Question

Mr. Collins is a 55-year-old physician’s assistant with a history of chronic hepatitis C. Past history was remarkable for a needle stick injury on the job that occurred two years ago. Following the injury, he initially experienced sporadic episodes of mild flu-like symptoms with fever, chills, and diaphoresis. Over the past six months, his complaints increased to include generalized muscle weakness, fatigue, and weight loss. Mr. Collins is 5’9” tall and weighs 150 pounds with a usual weight of 162. On examination he was noted to have hepatomegaly and be markedly pale with icteric (jaundiced) conjunctiva and skin. Mr. Collins complains of a poor appetite. He generally eats two meals a day and prefers meat, potatoes, salted snacks, and an occasional beer. He dislikes sweets, and some vegetables and fruits. He states that he often has nausea and feels bloated after eating, but is unable to pass the gas. He feels most comfortable when his stomach is empty.

1.

Suppose Mr. Collins condition worsens and develops steatorrhea. Based on his EER with light activity recommend daily intakes of: (show calculations, get totals for this specific patient)

a. energy (kcals/day)

b. protein (g/kg)

c. total fat (% of kcals from fat)

Answer 1

Weight 150pounds (68kg)

Height 5.9inches (175cm)

A, energy requirements:

66+(13.7X 68)+(5X175) -(6.8X55)

66+932+875 - 374

1873 - 374

1499kcalories / day

B, protein (g/kg)

Multiply weight by average weight(0.36)

150X0.36= 54g/kg

C, total fat

Each grams of fat provide 9calories..so to convert total fat grams to calories multiply by 9..