Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med 2 > Nutritional Disorders > Flashcards

Nutritional Disorders Flashcards

1
Q

Kwashiorkor

A

Protein energy malnutrition

Inadequate protein intake with reasonable energy (caloric) intake.
Edema is characteristic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Marasmus

A

Protein energy malnutrition

Involves inadequate intake of protein and calories. Characterized by emaciation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kwashiorkor is likely secondary to _____

A

Hypermaetabolic acute illness

Such as trauma, burns, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Marasmus is likely secondary to

A

Chronic diseases
COPD
Cancer
Aids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does Kwashiorkor differ from Marasmus?

A

K is adequate carbohydrate consumption and decreased protein intake lead to decreased synthesis of visceral proteins
The resulting hypoalbuminemia contributes to extravascular fluid accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens to the CV system when you have protein- energy malnutrition?

A

Decrease in CO and contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you see in the liver when you have a pt with protein energy malnutrition?

A

Hepatic synthesis of serum protein and levels of circulating proteins are decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ABCD components of the nutritional assessment

A

Anthropometric measurements
Biochemical assessment
Clinical examination
Dietary assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anthropometric measurements

A

Triceps skin fold and mid arm muscle circumference are most commonly used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What clinical signs will you see with marasmus?

A

Weight loss
Proceeds to cachexia
Body fat stores disappear
Muscle mass decreases, most noticeably in the temporalis and interosseous muscles

Serum albumin may be normal or slightly decreased, rarely decreasing to less than 2.8g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What clinical presentation might you see with kwashiorkor?

A

Rapid onset
May develop in pts with normal subcutaneous fat and muscle mass
Serum protein level typically declines and the serum albumin is often less than 2.8 g/dL
Dependent edema, ascites, or anasarca may develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most important laboratory test to dx protein-calorie undernutrition?

A

Serum albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do transferrin, transthyretin, and prealbumin tell you about the protein deficiency pt?

A

Reflect short term changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What lab tests, according to WHO, will you get for a suspected protein deficiency pt?

A 
Blood glucose 
Blood smears
Hemoglobin 
Urine exam and culture 
Stool examination by microscopy for Ova and Parasites 
HIV 
Electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment for protein deficiency?

A

Phase 1:
Correction of fluid and electrolyte abnormality
Treat any infections

Phase 2:
Repletion of protein, energy, and micronutrients
Concomitant admin of vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which vitamins are fat soluble?

A

A, D, E, and K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which vitamin deficiency is most common with EtOHers?

A

Thaimine (B1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to pts with thiamine deficiency present?

A

Anorexia
Muscle cramps
Paresthesias
Irritability

Advanced deficiency:

  • wet beriberi - CV syndrome
  • dry beriberi - peripheral and CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What clinical manifestation will you see with wet berberi?

A 
Peripheral vasodilation 
High output heart failure 
Dyspnea 
Tachycardia
Cardiomegaly 
Pulmonary edema
Peripheral edema
Warm extremities mimicking cellulitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What clinical presentation will you see with dry beriberi?

A

Peripheral nervous system:
-polyneruopathy - affecting leg, footdrop, wrist drop, areflexia

CNS:

  • Wernicke encephalopathy
  • Korsakoff syndrome amnesia
  • Wernicke - Korsakoff syndrome: both neurologic and psychaitric symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you dx thiamine deficiency?

A

Erythrocyte transketolase activity and urinary thiamine excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for thiamine deficiency?

A

Thiamin 50-100 mg IM or IV bid

When in doubt - banana bag before glucose!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vitamin B2 deficiency

A

Riboflavin

Primary - inadequate intake of fortified cereals, milk, and other animal products

Secondary - interactions with a variety of medications, alcoholism, and other causes of protein - calorie undernutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the clinical manifestation of riboflavin deficiency?

A 
Cheilosis
Angular stomatitis
Glossitis
Seborrheic
Dermatitis
Weakness
Corneal vascularization 
Anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do you dx riboflavin deficiency?

A

Measuring the riboflavin - dependent enzyme erythrocyte flutathione reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the tx for riboflavin deficiency?

A

Riboflavin 5-15 mg po once/day is given until recovery

Other water-soluble vitamins should also be given

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Niacin

A

Vitamin B3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where do we get niacin from?

A

Protein foods containing tryptophan (synthesized from the amino acid tryptophan), cereals, vegetables, and diary products

29
Q

What is the clinical manifestations for B3 deficiency?

A 
Anorexia
Weakness
Irritability 
Mouth soreness
Glossitis
Stomatitis
Weight loss

Advanced deficiency: 3D’s - Pellegra
Dermatitis
Diarrhea
Dementia

30
Q

Pellegra

A

Advanced vitamin B3 deficiency

3Ds
Dementia
Diarrhea
Dermatitis

31
Q

What is the treatment for niacin deficiency?

A

Oral niacin usually given as nicotinamide (10-150 mg/day)

32
Q

What is a potential side effect of high dose niacin?

A

Hyperlipidemia

Cutaneous flushing
Gastric irritation
Elevation of liver enzymes, hyperglycemia, and gout - less common

33
Q

Pyridoxine deficiency

A

Vitamin B6

In most foods - dietary deficiency is rare

34
Q

How do people get vitamin B6 deficiency?

A

Secondary deficiency from EtOH, interactions with pyridoxine inactivating drugs (INH, cycloserine, penicillamine)

35
Q

How does vitamin B6 deficiency present?

A 
Mouth soreness 
Glossitis
Cheilosis
Weakness
Irritability 
Peripheral neuropathy
Pellegra-like syndrome 
Anemia
Seziures
36
Q

What is the treatment for vitamin B6 deficiency?

A

10-20 mg/day PO vitamin B6 supplements

37
Q

What happens if you take too much B6?

A

B6 toxicity:
Sensory neuropathy
At times irreversible
Occurs in pts receiving large doses of vitamin B6 (200-2000 mg/day)

38
Q

Folate deficiency

A

Vitamin B9

39
Q

What are the clinical features of folate deficiency?

A

Vitamin B9

Loss of appetite and weight loss 
Weakness
Sore tongue
HA
Heart palpitations
Slow growth rate 
Greater risk NEURAL TUBE DEFECTS
40
Q

What might cause vitamin B12 deficiency?

A

Lack of IF secretion by gastric mucosa or intestinal malabsorption

41
Q

What are the clinical features of vitamin B12 deficiency?

A 
Macrocytic anemia 
Glossitis 
Peripheral neuropathy 
Weakness
Hyperreflexia
Ataxia
Loss of proprioception 
Poor coordination 
And affective behavioral changes 
Neurologic defects
42
Q

Pernicious anemia

A

Macrocytic anemia caused by vitamin B12 deficiency that is due to lack of IF secretion by gastric mucosa

43
Q

Ascorbic acid

A

Vitamin C

44
Q

What population is ‘at risk’ for vitamin C deficiency?

A

Chronic illness such as CA and chronic kidney disease

And pts that smoke

45
Q

Scurvy

A

Rare

But can be seen with severe deficiency of Vitamin C deficiency

46
Q

What are the clinical features of vitamin C deficiency?

A 
Fatigue 
Depression 
Connective tissue defects (gingivits, petechiae, rash) 
Internal bleeding 
Impaired wound healing

Scurvy is characterized by hemorrhagic skin lesions, abnormal osteoid and dentin formation

47
Q

Vitamin C toxicity

A

Gastric irritation
Flatulence
Diarrhea
Oxalate kidney stones

Vitamin c can cause false negative results on FOBT and both false neg and positive results for urine glucose

48
Q

Retinol

A

Vitamin A

49
Q

What is the cause of Vitamin A deficiency?

A

Fat malabsorption syndromes or laxative abuse.

50
Q

What are the clinical manifestations of vitamin A deficiency?

A

Night blindness
Dryness of conjunctiva
Bitot’s spots (white patches on conjunctiva)
Ulceration and necrosis of cornea (keratomalacia)
Perforation
Endophthalmitis
Hyperkeratosis

51
Q

What is the treatment for Vitamin A deficiency?

A

30,000 IU PO daily for 1 week

52
Q

What is the toxicity of vitamin A?

A

Staining of the skin a yellow-orange color but is otherwise benign
Marked on the palms and soles, while the sclera remain white

Teratogenicity
Alopecia
Ataxia
Hepatotoxicity

53
Q

Vitamin D has shown to be protective against…

A

CV disease
Cognitive impairment
Asthma
CA

54
Q

What is the treatment for vitamin D?

A

50,000 IU/week for 6-8 weeks followed by maintenance dose every month

55
Q

What is the most common reason for vitamin E deficiency?

A

Malabsorption in adults

56
Q

What is the treatment for vitamin E deficiency?

A

Supplemental alpha tocopherol or mixed tocopherols

57
Q

What kind of anemia might you see with vitamin E deficiency?

A

Mild hemolytic anemia

58
Q

Vitamin E toxicity

A

Can increase vitamin K requirement and can result in bleeding in pts taking oral anticoagulants

59
Q

What clotting factors use Vitamin K

A

2, 7, 9, 10

1972

60
Q

Where is vitamin K found in the diet?

A

Leafy greens

61
Q

What are the clinical features of Vitamin K deficiency?

A

Bruisability and mucosal bleeding

62
Q

What are secondary causes of obesity?

A

Hypothyroidism

Cushing syndrome

63
Q

What lab tests should you run on an obese pt?

A 
Cholesterol 
LFTs
Fasting glucose
Thyroid 
EKG
64
Q

What is a reasonable rate of weight loss

A

0.5 - 2.0 pounds per week or 10% of body weight over 6 months

65
Q

What medications are used in obesity and weight loss?

A

Lorcaserin (Belviq) FDA approved to be combined with diet and exercise

Alli

Xenical

66
Q

What is the most common cause of Vitamin B6 deficiency?

A

Iatrogenic

From TB treatment - isoniazid

67
Q

Bitot’s spots

A

White spots on the conjunctive due to squamous metaplasia of the corneal epithelium

Seen with vitamin A deficiency

68
Q

Who is at risk of Vitamin A deficiency?

A

Liver disease, EtOHics, fat free diets

69
Q

Pts with vitamin A toxicity mimic______

A

Jaundice

Different than regular jaundice because the palms and sclera remain white for vitamin A toxicity

Clin Med 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions