Case 17.4
He had been initiated on micronutrient supplementation with Vitamin B12 1000mcg/day, Vitamin D3 10,000 IU/day, and Zinc 220mg/day on the inpatient setting.
The dietitian felt he was taking excess vitamin D and did not have clear indication to take vitamin B12 or zinc when there were no labs available to assess status. She acknowledged though that he could be at risk for ongoing deficiency due to active disease.
She made plans to discuss vitamin supplementation at the following doses with the medical team:
- Daily Multivitamin
- Calcium carbonate-vitamin D 500 mg calcium/200 international units of vitamin D twice daily
- Vitamin D2 (ergocalciferol) 50,000 international units by mouth weekly or Vitamin D3 (cholecalciferol) 2000 units by mouth once daily
- Vitamin B12 (cyanocobalamin) 1000 mcg by mouth once daily
- Zinc sulfate 220 mg by mouth once daily
The dietician diagnosis the patient with malnutrition.
Which of the following are used to make a diagnosis of malnutrition?
a) Decreased intake from oral diet b) Increased hunger sensation
c) Unintentional weight loss
d) Routine/bland diet
e) Signs and symptoms of sarcopenia
f) Biochemical Markers
A,C,E
Malnutrition is a constellation of specific signs and symptoms that indicate a compromised nutritional status. These include including decreased nutritional intake, unintentional weight loss, reduction in muscle mass (sarcopenia), loss of subcutaneous fat, fluid accumulation, and changes in functional capacity as well as changes in micronutrient and biochemical markers.
A,B,D
A, C
A
F
B, D