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Case 1
A 25-year-old otherwise healthy man with COVID-19 infection is admitted to the Intensive Care Unit for respiratory failure, dehydration, and inadequate nutrition. Along with requiring intubation for management of his respiratory failure, he has been unable to eat or drink anything for the past three days before presentation. Since he is expected to be intubated for a number of days due to his respiratory symptoms and is also too hemodynamically unstable to receive enteral nutrition at this time, the Intensive Care Unit has decided to start parental nutrition (i.e., intravenous nutrition).
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Case 2
AJ is a 9-year-old girl with autism who presents for a well-child visit. She appears well hydrated with adequate fat and muscle stores; oral cavity exam is unremarkable. She complains of dry eyes and will be seeing an ophthalmologist next week. AJ’s parents describe her as a “picky eater”; it has always been a struggle to find foods that she will eat. AJ’s anthropometrics are as follows:
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One year ago: Weight 30 kg, weight-for-age percentile = 80th, weight for age Z-score 0.84
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Height: 124.5 cm, height-for-age percentile = 30th, height for age Z-score –0.53
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BMI: 19.4 kg/m2, BMI-for-age percentile = 91st, BMI for age Z-score 1.36
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Today: Weight 30.5 kg, weight-for-age percentile = 61st, weight for age Z-score 0.27
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Height: 129 cm, height-for-age percentile = 26th, height for age Z-score –0.64
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BMI: 18.3 kg/m2, BMI-for-age percentile = 79th, BMI for age Z-score 0.80
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