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Level 91

NME 2 (III) Starvation and Malnutrition


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Non-availability and malabsorption
Starvation is a lack of nutrients, either due to [_________] (famine) or [_________]
Malnutrition
Any abnormality of nutrition, including excess nutrition
Undernutrition
A type of malnutrition where not enough food is being eaten
Short term, long term and hormonal
Adaptation to starvation is achieved via [______], [______], and [______] mechanisms
25%
[__]% of the energy from metabolism is used to maintain brain function
67%
[__]% of the energy from metabolism is used to maintain body temperature (homeothermic)
Glycogen, liver and brain
Starvation adaptation - short term: [______] stores within the [_____] are released to supply the [_____]
100
Amount of glucose essential for brain metabolism (gm/day)
Fat and protein, glucose and ketones
Starvation adaptation - long term: [____] and [____] is mobilised to produce [______] and [______]
Insulin, leptin and gonadotrophin
Starvation adaptation - hormones: Reduced levels of [_____], [_____] and [_____]
Leptin
A hormone that acts as a 'fat indicator'. Levels of it fall with reduced fat in the body
Starvation
Impaired mental ability, reduced work capacity, obsessive behaviours, reduced libido are behavioural changes in [________]
Weight For Age
WFA
Protein Energy Malnutrition
PEM
<80% WFA
A person is deemed underweight if they have a <[__]% [___]
<60% WFA
Marasmus is diagnosed at <[__]% [___]
<60% WFA and oedema
Marasmic-kwashiorkor is diagnosed at <[__]% [___] with the presence of [______]
<80% WFA and oedema
Kwashiorkor is diagnosed at <[__]% [___] with the presence of [_______]
Marasmus
A condition caused by chronic starvation
Slow growth, early stunting, good adaptation and variable long term outcome
The characteristics of marasmus
Kwashiorkor
A condition caused by acute starvation
Rapid growth, no stunting, poor adaptation and poor long term outcome
The characteristics of kwashiorkor
Height For Age
HFA
<80% HFA
A person is deemed to have stunted growth if they have a <[__]% [___]
Weight For Height
WFH
<80% WFH
A person is deemed to be thin if they have a <[__]% [___]
Small
Starvation during pregnancy results in [____] babies
Small babies
Concerning starvation: [______] are 10x more likely to suffer from congenital heart disease, chronic obstructive airways disease, hypertension and type 2 diabetes
Malnutrition
Patients with [_______] are thin, anaemic, apathetic, have poor hair/skin quality, increased lanugo hair and impaired immunity
Re-feeding syndrome
Reintroducing carbohydrates in large quantities too quickly can in result in a potentially fatal condition known as [____________]
Re-feeding syndrome
Regarding nutrition: massive insulin release, cellular uptake of magnesium, potassium and phosporus, rapid expansion of ECF, and thiamin deficiency are components of [_________]
20
Maximum amount of kcals allowed to avoid re-feeding sydnrome (kcal/kg/day)