Protein E Malnutrition Flashcards
Marasmus
“normal response to starvation”
severe wasting, due to E deficiency
Slower onset, better adaptation
Kwashiorkor
Edematous Protein E malnutrition (PEM), generally w/o wasting
Protein deficiency
- hypoalbuminemia & edema
Rapid onset, “mal adaption”
Cachexia
- what is it?
- can you fix by feeding?
Associated w/ inflammatory or neoplastic conditions
- NOT reversed by feeding (ie: anorexia, or cancer)
- can add on fat maybe, but not real tissue
Sarcopenia
subnl amt of skeletal muscle
w/o weight loss
PEM: Underweight
Low weight for age
>2SD below median (50th %)
- not same as being wasted
Stunting
aka Chronic malnutrition
Length for age
Wasting
Decreased WEight relative to LENGTH
“ideal body weight”
- 50th % wt/ht
Response to starvation in:
- muscle
- brain
- liver
- liver/kidney
Muscle:
- Increase utilization of TG/FA
- Decreased Protein degradation
Brain
- Increased util. of ketones
- (With decrease glucose)
Liver
- Gluconeogenesis
Liver/kidney
- Urea production & excretion
Sx of kwashiorkor
- Misery
- Edema
- Hepatomegaly
- Erythematous hyperpigmentation (Pellagroid)
- Dry, brittle, depigmented hair “flag sign”
- “Moon facies”
*look at ppt slide ++++
first 6 mo recommendation about diet
Exclusively breast fed
*tea
Juice: primarily carbohydrates, low protein
Management of Severe PEM
GO SLOWLY!
- or else they can decompensat - arrythmias
- disrupt homeostasis
- FIx life threatening conditions
- Restore nutritional status
Refeeding syndrome
- common derangements
Broad range of metabolic consequences occuring due to rapid reinstitution of nutrients in pts w/ PEM, can result in SUDDEN DEATH
Catabolic state –> anabolic state
- fluid shift –> heart failure
Common der: K+, P+, Mg++, Thiamine
