Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
22 Nutritional factors in disease MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 9 practice questions
- Carbohydrates
- Vitamins
- Energy balance
- Vitamin A
- Nutrition support
- Vitamin deficiency
- Obesity
- Iodine
1. A patient needs feeding for 6 weeks after stroke, and a patient with intestinal resection needs indefinite support. Which routes are appropriate?
- AParenteral nutrition, and gastrostomy
- BNasogastric tube, and enteral feeding
- CGastrostomy because nasogastric feeding suits up to 4 weeks, and parenteral nutrition for severe indefinite absorptive failure
- DJejunal feeding, and oral supplements
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C. Gastrostomy because nasogastric feeding suits up to 4 weeks, and parenteral nutrition for severe indefinite absorptive failure Enteral feeding has advantages of fewer infections, lower cost, earlier return of gut function and shorter stay.
2. A child has severe early-onset obesity, and a 50-year-old with BMI 38 and diabetes needs drug therapy. Which statements are correct?
- AMC4R mutations account for about 5% of severe early-onset obesity and GLP-1 agonists are most effective though costly and stopped if under 5% loss at 3 months
- BCFTR mutations, and naltrexone is most effective
- CPOMC accounts for 50%, and orlistat is most effective
- DLeptin mutations are commonest, and phentermine is most effective
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A. MC4R mutations account for about 5% of severe early-onset obesity and GLP-1 agonists are most effective though costly and stopped if under 5% loss at 3 months GWAS genes account for under 5% of weight variation; withdrawing an effective drug means weight regain.
3. A patient with BMI 14 who has eaten nothing for 12 days and lost 20% of weight is refed. Which statements are correct?
- AFeeding starts at full requirements, and thiamine is optional
- BInsulin is given first, and electrolytes are ignored
- CSteroids are given, and feeding is delayed a month
- DIV thiamine is given before refeeding and electrolytes corrected, starting 10-20 kcal/kg/day rising over 5-7 days
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D. IV thiamine is given before refeeding and electrolytes corrected, starting 10-20 kcal/kg/day rising over 5-7 days Refeeding drives K, Mg, phosphate and glucose into cells; without thiamine Korsakoff psychosis may result.
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