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GI > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What is malnutrition

A

A state of nutrition in which a deficiency, excess or imbalance of nutrients causes measurable adverse effects on tissue, body form, function and clinical result

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2
Q

Cause of malnutrition

A

Decrease intake - Poor appetite, dysphagia
Impaired digestion/absorption
Increased nutritional requirements
Increased nutrient loss - Vomiting, diarrhoea, stoma loss

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3
Q

Impact of malnutrition

A

GI dysfunction, increase incidence of infection, decrease wound healing. This leads to less food intake which eventually leads to more malnourishment

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4
Q

What happens to water and Na in starvation

A

There is an initial loss, retention later on

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5
Q

Why should saline be administered carefully to starved patients

A

Starvation leads to retention of Na and water, hence giving saline could make this worse

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6
Q

Metabolic rate in starvation vs injury

A

Decrease in starvation, increases in injury

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7
Q

Nitrogen loss in starvation vs injury

A

Starvation goes down, injury goes up

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8
Q

What happens to insulin in starvation

A

Decreases as body needs more Glucose in blood

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9
Q

Tool to assess malnutrition risk in patients

A

MUST - Malnutrition Universal Screening Tool

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10
Q

Common nutritional assessment tools

A

Mid-arm muscle circumference, triceps fat % and grip

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11
Q

Who needs nutritional support

A

BMI < 18.5, unintentional weight loss > 10% in last 3-6 months or BMI < 20 with unintentional weight loss > 5% within 3-6 months. Eaten little or nothing past 5 days

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12
Q

Forms of nutritional support available

A

Food fortification and dietary counselling
Oral nutrient support - snacks/supplements
Enteral feeding - Tube into the gut
Parenteral feeding - Nutrition intravenously

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13
Q

How can nutritional content of food be increased without increasing volume consumed

A

Fortification of food, adding full cream milk, cheese, butter
Small frequent meals

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14
Q

Example of oral nutritional supplements

A

Ready made drinks, powders, puddings, fat supplement (Calogen)

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15
Q

Indications for enteral tube feeding

A

Inadequate or unsafe oral intake due to unconscious patient, neuromuscular swallowing disorder, upper GI obstruction, GI dysfunction or increase nutrition need

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16
Q

Contraindication for enteral tube feeding

A

Lower GI obstruction, prolonged intestinal ileus, severe diarrhoea or vomiting, intestinal fistula

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17
Q

Type 1 intestinal failure indications for parenteral feeding

A

Severe malnutrition pre-op, post-op feeding, intestinal fistulae, post chemo mucositis

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18
Q

What is malabsorption

A

Defective mucosal absorption

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19
Q

Cause of malabsorption

A

Defective luminal digestion, mucosal disease, structural disorders

20
Q

Broad types of malabsorption of proteins, lipids, carbs

A

Digestive or absorptive

21
Q

Most common vitamin deficiency

A

Iron

22
Q

What is tropical sprue

A

Colonisation of intestine by infectious or alternation in bacterial flora

23
Q

Treatment for tropical sprue

A

Tetracycline + Folic acid

24
Q

Whipples disease

A

Rare bacterial infection caused by Tropheryma whipplei that interferes with normal digestion by impairing breakdown carbohydrates and fats and hamper ability to absorb nutrients

25
Q

Symptoms of Whipples disease

A

Weight loss, diarrhoea, steatorrhea, abdominal pain, arthritis, fever, nutritional deficiency

26
Q

Cause of Giardia lamblia

A

Contaminated water supply

27
Q

Diagnosing Giardia lamblia

A

Examination of stool for ova and parasites. 3 separate stool samples increase yield of positive result

28
Q

Treatment for Giardia lamblia

A

Metronidazole 1 week

29
Q

What is macrocytic anaemia

A

Anaemia due to abnormal increase in size of RBC

30
Q

What can small bowel overgrowth cause

A

Diarrhoea, steatorrhea and macrocytic anaemia

31
Q

Diagnosing small bowel bacterial overgrowth

A

Low cobalamin (B12) and high folate levels. Best way is Schilling test

32
Q

Treatment of small bowel bacterial overgrowth

A

Tetracyclines 2-3 weeks

33
Q

Common disease states causing malabsorption

A

Liver, pancreas and small bowels

34
Q

Diarrhoea as a symptom

A

Duration, floating, hard to flush away, offensive smelling, fat globules

35
Q

What deficiency makes you prone to bleeding gums

A

Vitamin C and K

36
Q

What is acrodermatitis enteropathica

A

Autosomal recessive disorder characterized by diarrhoea and an inflammatory rash around the mouth or anus

37
Q

What causes acrodermatitis enteropathica

A

Impaired Zinc uptake

38
Q

Symptoms of acrodermatitis enteropathica

A

Perioral dermatitis, acral dermatitis, alopecia (hair loss)

39
Q

Treatment of acrodermatitis enteropathica

A

Life long Zinc supplements

40
Q

What is dermatitis herpetiformis

A

Itchy, blistering, burning skin rash. May indicate coeliac disease

41
Q

What may cause dermatitis herpetiformis

A

Sub epithelial IgA deposition

42
Q

What is angular chelitis

A

Inflammatory condition affecting corners of the mouth. Also known as angular stomatitis

43
Q

What causes glossitis and angular stomatitis

A

B vitamins and Iron deficiency

44
Q

Cause of Koilonychia

A

Spoon nails, due to iron-deficiency

45
Q

Baseline investigations for liver disease

A

Full blood count, coagulation, liver function tests, albumin, calcium/magnesium, stool culture

46
Q

What does liver function test involve

A

Usually include prothromobin time (PTT/INR), albumin , bilirubin and others

GI (32 decks)

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