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Week 11: Weight Loss/Malabsorption > Weight Loss > Flashcards

Weight Loss Flashcards

1
Q

Malnutrition definition

A

Deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients

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2
Q

2 broad groups of conditions covered by malnutrition

A

Undernutrition and micronutrient deficiencies

Overweight, obesity, diet-related noncommunicable diseases

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3
Q

Food security encompasses what 3 things

A

Availability (sufficient, consistent)
Access (resources to obtain food)
Use (knowledge of basic nutrition, water and sanitation, safe storage)

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4
Q

What is the number one factor contributing to food insecurity and malnutrition?

A

Poverty

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5
Q

Who is most at risk of malnutrition

A 
Children under 5 (especially under 2 after weaning)
Adolescents and elderly
Pregnant and lactating women
Persons with chronic disease
Infectious disease
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6
Q

2 types of undernutrition

A

Protein energy malnutrition

Micronutrient deficiency

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7
Q

Protein energy malnutrition

A

Decrease in the amount of macronutrients (protein, carbs, fat)
Growth failure
2 types: wasting (acute) and stunting (chronic)

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8
Q

Micronutrient deficiency

A

Vitamins, minerals, trace elements

Less obvious, but can have serious impacts on ability to grow, develop, and deal with stress

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9
Q

Kwashiorkor vs Marasmus

A

Both are types of protein energy malnutrition and involve rapid weight loss
K: slightly older children, swelling of legs, sparse hair, moon face, flaky skin, swollen abdomen, thin muscles
M: children under 1, normal hair, old man or wizened appearance, thin limbs with little muscle or fat, very underweight body

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10
Q

Kwashiorkor

A

Usually 6 months to 3 years
Rapid
Often due to acute illness, infections, trauma
Protein deficiency

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11
Q

Marasmus

A

Usually under 1 year
Slow, chronic
Prolonged starvation (famine, conflict)
Protein and calorie deficiency

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12
Q

Stunting

A

Type of PEM (chronic malnutrition)
Low height for age compared to reference population
Look younger than age
Can have poor cognitive development

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13
Q

Consequences of malnutrition

A

Risk of death from a common illness is much higher
Poor pregnancy outcomes, anemia, mental and growth retardation, blindness, etc
Increased susceptibility to infection

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14
Q

Anorexia definition

A

The loss of appetite or reduced caloric intake

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15
Q

Cachexia

A

Multifactorial syndrome of continuous involuntary loss of skeletal muscle mass, which cannot be fully revered by conventional nutritional support
Includes 3/5 of following: decreased muscle strength, reduced muscle mass, fatigue, anorexia, biochemical alterations (anemia, inflammation, low albumin)

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16
Q

Anorexia-cachexia syndrome

A

Involuntary loss of weight and appetite with advanced illness
In cancer, HF, COPD, HIV, CKD
Poor prognostic indicator

17
Q

Pathogenesis of anorexia-cachexia

A

Cytokine driven
Causes dysregulation in 3 groups
1. Altered intake (gut-brain axis)
2. Inflammation/catabolism (muscle-liver axis)
3. Anabolic dysbalance (brain-muscle axis)

18
Q

Treatment principle for anorexia-cachexia

A

Medical optimization of secondary nutrition impact symptoms and acute/chronic conditions
Like nausea, pain, constipation, depression, dyspnea, etc etc

19
Q

Non-pharmacologic treatment for anorexia-cachexia

A

Useful for all patients
Quality over quantity
Counselling and education (increasing calories doesn’t reverse process and may harm, not starvation, it is natural and common in advanced illness)
Consultation with nutritionist

20
Q

Pharmacologic treatment for anorexia-cachexia

A

Does not reverse cachexia
No mortality benefit
May improve QoL with distressing anorexia
Progesterone analogs, corticosteroids, cannabinoids

21
Q

Is artificial nutrition and hydration ever used for A-C

A

Not indicated
No evidence that it prolongs life or improves QoL
Not without risks

22
Q

4 ways parasites can cause disease in humans

A

Mechanical effects
Invasion and destruction of host cells
Allergic or inflammatory immune reaction
Competition for specific nutrients

23
Q

Trophozoites vs cysts

A

Two life stages of protozoa
Trophs: motile, delicate, usually non-infectious
Cysts: resting stage, tough, infectious via fecal oral route

24
Q

Giardia lamblia symptoms

A

Can have asymptomatic carriage
Chronic watery diarrhea, cramping, bloating
NO VOMITING
Chronic malabsorption and weight loss

25
Q

Giardia lamblia

  1. Risk factors for infection
  2. Diagnosis
  3. Treatment
A
  1. Contaminated well or stream water, day care centers, sexual transmission (MSM)
  2. Wet mount of stool sample, antigen detection (EIA)
  3. Metronidazole
26
Q

Entamoeba histolytica symptoms

A

Can have asymptomatic carriage (E. dispar)
Diarrhea, abdominal pain, dysentery
Liver, lung, brain abscesses

27
Q

Entamoeba histolytica

  1. Risk factors for infection
  2. Diagnosis
A
  1. Contaminated food/water, travellers/immigrants, sexual transmission (MSM)
  2. Wet mount of stool sample, antigen detection (EIA), Antibody detection
28
Q

Treatment for Entamoeba histolytica

A

Metronidazole (for the trophs)

Iodoquinol/Paramomycin (for cysts)

29
Q

3 groups of helminths

A

Trematodes (schistosomes vs non-schistosomes)
Nematodes (filaria vs soil transmitted helminths)
Cestodes

30
Q

3 main soil-transmitted helminths

A

Roundworm
Hookworm
Whipworm

31
Q

3 ways worms cause malnutrition

A

Feeding on host tissues and blood (Fe and protein loss)
Competing for nutrients and causing malabsorption
Causing appetite loss, diarrhea or dysentery

32
Q

Biggest human impact of helminths is on which age group? Why?

A

Children ages 3-8

Growth stunting, malnutrition and cognitive impairment

33
Q 
Species of
1. Roundworm
2. Hookworm
3. Whipworm
that cause disease
A
  1. Ascaris lumbricoides
  2. Acyclostoma duodenale and Necator americanus
  3. Trichuris trichiura

Week 11: Weight Loss/Malabsorption (8 decks)

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