12-04-2010, 05:22 PM
A 19-year-old woman with anorexia nervosa undergoes
surgery for acute appendicitis. The postoperative
course is complicated by acute respiratory distress
syndrome, and she remains intubated for 10 days. She
develops wound dehiscence on postoperative day 10.
Laboratory data show a white blood cell count of 4000/
μL, hematocrit 35%, albumin 2.1 g/dL, total protein 5.8
g/dL, transferrin 54 mg/dL, and iron-binding capacity 88
mg/dL. You are considering initiating nutritional therapy
on hospital day 11. Which of the following is true regarding
the etiology and treatment of malnutrition in this
patient?
A. She has marasmus, and nutritional support should
be started slowly.
B. She has kwashiorkor, and nutritional support should
be aggressive.
C. She has marasmic kwashiorkor, kwashiorkor predominant,
and nutritional support should be aggressive.
D. She has marasmic kwashiorkor, marasmus predominant,
and nutritional support should be slow.
surgery for acute appendicitis. The postoperative
course is complicated by acute respiratory distress
syndrome, and she remains intubated for 10 days. She
develops wound dehiscence on postoperative day 10.
Laboratory data show a white blood cell count of 4000/
μL, hematocrit 35%, albumin 2.1 g/dL, total protein 5.8
g/dL, transferrin 54 mg/dL, and iron-binding capacity 88
mg/dL. You are considering initiating nutritional therapy
on hospital day 11. Which of the following is true regarding
the etiology and treatment of malnutrition in this
patient?
A. She has marasmus, and nutritional support should
be started slowly.
B. She has kwashiorkor, and nutritional support should
be aggressive.
C. She has marasmic kwashiorkor, kwashiorkor predominant,
and nutritional support should be aggressive.
D. She has marasmic kwashiorkor, marasmus predominant,
and nutritional support should be slow.