Malnutrition

Question 1

What causes malnutrition by malabsorption? (8)

Answer 1

Coeliac, Pancreatitis, Crohns, reduced bile, pancreatic insufficiency (cancer or CF), bacterial overgrowth, infection, intestinal hurrying e.g post-gastrectomy dumping

Question 2

What are some other causes of malnutrition? (8)

Answer 2

Increased nutritional need e.g burns or sepsis, increased losses e.g stoma, decreased intake e.g dysphagia, treatment effects e.g nausea, starvation e.g NBM, missed meals due to treatment, feeding difficulties, unappetising food

Question 3

Is it common?

Answer 3

Yes, 25% of hospital patients become malnourished which can result in poor healing

Question 4

What history would the patient have? (7)

Answer 4

Recent weight loss, pain, reduced intake, diarrhoea, nausea, vomiting, diet change

Question 5

What examinations signs would there be? (5)

Answer 5

State of dehydration e.g skin turgor and dry mucous membranes, pressure sores, skin hanging off muscles, sores in mouth creases, rough/wirey hair

Question 6

Other signs and symptoms: (5)

Answer 6

Diarrhoea, weight loss, lethargy, steatorrhoea, bloating

Question 7

Treatment (4)

Answer 7

Encourage oral feeding but can use jejunal or enteric, (polymeric, elemental and disease specific feeds are available), protected meal times, adequate support with feeding, identify those at risk