September 23, 2015 - SG - Nutrition

Question 1

Starvation

Answer 1

A severe deficiency in caloric energy intake. It is the most extreme form of malnutrition.

Can be reversed through feeding and nutrition.

Question 2

Cachexia

Answer 2

Also known as wasting syndrome.

A loss of weight, muscle atrophy, fatigue, weakness, in somebody who is not trying to lose weight. The loss of body mass that cannot be reversed nutritionally.

Commonly seen in AIDS, end-stage cancer, tubercolosis, among others.

Question 3

Determining Nutritional Status

Answer 3

You can assess for loss of subcutaneous fat, look for muscle wasting (particularly temporalis), the presence of edema/ascites, the squaring of shoulders.

Question 4

SGA

Answer 4

Subjective Global Assessment

SGA-A: Well-nourished. No weight loss, change in intake, or any physical findings. Also for recovering patients.

SGA-B: Moderately malnourished. Unintentional 5-10% weight loss, decreased energy intake, and mild signs on PE.

SGA-C. Severely malnourished. >10% weight loss, decreased intake, and marked findings on PE.

Question 5

Short Bowel Syndrome

Answer 5

A malabsorption disorder caused by the surgical removal of the small intestine, or rarely due to the complete dysfunction of a large segment of bowel. Most cases are acquired, although some children are born with a congenital short bowel.

Usually develops when more than 2/3 (400cm) of the small intestine are removed. Not enough bowel for proper nutrient absorption.

Question 6

72-Hour Fecal Fat

Answer 6

Can be used to determine if fat malabsorption is taking place.

Normally, up to 7% of fat can be secreted in stool.

Question 7

High INR in SBS

Answer 7

Often caused by Vitamin K deficiency.

Question 8

Codeine and Transit Time

Answer 8

Greatly slows transit time.

Question 9

Risks of TPN

Answer 9

Central line complications.

Liver disease (particularly cholestatic).

Metabolic bone disease.