Anatomical pathology- Metabolic disorders

Question 1

What is obesity?

Answer 1

-results from excessive intake of calories relative to the needs of the body
-measured using BMI
-high BMI is associated with higher mortality

Question 2

What are the causes of obesity?

Answer 2

-excessive ingestion of calories
-genetic e.g. appetite and metabolism efficiency
-psych reasons
-endocrine disorders e.g. hypothyroidism

Question 3

Condition associated with obesity

Answer 3

-diabetes mellitus
-hypertension
-atherosclerosis
-gallstones and gallbladder disease
-osteoarthritis
-surgical complications
-respiratory coplications
-cancer

Question 4

Measuring the state of nutrition

Answer 4

-body weight
-subcutaneous fat by skinfold thickness
-muscle mass by midarm circumference
-serum proteins

Question 5

What is Kwashiorkor?

Answer 5

-lack of protein with more or less calorie intake
-protein deficiency with excessive carb diet
-muscle wasting
-failure to grow
-hypoproteinaemia and hypoalbuminaemia
-body fat is maintained
-underweight and oedematous
-depigmentated hair and skin rash
-secondary infections and lethargy
-fatty liver
-anaemia
-decreased immune response

Question 6

pathological exam of kwashiorkor

Answer 6

-skeletal muscles appear wasted and pale
-small heart and heart failure
-atrophic pancreas
-villous atrophy of intestines
-marked fatty change of liver
-infections

Question 7

What is Marasmus?

Answer 7

-the normal body weight for is age if less than 60%
-loss of muscle bulk and fat
-skin is wrinkled and shrunken
-no oedema or hepatomegaly
-growth failure and retardation
-more fatal than kwashoirkor

Question 8

Vitamin deficiencies

Answer 8

-A,D,E,K are fat soluble
-B,C are water soluble
-B includes thiamine (B1), niacin (B12), B6, riboflavin (B2)

Question 9

Vitamin A deficiency

Answer 9

-characterised by ocular complications that result in night blindness, xerophthalmia and keratomalasia
-squamous metaplasia of epithelium such as bronchopneumonia, kidney stones and folicular hyperkeratosis

Question 10

Vitamin D deficiency

Answer 10

-rickets in children
-osteomalacia in adults
-low serum Ca2+ and high ALP

Question 11

Vitamin K deficiency

Answer 11

-synthesized by gut bacteria
-required for the formation of PT and factor V and VII
-leads to haemorrhagic state

Question 12

Vitamin B1 (thiamine) deficiency

Answer 12

-causes chronic alcoholism

Question 13

Vit B12 and iron deficiency

Answer 13

-iron deficiency results in hypochromic, microcytic anaemia
-Vit B12 results in megaloblasic anaemia same with folic acids
-Vit B12 causes pellagra which shows dermatitis, diarrhoea, dementia and death if untreated

Question 14

Vit B6 deficiency

Answer 14

-have an impact on a type of anaemia in which iron cannot be used properly in Hb formation
-sideroblastic anaemia

Question 15

Vit B2 (riboflavin) deficiency

Answer 15

-causes sore tongue and fissuring of corner of mouth
-dermatitis
-intestitial keratitis

Question 16

Vit C deficiency

Answer 16

-also known as scurvy
-causes weakness of collagen in blood and vessel walls
-complications includes bleeding into skin and gums, subperiostial haematoma and bleeding into joints, defective osteoid formation and bone deformities in children, impaired wound healing and anaemia
-

Question 17

Diabetes Mellitus

Answer 17

-lack of insulin or failure of its action
-impaired CHO metabolism and hyperglycaemia

Question 18

Type 1 DM (IDDM)

Answer 18

-less common
-younger
-thin
-vral/autoimmune
-no insulin
-MHC link and concordance 40%
-ketotic coma

Question 19

Type 2 DM (NIDDM)

Answer 19

-common
-older
-obese
-resistance to insulin
-normal insulin
-no MHC link and concordance 100%
-hyperosmolar coma

Question 20

Complications of DM

Answer 20

-accelerated atherosclerosis and micro-angiopathy (MI, stroke, PVD)
-chronic renal failure
-infections