Ch 9 Nutritional Diseases

Question 1

marasumus

Answer 1

somatic compartment - proteins in skeletal mm
weight falls 60% of normal
growth retardation and loss of mm
skeletal mm is broken down to supply body with AA for energy
low leptin - stimulation of lipolysis
head is too large for body
anemia, vitamin deficiencies, immune deficiency
concurrent infections

Question 2

kwashiorkor

Answer 2

visceral compartment - proteins in visceral organs, primary is liver
protein deprivation is more sever than the deficit in total calories
weaned too early and fed CHO
generalized or dependent edema due to hypoalbuninemia
skin lesions w/ alternating zones of hyper pigmentation
hair changes, overall loss of color or alternating bands
enlarged fatty liver

Question 3

main anatomic changes of protein energy malnutrition (PEM)

Answer 3

growth failure
peripheral edema - kwashiorkor
loss of body fat and trophy of mm - marasmus

Question 4

morphology - PEM

Answer 4

bone marrow - hypoplastic, decreased RC precursors due to anemia
brain - cerebral atrophy, reduced number of neurons, impaired myelination of white matter
thymic and lymphoid atrophy

Question 5

cachexia

Answer 5

characterized by extreme weight loss, fatigue, mm atrophy, anemia, anorexia, edema
mortality is due to atrophy of the diaphragm and resp. mm
mediators work through NF kappa B induced activation of Ub proteasome pathway

Question 6

fat soluble vit.

Answer 6

A, D, E, and K

Question 7

vitamin A function

Answer 7

maintenance of normal vision, regulation of cell growth and differentiation, regulation of lipid metabolism

Question 8

vitamin A deficiency

Answer 8

night blindness, xerophthalmia, blindness
squamous metaplasia
vulnerability to infections (measles)

Question 9

vitamin D function

Answer 9

maintenance of adequate plasma levels of Ca and P to support metabolic functions, bone mineralization, neuromuscular transmission

Question 10

vitamin D deficiency

Answer 10

rickets - children

osteomalacia - adults

Question 11

vitamin D deficiency - morphology

Answer 11

rachitic rosary - deformation of chest due to overgrowth of cartilage
pigeon breast deformity
lumbar lordosis
bowing of the legs

Question 12

vitamin C function

Answer 12

activation of prolyl and lysyl hydroxylase - hydroxylation of pro collagen

Question 13

vitamin C deficiency

Answer 13

leads to the development of scurvy, characterized by bone disease in growing children and hemorrhages and healing defects in children and adults

Question 14

BMI less than 18.5

Answer 14

underweight

Question 15

BMI 18.5 - 24.9

Answer 15

normal

Question 16

BMI 25 - 30

Answer 16

overweight

Question 17

BMI greater than 30

Answer 17

obese

Question 18

general consequences of obesity

Answer 18

insulin resistance and hyperinsulinemia ( DM2) 
coronary artery disease
nonalcoholic fatty liver disease 
cholelithiasis (6x more common) 
hypoventilation 
hypersomnolence 
osteoarthritis

Question 19

obesity and cancer

Answer 19

increase in insulin increases IGF-1 which activates RAS and PI3K and AKT pathways promoting growth
steroid hormones that regulate cell growth and differentiation in the breast, uterus, and other tissues
proinflammatory state

Question 20

aflatoxin

Answer 20

hepatocellular carcinomas due to mutation in 249 of TP53

Question 21

nitrosamines and nitrosamines

Answer 21

gastric carcinomas

Question 22

high animal fat w/ low fiber

Answer 22

colon cancer