47 Questions
Which of the following is a benefit of early assessment of malnutrition in patients?
Designing appropriate nutrition support
In which condition is metabolic regulation different compared to malnutrition in metabolic stress?
Starvation
What is the estimated cost-effectiveness of investing in nutrition support according to the Canadian Malnutrition Task Force?
Saves $99 for every dollar invested
Which of the following is a characteristic of cytokines?
They can act locally and systemically
What effect do proinflammatory cytokines have on serum levels?
They have been found to be high in some, but not all types of cancer
What is a possible effect of cytokines on appetite and food intake?
Decrease in appetite and food intake
Which of the following is a metabolic alteration associated with cachexia?
Increased basal metabolic rate
What is the effect of cytokines on insulin resistance?
They increase insulin resistance
Which of the following is a metabolic alteration related to lipids in cachexia?
Mobilization of lipids and increased turnover of fatty acids
What is the role of glucose in tumors?
Glucose is a fuel for tumors
What is the impact of surgical stress on glycogenolysis and gluconeogenesis?
Increased glycogenolysis and gluconeogenesis
What is the effect of nutrition support on protein synthesis?
Increased protein synthesis
What is the primary mechanism by which cytokines affect glucose metabolism?
Inducing insulin resistance
Which of the following hormones is associated with increased basal metabolic rate in cachexia?
Thyroid hormone
What is the impact of cytokines on lipoprotein lipase (LPL) activity?
They inhibit LPL activity
What is the primary characteristic of cachexia?
Loss of muscle with or without loss of fat mass
What is the prevalence of cachexia in cancers?
50-80%
What is the primary consequence of muscle wasting in cachexia?
Predicts poor cancer-associated outcomes
What is the primary goal of anti-cancer treatment in relation to cachexia?
Increase lean body mass and improve response to treatment
What is the primary association of anorexia in cachexia?
Associated with over 50% cases of cachexia
What is the primary consequence of anorexia in cachexia?
Reduced food intake
What is the primary goal of treatment in cachexia?
Increase lean body mass and improve immunocompetence
What is the primary impact of inflammation on acute phase response?
Coordinated adaptations of the body to limit and clear tissue damage
What is the primary role of albumin in acute phase response?
Most abundant protein in plasma, concentration decreases during infection/inflammation
What is the primary function of acute phase proteins in infection?
Increase protein concentration to fight infections
What is the primary impact of C-reactive protein during infection?
Increases severely during inflammatory responses
What is the primary role of IGF-1 in infection?
Anabolic hormone associated with inflammatory responses
Discuss the differences in metabolic regulation between simple malnutrition and malnutrition in metabolic stress, providing examples of conditions that fall under each category.
Metabolic regulation in simple malnutrition primarily involves conditions such as starvation, while malnutrition in metabolic stress encompasses conditions like cancer and surgical stress. The differences in metabolic regulation can impact cellular and clinical aspects, leading to varied metabolic responses.
What is the consensus definition of cachexia?
A complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass.
What are the consequences of muscle wasting in cachexia?
Increased fatigue, treatment-induced toxicity, decreased host response to tumor, decreased performance status, and decreased survival.
What is the primary clinical feature of cachexia?
Weight loss.
What is sarcopenic obesity?
Obesity with depleted muscle mass.
What are the goals of treatment for cachexia?
Increase lean body mass, predispose to a better response to antineoplastic therapy, increase immunocompetence, manage symptoms causing decreased food intake, and increase perception of well-being.
What are the primary causes of reduced food intake in cachexia?
GI problems, early satiety, pain, depression/anxiety, radio- and chemo-therapy, inflammation, defective central regulation of appetite and food intake, medications, and nausea and chemosensory abnormalities.
What is the role of acute phase proteins in infection?
Their plasma concentrations increase by more than 25% to fight infections.
What is the primary impact of inflammation on acute phase response?
It leads to the synthesis of acute-phase proteins to limit and clear tissue damage caused by hydrolases released from inflammatory, injured, or malignant cells.
What is the primary effect of cytokines on appetite and food intake?
They can cause defective central regulation of appetite and food intake.
What is the prevalence of cachexia in cancers?
50-80%.
What is the primary consequence of anorexia in cachexia?
Decreased food intake.
What are the stages of cachexia?
Pre-cachexia, cachexia, and refractory cachexia.
What are the primary effects of proinflammatory cytokines on appetite and food intake in cachexia?
Proinflammatory cytokines can decrease appetite and food intake in cachexia.
What are the metabolic alterations associated with glucose in tumors?
Glucose is utilized as a fuel for tumors, leading to increased lactate production and gluconeogenesis.
What are the primary impacts of surgical stress on glycogenolysis and gluconeogenesis?
Surgical stress increases glycogenolysis and gluconeogenesis.
What are the main consequences of muscle wasting in cachexia?
Muscle wasting in cachexia leads to decreased total energy expenditure and increased basal metabolic rate.
What is the primary mechanism by which cytokines affect glucose metabolism?
Cytokines can induce insulin resistance, leading to altered glucose metabolism.
What are the estimated impacts of cytokines on lipoprotein lipase (LPL) activity?
Cytokines can inhibit lipoprotein lipase (LPL) activity.
What is the primary role of IGF-1 in infection?
IGF-1 is associated with anabolic processes and can be affected during infection.
Test your knowledge of metabolic regulation in simple malnutrition versus malnutrition in metabolic stress with this quiz. Explore the impact of conditions like starvation, cancer, and surgery on clinical, metabolic, and cellular levels. Learn about the benefits of assessing nutrition to identify and intervene early in patients at risk of malnutrition.
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