Exam 5 Nutritional Assessment

Define the following:
Malnutrition
An imbalance and/or deficiency in one or more nutrients (proteins, fats, carbohydrates, vitamins, etc)
What does Malnutrition cause a reduction in?
Organ muscle mass
True or False:
Malnutrition affects every major organ function
True
Some degree of malnutrition is present in what percent of ALL hospitalized patients?
30-50%
What percent of elderly residents in long-term care facilities are affected by malnutrition?
50-85%
True or False:
Malnutrition affects recovery from surgery and disease
True
Define the following:
Kwashiorkor
Deficiency of protein; causes edema, rash, infections, fatigue, loss of muscle mass
Define the following:
Marasmus
Deficiency of all calorie sources; chronic malnutrition/wasting, retardation
Define/What can cause the following:
Chronic
long-term disease, poor food choices,
alcoholism, pregnancy, poverty,
homelessness
Define/What can cause the following:
Acute
Disease, drug therapy, or depression
What is Marasmus brought on by?
drought, natural disasters, political unrest, child abuse/neglect
Which of the following has a 40% Death Rate:
Kwashiorkor Or Marasmus
Marasmus
What is the term used to describe the following:
Need only small quantities per day
Micronutrients
What is the term used to describe the following:
Needed in higher levels per day. Used for energy
Macronutrients
What are some types of micronutrients?
Vitamins, minerals, and trace elements
What are some types of macronutrients?
Carbohydrates, Proteins, Fats
True or False:
Many vitamins act as enzyme cofactors in widespread cellular reactions
True
What does a deficiency in vitamins result from?
poor diets, GI malabsorption diseases, liver dysfunction
Which Vitamins are Fat Soluble?
A, D, E, K
Which Vitamins are Water Soluble?
C, Folate, & Bs
What is another name for Retinol?
Vitamin A
What is another name for Vitamin A?
Retinol
What are precursors of vitamin A?
Carotenes
Carotenes are precursors of what vitamin?
Vitamin A
What does a deficiency in Vitamin A cause?
night blindness, abnormal taste sensation, keratosis
Vitamin A Toxicity leads to what?
Liver Failure
What is Vitamin E?
Antioxidant
What does Vitamin E do?
Protects RBC membranes from oxidant stress
What does a deficiency in Vitamin E cause?
Hemolytic anemia and neurologic dysfunction
Which Vitamin is Key in skeletal and teeth formation?
Vitamin D
Which Vitamin is Necessary for calcium
& phosphate absorption and metabolism?
Vitamin D
A Deficiency in Vitamin D causes what?
rickets (kids) and osteomalacia (adults)
What does a Toxicity of Vitamin D cause?
Calcium deposits, renal and cardiac damage
What Vitamin is needed for formation of prothrombin and 5 other coag factors?
Vitamin K
What does a Deficiency of Vitamin K cause?
bleeding disorders and hemorrhagic episodes
What may a deficiency of Vitamin K result from?
Antibiotic therapy
What is used as an indicator of Vitamin K status?
PT/PTT
Which vitamin is tied to the following:
Antioxidant, connective tissue
and collagen formation, cholesterol metabolism
Vitamin C
What is another name for Vitamin C?
Ascorbic Acid
What is another name for Ascorbic Acid?
Vitamin C
What will a deficiency of Vitamin C cause?
Scurvy
Describe scurvy
hemorrhages, bleeding gums, delayed wound healing
What are the following considered:
Thiamine, riboflavin, pyridoxine
B Vitamins
What do B Vitamins function as?
coenzymes and cofactors
What B Vitamin Deficiency is becoming more common in alcoholics in the U.S.?
Beriberi – B1 Deficiency
What is another name for B3?
Niacin
What is another name for Niacin?
B3
What is Niacin/B3 a component of?
NAD & NADP
What is Niacin used in?
Respiration, lipid & glucose metabolism
What does a deficiency in Niacin/B3 cause?
Pellagra
Describe Pellagra
diarrhea, dementia, dermatitis, death
What is another name for Vitamin B12?
Cobalamin
What is another name for Cobalamin?
Vitamin B12
Which Vitamin does the following describe:
Cobalt-containing compounds
Vitamin B12 / Cobalamin
What is Vitamin B12 necessary for?
DNA Synthesis
What does Vitamin B12/Cobalamin require for intestinal absorption?
Intrinsic factor(s)
What does a Deficiency of B12/Cobalamin cause?
Pernicious Anemia
Describe Pernicious Anemia
lack of, or antibodies against intrinsic factor
What are characteristics of PA?
Megaloblastic changes in BM
Macro-ovalocytes, hypersegmented neutrophils
Dementia,
GI problems due to anaciditiy
GI problems with PA are due to what?
Anacidity
What happens to MCV, MCH, & MCHC in PA?
Increases
What happens to H&H in PA?
Decreases
What test is used for Vitamin B12/Cobalamin?
Schilling Test
Describe the Schilling Test
Inability to absorb tagged B12 will result in low levels of tagged B12 in serum and urine
True or False:
Vitamin B12/Cobalamin is sensitive to light
True
What is Folate needed for?
DNA Synthesis and homocysteine metabolism
What does a deficiency in Folate look like?
Megaloblastic anemia
What are the 2 most common causes of Folate Deficiency?
Low intake (bad diet, alcoholism) and increased use (pregnancy)
True or False:
Low levels of Folate during pregnancy may increase the risk of neural tube defects
True
What does a deficiency of Folate cause?
Elevated homocysteine
Elevated levels of homocysteine is considered a risk factor for what disease?
Cardiac disease
What does Serum Folate indicate?
Circulating Levels
What does RBC Folate indicate?
Folate stores
True or False:
Folate is sensitive to light
True
What are the following considered:
Iron, Iodine, Copper, Zinc
Trace Elements
Where is most iron found in the body?
RBCs
What is Iron stored as in the body?
Ferritin
What is the most common anemia in the world?
IDA
What are the 2 most common causes of IDA?
1. chronic blood loss
2. dietary insufficiency
What does IDA look like under the microscope?
Microcytic
Hypochromic
What happens to H&H with IDA?
Decreases
What happens to MCV with IDA?
Decreases
What happens to TIBC with IDA?
Increases
What happens to Serum Fe and Ferritin with IDA?
Decreases
What is the half life of Albumin?
20 days
What is an indicator of long periods of malnutrition?
Albumin
True or False:
Liver disease may alter albumin levels in the absence of malnutrition
True
Low levels of Albumin in hospitalized patients results in what?
4x Morbidity
6x Mortality rates
Levels of what protein marker may be useful in distinguishing kwashiorkor from marasmus?
Albumin
In kwashiorkor what are the levels of albumin like?
Low
In marasmus what are the levels of albumin like?
Normal
What protein marker is a Major transport protein for T4 & Vitamin A
Prealbumin (transthyretin)
What does prealbumin transport?
T4 & Vitamin A
What protein marker is the BEST indicator of recent, short-term malnutrition and the effects of a feeding plan?
Prealbumin (transthyretin)
What is the half life of Prealbumin?
1-2 days
What protein marker is an Early indicator of iron deficiency?
Transferrin
What protein marker is decreased in Nephrotic syndrome and Liver disease?
Transferrin
What other biochemical marker reflects dietary fat intake?
Triglyceride
What other biochemical marker is used for detection of malnutrition due to malabsorption?
Fecal Fat Analysis
What are the following known as:
Glucose & HBA1C
Other Biochemical Markers
x

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