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*B32 GI and Surgery* > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

Refeeding syndrome

A

Complication resulting from rapid reintroduction of feeding following starvation

Causes metabolic imbalances

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2
Q

Metabolic imbalances seen in Refeeding syndrome

A

Hypophosphataemia
Hypokalaemia
Hypomagnesaemia
Abnormal fluid balance

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3
Q

What are the complications of refeeding syndrome

A

Arrhythmias
Respiratory/Cardiac failure
Rhabdomyolysis, weakness, seizure

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4
Q

Which patients are at high risk of refeeding syndrome

A

BMI <18.5
Unintentional weight loss >15% over last 3-6 months
Little nutritional intake >5 days
History of alcoholsm, cancer, insulin therapy, chemotherapy

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5
Q

Treatment of refeeding syndrome

A

Introduce small amounts of food

Additional vitamin supplements - thiamine, vitamin B

Monitor FBCs, UE, PO4, Mg

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6
Q

Parenteral feeding (IV) can be done via

A

PICC line (central catheter via basilic vein)

Central venous catheter (subclavian line)

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7
Q

Deficiency of Vitamin D can cause..

A

Osteomalacia and rickets

Sign = proximal weakness of limbs

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8
Q

Deficiency of Vitamin K can cause..

A

Poor clotting

Sign= bruising, bleeding

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9
Q

Deficiency of Vitamin B1/thiamine can cause..

A

Beri Beri (Wet and dry)

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10
Q

Wet Beriberi

A

Affects CV system

Left-ventricular HF
Leg swelling
Tachycardia
Tachypnoea

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11
Q

Dry beriberi

A

Affects nervous system

Motor and sensory neuropathy of hands and feet

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12
Q

B12 deficiency causes

A

Pernicious anaemia (macrocytic)

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13
Q

Deficiency of Niacin can cause..

A

Pellagra

3Ds =
Dermatitis
Diarrhoea
Dementia

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14
Q

Pellagra is common in

A

Alcoholics

Those on isoniazid (TB)

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15
Q

Vitamin C deficiency can cause

A

Scurvy

Gingivitis
Bleeding

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16
Q

Coeliac disease =

A

Autoimmune condition

Sensitivity to gluten

17
Q

Which genes are associated with coeliac disease

A

HLA-DQ2 (95%) HLA-DQ8 (80%).

18
Q

Which patients should be screened for Coeliacs?

A 
Autoimmue thyroid disease
Dermatitis herpetiformis
IBS
T1D
First-degree relatives with coeliac disease
19
Q

Main symptoms of coeliacs

A 
Diarrhoea 
Failure to thrive in children
Persistent and unexplained GI symptoms = abdo pain, NandV, cramping
Prolonged fatigue
Unexplained iron deficiency anaemia
20
Q

Coeliacs tends to affect __________ of small intestine

A

Duodenum

21
Q

Histology of Coeliacs

A 
Villous atrophy (Flat mucosa)
Crypt hyperplasia  Infiltration with lymphocytes
22
Q

Investigation for Coeliacs

A

TTG Ab (Tissue transglutaminases)

Endomyseal Ab (IgA)

23
Q

Intestinal causes of malabsorption

A

Coeliac disease

Crohn’s disease

24
Q

Pancreatic causes of malabsorption

A

chronic pancreatitis
cystic fibrosis - Pancreatic insufficiency
pancreatic cancer

25
Q

Biliary causes of malabsorption

A

biliary obstruction
primary biliary cirrhosis

Lack of bile for fat absorption

26
Q

Pancreatic insufficiency =

A

Inability of exocrine pancreas to secrete digestive enzymes

Pancreatic proteases (trypsin and chymotrypsin), amylase, lipase

27
Q

In which conditions do you tend to see pancreatic insufficiency

A

Chronic pancreatitis

CF

28
Q

Pancreatic insufficiency

A

Creon (contains enzymes)

29
Q

Pancreatic insufficiency symptoms

A

Maldigestion, malnutrition and ↓levels of micronutrients, vitamins, lipoproteins

Steatorrhea common

30
Q

Pancreatic insufficiency investigations

A

Faecal pancreatic elastase-1

31
Q

Kwashiorkor

A

Malnutrition caused by a PROTEIN deficiency

Oedema is present
subcut fat still present

32
Q

Marasmus

A

Malnutrition caused by a deficiency of everything

Tend to look emaciated (loss of muscle mass, prominent bones)

33
Q

Intrinsic factor is produced by _______ cells in __________ and is needed for ____ absorption

A

Parietal cells
Fundus and body of stomach
B12

34
Q

What might cause a decrease in intrinsic factor

A

Autoimmune condition = pernicious anaemia -> B12 deficiency

Gastrectomy (removing part of stomach that reduces IF production)

35
Q

Reduced B12 absorption =

A

Can cause neurological problems (numbness and tingling in hands and feet)

36
Q

Vitamin C (ascorbic) deficiency symptoms

A

SCURVY

Gingivitis and bleeding gums

*B32 GI and Surgery* (9 decks)

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