by weakness and muscle atrophy reducing lung volumes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what GIT dysfunction occurs from protein malnutrition?

A

malabsorption occurs with loss of mucosal definition and loss of vili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what immune dysfunction occurs from protein malnutrition?

A

T lymphocytes decrease and B cell function is depressed resulting in infections and impaired wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are the clinical findings of protein-energy malnutrition?

A

progressive muscle wasting in setting of early weight loss to severe cachexia
-TEMPORAL MUSCLE WASTING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

progressive muscle wasting in protein-energy malnutrition is typically in what patients?

A

patients with marasmus-like secondary protein-energy malnutrition

53
Q

who should you call ASAP if pt has protein malnutrition?

A

nutrition colleagues - call ASAP for protein malnutrition

54
Q

protein malnutrition should be followed by what?

A

daily by nutrition consultant

55
Q

CHECK THIS CARD-nutrition consultants do what for protein malnutrition?

A
  • Help manage dietary requirements
  • Correct electrolyte abnormalities
  • Replace vitamins and minerals
  • Supplements with enteral or parenteral nutrition
56
Q

obesity definition

A

excess adipose tissue

57
Q

obesity a direct result of what and in what setting?

A

excess caloric ingestion in setting of sedentary lifestyle

58
Q

for obese pts, what hx should you obtain when evaluating them?

A
  • Recent weight changes
  • Occupation
  • Eating behaviors
  • Exercise
  • Smoking and alcohol consumption
  • Medications: OTC, herbal, prescribed, supplemental
59
Q

do many obese pts have an identifiable secondary cause? if concerned, refer to who?

A

NO!!!

Very small population of patients will have an identifiable secondary cause such as hypothyroidism or Cushing’s syndrome

-if concerned, refer to endocrinologist

60
Q

what is essential to tx of obesity?

A

close follow-up

61
Q

where do you refer obese motivated pts to?

A

active tx programs

62
Q

tx programs for obesity emphasize what?

A

maintenance of weight loss

63
Q

through what do tx programs for obesity emphasize maintenance of weight loss?

A
  • Dietary instruction and education
  • Behavior modification
  • Exercise
  • Medications
  • Bariatric surgery
64
Q

anorexia nervosa definition

A

disturbance in body image and intense fear of weight gain

65
Q

anorexia nervosa is most common in who?

A

females

66
Q

some anorexia nervosa pts may exhibit features of disease without having what?

A

severe weight loss

67
Q

important clinical findings of anorexia nervosa

A
  • Weight loss leading to body weight 15% below expected

- In female patients, amenorrhea is almost always present

68
Q

in female anorexic pts, what is almost always present?

A

amenorrhea

69
Q

other clinical s/sx’s of anorexia nervosa

A
  • Constipation
  • Cold intolerance
  • Bradycardia
  • Hypotension
  • Loss of body fat
  • Dry and scaly skin
70
Q

dx of anorexia nervosa

A

Behavioral features such as distorted body image, fear of weight gain and refusal to maintain normal body weight in setting of weight loss to a body weight 15% below expected

in female, absence of at least 3 menstrual cycles

71
Q

what is the goal of tx for anorexia nervosa?

A

restoration of normal body weight and elimination of psychological features

72
Q

inpatient tx programs for anorexia nervosa may be necessary in what cases of anorexia?

A

in severe cases for management of volume status and electrolytes

73
Q

does psychotherapy and meds show evidence of improvement for anorexia nervosa?

A

NO!!!

74
Q

what is essential in tx of anorexia nervosa?

A

referral to psychiatrist is essential

75
Q

what is bulimia nervosa?

A

Episodic, uncontrolled ingestion of large quantities of food followed by recurrent inappropriate compensatory behavior to avoid weight gain

76
Q

how do bulimia pts avoid weight gain?

A
  • Self-induced vomiting
  • Diuretics
  • Cathartics
  • Strict dieting
  • Vigorous exercise
77
Q

bulimia is common in who?

A

young, white females in middle and upper class

78
Q

is bulimia obvious to the clinician?

A

NO! less obvious than anorexia

79
Q

are bulimia pts usually within in normal body weight?

A

Body weight fluctuations but generally within 20% of normal body weight

80
Q

what issues do bulimia pts commonly describe?

A

family and psychological issues

81
Q

what type of behavior may be present in bulimia pts?

A

Impulsive or antisocial behavior

82
Q

what is preserved in bulimia that isn’t preserved in anorexia?

A

menstruation

83
Q

what bulimia complications can occur after binges?

A

Gastric dilatation, pancreatitis

84
Q

what bulimia complications can occur secondary to vomiting?

A

poor dentition, esophagitis

85
Q

what bulimia complications can occur secondary to diuretics and cathartics?

A

Electrolyte abnormalities, dehydration secondary

86
Q

bulimia nervosa tx’s

A

Supportive care to include psychotherapy

Antidepressants may be helpful

All patients should be referred to psychiatrist

87
Q

what is worse in bulimia than with anorexia?

A

long-term psychiatric prognosis

88
Q

are pts usually deficient in one or multiple vitamins?

A

multiple vitamines

89
Q

do vitamin deficiencies usually exhibit noticeable exam findings?

A

not until later in the course of the syndrome

90
Q

what is the most common cause of anemia worldwide?

A

iron deficiency

91
Q

what is a reliable indicator of iron deficiency?

A

Serum ferritin value < 12 ng/mL without anemia or < 30 ng/mL with anemia

92
Q

iron deficiency developing stages

A
  1. Depletion or iron stores without anemia
  2. Anemia with a normal red blood size (MCV)
  3. Anemia with low MCV, low reticulocyte count
93
Q

iron deficiency signs and sx’s

A

Fatigue, Tachycardia, Palpitations, Dyspnea on exertion

ALL ARE ANEMIA SX’S

94
Q

severe iron deficiency signs and sx’s

A
  • Smooth tongue
  • Brittle nails
  • Spooning of nails
  • Cheilosis
95
Q

what do many iron deficient pts develop?

A

pica

96
Q

tx for iron deficiency?

A

First identify cause b/c often d/t blood loss

Treat with PO iron (Ferrous sulfate and continue for 3-6 months after restoration of normal labs)

-use parenteral iron if indicated

97
Q

when is parenteral iron tx indicated for iron deficiency?

A
  • Refractory to PO iron
  • GI disease
  • Hemodialysis
98
Q

what is thiamine deficiency due to?

A

chronic alcoholism

99
Q

early sx’s of thiamine deficiency

A
  • Anorexia
  • Muscle cramps
  • Paresthesias
  • Irritability
100
Q

late sx’s of thiamine deficiency

A
  • Cardiovascular dysfunction – wet beriberi

- Neurological dysfunction – dry beriberi

101
Q

what is wet beriberi?

A

cardiovascular dysfunction in thiamine deficiency (late sx)

  • Marked peripheral vasodilation caused high output heart failure
  • Dyspnea, tachycardia, cardiomegaly, edema
102
Q

what is dry beriberi?

A

neurological dysfunction in thiamine deficiency (late sx)

Peripheral nerve involvement causing motor and sensory neuropathy, paresthesias and loss of reflexes

103
Q

what is Wernicke – Korsakoff Syndrome?

A

develops from severe acute thiamine deficiency

dry beriberi

CNS involvement causing encephalopathy, amnesia, and confabulation

104
Q

tx of thiamine deficiency?

A

replace thiamine, initially IV followed by PO

105
Q

what must you have to absorb vitamin B12?

A

intrinsic factor

106
Q

what is pernicious anemia?

A

autoimmune disease where there are autoantibodies against gastric parietal cells that produce intrinsic factor

-no intrinsic factor, no B12 absorption -> B12 deficiency

107
Q

what surgery can cause vitamin B12 deficiency? what does it eliminate?

A

gastrectomy (abd surgery)
-eliminates site of intrinsic factor production

-surgical resection of ileum eliminates site of B12-intrinsic factor complex

108
Q

B12 deficiency causes what kind of anemia?

A

moderate-severe anemia of slow onset

has elevated MCV (MCV >100)

109
Q

pts can have what manifestations of B12 deficiency despite having what?

A

patients can have non-hematologic manifestations of this deficiency despite having a normal CBC

110
Q

sx’s of B12 deficiency

A

Complex neurologic syndrome

  • Paresthesias
  • Balance difficulty
  • Cerebral dysfunction: dementia
111
Q

what is a normal B12 level?

A

> 210 pg/mL

112
Q

Vitamin B12 deficiency anemia and folic acid anemia peripheral smear

A

megaloblastic and hypersegmented neutrophils

113
Q

tx for B12 deficiency

A

with parenteral therapy

  • IM or subcutaneous injections of 100mcg
  • Daily for first week
  • Weekly for first month
  • Monthly for life
114
Q

folic acid deficiency due to?

A

lack of dietary intake

115
Q

when do requirements for folic acid increase?

A

during pregnancy

116
Q

signs and sx’s of folic acid deficiency

A
  • GI symptoms
  • Swollen, painful tongue
  • Neurologic symptoms such as cognitive impairment, dementia, depression
117
Q

what type of anemia is seen in folic acid deficiency?

A

Megaloblastic anemia is again seen

-identical in appearance to vitamin B12 deficiency

118
Q

tx of folic acid deficiency

A

folic acid 1mg PO daily

119
Q

what should you always measure during folic acid deficiency evaluation?

A

vitamin B12

120
Q

supplementation with large doses of folic acid can improve what but allow what to progress?

A

Critical to recognize that supplementation with large doses of folic acid can improve anemia seen with vitamin B12 deficiency but allow the neurologic damage to progress

121
Q

where is vitamin D synthesized?

A

in skin during exposure to UV-B light

122
Q

vitamin D gets converted into what hormone?

A

1,25 dihydroxyvitamin D

123
Q

what does 1,25 dihydroxyvitamin D do?

A

increases absorption of dietary calcium in addition to stimulating osteoclasts which release calcium from bone

124
Q

vitamin D deficiency causes what?

A

decreased bone density from defective mineralization

125
Q

vitamin D deficiency is the most common cause of what?

A

osteomalacia

126
Q

vitamin D deficiency arises from what?

A

insufficient sun exposure, malnutrition, or malabsorption

127
Q

what levels may you check with vitamin D deficiency and when do you check it?

A

calcium levels and check if pt is malnourished

128
Q

vitamin D deficiency tx?

A

Ergocalciferol (D2) 50,000 units 1x weekly x8 weeks

Cholecalciferol (D3) 2,000 units daily

Clin Med 3 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions