Chapter 072 Malnutrition and Nutritional Assessment (Part 2) ppt
Chapter 072. Malnutrition and Nutritional Assessment (Part 2) ppt
... in adults and older children) and lack of response to skin test antigens (anergy). The prognosis of adult patients with full-blown kwashiorkor is not good, even with aggressive nutritional ... illnesses such as trauma and sepsis, and chronic illnesses that involve acute-phase inflammatory responses. The physiologic stress produced by these illnesses increases protein and energy requirements ... is blocked by the stressed state and by carbohydrate infusion. In its early stages, the physical findings of kwashiorkor are few and subtle. Fat reserves and muscle mass are initially unaffected,...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 1) ppt
... Chapter 072. Malnutrition and Nutritional Assessment (Part 1) Harrison's Internal Medicine > Chapter 72. Malnutrition and Nutritional Assessment Malnutrition and Nutritional Assessment: ... detecting, and treating malnutrition. Protein-Energy Malnutrition The two major types of PEM are marasmus and kwashiorkor. These conditions are compared in Table 72-1. Marasmus and kwashiorkor ... that protein-energy malnutrition (PEM) affects one-third to one-half of patients on general medical and surgical wards in teaching hospitals. The consistent finding that nutritional status influences...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 6) pptx
... avoid assigning nutritional significance to tests that may be abnormal for nonnutritional reasons. Table 72-5 Laboratory Tests for Nutritional Assessment Test (Normal Values) Nutritional Use ... patient who is edematous and has easily pluckable hair and inadequate protein intake, the diagnosis of kwashiorkor is clear-cut. Commonly used laboratory tests for assessing nutritional status are ... BUN/creatinine (g) + 4] x 6.25 Adjustments required in burn patients and others with large nonurinary nitrogen losses and in patients with fluctuating BUN levels (e.g., renal failure)...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 7) pptx
... Modern Nutrition in Health and Disease, 10th ed. Baltimore, Lippincott Williams & Wilkins, 2005 Chapter 072. Malnutrition and Nutritional Assessment (Part 7) Assessment of Circulating ... increased dermal losses of protein may not indicate malnutrition. On the other hand, adequate nutritional support of the patient's calorie and protein needs is critical for returning circulating ... rates of synthesis and catabolism, "third spacing" (loss into interstitial spaces), and, in some cases, external loss. Although an adequate intake of calories and protein is necessary...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 3) pps
... infections such Chapter 072. Malnutrition and Nutritional Assessment (Part 3) Physiologic Characteristics of Hypometabolic and Hypermetabolic States The metabolic characteristics and nutritional ... kwashiorkor seen in developing countries. Metabolic Rate In starvation and semistarvation, the resting metabolic rate falls between 10% and 30% as an adaptive response to energy restriction, slowing ... gram-negative septicemia, and as much as 110% after major burns. If the metabolic rate (energy requirement) is not matched by energy intake, weight loss results—slowly in hypometabolism and quickly in...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 4) pdf
... an underlying illness does not necessarily indicate malnutrition. Chapter 072. Malnutrition and Nutritional Assessment (Part 4) Protein Catabolism The rate of endogenous protein breakdown ... life-threatening. Nutritional Assessment Because interactions between illness and nutrition are complex, many physical and laboratory findings reflect both underlying disease and nutritional status. ... problems and to avoid concluding that isolated findings indicate nutritional problems when they do not. For example, hypoalbuminemia caused by an underlying illness does not necessarily indicate malnutrition. ...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 5) ppsx
... Chapter 072. Malnutrition and Nutritional Assessment (Part 5) Nutritional History A nutritional history is directed toward identifying underlying mechanisms that put patients at risk for nutritional ... drop, and decreased tendon reflexes, fine tactile sense, vibratory sense, and position sense) Thiamine, pyridoxine, vitamin B12 Pyridoxine Tetany Calcium, magnesium Other Chapter ... vitamin, mineral, and protein-energy deficiencies and excesses are outlined in Table 72-4. Most of the physical findings are not specific for individual nutrient deficiencies, and they must be...
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Chapter 024. Gait and Balance Disorders (Part 2) pptx
... in the legs, an imbalance of muscle tone, and a tendency to circumduct and scuff the feet. The disorder reflects compromise of corticospinal command and overactivity of spinal reflexes. The patient ... tone in the adductors. Upper motor neuron signs are present on physical Chapter 024. Gait and Balance Disorders (Part 2) Disorders of Gait The heterogeneity of gait disorders observed in ... there is exaggerated lordosis of the lumbar spine and overactivation of antagonist muscles, which restricts trunk and lower limb movement and results in a wooden or fixed posture. Cases...
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Chapter 084. Head and Neck Cancer (Part 2) ppt
... detectable distant metastases in the future. Chapter 084. Head and Neck Cancer (Part 2) Clinical Presentation and Differential Diagnosis Most head and neck cancers occur after age 50, although ... physical examination should include inspection of all visible mucosal surfaces and palpation of the floor of mouth and tongue and of the neck. In addition to tumors themselves, leukoplakia (a white ... early symptom of laryngeal cancer, and persistent hoarseness requires referral to a specialist for indirect laryngoscopy and/ or radiographic studies. If a head and neck lesion treated initially...
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Chapter 070. Nutritional Requirements and Dietary Assessment (Part 2) pps
... .4 50 25 31–50 y 00 5 5 0 .1 .1 4 .3 00i .4 50 25 Chapter 070. Nutritional Requirements and Dietary Assessment (Part 2) Water For adults, 1.0–1.5 mL water per kcal of energy ... body water and blunted thirst sensation, and may be taking diuretics. Other Nutrients See Chap. 71 for a detailed description of vitamins and trace minerals. Dietary Reference Intakes and Recommended ... be established, the adequate intake (AI), and the tolerable upper level (UL). The current DRIs for vitamins and elements are provided in Tables 70-1 and 70-2, respectively. Table 70-1 Dietary...
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