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Clin Med III Exam I > Nutritional disorders > Flashcards

Flashcards in Nutritional disorders Deck (40)
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1
Q

What is your basal energy expenditure

A

amount of energy required to maintain basic physiologic function

2
Q

What are the three factors that play a role in energy expenditure?

A
  • basal energy expenditure
  • thermic effect of food
  • physical activity
3
Q

How is a persons BEE measured

A

patient resting in a warm room, not having eaten for 12 hours

4
Q

What is the equation that can be used to estimate BEE

A

Harris Benedict equation

5
Q

What is the thermic effect of food

A

amount of energy expended during and following the ingestion of food

6
Q

Which fatty acid is required by the body? Why?

A

linoleic acid

lack can lead to dermatitis, hair loss, impaired wound healing

7
Q

Most important lab in the evaluation of protein-calorie undernutrition

A

albumin

8
Q

Kwashiorkor syndrome

A

deficiency of protein in presence of adequate energy

enough calories, not enough protein

9
Q

Marasmus syndrome

A

combined protein and energy deficiency

10
Q

When does Kwashiorkor typically develop in industrialized countries

A

secondary to things like trauma, sepsis, and burns

losing proteins

11
Q

When does Marasmus typically occur in industrialized countries

A

chronic disease states

12
Q

Where does protein loss begin? Where does it progress to?

A

starts with skeletal muscle and progresses to liver, GI tract, kidneys and heart

13
Q

Low protein affect on liver. Heart. Respiratory. GI. Immune.

A

Liver: hepatic synthesis slows, circulating proteins decrease

Heart: decreased CO, poor contractility

Respiratory: reduced lung volumes

GI: malabsorptions

Immune: decreasing cell function–> risk for infection

14
Q

Where does muscle wasting first present

A

thenar eminence and temple

15
Q

Treatment of protein-energy malnutrition

A

call a nutrition consult!

16
Q

What body weight can lead to a diagnosis of anorexia

A

15% below the expected weight

17
Q

What is the other finding that should make you think about anorexia

A

amenorrhea

absence of 3 menstrual cycles

18
Q

Clinical features of bulimia

A

fluctuation of body weight, family and psychological issue, impulsive or antisocial behavior

19
Q

Tx of bulimia

A

refer to psychiatrist

-anti depressants

20
Q

Most common type of anemia? What is it until proven otherwise?

A

iron deficiency

bleeding until proven otherwise

21
Q

What are the stages of iron deficiency

A
  • depletion of iron stores without anemia
  • anemia with a normal red blood size
  • anemia with a low MCV, low reticulocyte count
22
Q

Signs of severe Fe deficiency

A

skin and mucosal changes

  • smooth tongue
  • brittle nails
  • spooning of nails
  • cheilosis
23
Q

Tc of FE deficiency

A

identify cause

ferrous sulfate PO

24
Q

When do you give parentral iron

A
  • refractory to PO iron
  • GI disease
  • dialysis
25
Q

Most common cause of thiamine deficiency

A

chronic alcoholism

26
Q

What are the early sx of thiamine def

A
  • anorexia
  • muscle cramps
  • paresthesias
  • irritability
27
Q

Late sx of thiamine def

A

cardiovascular dys, neurological dys

28
Q

What is wet beriberi? Sx?

A

peripheral vasodilation caused by high output heart failure

Sx: dyspnea, tachy, cardiomegaly, edema

29
Q

What is dry beriberi?

A

perhipheral nerve involvement causing motor and sensory neuropathy, paresthesias and loss of reflexes

30
Q

What is Wernicke-Korsakoff syndrome

A

severe complication causing encophalopathy, amnesia, confabulation

31
Q

What do you need to absorb B12

A

intrinsic factor

32
Q

What is pernicious anemia

A

autoimmune disease where the autoantibodes against parietal cells that produce intrinsic factor

no intrinsic factor=no B12

33
Q

Who is at risk for b12 def

A

pts with hx of abd surgery, alcoholic, elderly

34
Q

What type of anemia does b12 def cause

A

macrosidic with hypersegmented neutrohils

35
Q

How do you treat b12 def

A

IM b12 daily for first week, weekly for first month, monthly for life

36
Q

Typical cause of folic acid def

A

lack of dietary intake

37
Q

Type of anemia caused by folic acid def

A

macrocidic

38
Q

How is vit D synthesized

A

synthesized in skin during exposure to UVB light and through diet

39
Q

Vit D def causes

A

osteomalacia

40
Q

Tx of Vit D def

A

ergocalciferol or cholecalciferol