Biochem- starvation and malnutrition Flashcards

1
Q

Post-absorptive period fuels produced/used

A

Produced: glucose from hepatic glycogenolysis and gluconeogenesis
Fatty acids from adipose tissue

Used: glucose by all

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2
Q

Gluconeogenesis begin and when fully active

A

4-6 hours after last meal begins

fully active at 10-18 hours after last meal – glycogen stores depleted

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3
Q

Fuel production and usage in early starvation (24 hours last meal)

A

Produced: glucose from gluconeogenesis
Fatty acids from adipose tissue

Used:
Brain: glucose – can used ketone bodies
Muscles and other tissues: some glucose, mostly fatty acids

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4
Q

Fatty acid breakdown

A

FA -> acetoacetate – +NADH to NAD+ –> b-hydroxybutyrate

Ketone bodies

Urine test for ketones only detects acetoacetate, not b-hydroxylbutyrate

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5
Q

Fuel production and usage in intermediate starvation (48 hrs after last meal)

A

Produced:
Glucose
Fatty acids
Ketone bodies from liver

Used:
Brain: mostly glucose, some ketone bodies
Muscles, other tissues: fatty acids, some ketone bodies

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6
Q

Metabolic scenario favoring synthesis of ketone bodies

A

When production of acetyl CoA from b-oxidation of FA exceeds oxidative capacity of the TCA cycle

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7
Q

Fuel production and usage in prolonged starvation (5 days after last meal)

A

Produced:
Glucose
Fatty acids
Ketone bodies

Used:
Brain: ketone bodies -> 2 acetyl CoA -> TCA cycle
Other tissues: fatty acids, some ketone bodies and glucose

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8
Q

Overnight fast vs 3 day fast glucose to ketone body usage

A

Overnight: 90% glucose, 5% ketone body

3 day: 60% ketone body, 40% glucose

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9
Q

Ethanol metabolism effect on gluconeogenesis

A

NAD+ regeneration by liver

When liver metabolizing ethanol it can’t perform gluconeogenesis -> severe fasting hypoglycemia when consume a lot of alcohol in a fasting state

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10
Q

Fate of Aceytl CoA

A

TCA cycle
Fatty acid synthesis
Cholesterol synthesis
Ketone synthesis

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11
Q

Refeeding syndrome

A

Negligible nutrient intake at least 5 days

Cells intracellular depleted

Eat -> nutrients pulled back into cells, drops serum levels of Mg2+, phosphate, K+
-> arrhythmias and neurological problems

monitor electrolytes closely
slow feeding

phosphorylate to keep in cells -> depletion of ATP

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12
Q

Kwashiorkor

A

“FLAMES”

Fatty Liver disease – can’t make apoB100 -> lipid accumulation
Anemia
Malnutrition – protein
Edema – lack serum proteins
Skin lesion s- depigmetnaiton of skin and hair

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13
Q

Marasmus

A

Total energy malnutrition
Muscle wasting
SQ fat loss
Edema

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