B5.060 Nutrition Metabolism Flashcards

Question

sources of soluble fiber

Answer 1

fruits vegetables rice bran psyllium seed

Answer 2

``` milk eggs peanuts tree nuts soy fish shellfish wheat ```

Answer 3

GI (70%) cutaneous (24%) respiratory (6%)

Answer 4

acute, severe allergic response that results in lowered BP, respiratory and GI distress can be fatal

Answer 5

family history of allergies history of prior allergen exposure GI permeability atopic dermatitis

Answer 6

occurs throughout small intestine protein balance reflects the sum of protein synthesis and degradation protein turnover is dynamic

Answer 7

proteins are made from 20 different AAs, 9 are essential each AA has an amino group, an acid group, a hydrogen atom, and a side group side group makes each AA unique

Answer 8

1 in 1000 newborns | autosomal recessive

Answer 9

pancreatic juices contain proteolytic enzymes in their inactive, precursor forms when juice enters duodenal lumen, trypsinogen contacts enterokinase expresses on enterocytes trypsinogen is cleaved to trypsin which can activate additional trypsin and the remaining proteolytic enzymes

Answer 10

dipeptides and tripeptides are transported into intestinal cells cytoplasmic peptidases hydrolyze them into AAs

Answer 11

it can't be | need to eat protein every day or the body breaks down tissues

Answer 12

``` fat & lean mass is lost edema from low plasma oncotic pressure hair pluckability & color change, skin breakdown, poor wound healing, dermatitis, edema trauma/sepsis patients susceptible requires aggressive nutrition support ```

Answer 13

body fat stores have been exhausted due to starvation and muscle wasting follows

Answer 14

state that involves substantial loss of fat and lean body mass in the presence of chronic inflammation and disease

Answer 15

accumulation of nitrogenous waste decreased production of active vit D decreased production of EPO decreased glucose production decreased degradation of bioactive peptides accumulation of water, Na, K, inability to handle phosphorus, magnesium, or other vitamins and minerals

Answer 16

``` energy intake: 25-35 kcal.kg low protein low sodium no fluid restriction low potassium low phosphorus moderate calcium individualize vit D, iron, and zinc ```

Answer 17

``` minimize protein energy malnutrition tissue catabolism increases the kidney load of nitrogenous waste indirectly limits phosphorus less protein-induced hyperfiltration lowers intraglomerular pressure ```

Answer 18

slows progression

Answer 19

adverse response to gluten storage proteins (gliadin) that triggers an immune response resulting in damage to the mucosa of the small intestine

Answer 20

1. you must inherit the gene (HLA, DQ2 and/or DQ8) 2. consume gluten 3. have the gene triggered (stress, trauma, viral infection)

Answer 21

``` classic steatorrhea increased stool mass weight loss, weakness iron def anemia metabolic bone loss inflamed mucosa ```

Answer 22

edema, protein malabsorption non-absorption of healing agents leaky gut

Answer 23

undiagnosed or poor diet adherence have increased mortality metabolic bone disease increased risk of DM1 and thyroiditis increased risk of non Hodgkin lymphoma

Answer 24

triggers immune response | more permeable intestine increases gliadin peptide access to immune cells

Answer 25

villous atrophy decreased surface area for absorption chronic inflammation downregulates transport proteins in epithelium decreased CCK and secretin resultin in pancreatic insufficiency bacterial overgrowth

Answer 26

steatorrhea due to changes in jejunal mucosal function secondary lactase deficiency bile acid malabsorption endogenous fluid secretion from crypt hyperplasia

Answer 27

1. digestive phase that includes lipolysis and micelle formation requiring pancreatic lipase and conjugated bile acids respectively 2. absorptive phase for mucosal uptake and re-esterification 3. postabsorptive phase that includes chylomicron formation and exit into lymphatics

Answer 28

1. do not require pancreatic lipolysis, absorbed intact by intestinal epithelim 2. after absorption, MCTs are hydrolyzed by MCFAs 3. MCT exit is via portal vein and not lymphatics

Answer 29

``` usually do to lipase deficiency -pancreatic disease > inadequate lipase -hypersecretion of gastric > low duodenal pH > inactive lipase depleted bile acids pool -ileal resection -bacterial overgrowth ```

Answer 30

bloating gas explosive diarrhea

Answer 31

dry hair hair loss fluid retention (edema, swelling)

Answer 32

light colored, foul smelling stools that are soft and bulky

Answer 33

``` increased energy intake from stage 4 increased protein from stage 4 low sodium fluid restriction low phosphorus moderate calcium moderate potassium ```

Answer 34

renal vitamin to supplement B and C vitamins sometimes have zinc and iron too take after dialysis so nutrients aren't lost

Answer 35

A,D,E,K | too large to pass through dialyzer membrane, can accumulate in blood at dangerous levels

Answer 36

B,C | pass through membrane and removed from body with fluid and wastes

Answer 37

A,D,E,K ingested as esters digested by cholesterol esterase highly insoluble in gut, absorption dependent on incorporation into micells

Answer 38

thiamin, riboflavin, niacin, pyridoxine, pantothenate, biotin and ascorbic acid are Na+ dependent co-transport folate is Zn dependent B12 more complicated

Answer 39

decreased absorption ability | achlorhydria, esp in elderly

Answer 40

pernicious anemia nerve degeneration, weakness tingling/numbness in extremities paralysis and death

Answer 41

30-80% of ingested is absorbed intestinal transport process regulated by calcitriol calcitriol level falls with increased plasma Ca2+ absorption increased with Ca2+ def

Answer 42

3-6% of ingested iron is absorbed most of iron in diet is ferric, but ferrous (Fe2+) is absorbed Fe3+ reduced to Fe2+ by ascorbic acid in lumen absorption regulated by dietary intake, current state of iron stores, and state of EPO

Answer 43

reactions that form cellular molecules energy requiring molecules are building blocks for macromolecules (proteins, nucleic acids, lipids, etc)

Answer 44

CHO, protein, and fat oxidized to CO2 and H2O and liberated electrons passes to O2 to make ATP principle pathways: glycolysis, TCA, ETC, oxidative phosphorylation, hexose monophosphate shunt

Answer 45

glucose dependent insulinotropic peptide (+ insulin) CCK (+ gallbladder contraction) gastrin (+gastric motility and gastric acid release) secretin (+pancreatic juice and enzyme secretion)

Answer 46

glucose AAs FAs

Answer 47

primary hormone responsible for direction of energy metabolism during fed state

Answer 48

insulin stimulated membrane changes | GLUT4 translocation

Answer 49

activation of inhibition of enzymes | insulin stimulated synthesis of glycogen, TG, and protein while inhibiting opposing catabolic actions

Answer 50

further regulation of enzyme action by selective induction or repression of enzyme synthesis increased glucokinase synthesis by promoting gene activity

Answer 51

promotion of growth through mitogenesis and cell replication

Answer 52

uptake of glucose via translocation of GLUT4

Answer 53

increases fatty acid uptake and TAG storage via increase in activity of lipoprotein lipase concomitantly, insulin decrease lipolysis via decrease in activity of hormone sensitive lipase

Answer 54

liver glycogenolysis is used to maintain blood glucose levels and fatty acids are used to make ketone bodies for organ systems and tissues to use for gluconeogenesis decreasing overall demand and depletion of glucose use and stores

Answer 55

lactate glycerol alanine

Answer 56

glucagon epi & NE low levels of insulin

Answer 57

synthesized in a cells of pancreas secreted when circulating glucose is low (some AAs like alanine stimulate secretion) primary site of action is liver increased cAMP levels in cell to phosphorylate proteins

Answer 58

liver takes up blood glucose and stores as glycogen or converts to adipose

Answer 59

packed into CM or packaged at liver in VLDL and transported in circulation to adipose for storage

Answer 60

processed at liver to be stored as glycogen, used to make fat, or sent to muscle used by various tissues to synthesize proteins and nitrogen-containing compounds

Answer 61

liver glycogen major provider of glucose for whole body when glycogenolysis is occurring, synthesis of glycogen and TG in the liver is diminished and gluconeogenesis begins to increase to help maintain blood glucose levels -lactate from muscle and RBCs important source of carbons for GNG -glucose-alanine cycle provides pyruvate for GNG -glycogen lasts 24 hours

Answer 62

glycogen depleted and GNG picks up AA from muscle breakdown provide man of the substrates for GNG glycerol from lipolysis also and lactate from anaerobic metabolism of glucose also contributes the some extent

Answer 63

metabolic shift to spare body protein GNG to lipolysis as fat becomes major supplies of GNG to spare protein glycerol liberated from TG breakdown still used by liver to make glucose blood levels of FA increase sharply amount of excess stores determine survival time