1 - Nutritional Disease Flashcards
1
Q
Emaciation resulting from inadequate intake of calories (starvation); carb, protein, and fats all equally deficient.
A
Marasmus
2
Q
How is the protein depletion manifested in Kwashiorkor?
A
Loss of organ protein (albumin) causing generalized edema (anasarca) and fatty liver
3
Q
What are the hair and skin changes due to protein deficiency in Kwashiorkor?
A
- Depigmented hair and alopecia
- Flaky paint skin
4
Q
What is the acid erosion of lingual surfaces of upper anterior teeth associated with Bulimia called?
A
Perimolysis
5
Q
In Bulimic patients, yellow skin can result from what?
A
Carotemia
6
Q
Anorexia Nervosa and Bulimia can feature deficiencies of what?
A
Vitamin C, Niacin, Zn?
7
Q
What 3 things do fat cells produce?
A
leptin, adiponectin, and cytokines
8
Q
- Turns off appetite control in hypothalamus
- Causes secretion of NE which burns fat (exercise and heat). GOOD.
A
Leptin
9
Q
- Directs fatty acids to muscle for oxidation
- Makes liver sensitive to insulin. GOOD.
A
Adiponectin
10
Q
- Cause subclinical inflammation
- High C-reactive protein. BAD.
A
Cytokines
11
Q
What does the stomach produce, which increases appetite?
A
Ghrelin
12
Q
What are Gallstones composed of?
A
Cholesterol
13
Q
What does Hyperestrogenemia contribute to?
A
breast and endometrial cancer
14
Q
What Obesity associated health risk is characterized by: Enormous abdominal obesity compresses diaphragm causing restriction of ventilation, sleep apnea, hypoxia.
A
Pickwickian (Hypoventilation) Syndrome
15
Q
What are the sources of Vitamin A?
A
vegetables and dairy
16
Q
Where is Vit. A stored?
A
Ito cells in liver for 6 months
17
Q
What are the sources of Vitamin D?
A
Suntanned skin (only 15 mins daily); Dairy, fish oil, grains
18
Q
What is the function of Vit. D?
A
Maintains serum Ca
- increasing intestinal absorption
- mobilizes Ca from bone (with PTH)
- Reabsorption of Ca from distal renal tubules
19
Q
What does Vit. D deficiency in kids result in?
A
Rickets
20
Q
What does Vit. D deficiency in adults result in?
A
Osteomalacia
21
Q
In Vit. A Deficiency, there is increased mortality from infections, especially …?
A
Measles
22
Q
What are 2 Vit. A Deficiency Diseases?
A
- Night Blindness
- Squamous Metaplasia (dry eyes, coral blindness, dry mouth, skin lesions, white premalignant oral lesions)
23
Q
What is caused from an excess in Vit. A? (3)
A
- Carotemia (yellow color in skin and fat from stored beta carotene)
- Headache, vomiting
- Birth defects (retinoids)
24
Q
Why is there is no Hypocalcemia associated with Vit. D Deficiency?
A
PTH mobilizes Ca from bones
25
What is the biggest increased risk of cancer associated with Vit. D Deficiency?
Colon; breast and prostate to a lesser extent
26
In Vit. D what is produced but not mineralized; Children - soft deformed bones, bow legs, hypo plastic teeth; Adults - fractures?
Osteoid
27
What is the therapeutic use of Vit. D?
- Enhance the immune system
| - Prevent bacterial and viral infections
28
Therapeutic treatment of Vit. D might be helpful in patients with what?
Sepsis
29
What is the function of Vit. E?
Major Antioxidant - scavenges free radicals (along with selenium)
30
What is the result of excess Vitamin E?
Bleeding Diathesis - excessive bleeding
31
What are the Deficiency Diseases of Vit. E
- loss of nerve cells in spinal cord and nerve myelin (causing los of reflexes, proprioception and pain sensation)
- Shortened RBC life
32
What is Vit. K a cofactor to?
carboxylate glutamate
33
Vit. K is a cofactor to carboxylate glutamate which allows calcium binding sites on ...
- Clotting factors VII, IX, X, prothrombin
| - Osteocalcin (Ca binding of bone matrix)
34
In what patients is Vitamin K Deficiency seen?
- Diseases of fat malabsorption
- Pts on Coumadin
- Not gut bacteria (antibiotics, neonates)
35
What are the Deficiency states in pts with Vitamin K Deficiency?
- bleeding especially in neonates
| - poor calcification of bone matrix
36
What Thiamine (B1) Deficiency Disease is characterized by, symmetric demyelinization of peripheral nerves causing wrist and ankle drop, loss of reflexes, muscle weakness?
Dry beri beri
37
What Thiamine (B1) Deficiency Disease is characterized by, peripheral vasodilation, flabby heart, AV shunting of blood (doesn't go through capillary beds, so the heart has to pump harder to get blood to peripheral areas = High Output Cardiac Failure, edema?
Wet beri beri
38
What Thiamine (B1) Deficiency Disease is characterized by, unsteady gait, mental confusion; primarily seen in Alcoholics?
Wernicke-Korsakoff Syndrome
39
What are the functions of Riboflavin (B2)?
- FAD which is involved in oxidation-reduction runs in intermediary metal.
- Mitochondrial enzymes
40
Niacin is synthesized in the body from what?
Tryptophan
41
In large doses (therapeutic) what does Niacin do?
Lowers LDL
42
Where is there no Niacin?
Corn
43
What is the Niacin Deficiency Disease?
Pellagra
44
What are the 3 D's of Pellagra?
1. Dermatitis - thick, red, dry scaly skin, patches around neck; oral lesions
2. Diarrhea - caused by atrophy of columnar intestinal lining
3. Dementia - caused by neuronal degeneration
45
Pyridoxine (B6) Deficiency causes elevated ..., which favors atherosclerosis and thrombosis.
Homocysteine
46
What are therapeutic doses of Pyridoxine used for?
Carpal Tunnel Syndrome
47
What does Cobalamin (B12) require in stomach to be absorbed in distal ileum?
Intrinsic Factor
48
What is the source of Cobalamin (B12)?
Meat (vegans must supplement)
49
How long is Cobalamin (B12) stored in the liver?
5-20 years
50
What are the 4 Functions of Cobalamin (B12)?
- Homocysteine --> methionine
- Methylmalonyl CoA --> succinyl CoA
- Folate metabolism and DNA synthesis
- Maintenance of myelin in spinal cord
51
What are the 3 non-dietary Cobalamin (B12) Deficiency causes (except in vegans)?
- Chronic Atrophic Gastritis (with loss of parietal cells - intrinsic factor)
- Malabsorption in ileum (Crohns)
- Lymphoid Malignancies that steal B12
52
Humans are one of the few animals that cannot make Vit C due to what missing enzyme?
L-gluconolactone oxidase
53
What are the functions of Vit C?
- Hydroxylation of procollagen
| - Antioxidant (acting synergistically with Vit E)
54
What is the Vitamin C Deficiency Disease; deficiency occurs 2-3 months after 0 intake?
Scurvy - puerpera and hematomas in gingiva, skin, joint and periosteum
55
What is the Pathogenesis of Scurvy?
Collagen without hydroxyproline is weak especially in capillaries and venules
56
Scurvy causes deformed bones due to the lack of what?
osteoid matrix --> no bone matrix forming
57
What is the Pathogenesis of Hypocalcemia?
No Parathyroid = DiGerorge Syndrome
58
What is the Pathogenesis of Hypercalcemia? (5)
- Parathyroid tumor
- End Stage Renal Disease (with phosphate retention)
- Bone destroying tumors
- Excess dietary Ca (antacids) or Vit D
- Granulomatous Disease (Sarcoid)
59
What is a B12 Deficiency State due to impaired folate utilization?
Megaloblastic Anemia w/o neural defects
60
B12 Deficiency State due to loss of other rapidly diving cells, what are they?
- Neutrophils
- Germ cells
- Intestinal Epithelium
- Chronic Atrophic Glossitis
61
B12 Deficiency raises levels of serum homocysteine which ...
make blood hypercoagulable and accelerates atherosclerosis
62
B12 Deficiency raises levels of methylmalonic acid with causes ...
demineralization of spinal tracts (numbness and tingling of extremities followed by irreversible paraplegia)
63
What is the source of Folate?
Vegetables, cooking destroys folate
64
Where is Folate absorbed?
Proximal ileum; liver stores 6 mo supply
65
What is the function of Folate?
Required for DNA replication and cell division
66
What does Folate Deficiency contribute to the development of?
Colon Cancer
67
What are the sources of iron?
Meat and green vegetables
68
A source of Iron is from it being conserved in the body from worn out RBC by macrophages as what?
hemosiderin
69
What is Iron required for (its function)? (4)
hemoglobin, myoglobin, cytochromes, catalase
70
What are the 3 Iron Deficiency Diseases?
- Anemia
- Oral Mucosal Atrophy
- Plummer Vinson Sx (oral and esophageal atrophy with cancers)
71
What is the disease of Excess Iron where; iron is stored in macrophages, marrow, lymph nodes, spleen, causing NO SYMPTOMS?
Hemosiderosis
72
What is the disease of Excess Iron where; massive iron overload in many organs causing systemic disease?
Hemochromatosis
73
What is the function of Iodine?
Required to make thyroxin
74
What are some Iodine antagonist foods causing Iodine deficiency?
Broccoli, cauliflower, cabbage, Brussels sprouts, rutabaga, turnips
75
What is the Deficiency disease of Iodine?
Simple and Multinodular Goiter
76
What are the sources of Zinc?
meat, fish, dairy
77
What are the functions of Zinc?
- Component of oxidase enzymes
| - Needed for gene regulation, protein synthesis, and immune function
78
What is the function of Pyridoxine-B6?
involved in metabolism of lipids and amino acids
79
What does Folate Deficiency raise the levels of (like B12)?
Homocysteine
80
In Hypercalcemia, there is metastatic calcification in alkaline tissue (stomach, lungs, kidney), where it causes ..., and ... with kidney damage
nephrocalcinosis, and nephrolithiasis
81
Zinc Deficiency can result form cereals that have what, that binds zinc and blocks absorption?
phytic acid & fiber
82
Because Zn is bound to albumin what can result in Zn Deficiency?
Hypoalbuminemia
83
What is the Deficiency Disease of Zinc?
Acrodermatitis Enteropathia
84
What are the 3 therapeutic uses of Zinc?
- improve taste
- prevent diabetic cardiomyopathy
- reverse effects of anorexia nervosa
85
Copper is the component of what enzymes?
cytochrome c oxidase, dopamine, tyrosinase, lysol oxidase, etc.
86
Copper deficiency is seen in pts with what syndrome?
Ehlers-Danlos Sx - copper can't bind to lysol oxidase
87
What is the Copper Excess condition where, excessive copper storage in liver, brain, and eye causes cirrhosis, liver cancer, dementia and green iris?
Wilson Disease (auto recessive)
88
What is the Deficiency disease of Selenium?
Keshan Disease (common in China) --> myopathy, cardiomyopathy
