Nutritional deficiency PPT (Obesity lecture) - Josh Flashcards Preview

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Flashcards in Nutritional deficiency PPT (Obesity lecture) - Josh Deck (54):
1


What are 5 types of nutritional Disorders

 

  1. Anorexia Nervosa
  2. Bulimia Nervosa
  3. Binge Eating
  4. Malnutrition
  5. Micronutrient

2


What are 3 Malabsorption Syndromes

 

  1. Caloria Deficieny
  2. Micronutrient Deficiencies
  3. Vitamin Deficiency

3


Nutritional Disorders:

using the categories below define Anorexia

  1. Weight
  2. Eating habits
  3. Body image
  4. Physical symptoms
  5. Emotional symptoms
  6. Relationships

  1. Underweight
  2. takes in fewcalories
  3. think they are fat
  4. weight loss, low bp, heart/kidney problems, LANUGO
  5. Depression, OCD, Anxiety
  6. withdrawn

4

Nutritional Disorders:

using the categories below define Bulimia

  1.     Weight
  2.     Eating habits
  3.     Body image
  4.     Physical symptoms
  5.     Emotional symptoms
  6.     Relationships

  1. normal or overweight
  2. Binge & Purge
  3. obsesed w/ weight
  4. Weight flunctuation, ulcers/sores in mouth, dehydration, dental problems
  5. Depression, guilt, anxiety
  6. withdrawn but able to be around others

5


Nutritional Disorders:

using the categories below define Binge eating

  1.     Weight
  2.     Eating habits
  3.     Body image
  4.     Physical symptoms
  5.     Emotional symptoms
  6.     Relationships

  1. Overweight
  2. Binges large amount of food in short period
  3. overy focused on weight and appearance
  4. excessive weight gain, High bp, DM,
  5. depression, guilt
  6. withdrawn overly sensitive

6

Nutritional Disorders: Anorexia

Is defines as the maintenance of body weight less than __% of that expected for age and height, or failure to make expected weight gain during period of growth!


85%

7


Nutritional Disorders: Anorexia

what are the 2 types

  1. Restrictive
  2. Binge /Purge

8


Nutritional Disorders: Anorexia

what is the restrictive type?


restriction of food intake on their own and does not engane in binge-eating or purging behavior

9


Nutritional Disorders: Anorexia

what is teh binge eating/purging type


The individual self-induces vomiting or misuses laxatives, diuretics, or enemas

10


Nutritional Disorders: Anorexia

CV s/s

 

  • Hypotension
  • bradycardia
  • MV prolapse
  • Decreased Myocardial contractility
  • Cardiomyopathy

11


Nutritional Disorders: Bulimia

Is defines as eating an amount of food that is significantly ______ than most people would eat under similar circumstances w/ inappropriate compensatory behaviors to prevent weight gain.


larger

12


Nutritional Disorders: Bulimia

they typical pattern of behavior is calorie restriction, binge eatin, and self induced vomiting occuring on average at least __ x's a weeks for ____ months, and is commonly assosciated w/ depression

 

  • 2 times a week
  • 3 months

13


Nutritional Disorders: Binge eating

Binge eating resembles Bulimia, but in contrast binge patients do not what?

Purge

14



Nutritional Disorders: Binge eating

the principle medical complications w/ binge eating are what?

 

  • Morbid Obesity
  • HTN
  • NIDDM
  • high cholesterol
  • Joint disorders
  •  

15



Nutritional Disorders: Anesthetic Implications

Preop:

What do you look for on PE

  • S/S of starvation
  • Medication abuse 9amphetamines, diuretics, laxatives)

16

 

Nutritional Disorders: Anesthetic Implications

Preop:

Are EKG and ECHOs warrented in these pt's? why or why not?

 

  • EKG- Yes- to detect cardiovascular function
  • ECHO- only in severe instances

17

 

Nutritional Disorders: Anesthetic Implications

Preop:

What Labs do you want

 

  • Blood and Urine
  • especially Electrolytes

18

 

Nutritional Disorders: Anesthetic Implications

Preop:

Why is an airway assessment so important w/ these pt's

 

  • Dental disease including periodontal disease are VERY likely

19

 

Nutritional Disorders: Anesthetic Implications

Preop:

What metabolic disorder is popular w these pt's secondary to purging?


Metabolic Alkalosis (frequently present w/ increased bicarb concentrations)

 

(fun fact how I remeber alkolosis vs acidosis w/ pt how vomit and shit, if it comes out the ASS it is ASSidosis, if out the mouth its just he other)

20

 

Nutritional Disorders: Anesthetic Implications

Intraop:

what should you be vgalent for in these individuals

 

 

  • Abnormal ECGS
  • Prologed QT
  • multi organ failure

21

Nutritional Disorders: Anesthetic Implications

Intraop

what medicatio are these pt's specifically sensitive to?


reversal for NMBD

22


Nutritional Disorders: Anesthetic Implications

Intraop:

What are 2 important task in these pt's?

 

  • HYDRATE
  • NGT/OGT gastroporesis (may want to place prior to induction)

23


Malabsorption Syndromes:

The ______ _______ does most the digesting of the foods we eat?


small intestines

24



Malabsorption Syndromes:

if you have a malabsorption Syndrome your ____ _____ connot absorb nutrients from food


Small intestine

(cathing on to a theme here?)

 

25



Malabsorption Syndromes:

What causes Malabsorption Syndromes?

 

  • Celiac disease
  • Lactose intolerance
  • Short Bowel
  • Whipple disease (rare bacteria infection0
  • Genetic diseases
  • Certain Medications

26


Malabsorption Syndromes:

what are 3 classifications of malabsorption syndromes

Malnutrition

Micronutrient Deficiences

Vitamin deficiencies

27



Malabsorption Syndromes:

Which subtype is defined as an altered metabolism due to an imbalance of intake and nutrient dense food resulting in loss of body mass or a deficiency in energy, protein, and other nutrients which cause measurable adverse effects


Malnutrition

28


Malabsorption Syndromes: Malnutrition

Malnutrition is a meddically distinct syndrome that is responsive to caloric support provided by _____ or _____ nutrition


enternal

or

TPN

29

Malabsorption Syndromes: Malnutrition

what are major causes of malnutrition in hospitals

 

  • N/V
  • Trauma
  • Inflammatory disease
  • Loss of appetite
  • Mechanical obstruction

30


Malabsorption Syndromes: Malnutrition

what are the SE of malnutrition

 

 

  • reduced Muscle strength
  • Hypothermia
  • Loss of cardiac muscle
    • decreased CO, bradycardia, hypotension
  • Decreased GFR
  • Infection response weakened
  • Electrolyte inbalances
  • Higher concentrations of water

 

31


Malabsorption Syndromes: Malnutrition

Malnurished pt's are identifeied by what?

 

  • Serum albumin concentration < 3g/dL
  • Transferrin Levels below 200 mg/dL

32


Malabsorption Syndromes: Malnutrition

malnutrition is associated w/ increased morbidity and mortality due to what mpaired symptoms?

 

  • Respiratoy
  • CV
  • Renal
  • Immune response

33


Malabsorption Syndromes: Malnutrition

an average adult requires how many calories daly to mantain basal energy levels

1500-2000

34


Malabsorption Syndromes: Malnutrition

What are 4 main events that can increase the caloric requirement? and for fun by how much?

 

  • Increase in Body temp (1 degree C=15% increase)
  • Multiple fractures (25% increase)
  • Major Burns (100% increase)
  • large tumor (100% increase)

35


Malabsorption Syndromes: Malnutrition

Preop

it is reccomended that pt's who have lost more than ____% of their body weight, they should be treated nutritionally before undergoing elective sx

20%

36


Malabsorption Syndromes: Malnutrition

Preop

Provision of nutritional support for ___ days before sx decreases the postoperative complications, especially in pts w/ gastrointestinal Ca and elderly pt's undergoing sx for hip fxs

 

7 days

37


Malabsorption Syndromes: Malnutrition

Preop

why are antibiotics given prophylacticly in these pt's


b/c changes in GI flora increases the susceptibility to infections

38


Malabsorption Syndromes: Malnutrition

Intraop

what are some important interventions for these individuals?

 

  • Care positioning (loss of body mass)
  • Maintain Body temp (bair hugger)
  • Hydrate
  • Sympathomemetics (bp)
  • expect a bad response to hypoxia and hypercarbia (due to decreased Muscle mass of respiratory muscles)

39


Malabsorption Syndromes: Malnutrition

Postop

why are they difficult to wean from vent?

 

  • decreased muscle mass and function
  • Prone to coughing

40

Micronutrient Deficiencies: Vit B12

the most significant effects of B12 def are seen in what system?


Nervous system

41


Micronutrient Deficiencies: Vit B12

treatment for B12 def

 

  • oral B12
  • increase foods high in B12
  •  

42


Micronutrient Deficiencies: Vit B12

what is recomended intake of Vit B12


10-15mcg/day

43


Micronutrient Deficiencies: Vit B12

for food malabsorption induced Vit B12 deficiency what is the recomended replacement dose?


1,000 mcg/day

44


Micronutrient Deficiencies: Vit D

A deficiency in Vit D has been associated w/what dysfunctions

 

  • muscle weakness
  • Functional impairment
  • Depression
  • Increased risk of fx

45


Micronutrient Deficiencies: Vit D

pt's w/ a vit D def may also present with _____calcemia and _____ serum parathyroid hormone (PTH)


hypocalcemia

High

46


Micronutrient Deficiencies: Vit D

there has been studies that show a corrolation b/t low Vit D and increased prevalence of what other Health disorders

DM

HTN

Hyperlipidemia

PVD

47


MENs

what does it stand for?


Multiple

Endocrine

Neoplasm

syndromes

48


MENs:

what are the different classes


MEN 1

MEN 2A

MEN 2B

49


MENs:

what is MENs?


rare autosomal dominat conditions that predispose affected individuals to benign and malignant tumors of the endocrine and non endocrine organs

50


MENs:

How do these syndromes differ from other hereditary cancer syndroms?


most of these tumors occur in hormone-secreting glands

51


MENs:

The fact that they occur in mostly hormone secreting glands, gives this syndrome 2 primary consequences of clinical importance. What are they?

 

  1. Excess hormone production-results in hormonal syndromes
  2. Excess hormone production serves as a sensitive tumor marker

52


MENs:

where are the tumors located with each type?

 

  1. MEN 1 (PPP)
    • Pancrease
    • Parathyroid
    • Pituitary
  2. MEN II (PPM)
    • Phenochromocytoma
    • Parathyroid
    • Medullary thyroid Ca
  3. MEN III (IIB) (PMM)
    • Phenochromocytomas
    • Mucocutaneous Tumors
    • Medullary Thyroid Ca

53


MENs:

Preop eval?

 

  • Thorough H&P
  • EKG
  • Labs
  • Attenuation of symptoms

54

thats if for this shit


fucking gay and probally no good questions