Gastroenterology Flashcards
List the daily requirements of fat, protein and carbohydrate utilised by the body
men = 2500 cals/day, women = 2000cals/day
55-70% carbs, 30% fat, 15% protein
0.75g protein/Kg
List the water soluble and fat-soluble vitamins
Water soluble: B,C
Fat soluble: A, D, E and K
List the incidence and complications 8 of undernutrition
25-33% of hospital patients are subject to undernutrition. Complications: Muscle wasting Poor immune function Depression Anxiety Loss of libido Poor wound healing fatigue Failure of reproductive system
List the indications for insertion and removal of a nasogastric tube and describe alternative methods of gastric intubation
NG tubes are used to drain the stomach eg intestinal obstruction or to feed the patient (stroke, oesophagus surgery, high risk of aspiration.
A PEG may be inserted - Useful for those who need feeding over 30 days.
Specify the definition, approximate prevalence and the risk factors 7 for obesity
A BMI of over 30. Class 1 (moderate) 30-35, class 2 (severe) 35-40, class 3 (morbidly) >40. 25% of UK adult population is obese RFs: Hypothyroidism Poor Increased energy intake Sedentary lifestyle Giving up smoking Hyopthalamic damage Corticosteroid treatment
What are the clinical consequences of obesity?
Mechanical: Osteoarthritis and lower back pain, stress incontinence
Metabolic Syndrome: Hypertension, MI, stroke, DVT, PE, T2DM.
Malignancy: Such as breast, uterus and CRC - due to steroid conversion in peripheral adipose tissue. Humoral: Menstrual abnormality/erectile dysfunction/infertility.
Respiratory Restriction: Sleep apnoea, asthma.
Abdominal: Non-alcoholic fatty liver disease, GORD, hiatus hernia, gall stones,
Inability to maintain hygiene: Skin infections,
Psychological Consequences: Stress, low self-esteem, inability to exercise/fit-in etc.
How is BMI calculated?
Weight divided by Height squared
Describe main interventions used in management of obesity
Counseling: Less food, more exercise Drugs - Orlistat Surgery - BMI<40 potentially over 35. Vertical banded gastroplasty (anastomose GOJ with GDJ) Laproscopic banding Roux-en-Y gastric bypass
