8. Nutrition Flashcards
What’s the big difference between anorexia and bulimia?
Body image extremely distorted in anorexia - 60 lb woman
Bulimia - binges
Why do people with anorexia and bulimia have amenorrhea?
Decreased GnRH
What do people with anorexia die of?
Cardiac problems
What acid base disturbance do you get with vomiting?
Metabolic alkalosis
What major esophageal complication are bulimics at risk of?
Boeerhave syndrome (+ Mallory Weiss)
What BMI means obese?
> 30
What is the main complication of obesity?
Hypertension, left ventricular hypertrophy, potential risk of heart failure
What kinds of cancer does obesity predispose you to?
Estrogen cancers because adipocytes increase aromatic activity - e.g. breast cancer
What’s the major function of water soluble vitamins?
Cofactors
What does Vitamin A deficiency look like?
Night blindness, failure to thrive, squamous metaplasia (particularly white spots in the cornea)
Big game hunter who eats bear liver with headaches?
Hypervitaminosis A (cerebral edema and liver)
What is the most common source of vitamin D?
Sunlight
Is there vitamin D in breast milk?
No - that’s why babies need to be exposed to sunlight
Where is vitamin D absorbed in the gut?
Jejunum
Where is 1 alpha hydroxylase synthesized?
PCT (stimulated by PTH)
What does vitamin D do?
Increase absorption of calcium and phosphate
Why do thiazides have a risk of hypercalcemia?
Na and Ca take turns in the DCT but thiazides block reabsorption of Na so Ca is more able to be reabsorbed
What is the only hormone that has a receptor on an osteoclast?
Calcitonin
Where is PTH’s receptor?
Osteoblast
When PTH binds to osteoblast what does it release?
IL-1 also called osteoclast stimulating factor
How do cytochrome p450 inducers/inhibitors affect calcium levels?
Inducers (e.g. phenytoin, chronic alcohol) cause increased metabolism of vitamin D so it leads to hypocalcemia
What is the enzyme of the smooth ER (marker of revved up cyp450)?
Gamma glutamyl transferase
What is the most common cause of vitamin D deficiency?
Renal disease (e.g. from diabetes mellitus)
What’s the most common complication of hypervitaminosis D?
Hypercalcemia –> Calcium stones
What is Vitamin E’s main function?
- Maintain cell membranes - prevent membrane peroxidation
2. Neutralizes oxidized LDL (cardio protective)
What are the complications of Vitamin E deficiency?
Neurologic symptoms (demyelination of dorsal columns) and hemolytic anemia (membrane damage)
What does Vitamin E toxicity look like?
Makes someone anticoagulable (prevents synthesis of K dependent factors)
Where does most of Vitamin K come from?
Made by colonic bacteria (some comes from diet but most is made in the GI)
What enzyme activates vitamin K?
Epoxide reductase
What does vitamin K do?
Gamma carboxylation of coagulation factors - allows calcium to bind to these factors so that they can form a clot (basically form an anchor point)?
What does warfarin do?
Block epoxide reductase
What’s the most common cause of vitamin K deficiency in the hospital?
Broad spectrum antibiotics - wipe out GI bacteria
Rat poison is what?
Warfarin
