Nutrition and fluid therapy
General Surgery · Topic 12
Source: NMC CBME Curriculum 2024 · Volume III · General Surgery · Topic 12 · combined PDF page 405
Practice questions
- According to the consensus-informed review of patients receiving tandem ECMO and CRRT, when should malnutrition assessment be performed after ICU admission?
- Which adult protein target is identified by the tandem ECMO/CRRT review as a heightened, consensus-informed target?
- For a patient receiving tandem ECMO and CRRT who can be fed enterally, which route does the consensus-informed review prefer early?
- A patient receiving CRRT has concern for treatment-associated micronutrient losses. Which approach is specifically highlighted in the tandem ECMO/CRRT review?
- Which monitoring priority is emphasized for patients receiving both ECMO and CRRT?
- Why does the tandem ECMO/CRRT review advise careful administration of carbohydrate and lipid?
- A clinician asks whether the tandem ECMO/CRRT nutrition recommendations are based on studies directly examining patients receiving both therapies simultaneously. Which answer best reflects the review?
- In the modified Delphi process used for the tandem ECMO/CRRT review, what proportion of respondents had to rate a statement at least 3 on a 5-point Likert scale for it to be considered clinically relevant?
- Why does the tandem ECMO/CRRT review call for individualized energy and protein estimates?
- For a patient receiving tandem ECMO and CRRT in whom enteral feeding is not feasible, which route does the review describe as a safe alternative when needed?
- A clinician applies the 2–2.5 g/kg/day adult protein target from the tandem ECMO/CRRT review to a neonate on extracorporeal kidney replacement therapy. What is the principal problem with this decision?
- According to the cited review of infant kidney replacement therapy, what protein intake is recommended during kidney replacement therapy?
- What treatment-related nutritional concern is specifically noted for infants receiving continuous or prolonged intermittent kidney replacement therapy?
- In the retrospective series of 17 infants receiving extracorporeal kidney replacement therapy, how did median prescribed protein change between week 1 and week 6?
- In the same infant cohort, what was the reported change in median prescribed energy from week 1 to week 8?
- Despite early kidney replacement therapy and nutritional optimization in the 17-infant retrospective series, what happened to anthropometric z-scores over the first eight weeks?
- The authors of the 17-infant retrospective series suggest that early provision of which intake may help prevent cumulative nutritional deficits?
- Which conclusion is most defensible from the retrospective study of 17 infants receiving extracorporeal kidney replacement therapy?
- Which initial extracorporeal kidney replacement modality was used in most infants in the 17-patient series?
- Which device-related development has helped make continuous kidney replacement therapy more feasible in neonates, according to the neonatal review?
- Which set of indications for neonatal continuous kidney replacement therapy is consistent with the review?
- In the incretin-therapy nutrition review, which combination is identified as potentially limiting real-world treatment effectiveness?
- A patient taking a GLP-1 receptor agonist reports reduced food intake and meal-related symptoms. Which response best matches the nutrition-first framework described in the review?
- Which strategy is included in the nutrition-first framework to support body composition during incretin-associated weight loss?
- Which longer-term concern should be included in planning for a patient who may discontinue incretin-based obesity therapy?
- Which combination best represents the meal-pattern and intake components proposed for patients receiving incretin-based obesity therapy?
- How should the evidence for structured nutrition interventions specifically in patients receiving GLP-1 or dual incretin therapy be characterized, according to the review?
- A patient asks whether substantial weight loss on an incretin medication guarantees that only fat mass has been lost. Which response is most consistent with the review?
- Which statement best distinguishes a consensus-informed practice point from a definitive evidence-based rule in tandem ECMO/CRRT nutrition care?
- Which statement best integrates nutritional and growth monitoring for an infant receiving extracorporeal kidney replacement therapy?
- Which statement about enteral and parenteral nutrition in tandem ECMO/CRRT is most accurate?
- Which statement best characterizes the role of hydration management in the nutrition-first framework for incretin-treated patients?