Malnutrition
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Contents |
More Specific Terms
- malabsorption
- nutritional deficiency
- nutritional disorder
- protein-calorie malnutrition (kwashiorkor)
Introduction
- State of nutritional insufficiency.
Etiology
- inadequate dietary intake
- defective assimilation or utilization of food ingested
Pathology
- increased serum IgE is common
- thymic atrophy is common
- patients often fail to respond to delayed-type hypersensitivity skin testing
Clinical-manifestations
- weight loss > 15%
Laboratory
-
- absolute lymphocyte count < 1,800/ mm3
- serum albumin < 3.5 mg/dL
- serum cholesterol < 160 mg/dL
- erythrocyte sedimentation rate
- serum TSH
- serum 25-hydroxvitamin D
- serum peralbumin may be useful for monitoring recovery [4]
Radiology
Differential-diagnosis
- cancer
Management
- all older patients should receive
- adequate hydration
- if possible, remove disease-specific dietary restrictions
- no appetite stimulants are RDA-approved to treat malnutrition
- protein & energy supplements (Ensure etc) may have some benefit
- enteral nutrition is preferred over parenteral nutrition [4]
More General Terms
References
- nlmpubs.nlm.nih.gov/hstat/ahcpr/
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 696-698
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- National Guideline Clearinghouse Altered nutritional status American Medical Directors Association (AMDA). ngc-guideline: [1]
- Nutrition support in adults National Institute for Health and Clinical Excellence (NICE) [2]
