In regard to the epidemiology of this condition, are individuals ...

[karen]

In regard to the epidemiology of this condition, are individuals of specific ethnicities or of either gender at higher risk for the development of NAFLD?
 
  What will be an ideal response?

Question 2

Are you able to diagnose Mr. McKinley using the proposed ASPEN/AND criteria for malnutrition? If so, describe the information you used to make this diagnosis.
 
  What will be an ideal response?

[bob]

Answer to Question 1

 Hispanic population is at a greater risk than those of European descent
 African-Americans exhibit protective genetics in relation to NAFLD (this finding is independent to risk factors such as diabetes and BMI)
 Males appear to have a higher risk factor for NAFLD than women

Answer to Question 2

This patient's weight loss due to bariatric surgery and edema associated with his acute illness make this malnutrition diagnosis difficult. Guidelines indicate that you need 2 of the 6 criteria and this case does not provide any physical assessment data. Assessing for muscle or subcutaneous fat wasting would provide additional criteria but are also difficult in this morbidly obese patient. Certainly his diagnosis of sepsis and the critical nature of illness and inflammatory response places him at significant risk. Furthermore, his recent bariatric surgery presents potential nutrient deficiencies that could further compromise the pre-injury state. It would be useful to know from previous physician visits and assessments how supplementation has been going and if his feeding has been successful post-treatment.