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Y3R6: Surgery I 👨‍⚕️ > L2: Surgical Nutrition > Flashcards

L2: Surgical Nutrition Flashcards

1
Q

Def of Malnutrition

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2
Q

Causes of Malnutrition

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3
Q

Metabolic Response to Starvation

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4
Q

Mechanism of metabolic response to trauma & sepsis

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5
Q

Body response to Trauma & Sepsis

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6
Q

Mechanism of metabolic response to surgery

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7
Q

triggers for metabolic response to surgery

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8
Q

Risk factors for metabolic response to surgery

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9
Q

How to Decrease IR before surgery?

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10
Q

Evaluation of Malnutrition

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11
Q

Hx

Evaluation of Malnutrition

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12
Q

History of poor nutrient intake

Evaluation of Malnutrition

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13
Q

Significant Loss of body weight (see table)

Evaluation of Malnutrition

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14
Q

Social & economic conditions may lead to poverty & malnutrition

Evaluation of Malnutrition

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15
Q

Gastrointestinal symptoms

Evaluation of Malnutrition

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16
Q

Other chronic medical illnesses

Evaluation of Malnutrition

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17
Q

Physical Examination

Evaluation of Malnutrition

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18
Q

general appearence

Evaluation of Malnutrition

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19
Q

Skin,Nails & Hair

Evaluation of Malnutrition

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20
Q

Effect of decrease in protein

Evaluation of Malnutrition

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21
Q

Effect of low iron

Evaluation of Malnutrition

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22
Q

effect of low vit C

Evaluation of Malnutrition

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23
Q

effect of low zinc

Evaluation of Malnutrition

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24
Q

Effect of low Vit A

Evaluation of Malnutrition

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25
Q

Eyes

Evaluation of Malnutrition

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26
Q

Effect of anemia

Evaluation of Malnutrition

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27
Q

effect of low thiamine

Evaluation of Malnutrition

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28
Q

effect of low vitamin A on eyes

Evaluation of Malnutrition

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29
Q

Def of Anthropometry

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30
Q

Anthropometry can assess the level of energy reserves by ……

A

estimating the amount of subcutaneous adipose stores.

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31
Q

However, Anthropometry ……. identify specific nutrient deficiency

A

cannot

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32
Q

Anthropometric assessment

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33
Q

Triceps skin fold thickness (mm)

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34
Q

Mid arm circumference (cm)

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35
Q

Investigations to detect subclinical nutritional deficiencies in surgical patients.

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36
Q

To detect subclinical nutritional protein deficiencies in surgical patients:

A
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37
Q

Nitrogen Balance

A
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37
Q

…… protein gained = ….. g nitrogen.

A

6.25 , 1

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38
Q

Equations for Nitrogen balance

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39
Q

Serum Albumin

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40
Q

Serum albumin level ….. during the acute stress of surgery, sepsis, or other acute inflammatory illness because of ……

A
  • ↓

^^^^^^^

  • ↑ circulating extravascular volume.
  • TNF-α mediated inhibition of albumin synthesis.
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41
Q

Normal albumin level (used as an index of malnutrition) → …….

A

35g/L = 3.5g/dl (half-life of → 14 to 18 days).

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42
Q

Prealbumin (half-life, 3 to 5 days) or transferrin (<200 mg/dL; half-life, 7 days) → …….

A

ore sensitive indicators of rapid changes in nutritional status.

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43
Q

Creatinine excretion

A
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44
Q

Creatinine is a metabolic product of ……

A

skeletal muscle creatine

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45
Q

Creatinine amount is …… proportional to skeletal muscle mass.

A

directly

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46
Q

…… g creat = …..g of fat free skeletal muscle in the 24-h urine collection (With steady state of day-to-day renal function).

A
  • 1
  • 18.5
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47
Q

Creatinine Levels & Assessment of surgical Patients

A
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48
Q

Immunological assessment

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49
Q

Delayed cutaneous hypersensitivity or anergy → Most commonly tested by delayed reaction to skin recall antigens.

A

….

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50
Q
  • It was widely used in early studies of nutritional assessment and is a manifestation of cell-mediated immunity.
  • Total Lymphocyte count is often <1000 /μL and may accompany anergy to common skin test antigens.
  • Not all malnourished patients are at Immunological risk.
A
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51
Q

Adverse effect of protein or calories depletion

A
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52
Q

Read Dietary assessment tools

A
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53
Q

Assessment of nutritional requirement

A
54
Q

Estimating Energy Requirement

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55
Q

Aim of fluid maintenance

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56
Q

Methods of Fluid input

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57
Q

Methods of Fluid output

A
58
Q

Indications of Intravenous fluid replacement solutions

A
59
Q

Selection of Intravenous fluid replacement solutions

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60
Q

Types & Uses of Intravenous fluid replacement solutions

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61
Q

Effect of intestinal resection on fluid & nutrient absorption

A
62
Q

Effect of Jejunal resection

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63
Q

result of Jejunal resection

A
64
Q

Effect of Ileal resection

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65
Q

Result of Ileal resection

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66
Q

Def of Short Bowel Syndrome

A
67
Q

CP of Short Bowel Syndrome

A
68
Q

Complications of Short Bowel Syndrome

A
69
Q

Recovery of Short Bowel Syndrome

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70
Q

TTT of Short Bowel Syndrome if no normal recovery

A
71
Q

Types of Nutritional Support

A
72
Q

Daily Requirements of

  • Water
  • Calories
  • Sodium
  • Potassium
A
73
Q

Total energy need in:

  • Unwell Patients
  • Stable patients
  • Severe illness
A
74
Q

CHO Req per day

A
75
Q

Protein Req per day

A
76
Q

Fat Req per day

A
77
Q

Effect of Mixture of glucose and fat in TPN

A
78
Q

Effect of Vit B

Surgical Nutrition

A
79
Q

Effect of Vit C

Surgical Nutrition

A
80
Q

Obstructive jaundice & pancreatic duct obstruction → …. in fat soluble vitamins (ADEK)

A

↓

81
Q
  • ↑ intestinal losses → ↓ in Na, K, phosphate.
  • ↓ in trace elements (zinc magnesium, Fe) due to inflammatory response → needed for increased utilization of AA and decrease refeeding syndrome
A

..

82
Q

Indications Of Nutritional Support

A
83
Q

Advantages of enteral feeds

A
84
Q

Who Needs Nutritional Support?

A
85
Q

Algorithm of feeding

A
86
Q

Methods of Enteral Feeding

A
87
Q

Indications of N/G tube feeding.

A
88
Q

Types of Gastrostomy tube feeding

A
89
Q

Types of Jejunostomy tube feeding

A
90
Q

NJT are better than NGT and gastrostomy as NJT
bypass the pylorus so ……

A

decrease aspiration and also not need for TPN with

91
Q

Types of Tube feeding techniques

A
92
Q

Installation of Nasogastric tube

A
93
Q

Indications of Fine bore tube

A
94
Q

charachters of Fine bore tube

A
95
Q

Disadvantages of Fine bore tube

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96
Q

Installation of Nasojejunal feeding

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97
Q

Types of Gastrostomy

A
98
Q

complications of Gastrostomy

A
99
Q

Types of Jejunostomy tube

A
100
Q

Complications of Jejunostomy tube

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101
Q

Complications of enteral feeding

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102
Q

GIT Complications of enteral feeding

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103
Q

Metabolic Complications of Enteral feeding

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104
Q

Contraindications to Enteral Nutrition

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105
Q

Def of Parentral Nutrition

A
106
Q

Indication of Parentral Nutrition

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107
Q

Compositions of parenteral solutions

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108
Q

Types of parenteral Nutrition

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109
Q

Characters of Peripheral parenteral nutrition

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110
Q

Characters of Total parenteral nutrition

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111
Q

Sites for insertion in Parentral Nutrition

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112
Q

Advantages of parentral nutrition

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113
Q

Characters of Parenteral Amino Acid Solutions

A
114
Q

Special Parenteral Amino Acid Solutions (Formulas)

A
115
Q

Designing parenteral nutrition formula

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116
Q

Mechanical complications of Parentral Nutrition

A
117
Q

Metabolic complications of Parentral Nutrition

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118
Q

Infection complications of Parentral Nutrition

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119
Q

Other complications of Parentral Nutrition

A
120
Q
  • In patients with diabetes and those with impaired blood glucose control owing to critical illness → administration of parenteral nutrition should coincide with a variable insulin infusion regimen to avoid hyperglycemia.
  • Conversely, insulin dosing should be reduced accordingly when parenteral nutrition is interrupted to avoid hypoglycemia.
A

..

121
Q

Def of Refeeding Syndrome

A
122
Q

CP of Refeeding Syndrome

A
123
Q

Who are at risk of Refeeding Syndrome?

A
124
Q

Prevention & Therapy of Refeeding Syndrome

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125
Q

Incidence of Liver Dysfunction

Complications Related to TPN

A
126
Q

Types of Diseases in liver dysfunction

Complications Related to TPN

A
127
Q

RF for Liver Dysfunction

Complications Related to TPN

A
128
Q

Metabolic bone Disease & Vitamin Deficiency

  • Complications Related to TPN
A
129
Q

Cause of Overfeeding

Complications Related to TPN

A
130
Q

CP of Overfeeding

Complications Related to TPN

A
131
Q

Monitoring

Complications Related to TPN

A
131
Q

Take Home messages

  • Surgical Nutrition
A
132
Q

Doneeeeee

A

Y3R6: Surgery I 👨‍⚕️ (30 decks)

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