Pulmonary

Question 1

which type of respiratory failure can develop from overfeeding?

Answer 1

type II (hypercapnic respiratory failure = increased CO2 concentration in blood)

Question 2

what is malnutrition associated with advanced lung disease called?

Answer 2

pulmonary cachexia syndrome, defined as lean BMI <17 kg/m2 in men and <14 kg/m2 in women

Question 3

most common micronutrient deficiencies in CF

Answer 3

fat soluble vitamins

Question 4

do COPD pts have increased or decreased REE?

Answer 4

usually increased (exact cause of hypermetabolism not well understood)

Question 5

how do macronutrient needs compare between pts with pulmonary failure and other critically ill pts?

Answer 5

same

Question 6

vitamin D deficiency supplementation in chronic lung disease

Answer 6

50,000 1x/week x 8 weeks (or 6000 IU/d x 6 weeks)»_space; maintenance dose of 2000 IU/day

Question 7

what is the evidence for glutamine supplementation in pulmonary disease?

Answer 7

may cause harm

Question 8

which patient positionings can help reduce ventilator associated pneumonia?

Answer 8

supine in semi recumbent position with HOB 45 degrees

if ARDS pt that is in prone position, HOB elevation can be achieved using reverse Trendelenburg to 10-25 degrees

Question 9

salt recommendations in CF for 0-6 month olds, >6 months, and older kids

Answer 9

0-6 mos: 1/8 teaspoon per day
>6 months: 1/4 teaspoon per day
Older kids: liberal salt diet

Question 10

maximum PERT for CF

Answer 10

2500 units/kg lipase per meal
OR
10,000 units/kg/day

Question 11

high doses of pancreatic enzymes can cause…

Answer 11

fibrosing colonopathy (rare)

Question 12

how often should FSV levels be checked in CF?

Answer 12

annually