Malnutrition

Question 1

___________ refers to severe wasting of fat and muscle mass, due primarily to energy deficiency; it is most equivalent to “simple” starvation

Answer 1

Marasmus, or severe acute malnutrition (SAM)

Question 2

______ refers to edematous PEM, without wasting and classically attributed to “protein deficiency”; now clearly related to metabolic stress & inflammation

Answer 2

Kwashiorkor

Question 3

________ is a combination of chronic energy deficiency and chronic or acute protein deficit, and is manifested clinically with evidence of both wasting and edema.

Answer 3

Marasmic kwashiorkor

Question 4

Poor nutrition causes nearly _____ of the deaths of children under 5 yrs (= 3.1 million children/year)

Answer 4

half (45%)

Question 5

Malnutrition impairs the function of the _____ and the function of the _______.

Answer 5

immune system,

gastrointestinal tract

Question 6

The most common PEM for Infants (0-12 mo) is:

Answer 6

marasmus/severe wasting

Question 7

Older infants (12 - 24 mo): are at risk for which PEM

Answer 7

kwashiorkor; voluntary restrictive/alternative feeding

Question 8

who is at risk for Acute weight loss:

Answer 8

anorexia nervosa,
s/p bariatric surgery,
intentional restriction,
social deprivation

Question 9

Which chronic illnesses are risks for malnutrition

Answer 9

alcoholism,
pancreatitis,
HIV/AIDS,
malabsorption

Question 10

the elderly are at risk for Elderly:

Answer 10

wasting/loss of LBM (sarcopenia)

Question 11

what is considered the Ideal Body Weight in children

Answer 11

(50th percentile for Wt/ht)

Question 12

what is considered normal in Wt-for-Ht (deficit = wasting) ratio in children

Answer 12

90-110 % of ideal body weight

i.e. if the 50 percentile is 10 kg for a certain height, then normal would be 9-11 kg

Question 13

what is considered severe wasting in wt/ht growth charts

Answer 13

< 75 % ideal body weight ( 50th percentile), or w/ edema.

i.e. if the 50 percentile is 10 kg for a certain height, then severe wasting would be less than 7.5 kg

Question 14

what is considered mild wasting in Wt-for-Ht growth charts

Answer 14

80-89% of ideal body weight (50th percentile).

i.e. if the 50 percentile is 10 kg for a certain height, then mild wasting would would be 8-8.9 kg

Question 15

what is considered moderate wasting in wt/ht growth charts

Answer 15

75-79% of ideal body weight (50th percentile)

i.e. if the 50 percentile is 10 kg for a certain height, then moderate wasting would be 7.5-7.9kg

Question 16

In Ht-for-Age growth charts whats considered Normal,mild stunting, moderate stunting and severe stunting

Answer 16

Normal: 95-105 %
Mild: 90-94%
Moderate: 85-89%
Severe: < 85%

Question 17

Hepatomegaly, skin lesions, and edema are only seen in which PEM

Answer 17

KWASHIORKOR

Question 18

loss of functional reserve and loss of physiological responsiveness to stress are hallmarks of adaptation to ______

Answer 18

sever acute malnutrition (SAM). aka marasmus

Question 19

Fat reserves and muscle mass tend to be unaltered in ________

Answer 19

KWASHIORKOR

Question 20

Refeeding a starved person may result in predictable metabolic derangements, esp due to acute shifts from extracellular to intracellular spaces. Most common & potentially dangerous: _______

Answer 20

K+,
P, &
Mg++ (increased requirement with increased metabolism)

Question 21

what are Endocrine changes in response to starvation

Answer 21

Decreased: insulin, thyroid,
Increased: corticosteroid, epinephrine

Question 22

In response to starvation, the Basal Metabolic Rate is decreased which manifests itself as ______:

Answer 22

Hypothermia, hypotension, bradycardia

Question 23

how does the GI tract respond to starvation

Answer 23

mucosal atrophy, decreased secretions and motility

Question 24

Kwashiorkor is characterized by an “Abnormal” Adaptive Response: which include:

Answer 24

Increased insulin, decreased lipolysis (esp. w/ continued CHO )
Increased hepatic fatty acid synthesis -> fatty, enlarged liver