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Block 32- GI/surgery > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

malnutrition=

A

insufficient dietary intake to meet metabolic requirements

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2
Q

malabsorption

A

digestive tract disorder inability to utilise an appropriate dietary intake

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3
Q

2 types of malnutrition

A
  • protein energy malnutrition

- specific nutrient malnutrition

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4
Q

kwashiorkor=

A

protein lack

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5
Q

marasmus=

A

total dietary lack

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6
Q

dysphagia=

A

inability to swallow

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7
Q

iron deficiency anaemia=

A

microcytic

hypo chromic

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8
Q

vitamin A deficiency=

A

night blindness

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9
Q

who often has vitamin B deficiency

A

alcoholics

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10
Q

B1 deficiency= (2)

A

cardiomyopathy

encephalopathy

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11
Q

B3 niacin deficiency=

A

pellagra

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12
Q

pellagra symptoms= (4)

A

diarrhoea
dermatitis
dementia
death

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13
Q

B12 deficiency= (5)

A
  • megaloblastic anaemia
  • neuropathy
  • SACD
  • ataxia
  • dementia
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14
Q

B2 deficiency=

A

stomatitis

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15
Q

B6 deficinecy=

A

neuropathy

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16
Q

folic acid anaemia=

A

megaloblastic

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17
Q

vitamin D deficiency =

A

osteomalacia / rickets in children

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18
Q

vitamin C deficiency =

A
  • scurvy

- impaired wound healing

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19
Q

scurvy characterised by (3)

A
  • red-blue spots on skin
  • fatigue
  • limb pain (legs)
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20
Q

vitamin K deficiency leads to lack of which clotting factors

A

II
VII
IX
X

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21
Q

measurement scale for malnutrition in hospital

A

malnutrition universal screening tool (MUST)

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22
Q

enteral=

A

delivery of nutritionally complete food directly into stomach duodenum or jejunum

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23
Q

who can enteral feeding be given (2)

A

oral feeding or tube feeding

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24
Q

what does nasogastric tube bypass

A

mouth and oesophagus if patient has dysphagia or can’t coordinate swallowing

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25
Q

if enteral feeding is going to last >4-6 weeks what is used

A

enterostomy feeding -percutaneous

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26
Q

parenteral feeding=

A

intravenous administration of nutrients

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27
Q

when is a peripheral line used for parenteral feeding

A

<2 weeks of feeding

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28
Q

longer than 2 weeks of parenteral feeding requires

A

central access - central catheters tunnelled subclavian vein central lines

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29
Q

when makes tolerance to peripheral line feeding better

A

low osmolarity
neutral pH
soft paediatric cannulas

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30
Q

clinical features of malabsorption

A 
chronic diarrhoea 
weight loss
steatorrhea 
vitamin and iron deficiencies 
central and peripheral oedema
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31
Q

most iron is absorbed in the

A

duodenum

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32
Q

most common nutritional anaemia=

A

iron

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33
Q

B12 absorbed mainly in the

A

ileum

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34
Q

most common inflammatory disorder of the small bowel=

A

coeliac disease

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35
Q

what is coeliac disease an exaggerated autoimmune response to

A

gliadin

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36
Q

3 main food groups containing gluten

A

wheat
barley
rye

37
Q

what happens to the small intestine in coeliac

A

shortening of the villi lining the small intestine + villous atrophy

38
Q

most common blood disorder of coeliac

A

iron deficiency anaemia

39
Q

treatment for coeliac

A

life-long gluten free diet

40
Q

coeliac symptoms after eating gluten (4)

A
  • chronic diarrhoea
  • abdominal discomfort
  • malabsorption
  • loss of appetite
41
Q

blood test in coeliac

A

TTG

42
Q

blood condition of Crohn’s

A

megaloblastic anaemia -as Crohn’s mainly affects terminal ileum

43
Q

diverticulosis symptoms (4)

A
  • pain in epigastrium
  • muscle guarding
  • change in bowel habit
  • palpable mass and tenderness on left side
44
Q

most common place for diverticular

A

sigmoid colon

45
Q

what can diverticular disease be related to

A

a low fibre diet and constipation

46
Q

possible consequences of diverticulitis (4)

A
  • bowel perforation
  • abscess formation
  • fistula formation
  • general peritonitis
47
Q

symptoms of haemorrhoids

A

perianal discomfort
pruritus ani
rectal bleeding
mucus stool

48
Q

are haemorrhoid cushions normally present

A

yes

49
Q

what are haemorrhoids made off (3)

A

sinusoids
connective tissue
smooth muscle

50
Q

what are haemorrhoid cushions important for (2)

A
  • continence -provide anal closure at rest

- protect internal/external anal sphincters

51
Q

2 types of haemorrhoids

A

internal

external

52
Q

where are internal haemorrhoids found

A

above the dentate /pectinate line

53
Q

what covers internal haemorrhoids

A

columnar epithelium

54
Q

are internal haemorrhoids painful

A

no -unless strangulated blood supply

55
Q

where do external haemorrhoids occur

A

below the dentate line

56
Q

are external haemorrhoids normally painful

A

yes

57
Q

anal fissures symptoms (4)

A
  • sharp, stinging pain during defection
  • pain lasting after passing stool
  • pruritus ani
  • rectal bleeding
58
Q

what is an anal fissure

A

tear in lower part of rectum

59
Q

what can cause anal fissures (7)

A 
trauma 
chronic diarrhoea
large stool 
constipation 
childbirth 
anal intercourse 
Crohn's
60
Q

what does calprotectin in stool indicate

A

Crohn’s disease

61
Q

right colon cancer symptoms (5)

A
  • malaise
  • weight loss
  • vague abdo pain
  • palpable mass
  • iron deficiency anaemia
62
Q

left colon cancer symptoms (4)

A
  • obstructive symptoms
  • colicky abdo pain
  • change in bowel habit
  • passage of mucus
63
Q

rectal tumours symptoms

A

rectal bleeding
mucus discharge
tenesmus

64
Q

anal cancer is what type of cancer

A

squamous cell carcinoma

65
Q

biggest risk factor for anal cancer=

A

HPV

66
Q

first line treatment for anal cancer =

A

chemotherapy

67
Q

2 inherited conditions for bowel cancer

A

FAP

HNPCC

68
Q

what mutations occurs in FAP

A

APC

69
Q

what is APC

A

a tumour suppressor gene

70
Q

what does APC regulate

A

beta catenin -which coordinates DNA replication

71
Q

sequence of mutation in FAP

A 
APC
APC -Beta catenin 
K-RAS 
TP53 
Telomerase
72
Q

other name for HNPCC

A

lynch syndrome

73
Q

what part of the colon does HNPCC mainly affect

A

right colon

74
Q

what is the defect in HNPCC

A

DNA mismatch repair causing

microsatellite instability

75
Q

2 types of sporadic colon cancer

A

chromosome instability pathway (85%)

CpG island methylater phenotype (15%)

76
Q

when are investigations of rectal bleeding indicated (3)

A
  • strong family history/ anxiety about colorectal cancer
  • persistent rectal bleeding
  • history of pelvic radiotherapy
77
Q

> 40 urgent referral if

A

rectal bleeding+ change in bowel habit >6 weeks

78
Q

> 60 urgent referral if

A

rectal bleeding >6 weeks without change in bowel habit

79
Q

what investigation not to use for colorectal cancer

A

barium enema

80
Q

suspect colorectal cancer –>

A

urgent 2 week referral

81
Q

best treatment for haemorrhoid

A

rubber band ligation

82
Q

when is a haemorrhoidectomy indicated

A

bleeding or prolapsing haemorrhoids not responding to treatment

83
Q

treatment options for haemorrhoids (4)

A
  • lifestyle changes
  • topical corticosteroids
  • rubber band ligation
  • sclerotherapy
84
Q

treatment for anal fissures

A

glyceryl trinitrate ointment

85
Q

what does glyceryl trinitrate due

A

relaxes the muscle in the back passage

86
Q

in secondary care what is anal fissure treatment

A

diltiazem ointment

87
Q

diverticular disease treatment

A
  • high fibre diet
  • adequate fluid intake
  • bulk-forming laxatives
88
Q

2 bulk-forming laxatives

A

ispaghula

methylcellulose

89
Q

avoid what drugs in diverticulosis

A

avoid NSAID or opioid analgescis

Block 32- GI/surgery (9 decks)

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