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Flashcards in refeeding article Deck (28)
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1
Q

minor risk factors?

A

BMI <18.5, unintentional wt loss >10% past 3-6 months, little/no nutr intake for >5 days, hx alcohol/drugs

2
Q

major risk factors?

A

BMI <16, unintentional wt loss >15% past 3-6 months, little/no nutr intake for >10d, low baseline lvl K/P/Mg

3
Q

specific pt populations to assess risk:

A

chronic severe dieting, hunger strike, hx bariatric surgery, SBS, tumour, frail elderly

4
Q

low risk is ____, high risk is ____

A

1 minor risk factor; 1 major or 2 minor risk factors

5
Q

what is very high risk?

A

BMI <14, wt loss >20%, starvation >15d

6
Q

if low risk, provide energy as ___kcal/kg/d, if high risk ___kcal/kg/d

A

15-25; 10-15

7
Q

if very high risk, provide ___kcal/kg/d

A

5-10

8
Q

restrict Na intake in ____ risk refeeding

A

high and very high

9
Q

diagnose if shift in electrolytes within 72h show:

A

decrease of P from baseline >30% or <0.6mmol/L, or any other 2 electrolyte shifts below normal

10
Q

if see electrolyte shifts but no clinical symptoms, call this ____ RFS

A

imminent

11
Q

if shift in electrolyte and also clinical symptoms, call this ___ RFS

A

manifest

12
Q

in low risk, bring to goal rate by day ___, if high risk by day ___, and if very high by day ___

A

4; 6; 10

13
Q

RFS is ___ reaction caused by nutr therapy and associated with ____ resulting from metabolic changes and fluid imbalance

A

anabolic; serum electrolyte shifts and clinical symptoms

14
Q

RFS first described in ____

A

prisoners liberated from concentration camps

15
Q

why not include anorexia nervosa?

A

believed to have diff pathophysio perspective

16
Q

role of phosphate?

A

intracell metabolism of macros and major component of enzymatic cofator, second messengers, and reg processes

17
Q

magnesium role?

A

maintaining neuromuscular and enzymatic fxn

18
Q

___ is retained even during catabolic situations

A

sodium

19
Q

why hypokalemia occur?

A

rapid cell uptake of K as gluc and a.a. taken up during cell synthesis of glyco and protein

20
Q

why hypophosphatemia?

A

increased phosphorylation of gluc and other high energy phosphorylated molecules

21
Q

nutr rich in ____ and ___ may reduce serum phosphate

A

Ca and CHO (Ca is binder, CHO leads to intracell shift of P cuz of insulin ^)

22
Q

Na and water retention aggravated by _____

A

preexisting pathology of heart or thiamin deficiency

23
Q

severe nutr depletion, atrophy of gut mucosa and impairment of pancreatic fxn predispose to severe ____

A

diarrhea

24
Q

v Mg and K cause ____

A

heart arrhythmia

25
Q

Na retention further aggravated by ^ ___ and resulting extracell fluid expansion

A

insulin

26
Q

main symptoms of RFS:

A

tachycardia, tachypnea, peripheral edema

27
Q

prophylactic admin of _______ in pt at risk of RFS effective

A

phosphate and thiamine

28
Q

main criterion for RFS

A

hypophosphatemia