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PHM 604- Nutrition and Cirrhosis > Nutrition Therapeutics Overview > Flashcards

Nutrition Therapeutics Overview Flashcards

1
Q

What is the NUTRIC score used for?

A

Used to determine how soon to start enteral/parenteral feeding and risk of refeeding syndrome

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2
Q

Low risk NUTRIC score characteristics

A

Normal baseline, NUTRIC score <5, can withhold feeding for up to 7 days

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3
Q

High risk NUTRIC score characteristics

A

Compromised baseline, NUTRIC ≥5, >80% of estimated or calculated goal energy and protein within 48-72 hours, monitor closely for refeeding syndrome

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4
Q

Physical exam: findings suggestive of malnutrition

A

General appearance, skin and mucous membranes, musculoskeletal, neurologic, hepatic

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5
Q

What does the subjective global assessment do?

A

Classifies patients subjectively on the basis of data obtained from history and physical examination

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6
Q

What is the subjective global assessment NOT?

A

It’s not a screening tool for detecting nutritional risk, it’s an assessment tool for malnutrition

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7
Q

Assessment of nutritional status: ways to assess body weight

A

%IBW, %UBW, BMI

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8
Q

BMI of a healthy weight

A

19-24.9

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9
Q

BMI of mild malnutrition

A

17-18.9

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10
Q

BMI of moderate malnutrition

A

16-16.9

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11
Q

BMI of severe malnutrition

A

<16

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12
Q

Assessment of nutritional status: ways to measure body composition

A

Bioelectric impedance, body measurements (triceps skin fold test, midarm muscle circumference, waist circumference), hand-grip strength

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13
Q

Assessment of nutritional status: visceral proteins

A

Albumin, transferrin, prealbumin

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14
Q

Assessment of nutritional status: ways to assess immune function

A

Total lymphocyte count, delayed cutaneous hypersensitivity

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15
Q

Assessment of nutritional status: ways to assess nutrient deficiencies

A

Assessment for signs and symptoms of vitamin, trace mineral, and essential fatty acid deficiency must be included in the physical and evaluated using serum concentrations and surrogates of nutrient function

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16
Q

Starvation-associated malnutrition

A

Chronic starvation without inflammation

17
Q

Examples of starvation-associated malnutrition

A

Anorexia, comprised intake in the setting of depression

18
Q

Characteristics of chronic disease-associated malnutrition

A

Inflammation is chronic and mild-moderate

19
Q

Examples of chronic disease-associated malnutrition

A

Organ failure, pancreatic cancer, RA

20
Q

Examples of acute disease or injury-associated malnutrition

A

Major infection, burns, trauma, closed-head injury

21
Q

Relationship between severe inflammation and malnutrition

A

The more severe inflammation there is, the harder it is to reverse the malnutrition

22
Q

Relationship between severity and energy requirements

A

The severity determines how much the patient needs in reference to their baseline (ex: burn patients need way more in comparison but starvation needs less)

23
Q

Ways to estimate energy requirements

A

Kcal/kg/day
Resting energy expenditure with Harris-Benedict equation
Energy expenditure with indirect calorimetry

24
Q

Ways to estimate protein requirements

A

Stress level (g/kg/day), obesity based on BMI, nitrogen turnover studies

25
Q

g/kg/day of protein needed in critical illness

A

1.2-2

26
Q

g/kg/day of protein needed in burn patients

A

2.5-3.5

27
Q

g/kg of protein needed for obese patients with a BMI of 30-40

A

2g/kg

28
Q

g/kg of protein needed for obese patients with a BMI of >40

A

2.5g/kg

29
Q

Conversion between nitrogen and protein

A

1g nitrogen=6.25g protein

30
Q

Estimating fat requirements

A

10-35% of total calories in adults

31
Q

Predisposing factor of Marasmus malnutrition

A

Pure starvation (anorexia)

32
Q

Predisposing factor of Kwashiorkor malnutrition

A

Acute illness, hypermetabolic states

33
Q

Predisposing factor of mixed malnutrition

A

Acute illness with underlying starvation

34
Q

Characteristics of proteins, tissues, immune function, and substrate abnormality in Marasmus malnutrition

(Reduced or intact for proteins and tissues)

A 
Somatic proteins are reduced
Adipose tissues are reduced
Visceral proteins are intact
Immune function is reduced
Substrate abnormality- inadequate intake
35
Q

Characteristics of proteins, tissues, immune function, and substrate abnormality in Kwashiorkor malnutrition

(Reduced or intact for proteins and tissues)

A 
Somatic proteins are intact
Adipose tissues are intact
Visceral proteins are reduced
Immune function is reduced when severe
Substrate abnormality- excessive requirements
36
Q

Characteristics of proteins, tissues, immune function, and substrate abnormality in mixed malnutrition

A

All proteins and tissues are reduced

Substrate abnormality is both inadequate intake and needing excessive requirements

PHM 604- Nutrition and Cirrhosis (6 decks)

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