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27 Cards in this Set
- Front
- Back
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what type of malnutrion can pts get from gastrectomies?
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calcium and vita D def
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what def are you predisposed to with renal insufficiency?
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Vitamin D
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why do you need more calories if you have a fever?
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metabolism goes up
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what can reanl dialysis pts lose?
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AA and glucose
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what can you lose if you have proximal fistulas?
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pancreatic secretions
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what can methotrexate cause a def of?
what is it used to treat? |
psoriasis and RA
def of folic acid |
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what is the def of marasmus?
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lack of calories and protein over long time, great wasting
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are most lab findings in marasmus normal?
high mortality? |
yes
low mortality |
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easy hair pluckability
pitting edema (bc of low serum albumin) |
kwashiorkor
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what is the time course of kwashiorkor?
how is stress related? |
very rapid, stress state: negative nitrogen balance, break down own tissue to survive
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waht are lab findings for kwashiorkor?
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low serum albumin
ranferrin iron bidninding lymphocytes all low |
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what is the clinical course of kwash?
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very bad, ulcers poor wound heal high mortality
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what does cellophane like skin indicate?
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kwashiorkor;
aka peelin paint flaky dermatosis |
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what are the 4 Ds of pellagra
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diarrhea
dermatitis death dementia nican Vita B3 def |
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what is perifollicular petechia a classic finding of?
Scorbutic gums? |
Vitamin C def
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what is the physiology of starvation?
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1st use up glycogen stores, then gluconeogenesis, then fat stores to provide keton bodies for energy
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how do cytokines and conter reg hormoe levels compare in marasmus and kwash?
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low in marasmus
high in kwash |
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why do you lose lean muscle mass in kwash?
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your body doesnt' stop gluconeogenesis: doesnt' switch to protein sparing ketone metabolism
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will kwas peopl have high or low insulin?
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high, they will become glucose intolerant
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whay happens to oxygen consumptoin in kwash and marasmus?
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goes up in kwash (hypermetabolic)
down in marasmus body trying to conserve its self |
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who become ketotic?
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hypometabolic, but both use fat
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what is a 24 UUN?
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a nitrogen balance procedure
excreted nitrogen is related to metabolic rate compare with protein intake |
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what is the equation for estimating protein requirements?
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(24hr UUN+4) x 6.25 = protein catabolic rate
g protein/g nitrogen |
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waht is refeeding syndrome?
who gets it more? |
marasmus pts; cardiac atrophy dec wt of diaphragm, low metbolic rate
give a lot of glucose: fluid challenge. metabolic rate and catecholamines increase. w/o enough phosphoros to transport glucose accross you get phosphatemia, leads to fluid overload: cardiac failure |
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waht is the strategy for refeeding in marasmus?
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rebuild slowly, use fat
if you give glucose, give phosphate |
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strategy for refeeding kwash?
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replace catabolic losses, feed aggressively
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strategy for refeed for mix of marasmus and kwash?
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feed aggresively like kwash
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