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Flashcards in Nutrition in Health and Disease Deck (28)
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1
Q

Where does our nutriotion demand come form?

A

Basal Requirements:

Membrane function:

  • Pumps
  • Transport
  • Signalling

Mechanical Work:

  • Cellular level
  • Tissue level

Substrate turnover

Variable Component:

Cost of processing the dietary intake

Cost of Physical activity

Cost of maintaining body temperature

Cost of growth

2
Q

What is meant by nutritional failure?

A

Failure to meet the nutritional requirements of the individual

Development of deficiencies

[Weight loss]

Or Excess

[Obesity]

3
Q

What are two clincal examples if malnutrition?

A

Marasmus

Kwashiorkor

It can be distinguished from kwashiorkor in that kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein

4
Q

Define malnutrition

A

When there is an imbalance of energy, protein or other nutrients that results in adverse effect on tissue / body form, body function and clinical outcome

5
Q

How do you calculate BMI?

A

Weight divided by height squared

6
Q

What BMI is defined as overqeight and obese?

A

BMI > 25 overweight

BMI > 30 obese.

7
Q

What are the contributing factors to obesity?

A

Environment

Exercise

Genes

8
Q

What is metabolic syndrome composed of?

(as a result of obesity)

A
  • Hypertension.
  • Cardiovascular disease.
  • Type II diabetes mellitus.
  • Fatty liver.
  • NASH
  • Cirrhosis
9
Q

What types of cancer are obese people most likely to get?

A

Breast

Bowel

10
Q

What are the aetiologies for indernutriotion?

A

Partly environmental

Mostly disease related

11
Q

What are the BMI classifications for those who are malnourished?

A

BMI less < 20 underweight

BMI < 18 physical impairment

BMI < 16 increasingly severe consequences.

12
Q

Why is BMI insufficient when determining undernutrition?

A

An obese patient who is experiencing weight loss would be indicative of undernutrition, however BMI would not be able to inform you of this

13
Q

How do we screen for undernutrition?

A

Malnutrition Universal Screening Tool

Picks up patients at risk of malnutrition

14
Q

What are the aspects of the Malnutrition screening tool?

A

BMI

If < 20 Score 1

If < 18 Score 2

Unintentional weight loss?

Yes - 10% score 2

Yes - 5% score 1

Patient eaten in the last 5 days or is expected to eat in the next 5 days? No - score 2

15
Q

What do the scores indicate for the malnutrition universal screening tool?

A

A score over 2 suggests a risk of undernutrition

Score 1: supplements and watch

Score 0: Monitor

16
Q

Which admission source is most likely to have malnourished patients?

A

Care homes

Other Hospitals

17
Q

Which type of ward has the largest percentage of malnourished patients?

A

Care of the elderly / Stroke

18
Q

What does malnutriotion associate with?

A

Illness

Social Isolation

Age

Socially Vulnerable groups

‘Food deserts’ - inability to reach food shops, reliance on conveniance stores

19
Q

What are the clinical consequences of malnutrition?

A
  • Impaired immune response
  • Reduced muscle strength
  • Impaired wound healing
  • Impaired psycho-social function
  • Impaired recovery from illness and surgery
  • Poorer clinical outcomes
20
Q

What are causes of undernutrition?

A

Appetite failure

Access failure

Intestinal Failure

21
Q

What are the causes of appetite failure?

A

Anorexia nervosa

Disease related

22
Q

What are the reasons for access failre?

A

Teeth

Stroke

Cancer of head and neck

Head injury

23
Q

What is meant by intetinal failure?

A

Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients

24
Q

For patients with access failure, what is the feeding method?

A

Sip feeding

Fine bore nadogastric tube

PEG - Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient’s stomach through the abdominal wall

25
Q

What causes the fluid build up in Kwashiorkor?

A

Leaky capillaries, fluid retention.

(Probably as a result of loss of oncotic pressure)

26
Q

Where would you be likely ot find marasmus?

A

Any Care of the Elderly Ward

General medical admissions

Oncology

27
Q

Where would you be likely to find kwashiorkor?

A

ITU or HDU

28
Q
A