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Endocrinology/Nutrition > 05a: Nutrition/Vitamins > Flashcards

05a: Nutrition/Vitamins Flashcards

1
Q

List the various forms of Vitamin A

A
  1. Retinol (transport form)
  2. Retinol ester (storage)
  3. Retinal (visual pigment)
  4. Retinoic acid (oxidized)
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2
Q

Functions of Vit A

A
  1. Maintain normal vision (in reduced light)
  2. Differentiation of mucus-secreting epithelium (an other cells; ex: APML, acne)
  3. Enhancing immunity to infections (increase T-cells, esp CD4)
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3
Q

Vit A deficiency effects which systems?

A
  1. Vision (night blindness)
  2. Pulm (infections)
  3. Renal (stones)
  4. Skin (follicular/papular dermatitis and dry skin)
  5. Immunity (infections)
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4
Q

Acute (X) toxicity has been associated with eating liver of polar bears, sharks, whales. What are symptoms?

A

X = vit A

HA, dizziness, vomiting, stupor, blurry vision (pseudotumor cerebri)

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5
Q

Vit (X) toxicity causes extremely high risk for spontaneous abortions/birth defects.

A

X = A

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6
Q

Chronic vit A toxicity Sx:

A

Fatigue, skin changes, alopecia, arthralgia, sore throat

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7
Q

T/F: Vit A toxicity more common than Vit C toxicity.

A

True - lipid soluble vit toxicity more common than water soluble due to fat accumulation

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8
Q

Which groups/patients are at risk for lipid-soluble vitamin deficiency?

A

Elderly, alcoholics, liver disease pts

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9
Q

Vit C crucial in multiple processes, most notably (X).

A

X = collagen synthesis (hydroxylation of pro-collagen)

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10
Q

T/F: Vit C acquired entirely by diet.

A

True - not synthesized endogenously

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11
Q

Vit (X) facilitates Fe absorption by keeping it in (ox/red) state.

A

X = C

Red (Fe 2+)

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12
Q

Vit C deficiency commonly seen in which groups of people?

A
  1. Elderly
  2. Chronic alcoholics
  3. Dialysis pts
  4. Infants on formula
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13
Q

Vit C deficiency Sx:

A
  1. Hemorrhage (gum, skin/petechiae, joints)
  2. Disordered calcification/osteoid matrix formation
  3. Impaired wound healing
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14
Q

Vit C toxicity Sx:

A

N/V, diarrhea, fatigue, sleep issues

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15
Q

When assessing nutritional status, you realize your patient has lost weight (muscle and fat). What’s the next sign you check for?

A

Inflammation

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16
Q

When assessing nutritional status, you realize your patient has lost weight (muscle and fat). There are no signs of inflammation. What is the likely cause of malnutrition?

A

starvation-related malnutrition

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17
Q

When assessing nutritional status, you realize your patient has lost weight (muscle and fat). There is mild/moderate inflammation. What is the likely cause of malnutrition?

A

Chronic disease (organ failure, pancreatic cancer, Rheumatoid arthritis)

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18
Q

When assessing nutritional status, you realize your patient has lost weight (muscle and fat). There is severe inflammation. What is the likely cause of malnutrition?

A

Acute disease/injury-related (major infection, burns, trauma, head injury)

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19
Q

Why does Refeeding Syndrome occur?

A

Chronic starvation/malnutrition followed by refeeding causes high insulin secretion and high glucose/electrolyte uptake in cells (electrolyte imbalance)

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20
Q

Main electrolyte imbalances in Refeeding Syndrome:

A
  1. Hypophosphatemia***
  2. Hypokalemia
  3. Hypomagnesemia
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21
Q

Potential life-threatening complications of Refeeding Syndrome

A
  1. Cardiac dysfunction
  2. Rhabdo
  3. Hemolysis
  4. Resp failure
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22
Q

What are the internationally validated guidelines for Rx of Refeeding Syndrome?

A

There are none (no RCTs)

Replete electrolytes/thiamine replacement, restrict caloric intake

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23
Q

List some complications of jejunoileal bypass involving other organ systems

A
  1. Renal failure (oxalate storm)

2. Liver failure (bac overgrowth in blind gut)

24
Q

T/F: Up to 100% of patients that undergo jejunoileal bypass have hepatic abnormalities.

A

True - 40% have liver failure and 10% mortality from this

25
Q

Which mineral deficiency is relatively common in bariatric surgery?

A

Zn

26
Q

Pt undergoes bariatric surg and presents a year later with some hair loss. This could be due to (X), so you look for which other key symptoms?

A

X = Zn deficiency

  1. Alopecia
  2. Delayed wound healing
  3. Hypogonadism
27
Q

Pt being treated for Zn deficiency develops anemia, numbness/tingling and ataxia. What is the likely cause?

A

Cu deficiency (ALWAYS CHECK Zn and Cu at same time! absorbed together)

28
Q

Bariatric surg patient being treated for Zn deficiency must also (take/avoid):

A

Take Cu supplements (1 mg Cu for each 8-15 mg Zn)

29
Q

T/F: Sleeve Gastrectomy is a purely malabsorptive procedure.

A

False - purely restrictive (decrease stomach size) so less nutrient deficiencies

30
Q

Bariatric surg pt presents with ataxia, confusion, and double vision. What’s the likely diagnosis?

A

Thiamine deficiency! (triad: ophthalmoplegia, ataxia, altered mental status)

31
Q

Gastric bypass is a (restrictive/malabsorptive) procedure that commonly causes (X) deficiency.

A

Both

X = Fe

32
Q

Gold standard bariatric procedure up till now

A

Roux en Y bypass

33
Q

Patients with mild/moderate hypoglycemia have blood glucose around (X) mg/dL and which Sx?

A

X = 70

Sweating, trembling, difficulty concentrating, light-headed, lack of coordination

34
Q

Patients with mild/moderate hypoglycemia should be treated with:

A

Self treat (rule of 15)

15g glucose/snack
Recheck glucose after 15 min

35
Q

DM I patient feels hypoglycemic, so he goes to the fridge to pour a glass of milk. Would skim or whole milk be the better option?

A

Skim (or lowfat) - fat delays absorption of CHO

36
Q

Self-treating hypoglycemia: (fruit juice/doughnuts/cheese/raisins/chips) would be good options for quick-acting CHOs

A

Fruit juice, Raisins (the rest are high in fat)

37
Q

Severe hypoglycemia is usually characterized by:

A

Inability to self-treat (mental status change)

38
Q

Your friend with DM I becomes very lethargic and you are concerned he’s hypoglycemic. What would you grab right away if he can swallow?

A

Glucose gel, honey, juice

39
Q

Your friend with DM I becomes very lethargic and you are concerned he’s hypoglycemic. What would you grab right away if he can’t swallow?

A

Glucagon injection (from kit)

40
Q

Atkin’s diet is (low/high) (X) diet with which adverse effects?

A

Low
X = CHO (induction period only 20g CHO per day!)

Restrictive, increase CV disease risk (no restrictions on intake of calories, protein, or fat (except no trans fats))

41
Q

T/F: The DASH diet has no known cons

A

True

42
Q

The DASH diet recommends (X) servings of fruit and (Y) servings of vegetables per day.

A

X = Y = 4-5

43
Q

The (X) Diet is a vegetarian diet designed to provide calories in the following ratio: 10% (CHO/fat/protein), 20% (CHO/fat/protein), 70% (CHO/fat/protein). What are the caloric restrictions?

A

X = Ornish

Fat; protein; CHO
No caloric restrictions

44
Q

T/F: The Ornish diet can reverse heart disease

A

True - if followed strictly

45
Q

(X) Diet provides emphasis on exercise and stress reduction

A

X = Ornish

46
Q

Average consumption of American population: (X)% fat, (Y)% CHO, (Z)% protein.

A 
X = 45
Y = 30
Z = 25
47
Q

Cons of vegetarian diet include potentially inadequate (X) intake

A

X = vit B12 and omega-3 FA

48
Q

Vegetarian diet can reduce risk of:

A
  1. CV disease, HT, DM II
  2. Certain cancers
  3. RA, gallstones, kidney disease
49
Q

T/F: The paleo diet is high in Na

A

False - low in Na, excludes salt from diet

50
Q

Which major food groups are excluded in Paleo diet?

A

Grains and dairy

51
Q

T/F: Paleo diet is high in fat intake

A

True

52
Q

Gluten found in:

A

Barley, wheat, rye

53
Q

Many gluten-free food is also not enriched with (X), which can lead to deficiency in these if gluten-free diet is followed

A

X = Fe, fiber, folate

54
Q

Low CHO v low fat diet: which had greater weight loss at 12 mo?

A

Both had similar weight loss

55
Q

Low CHO v low fat diet: which was better with regard to dyslipidemia and glycemic control?

A

Low CHO

56
Q

(X) are orexigenic neurons located in (Y) part of brain. They (increase/decrease) satiety and (increase/decrease) food intake.

A 
X = NPY (neuropeptide Y)
Y = arcuate nucleus (hypothalamus)

Decrease; increase

57
Q

(X) are anorexigenic neurons located in (Y) part of brain. They (increase/decrease) satiety and (increase/decrease) food intake.

A 
X = POMC
Y = arcuate nucleus (hypothalamus)

Increase; decrease

Endocrinology/Nutrition (10 decks)

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