Undernutrion And Dietetics

Question 0

Malnutrition

Answer 0

Imbalance between the nutrients the body requires and the nutrients it receives

Question 1

Under nutrition definition

Answer 1

Generalised-> deficiency of calories
Specific-> deficiency of an essential nutrient
Primary-> related to diet
Secondary-> related to illness

Question 2

Causes of under nutrition

Answer 2

Reduced delivery of nutrients:
Decreased availability 
Mechanical-> can't swallow
Functional/neurological 
Increased demand:
Physiological-> pregnancy, growth, athletes
Pathophysiological-> cachexia, burns, cancer
Inability to absorb:
Intrinsic problem-> pancreatic cancer
Post surgery-> bowel resection

Question 3

Starvation

Answer 3

Carb stores in liver depleted in 24 hours
Hepatic gluconeogensis-> glucose from glycerol and amino acids
Initial phase of protein breakdown from skeletal muscle-> 3-4 days of energy
Decrease plasma glucose->increase insulin-> lipolyisis-> fatty acids used for energy, ketone bodies used by brain
Adaption takes 3 weeks and lasts as long as the fat does
Once fat is depleted-> structural proteins are broken down and there is rapid deterioration leading to death

Question 4

Responses to starvation

Answer 4

Immune system doesn’t function properly
Skeletal muscle decreases
Reduced acid secretion in digestive system, stomach shrinks diarrhoea
CV system-> decreased heart size and BP
Resp system-> slow breathing, reduced lung capacity
Reproductive-> decreased size of ovaries/testes
Nervous-> apathy, irritability, mental dysfunction
Metabolism-> decreased body temp, oedema
Anaemia

Question 5

Protein energy malnutrition

Answer 5

Dry PEM:
Marasmus 
No oedema, generalised
Severe calorie and protein deficiency 
Wet PEM:
Kwashiorkor 
Oedema over abdomen
Protein defieciency

Question 6

Re feeding syndrome

Answer 6

Increased carb uptake 
Increased circulating insulin 
Increased demand for intra cellular electrolytes
Hypophosphatemia 
Rhambodomyolysis
Cardiac and resp failure, leukocyte, dysfunction
Hypotension 
Arrhythmias
Seizures 
Comma and death

Question 7

Dietetics basic requirements

Answer 7

1. Normal nutritional requirements
2. Identity nature of disorder
3. Asses the patients nutritional status and intake
4. Know the composition of foods, supplements and artificial feeds
5. Devises a meal plan
6. Monitor compliance and progression
7. Reassessed and adjust