Nutritional disorders Flashcards

1
Q

What is your basal energy expenditure

A

amount of energy required to maintain basic physiologic function

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2
Q

What are the three factors that play a role in energy expenditure?

A
  • basal energy expenditure
  • thermic effect of food
  • physical activity
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3
Q

How is a persons BEE measured

A

patient resting in a warm room, not having eaten for 12 hours

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4
Q

What is the equation that can be used to estimate BEE

A

Harris Benedict equation

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5
Q

What is the thermic effect of food

A

amount of energy expended during and following the ingestion of food

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6
Q

Which fatty acid is required by the body? Why?

A

linoleic acid

lack can lead to dermatitis, hair loss, impaired wound healing

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7
Q

Most important lab in the evaluation of protein-calorie undernutrition

A

albumin

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8
Q

Kwashiorkor syndrome

A

deficiency of protein in presence of adequate energy

enough calories, not enough protein

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9
Q

Marasmus syndrome

A

combined protein and energy deficiency

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10
Q

When does Kwashiorkor typically develop in industrialized countries

A

secondary to things like trauma, sepsis, and burns

losing proteins

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11
Q

When does Marasmus typically occur in industrialized countries

A

chronic disease states

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12
Q

Where does protein loss begin? Where does it progress to?

A

starts with skeletal muscle and progresses to liver, GI tract, kidneys and heart

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13
Q

Low protein affect on liver. Heart. Respiratory. GI. Immune.

A

Liver: hepatic synthesis slows, circulating proteins decrease

Heart: decreased CO, poor contractility

Respiratory: reduced lung volumes

GI: malabsorptions

Immune: decreasing cell function–> risk for infection

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14
Q

Where does muscle wasting first present

A

thenar eminence and temple

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15
Q

Treatment of protein-energy malnutrition

A

call a nutrition consult!

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16
Q

What body weight can lead to a diagnosis of anorexia

A

15% below the expected weight

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17
Q

What is the other finding that should make you think about anorexia

A

amenorrhea

absence of 3 menstrual cycles

18
Q

Clinical features of bulimia

A

fluctuation of body weight, family and psychological issue, impulsive or antisocial behavior

19
Q

Tx of bulimia

A

refer to psychiatrist

-anti depressants

20
Q

Most common type of anemia? What is it until proven otherwise?

A

iron deficiency

bleeding until proven otherwise

21
Q

What are the stages of iron deficiency

A
  • depletion of iron stores without anemia
  • anemia with a normal red blood size
  • anemia with a low MCV, low reticulocyte count
22
Q

Signs of severe Fe deficiency

A

skin and mucosal changes

  • smooth tongue
  • brittle nails
  • spooning of nails
  • cheilosis
23
Q

Tc of FE deficiency

A

identify cause

ferrous sulfate PO

24
Q

When do you give parentral iron

A
  • refractory to PO iron
  • GI disease
  • dialysis
25
Most common cause of thiamine deficiency
chronic alcoholism
26
What are the early sx of thiamine def
- anorexia - muscle cramps - paresthesias - irritability
27
Late sx of thiamine def
cardiovascular dys, neurological dys
28
What is wet beriberi? Sx?
peripheral vasodilation caused by high output heart failure Sx: dyspnea, tachy, cardiomegaly, edema
29
What is dry beriberi?
perhipheral nerve involvement causing motor and sensory neuropathy, paresthesias and loss of reflexes
30
What is Wernicke-Korsakoff syndrome
severe complication causing encophalopathy, amnesia, confabulation
31
What do you need to absorb B12
intrinsic factor
32
What is pernicious anemia
autoimmune disease where the autoantibodes against parietal cells that produce intrinsic factor no intrinsic factor=no B12
33
Who is at risk for b12 def
pts with hx of abd surgery, alcoholic, elderly
34
What type of anemia does b12 def cause
macrosidic with hypersegmented neutrohils
35
How do you treat b12 def
IM b12 daily for first week, weekly for first month, monthly for life
36
Typical cause of folic acid def
lack of dietary intake
37
Type of anemia caused by folic acid def
macrocidic
38
How is vit D synthesized
synthesized in skin during exposure to UVB light and through diet
39
Vit D def causes
osteomalacia
40
Tx of Vit D def
ergocalciferol or cholecalciferol