Week 1 - Malnutrition

Question 1

Why does overeating occur?

Answer 1

Homeostatic system is override by the hedonic reward system, leading to overconsumption

Question 2

What is the definition of obesity?

Answer 2

+ fat mass and sufficient magnitude to produce adverse health consequences

Question 3

What is the glycaemic index?

Answer 3

Quantitative comparison of blood glucose responses to ingestion of equivalent amounts of carbohydrate, from different food sources

Question 4

How much should your daily carb intake be? How much should your daily fibre intake be?

Answer 4

50% daily energy 30% daily energy

Question 5

What is the effect of fibre on the digestiv system?

Answer 5

Has a bulking effect Speeds up colonic transit Lowers cholesterol

Question 6

Where do you find vitamin B12? What does a deficiency lead to?

Answer 6

In animal products and yeast Megaloblastic anaemia and neuropathy

Question 7

Where do you find folate? What does a deficiency lead to?

Answer 7

In green veg Anaemia and risk of neural tube defects

Question 8

Where do you find vitamin D?

Answer 8

Fish oils Egg yolk Butter

Question 9

What is the role of vitamin D in the body?

Answer 9

Intestinal calcium and phosphorus absorption Renal calcium and phosphate absorption Neuromuscular and immune functions –> apoptosis and inflammation

Question 10

What does a vitamin D deficiency lead to?

Answer 10

Rickets (children) Osteomalacia (adults)

Question 11

What are the symptoms of vitamin D toxicity?

Answer 11

Weakness Diarrhoea Nausea Headache Abdominal pain Hypercalcaemia

Question 12

What is a mineral?

Answer 12

Inorganic elements with physiological function in body

Question 13

What is iron required for in the body? Where is iron stored? How is iron transferred to bone marrow?

Answer 13

Red cells Electron transport Cytochrome P450 Spleen, liver, bone marrow Via transferrin

Question 14

What are the 2 sources of iron?

Answer 14

Meat = Haem = 10% Vegetables = non-haem = 90%

Question 15

What is dietetics?

Answer 15

Use of diet in prevention or treatment of a disease

Question 16

What things do you check in order to assess a person’s nutritional status?

Answer 16

Anthropometry Body composition Biochem and haematology Function Dietary assessment

Question 17

What is MUST?

Answer 17

Malnutrition universal screening tool

Question 18

What are the 4 types of undernutrition?

Answer 18

Generalised = calorie deficiency

Specific = deficiency of certain nutrient

Primary = related to diet

Secondary = related to illness

Question 19

What is the response to undernutrition?

Answer 19

Question 20

What are the 2 types of protein-energy malnutrition (PEM)?

Answer 20

Dry PEM = msarasmus = no oedema, general, severe calorie and protein deificiency

Wet PEM = kwashiorkor = oedema, specific, severe protein deficiency = hypoalbuminaemia

Question 21

What is the concept of refeeding syndrome?

Answer 21

Question 22

When is enteral nutritional support used?

How does it work?

Answer 22

When patients haven’t/ or are expected to not receive proper nutrition for 7 days

Small bowel feeding with pump, 8-20 hours

Formulas have different energy densities

Question 23

What is the function of Peyer’s patches?

Answer 23

Prevent growth of bacteria in intestines

Question 24

How can you investigate a potential GI infection?

Answer 24

Grow bacterial culture

Look for specific toxins

Look for parasites with microscope

Detect specific antigens (i.e. H. pylori)

Question 25

What are issues with C. diff?

Answer 25

Vegetative cells produce toxin

Can colonise and not cause disease

Antibiotic treatment kills other bacteria, allowing C. diff to multiply

Treat with metronidazole or vancomycin (severe cases)