Week 229 - Nutrition

Question 1

Week 229

What is the most abundant amino acid in the body?

Answer 1

Glutamine

Question 2

Week 229

What is “Refeeding syndrome”?

Answer 2

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

Question 3

Week 229

What are the indications for PEG?

Answer 3

• Stroke
• Patients with chronic neuro problems
• Head and neck malignancy
• pysch patients (?)

Question 4

Week 229

When a PEG comes out - what do you do!?

Answer 4

PUT A FOLEY CATHETER IN THERE! 20Fr, 30cc balloon.

Question 5

Week 229

What are the essential emino acids?

Answer 5

• These - Tryptophan
• ten - threonine
• valuable - valine
• amino acids - arginine
• have - histadine
• long - lysine
• preserved - phenylalanine
• life - leucine
• in - isoleucine
• man - methionine
  *

Question 6

Week 229

What are the symptoms of hypo and hyper ‘natraemia?

Answer 6

• HYPO: N and V, headache, malaise, hypotension
• HYPER: Muscle weakness, confusion, hypertension

Question 7

Week 229

What are the symptoms of Hyper and Hypo ‘kalaemia?

Answer 7

• Hypo: Muscle weakness, hypotonia, depression, paralytic ileus, confusion, arrhythmias
• Hyper: Ecg changes, malaise, palpatations, muscle weakness

Question 8

Week 229

What are the symptoms of hyper and hypo calcaemia?

Answer 8

• Hypo: Irritability, tremor, confusion, convulsions, ECG changes.
• HYPER: Weakness, respiratory paralysis, defects in cardiac conduction

Question 9

Week 229

What are the symptoms of hypo and hyper magnesaemia?

Answer 9

• HYPO: Parasthaesia, tetany
• HYPER: Fatigue, confusion, abdo pain, n and v , high urine output

Question 10

Week 229

What are the symptoms of hyper and hypo phosphataemia?

Answer 10

• HYPO: Muscle weakness and wasting, skeletal wasting
• HYPER: Chronic renal impairment, hypoparathyroidism

Question 11

Week 229

Which factors place a patient at high risk of refeeding sydrome?

Answer 11

• 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

Question 12

Week 229

What is short bowel syndrome?

Answer 12

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)

Question 13

Week 229

What is this?

Answer 13

This is normal ileum.

Question 14

Week 229

What is this?

Answer 14

Mucosal inflammation causes redness, friability (ease of bleeding) and oedema (swelling), giving rise to a granular appearance.

Question 15

Week 229

What is this?

Answer 15

As inflammation extends deeper into the bowel wall, oedema results in a cobblestone appearance.

Question 16

Week 229

What is this?

Answer 16

As inflammation progresses, ulcers appear, and may be punctate (left), linear, or more extensive.

Question 17

Week 229

What is this?

Answer 17

Repeated ulceration causes destruction of mucosa, giving the swollen surviving mucosa a raised, polypoid appearance (pseudopolyps).

Question 18

Week 229

Hypergastrinaemia is present in patients with which syndrome?

Answer 18

Short bowel syndrome

Question 19

Week 229

The ileum is the site of absoprtion of what?

Answer 19

Vitamin B12 and bile acids

Question 20

Week 229

What is absorbed in the jejenum?

Answer 20

• Glucose
• Amino acids
• Fat
• Thiamine
• Vitamin c

Question 21

Week 229

Where are copper, iodide, and fluoride absorbed?

Answer 21

The stomach

Question 22

Week 229

Where is vitamin K absorbed?

Answer 22

Large intestine

Question 23

Week 229

What does
Glucagon - like peptide -2 (GLP-2) do?

Answer 23

Increases glucose absorption (Villous hyperplasia)

Question 24

Week 229

Abdominal aorta comes through diaphragm at which level?

Answer 24

T12

Question 25

Week 229 What is this?

Answer 25

Abdominal aortic aneurysm

Question 26

Week 229 What is this?

Answer 26

This is chiladiti's syndrome

Question 27

Week 229 What is this?

Answer 27

HIatus hernia

Question 28

Week 229 What is this?

Answer 28

This is a hiatus hernia

Question 29

Week 229 What is this?

Answer 29

Hiatus hernia

Question 30

Week 229 What is this?

Answer 30

HIckman line

Question 31

Week 229 What is this?

Answer 31

Hickman line

Question 32

Week 229 What is this?

Answer 32

Inguinal hernia

Question 33

Week 229 What is this?

Answer 33

Look for IVC filter

Question 34

Week 229 What is this?

Answer 34

PICC line

Question 35

Week 229 What is this?

Answer 35

Picc line

Question 36

Week 229 What is this?

Answer 36

Spigelian hernia