Clinical Nutrition For Pharmacists Flashcards Preview

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Flashcards in Clinical Nutrition For Pharmacists Deck (26)
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1

List 3 ways to decrease the risk of cardiovascular disease

  1. Increase omega-3 fatty acid intake e.g. oily fish
  2. Reduce saturated fat intake e.g. processed meat, dairy
  3. Antioxidant supplementation e.g. cranberry juice

2

Name the mineral that causes hypertension

Sodium, Na+

3

What effect does calcium supplementation have on BP?

Small decrease in BP, however a reduction in salt has a greater effect

4

How is BMI calculated?

weight/(height^2) kg/m^2

5

List 3 groups which would BMI would be unhelpful for

  1. Elderly
  2. Children
  3. Athletes/bodybuilders

6

When should the patient be referred to their GP with regards to their weight?

If they are underweight or obese class 2 or 3

7

Define: Malnutrition

A state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue or body form

8

When does malnutrition occur?

When diet is insufficient to meet the demands of the body

9

Define: MUST score

Malnutrition Universal Screening Tool

Indicates risk of malnutrition, completed for all hospital admissions

10

List the 5 steps of the MUST score

  1. Height and weight for BMI
  2. Note unplanned weight loss and score
  3. Establish acute disease score
  4. Add scores from steps 1-3 for complete score
  5. Use management guidelines or local policies to create action plan

11

List 2 criteria of malnutrition according to NICE

  1. BMI of less than 18.5 kg/m2
  2. Unintentional weight loss greater than 10% within the last 3-6 months

12

List the 3 stages of starvation

  1. Glycogenolytic
  2. Gluconeogenic
  3. Ketogenic

13

Describe the glycogenolytic stage of starvation

  1. Glycogen stores in the liver and muscle used up in 24 hours
  2. Fall in blood glucose
  3. Increase in glucagon

14

Describe the gluconeogenic stage of starvation

  1. Fall in insulin
  2. Protein breakdown (lean tissue) releases amino acids for glucose production

15

Describe the ketogenic stage of starvation

  1. Lipolysis releases free fatty acids and glycerol from adipose tissue
  2. Glycerol converted to glucose by liver and kidneys
  3. Free fatty acids converted to ketones by liver

16

Define: Refeeding syndrome

When a person in a state of prolonged starvation is given nutrition which causes serious complications

17

Why can refeeding syndrome cause serious complications?

  • Sudden shift in energy source and insulin secretion when person starts to eat
  • Glycogen, fat and protein synthesis begins which requires phosphate, magnesium and thiamine
  • Increased absorption of potassium and magnesium into cells
  • This leads to a decrease in serum levels of K+, PO4- and Mg2+

18

List 4 symptoms of refeeding syndrome

  1. Cardiac failure
  2. Hypotension
  3. Coma
  4. Seizures

19

Which 4 minerals should be checked for their levels before re-feeding?

  1. Potassium
  2. Calcium
  3. Phosphate
  4. Magnesium

20

Name an alternative route for re-feeding

Parenteral (nutrition)

21

Why is parenteral nutrition sometimes used for re-feeding?

  • Non-functional, inaccessible or perforated (leaking) GI tract
  • It is a complete mixture of all nutrients

22

List 3 risks of providing nutrition via the parenteral route

  1. Infection
  2. Liver abnormalities
  3. Fluid abnormalities

23

List 3 pieces of dietary advice for diabetics

  1. Manage body weight
  2. Treat and prevent dyslipidaemia
  3. Treat and prevent hypertension

24

Who are coelicas?

Gluten intolerant

25

What does ingestion of gluten lead to in coeliacs?

Intestinal atrophy - malabsorption

26

List 3 symptoms of coeliac disease

  1. Weight loss
  2. Fatigue
  3. Diarrhoea