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Human Nutrition > Severe Acute Malnutrition > Flashcards

Severe Acute Malnutrition Flashcards

1
Q

True or False? Primary malnutrition results from inadequate dietary intake with no underlying illness while Secondary malnutrition accompanies any disease which disturbs appetite , digestion, absorption or utilisation of nutrients.

A

TRUE!!

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2
Q

Fill in the blanks. “ The Wellcome classification of malnutrition groups children based on which 2 criteria?

A
  1. The presence or absence of oedema
  2. Weight deficit of the child for his/her age
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3
Q

What are the different aspects of History taking are used in the Clinical assessment of the Malnutrition in children?

A
  1. Presenting History
  2. Past Medical History
  3. Perinatal History
  4. Immunisation
  5. Developmental History
  6. Family History
  7. Social History
  8. Dietary History
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4
Q

What is the Clinical Features of Marasmus?

A
  1. Apathetic
  2. Generalised Muscular Wasting
  3. Absence of subcutaneous fat
  4. ’ Skin and bones’ appearance
    5.Hair- sparse, thin, dry , loss of sheen
  5. Old person’s face - sunken cheeks due to disappearance of fat pads.
  6. Abdominal distention
  7. Skin- dry , thin, wrinkles easily
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5
Q

What are the Clinical Features of Kwashiorkor?

A
  1. Apathetic & irritable
  2. Pitting, painless oedema
  3. Dermatitis
  4. Hair changes
  5. Abdominal distension
  6. Hepatomegaly
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6
Q

The pathology ‘ Jowls ‘ is described?

A

Fullness of cheeks associated with oedematous malnutrition - also seen in Marasmus .

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7
Q

What are the different assessments apart of Anthropometry?

A
  1. weight
  2. Height
  3. Head circumference
  4. % weight/age
  5. % height/age
  6. weight/height
  7. z- scores
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8
Q

What are the clinical presentations of the MOUTH in a person with severe malnutrition?

A
  1. Angular Stomatisis
  2. Oral candidiasis
  3. Atrophic tondild
  4. Tongue - Hyperaemic , swollen
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9
Q

What are the clinical presentations of the HAIR in a person with severe malnutrition?

A

Scalp
- dully, dry, thin, fine, sparse, bald
- atrophy of hair roots- easily & painlessly placeable
- forest sign /flag sign

Eyelashes - long & luxuriant , colour change
Eyebrows- lost , colour change
Excess growth of Lanugo hair

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10
Q

What are the clinical presentations of the EYES in a person with severe malnutrition?

A
  1. Pale conjunctyiva
  2. Angular palpebritis
  3. Corneal & conductival xerosis
  4. Bitot’s spots
  5. Jaundice
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11
Q

What are the clinical presentations of BONES in patients with severe malnutrition?

A
  1. Enlargement of costochondral junction - rickety rosary ( calcium, vitamin D , Vitamin C, Copper , Phosphate deficiency ) .
  2. Frontal & Parietal bossing

3.Persistently open anterior fontanelle

  1. Knock - knees, bow legs
  2. X- ray- marked osteopenia
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12
Q

What is the treatment for patients with Severe malnutrition?

A

Resuscitative/ maintenance (1-2 weeks)

Rapid catch -up phase/ rehabilitation ( 4-6 weeks)

Preparation for home (1-2 weeks )

Follow - up after discharge

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13
Q

What happens during the Resuscitative phase of treatment for malnutrition?

A

To treat or prevent dehydration ( vomiting & diarrhoe)

  • oral route preferred
  • I.V. fluids only if there are definite signs of shock.
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14
Q

What is the first line treatment for infections and what is the duration of therapy?

A

Amoxil, Gentamycin , Flagyl - 10 days

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15
Q

What is the second line treatment for infections?

A

Cephalosporin & Amikacin

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16
Q

What is the treatment for Oral candidiasis?

A

Nyastin suspension

17
Q

What is the treatment for Groin candidiasis ?

A

Antifungal cream

18
Q

What is the treatment for Staphylococcus skin infection?

A

Cloxacillin

19
Q

True or False? Iron must be given in the Resuscitative phase of Treatment of malnutrition?

A

FALSE!! Iron is NOT given in this phase

20
Q

What are the signs of the end of the resuscitative phase?

A
  1. Treatment of infection
  2. Loss of oedema
  3. Return of appetite
  4. Return of affect
21
Q

What is the aim of the rehabilitation phase of treating for malnutrition?

A

To encourage the child to eat as much as possible to gain as much weight in the shortest time period.

22
Q

Fill in the blanks. “ Iron is added in the _________ phase .”

A

Rehabilitation

23
Q

What are the different processes that happen in the Rehabilitation phase?

A
  • FeSo4 is added
  • Daily weights plotted on a graph
  • Encouraged to complete feeds
  • Feeds increased daily at TMRU until child fails to complete feeds
  • Can be allowed out of crib for playtime - risk of cross infection is less, minimise delay in the mental development.
24
Q
A

Human Nutrition (13 decks)

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