Malnutrition

Question 1

What is NICE definition of malnutrition

Answer 1

BMI<18.5 OR

unintentional weight loss greater than 10% within the last 3-6 months
OR

BMI <20 and unintentional weight loss greater than 5% within last 3-6 months

Question 1

What is first line investigation

Answer 1

MUST

categorises patients into low,medium and high risk

Question 2

What are the components of MUST and what scores are given

Answer 2

BMI
>20 =0
18.5-20=1
<18.5 =2

Weight loss score
unexplained weight loss in 3-6 months
<5%= 0
5-10=1
>10% = 2

Acute disease effect
-if patient is acutely ill AND there has been or is likely to be no nutritional intake for >5 days

Question 3

How do you interpret the overall risk of malnutrition using MUST

Answer 3

0- low risk
1- medium risk - observe
2 or more-high risk - treat

Question 4

What is management for malnutrition

Answer 4

dietician support if patient at high risk

food-first approach always

Question 5

What and when is enteral feeding considered

Answer 5

consider if unsafe/ inadequate oral intake with functional GI tract

can be either NGT, NJT

Question 6

What are some complications of enteral feeding

Answer 6

diarrhoea
aspiration
metabolic
– hyperglycaemia
–refeeding syndrome

Question 7

What is parenteral nutrition

Answer 7

used in nutritionally compromised surgical patients with no functioning GI tract

food is given through vein

Question 8

What is risks and complications for parenteral feeding

Answer 8

thrombophlebitis

sepsis, refeeding syndromes, hepatic dysfunction