A 7-month-old infant receives chronic total parenteral nutrition for short gut syndrome. In preparing the parents for discharge from the neonatal unit, you discuss potential complications of this mode of nutrition. Which of the following is a typical complication of total parenteral nutrition?
b. Renal failure
c. Chronic diarrhea
d. Vitamin A deficiency
e. Irreversible atrophy of the mucosa of the small intestine
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is a; Sepsis.
Parenteral nutrition, particularly when a central line is used, has a relatively high risk of complications, so it should not be used without good indication. The most common complication, and one of the most serious, is sepsis (1 to 5% of patients). Cholestasis and subsequent liver dysfunction are also commonly seen in patients receiving TPN. In addition to the complications mentioned, thrombosis of central veins, perforations of veins with infusion and bleeding into the pleural space and other sites, pneumothorax, brachial plexus injury, and skin sloughing can also occur. Small intestinal mucosal atrophy is reversed with oral feedings. The other options are not typically noted to be complications of parenteral nutrition; although children with short gut do frequently have chronic diarrhea, parenteral nutrition is not the direct cause. Awareness of these complications and the practice of careful techniques may minimize the risks of this sometimes lifesaving nutritional procedure.