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Flashcards in Surgical nutrition Deck (15)
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0
Q

What are the calorie contents of the main metabolites?

A

Fats: 9kcal/ g
Protein: 4kcal/g
Carbohydrate: 4kcal/g

1
Q

What are the daily nutritional requirements in health?

A

25 kcal/ kg
100g glucose
0.15g nitrogen/ kg
0.8g protein/ kg

2
Q

How much recent weight loss if considered to be risky for surgery?

A

> 10% of original body weight

3
Q

What are the indications for parenteral nutrition?

A
  1. neurological disease (coma, intracranial surgery, CNS trauma)
  2. maxillofacial or neck trauma
  3. malfunctioning GIT (fistula, Crohn’sm massive small bowel resection, upper GI disease)
  4. hypercatabolic state {-ve nitrogen balance} (fever >38, severe polytrauma, extensive burns)
4
Q

What are the complications for parenteral feeding?

A
Same as central line +
increased glucose and risk of HHS
hypokalaemia, hyperchloride, risk of acidosis 
low magnesium and phosphate 
low essential fatty acids 
increased urea 
jaundice
5
Q

What is refeeding syndrome?

A

low potassium, magnesium, phosphate in a patient who is being re fed after a period of starvation

6
Q

When should enteric feeding start after laparotomy?

A

Once the patient has passed flatus

7
Q

What ate the fat soluble vitamins and where are they absorbed?

A

Vits A, D, E and K

in the terminal ileum

8
Q

Which water soluble vitamin is absorbed in the terminal ileum?

A

Vit B12 - dependent on intrinsic factor produced by the parietal cells i the stomach

9
Q

Describe the clinical features of Vitamin A deficiency

A

night blindness, xerosis of the conjunctiva and cornea
xerophthalmia and keratomalacia
keratinisation of the lung, GI tract and urinary tract epithelia
increased susceptibility to infections
follicular hyperkeratosis of the skin

10
Q

Describe the clinical features of Vitamin B deficiency

A
Vit B1 (thiamine)
Irritability, poor memory, sleep disturbances, chest pain, anorexia, abdominal pain, and constipation 
CVS symptoms (wet Beri Beri)
Vit B6 (pyridoxine)
Dermatosis, glossitis, cheilosis, peripheral neuropathy and lymphopenia 
Vit B12 (cobalamin)
Megalobalstic anaemia, peripheral neuropathy
11
Q

Describe the clinical features of Vitamin C deficiency

A

Scurvy

Bleeding gums, poor wound healing

12
Q

Describe the clinical features of vitamin D deficiency

A

Osteomalacia or rickets

Bowing of the long bones, short stature in children, and flattening of the pelvic bones

13
Q

Which vitamin increases Fe absorption

A

Vitamin C

14
Q

Which mineral is important in wound healing?

A

Zinc