Week 229 - Nutrition Flashcards
Week 229
What is the most abundant amino acid in the body?
Glutamine
Week 229
What is “Refeeding syndrome”?
Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished.
Symptoms:
- Switch of energy source from endongenous ketones to exogenous glucose
- rapid uptake of PO4/K+/Mg2+ into cells
- Na+ and water retention
- Hypophosphataemia
- Tissue hypoxia
- Confusion
- Thombocytopaenia
- Cardiac arrythmias
Week 229
What are the indications for PEG?
- Stroke
- Patients with chronic neuro problems
- Head and neck malignancy
- pysch patients (?)
Week 229
When a PEG comes out - what do you do!?
PUT A FOLEY CATHETER IN THERE! 20Fr, 30cc balloon.
Week 229
What are the essential emino acids?
- These - Tryptophan
- ten - threonine
- valuable - valine
- amino acids - arginine
- have - histadine
- long - lysine
- preserved - phenylalanine
- life - leucine
- in - isoleucine
- man - methionine
*
Week 229
What are the symptoms of hypo and hyper ‘natraemia?
- HYPO: N and V, headache, malaise, hypotension
- HYPER: Muscle weakness, confusion, hypertension
Week 229
What are the symptoms of Hyper and Hypo ‘kalaemia?
- Hypo: Muscle weakness, hypotonia, depression, paralytic ileus, confusion, arrhythmias
- Hyper: Ecg changes, malaise, palpatations, muscle weakness
Week 229
What are the symptoms of hyper and hypo calcaemia?
- Hypo: Irritability, tremor, confusion, convulsions, ECG changes.
- HYPER: Weakness, respiratory paralysis, defects in cardiac conduction
Week 229
What are the symptoms of hypo and hyper magnesaemia?
- HYPO: Parasthaesia, tetany
- HYPER: Fatigue, confusion, abdo pain, n and v , high urine output
Week 229
What are the symptoms of hyper and hypo phosphataemia?
- HYPO: Muscle weakness and wasting, skeletal wasting
- HYPER: Chronic renal impairment, hypoparathyroidism
Week 229
Which factors place a patient at high risk of refeeding sydrome?
- BMI less than 16kg/M2
- Weight loss is more than 15% in 3-6 months
- Little or no intake for more than ten days
- Low baseline phosphate, potassium and magnesium
Week 229
What is short bowel syndrome?
SBS is the state of malabsorption and malnutrition that occurs following massive anatomical or functional loss of the small intestine, normally by surgical resection.
Causes:
necrotizing enterocolitis
midgut volvulus
omphalocele and gastroschisis
jejunoileal atresia
internal hernia
congenital short bowel
meconium ileus (a condition associated with cystic fibrosis)
superior mesenteric artery deformities
intestinal atresias
aganglionosis
(Hirschsprung’s disease)
Week 229
What is this?
This is normal ileum.
Week 229
What is this?
Mucosal inflammation causes redness, friability (ease of bleeding) and oedema (swelling), giving rise to a granular appearance.
Week 229
What is this?
As inflammation extends deeper into the bowel wall, oedema results in a cobblestone appearance.
Week 229
What is this?
As inflammation progresses, ulcers appear, and may be punctate (left), linear, or more extensive.
Week 229
What is this?
Repeated ulceration causes destruction of mucosa, giving the swollen surviving mucosa a raised, polypoid appearance (pseudopolyps).
Week 229
What is this?
Abdominal aortic aneurysm
Week 229
What is this?
This is chiladiti’s syndrome
Week 229
What is this?
HIatus hernia
Week 229
What is this?
This is a hiatus hernia
Week 229
What is this?
Hiatus hernia
Week 229
What is this?
HIckman line
Week 229
What is this?
Hickman line
Week 229
What is this?
Inguinal hernia
Week 229
What is this?
Look for IVC filter
Week 229
What is this?
PICC line
Week 229
What is this?
Picc line
Week 229
What is this?
Spigelian hernia
