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Biochem Nutrition TBL Flashcards

1
Q

What happens to amino acids during extended fast, periods of poor energy or protein consumption?

A

Amino acids are obtained by proteolysis of body proteins to produce energy and nitrogen-containing biomolecules

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2
Q

What happens to the body’s muscle mass and the liver during proteolysis?

A

The body’s muscle mass declines and the liver slows its production of serum proteins

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3
Q

What is MUAMC?

A

Mid Upper Arm Muscle Circumference
Measure of general caloric inadequacy and/or negative nitrogen balance

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4
Q

What is the AMC compared to?

A

Compared to average values of individuals of the same GENDER and AGE

Significantly low AMC = muscle loss

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5
Q

What is CHI?

A

Creatinine-height index
Estimates body muscle mass

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6
Q

What is creatinine?

A

A waste product that is formed and excreted in urine in proportion to body’s muscle mass

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6
Q

What are the ranges for CHI?

A

80-90% = mild deficit
60-80% = moderate deficit
60% = severe deficit

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7
Q

What is the most prevalent protein in serum?

A

Serum albumin

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8
Q

What is Kwashiorkor? What is it caused by?

A

Protein malnutrition with ADEQUATE or SLIGHTLY DEPLETED calorie consumption and micronutrient deficiencies

Can be caused by DIETARY INADEQUACIES OR ILLNESSES that increase the body’s demand for protein

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9
Q

What is Marasmus?

A

PROLONGED protein and calorie malnutrition (body is persistently in STARVED FASTED STATE)

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9
Q

What happens when serum protein concentration declines?

A

The osmolarity of serum decreases

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9
Q

What happens to the liver when the amino acid pool is depleted?

A

It slows its production of serum ALBUMIN (easily measured) and other serum proteins

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10
Q

What happens in severe cases where the osmolarity of serum decreases?

A

It causes water to flow out of the circulatory system into interstitial space (EDEMA AND ASCITES)

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11
Q

Protein malnutrition is…

A

One of many conditions in which serum albumin levels decline

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12
Q

What is the difference between Marasmus and Kwashiorkor?

A

Individuals with Marasmus are persistently in STARVED FASTED state

Individuals with Kwashiorkor –> their body will remain in FED or BASAL state because insulin levels are NORMAL due to regular consumption of carbs BUT dietary protein is deficient

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13
Q

What does Kwashiorkor cause?

A
  • Wasting (causes a person to become progressively weaker)
  • loss of serum proteins (causing edema)
  • hair changes
  • dermatosis
  • decreased immunity
    and others
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14
Q

Poor appetite is due largely to…

A

Normal loss of enterocytes which are not replaced due to lack of proteins (cause digestive problems)

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15
Q

Immune system is…

A

severely compromised for both Kwashiorkor and Marasmus (death, especially Kwashiorkor, is often result of INFECTION)

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16
Q

What feature is present in both Kwashiorkor and Marasmus?

A

Growth failure and wasting

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17
Q

What feature is present in Kwashiorkor but not Marasmus?

A

Edema, hair changes, metal changes, dermatosis, reduced subcutaneous fat, and fatty infiltration of the liver

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18
Q

Explain appetite in Kwashiorkor and Marasmus

A

Poor appetite for Kwashiorkor due to loss of normal enterocytes that are not replaced because of lack of proteins but good for Marasmus

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19
Q

Explain anemia in Kwashiorkor and Marasmus

A

Severe in Kwashiorkor but less severe in Marasmus

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20
Q

Explain facial features in Kwashiorkor and Marasmus

A

Swollen in Kwashiorkor
Gaunt in Marasmus

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21
Q

What is anorexia nervosa?

A

protein and calorie malnutrition (involves nutritional and emotional disturbances)

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22
Q

Who is most likely to have anorexia nervosa?

A

Women

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23
Q

What are the risks associated with anorexia nervosa?

A

Osteoporosis
Heart and kidney damage

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24
Q

What are calcium and iron obtained from?

A

Leafy green veggies
Ca can also be found in dairy products, Fe in meat

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24
Q

What is significant about B12 that poses a concern for vegans?

A

B12 can only be obtained from ANIMAL sources

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25
Q

What is EAR?

A

Estimated Average Requirement

Quantity of nutrients required to meet needs HALF the population

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25
Q

What is RDA?

A

Recommended Dietary Allowance

EAR + 2 standard deviations, will meet the needs of 97-98% of the healthy population

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26
Q

What is AI?

A

Adequate Intake

Based on an estimate of nutrient intake in healthy people (used when insufficient scientific evidence is available to establish RDA)

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27
Q

What is UL?

A

tolerable Upper intake Limit

Highest average daily nutrient intake level that is likely to pose NO RISK of adverse health effects
(intake above UL occurs most often with dietary or pharmacological supplements)

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28
Q

What is significant about RDA and UL

A

May vary depending on a person’s AGE and GENDER

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29
Q

What is the function of water-soluble vitamins?

A

Most are precursors of coenzymes, some are used directly without modification

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30
Q

Vitamin C acts as…

A

An anti-oxidant

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30
Q

What is another function of vitamin C?

A

It serves as COFACTOR for enzymes involved in COLLAGEN BIOSYNTHESIS and important for IRON ABSORPTION

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30
Q

Why are B complex vitamins important?

A

They are important in ENERGY METABOLISM

Most act as cofactors for metabolic enzymes

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31
Q

What are the energy-releasing vitamins?

A

B1 (thiamine)
B2 (riboflavin)
B3 (niacin)
B5 (pantothenic acid)
B7 (biotin)

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32
Q

What are the hematopoietic vitamins?

A

B9 (folic acid)
B12 (cobalamin)

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32
Q

What are the other vitamins?

A

B6 (pyridoxine - AA metabolism)
Bp (choline - lipid metabolism)

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33
Q

Why are fat-soluble vitamins important?

A

They are transported and absorbed with fat which allows the body to obtain these necessary vitamins

34
Q

Explain the consumption of fat-soluble vitamins

A

Because they are long-term storage in the liver and adipose tissue, excess consumption of these vitamins (except K) results in toxicity

35
Q

Explain vitamin A

A

Aka retinols, beta-carotenes

Key role in vision and differentiation and proliferation of various cell types

35
Q

Explain vitamin D

A

Aka cholecalciferol

Important in bone metabolism, proliferation and metabolism, and apoptosis of various cell types

36
Q

Explain vitamin K

A

Aka phylloquinones and menaquinones

Essential for efficient blood clotting (factors)

37
Q

Explain vitamin E

A

Aka tocopherols

Structurally related compounds are important for cellular anti-oxidant (fat-soluble so they are embedded in membranes to protect against oxidative stress within membranes, and protect lipids from being oxidized)

37
Q

What are the electrolytes?

A

Potassium, sodium, and chloride

38
Q

What are the roles of essential minerals?

A

Acting as electrolytes to establish ION GRADIENTS, structural role in BONES AND TEETH, being incorporated in BIOMOLECULES, and acting as COFACTORS or STRUCTURAL ELEMENTS in proteins

38
Q

What disease does a deficiency in B3 cause?

A

(niacin)
Pellagra

38
Q

What are the essential minerals?

A

Calcium, iron, and zinc

39
Q

What disease does a deficiency in B1 cause?

A

(thiamin)
Beriberi

39
Q

What disease does a deficiency in vitamin C cause?

A

Scurvy

39
Q

What diseases does deficiency in vitamin B2 cause?

A

(riboflavin)
Arabinoflavinosis

40
Q

What disease does a deficiency in B9 and B12 cause?

A

(folate and cobalamin)
Macrocytic anemia

41
Q

What diseases does a deficiency in vitamin A cause?

A

Night blindness, xerophthalmia, keratinization

42
Q

What disease does a deficiency in vitamin D cause?

A

Rickets (kids), osteoporosis and osteomalacia (adults)

43
Q

What disease does a deficiency in calcium cause?

A

Osteoporosis (sometimes osteomalacia or rickets)

44
Q

What disease does a deficiency in iron, copper, and B6 cause?

A

Microcytic anemia

45
Q

Explain a deficiency in Fe

A

It is required for proper HEMOGLOBIN FUNCTION and is utilized by many enzymes including many required for CELL ENERGY PRODUCTION

Deficiency associated with MICROCYTIC, HYPOCHROMIC anemia

Dietary sources = heme iron (easier for digestive system to absorb iron attached to heme) from meat, seafood and non-heme iron (free iron) from nuts, legumes, veggies, and fortified grains

46
Q

Explain a deficiency in Ca

A

It is required for proper BONE STRUCTURE AND FUNCTION as well as in multiple PHYSIOLOGIC processes

Deficiency causes osteoporosis, less frequently osteomalacia or rickets

Primary dietary sources: dairy products but also bony fish, leafy green veggies, legumes (dried beans), and fortified foods

47
Q

Explain a deficiency in Zn

A

It is required for proper activity of 100+ enzymes including many TRANSCRIPTION FACTORS (zinc finger motif)

Deficiency associated with IMPAIRED IMMUNE FUNCTION, in severe cases = hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, eyes and skin lesions

Daily intake of Zn is required because body DOES NOT have specialized storage for Zn

Dietary sources: red meat, poultry, legumes, nuts, dairy products, and fortified foods

48
Q

What are the functions of B vitamins?

A

Water soluble
Key roles in cell energy production, and anabolism of nucleotides and amino acids

49
Q

Where are signs of B complex deficiencies seen?

A

Signs appear in rapidly growing epithelial cells, specially SKIN AND GI TRACT (readily noticed on tongue and throat)

CNS sometimes affected

49
Q

B complex deficiencies will…

A

Affect ALL tissues

49
Q

Who is most likely to have a deficiency in vitamin B1?

A

Alcoholics, homeless, and other malnourished populations

50
Q

What are the 3 types of Beriberi?

A

Dry Beriberi = damage to nervous system (numbness to feet, painful tender muscles, emaciation, aphonia)

Wet Beriberi = damage to cardiovascular system (edema, dilation of right heart, HEART FAILURE)

Infantile Beriberi = when infant is breast-fed by a thiamin-deficient mother

50
Q

What do prolonged deficiencies in B1 cause?

A

Beriberi and Wernike-Korsakoff syndrome

51
Q

What results in Wernicke-Korsakoff syndrome?

A

Chronic alcohol abuse
Mostly dry Beriberi

52
Q

What are the symptoms of Wernicke-Korsakoff syndrome?

A

Confusion, coma, and death

53
Q

What happens to people who are hypoglycemic and had thiamin deficiency?

A

They are given a dose thiamin prior to glucose administration in cases of alcohol-induced hypoglycemia

54
Q

Explain a deficiency in vitamin B3

A

Niacin deficiency primarily affects ALCOHOLICS but may also result from diseases that cause INTESTINAL MALABSORPTION or treatment with certain drugs

Pellagra

55
Q

What does Pellagra cause?

A

Photo-induced skin lesions (dermatitis), diarrhea, dementia, and glossitis

56
Q

Explain B2, B5, B6, B7 deficiencies

A

Symptomatic deficiencies are RARER than with other B vitamins
Riboflavin deficiency = arabinoflavinosis, biotin deficiency = multiple carboxylate deficiency

57
Q

Why are B9 and B12 important?

A

They are important in BIOSYNTHESIS of amino acids and nucleotides

58
Q

What does a deficiency in B9 and B12 cause?

A

MACROCYTIC anemia due to inadequate absorption called pernicious anemia

59
Q

What is the significance of a deficiency in vitamin C?

A

Causes scurvy which results from deficiencies in the synthesis of collagen

60
Q

What are the symptoms associated with a deficiency in vitamin A?

A

Night blindness, increased severity of infectious diseases, xerophthalmia, keratinization

60
Q

Why is vitamin C important?

A

It facilitates intestinal absorption of IRON and is an antioxidant

61
Q

Where is a deficiency in vitamin A most common?

A

In developing countries
About 250 million children have degree of deficiency (1-2% become blind and half will die within a year of becoming blind)

62
Q

Healthy adults have…

A

1-2 years of retinoids stored in their bodies

63
Q

Overt signs of vitamin D deficiency are…

A

Relatively RARE but common

64
Q

Explain rickets

A

Vitamin D deficiency in children that is rare in the US but affects up to half of children in countries like Mongolia and Tibet
- bowed legs
- beaded ribs
- delay closure of the anterior fontanel and growth retardation also observed

65
Q

Low levels of vitamin D are associated with…

A

Cardiovascular disease (hypertension, T2DM)
Cognitive impairment in older adults
Severe asthma in children
Increased risk of some type of cancer

65
Q

Deficiency in vitamin D also causes…

A

Osteoporosis (brittle bone) and osteomalacia (soft bones)

66
Q

Who are most susceptible to deficiencies in vitamin D and why?

A

Elderly because
- SKIN, LIVER, and KIDNEY capacity to MAKE and ACTIVATE vitamin D declines with age
- older adults typically drink little milk
- older adults tend to spend more time in doors and are often very cautious about sun exposure

67
Q

How many young adults in Northern climates have some degree of vitamin D deficiency by the end of winter?

A

2/3

68
Q

How many elderly and hospitalized patients have low vitamin D levels?

A

60%

69
Q

Explain vitamin E deficiency

A

Primary deficiencies are rare but secondary deficiencies are associated with fat malabsorption

70
Q

Why is vitamin E important?

A

Antioxidant properties of vitamin E are ESSENTIAL in maintaining erythrocyte membranes (deficiency causes HEMOLYTIC anemia)

71
Q

What results from a prolonged deficiency of vitamin E?

A

Neuromuscular dysfunction (loss of muscle coordination and reflexes, and impaired vision and speech)

72
Q

Transfer of vitamin E from mother to fetus occurs…

A

In the late 3rd trimester (premature infants can be deficient in vitamin E so are given a dose of vitamin E at birth)

73
Q

Why is vitamin K important?

A

It is required for synthesis of several blood clotting factors

74
Q

What does a deficiency in vitamin K cause?

A

Hemorrhaging

75
Q

Primary deficiencies of vitamin K are…

A

Rare

76
Q

Who are at high risk for vitamin deficiencies?

A

Alcoholics, patients with cystic fibrosis, and gastric bypass patients

76
Q

What is significant about newborns and vitamin K?

A

Newborns have a sterile intestinal tract and vitamin K microbes take weeks to establish so a single dose of vitamin K is given at birth

76
Q

When do secondary deficiencies for vitamin K occur?

A
  • fat malabsorption is present
  • intestinal flora is decimated by antibiotic treatment
77
Q

Explain why alcoholics are at high risk for vitamin deficiencies

A

They have a diet low in nutritional value, coupled with impairment of absorption and/or processing of certain vitamins increases susceptibility to deficiencies in
- vitamins A, B1, B6, B9, C and D

78
Q

Explain why patients with cystic fibrosis are at high risk for vitamin deficiencies

A

Their pancreas is not able to release enough pancreatic lipids leading to impaired ability to absorb fat

Fat malabsorption can cause deficiencies in
- vitamins A, D, E, K

79
Q

Explain why gastric bypass patients are at high risk for vitamin deficiencies

A

Depending on procedures used, loss of GI tract components may result in deficiencies in
- vitamins A, B1, B9, B12, C, D, E, K
- minerals Fe, Zn, and Ca

80
Q

What is the respiratory quotient?

A

The ratio of how much carbon dioxide the body releases to how much oxygen it consumes

81
Q

What are the respiratory quotient values for fats, carbs, and proteins?

A

Fats = 0.7
Carbs = 1.0
Proteins = 0.8

Diana's Flashcards (9 decks)

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