Chapter 28: MNT in Metabolic Disorders Flashcards
happens when abnormal chemical reaction in the body disturbs the process of metabolism causing the body to have too much of some substances or too little of other ones
metabolic disorder
refers to abnormally low glucose level in blood that occurs when the body utilized glucose too rapidly, rate of release of glucose falls behind tissue demands, or excess insulin enters the bloodstream
hypoglycemia
hypoglycemia - types
may occur in individuals with diabetes due to administration of too much insulin or oral diabetes medications
reactive hypoglycemia
hypoglycemia - types
may also occur to individuals without diabetes due to a sharp increase in insulin release after a meal
other caused may be associated with dumping syndrome after gastric injury
reactive hypoglycemia
hypoglycemia - types
symptoms: sweating, palpitations, anxiety, and tremulousness
reactive hypoglycemia
hypoglycemia - types
diet mgmt: small, frequent meals of complex cho, fiber, and a protein source
reactive hypoglycemia
hypoglycemia - types
results from excess insulin or insulin-like substances that are secreted as a result of external factors such as alcohol or drug ingestion, tumors, hepatic disease, and chronic renal insufficiency
fasting hypoglycemia
hypoglycemia - types
symptoms: neuroglycopenia
fasting hypoglycemia
hypoglycemia - types
diet mgmt: high cho to increase the blood sugar level
fasting hypoglycemia
refers to an excessive secretion of thyroxine
hyperthyroidism
the hormone that regulates basal metabolic rate
thyroxine
characteristics:
-weight loss
-engorgement in the eyes
-protrusion of the thyroid gland
-increased appetite
-increased bmr (at least 50%)
-heat intolerance
hyperthyroidism
hyperthyroidism - medical mgmt
antithyroid drugs, surgery
the deficient production of thyroxine due to lack of iodine
hypothyroidism
characteristics:
-decreased bmr (30-40%)
-weight gain
-puffy face, eyelids, hands
-muscular flabbiness
-fatigue
-cold intolerance
hypothyroidism
hypothyroidism - medical mgmt
thyroxine
hypothyroidism - dietary mgmt
diet?
rationale: to prevent weight gain due to low BMR
low calorie
hypothyroidism - dietary mgmt
diet?
rationale: for iodine deficiency
iodine
hyperthyroidism - dietary mgmt
diet: ?
rationale: for increased BMR
high kcal
hyperthyroidism - dietary mgmt
diet: ?
rationale: for energy metabolism
supplementation of vitamins/minerals
is the hypersecretion of the parathyroid gland characterized by hypercalcemia
hyperparathyroidism
manifestations: nausea, irritability, vomiting, osteoporosis, lethargy, kidney stones, and constipation
hyperparathyroidism
hyperparathyroidism - dietary mgmt
diet: ?
rationale: to lower Ca levels
phosphate binders
hyperparathyroidism - dietary mgmt
diet: ?
rationale: to prevent formation of Ca containing renal stones
high fluid intake
hyperparathyroidism - dietary mgmt
diet: ?
rationale: to promote renal clearance and Ca excretion
Na (infused IV)
hyperparathyroidism - dietary mgmt
diet: ?
rationale: acidifies urine and prevent Ca-stone formation
acid-ash diet
hyperparathyroidism - dietary mgmt
diet: ?
rationale: promotes deposition of Ca into the skeleton
phosphate
refers to the hyposecretion of the parathyroid gland characterized by the hyperirritability of the nervous system as manifested by convulsions, cramps, muscle twitching, and spasm
hypoparathyroidism
etiology: absence or abnormality of the parathyroid gland
hypoparathyroidism
nutritional and metabolic actions of what gland?
-increases renal calcium retention
-increases renal phosphate excretion
-stimulates intestinal calcium absorption
-stimulates bone resorption
-stimulates bone anabolism
-stimulates kidney production of the active form of vitamin D
parathyroid gland
hypoparathyroidism - dietary mgmt
diet: ?
rationale: to normalize calcium levels
high calcium
hypoparathyroidism - dietary mgmt
diet: ?
rationale: for increased calcium absorption
high vitamin d
refers to the hyposecretion of the adrenal cortex; low aldosterone and cortisol
addison’s disease
characteristics: weight loss, asthenia, hyperpigmentation. arterial hypotension, hyponatremia and dehydration, and hyperkalemia, increased glycogenolysis, decreased gluconeogenesis
addison’s disease
addison’s disease - dietary mgmt
diet: ?
rationale: to increase the level of Na
high Na
addison’s disease - dietary mgmt
diet: ?
rationale: for underweight because of weight loss due to low supply of glucocorticoids
high kcal
refers to the hypersecretion of hormones in the adrenal cortex
cushing’s disease
characteristics:
-weight gain
-increased glycogeneis, gluconeogenesis, and fatty acids synthesis
-hyperglycemia
-truncal obesity
-buffalo lump
-stimulation of appetite
-low calcium levels
-hypernatremia, edema, hypertension
-wasting
-menstrual changes
-emotional changes
-delayed wound healing
-hypokalemia
cushing’s disease
cushing’s disease - dietary mgmt
diet: ?
rationale: to control edema and hypertension
low Na
cushing’s disease - dietary mgmt
diet: ?
rationale: to prevent hypokalemia
high K
cushing’s disease - dietary mgmt
diet: ?
rationale: for obese to promote weight loss
low kcal
refers to the inability of the body to metabolize copper because of lack of ceruloplasmin
wilson’s disease
transport protein of copper
ceruloplasmin
characteristics: deposition of copper in the brain
wilson’s disease
wilson’s disease - dietary mgmt
diet: ?
rationale: to prevent Cu retention
copper-restricted
a disorder in iron metabolism
the deposition of hemosiderin in liver and spleen resulting to bronzed skin
hemochromatosis
hemochromatosis - dietary mgmt
diet: ?
rationale: because of increased storage of iron
fe-restricted
group of diseases that affect a wide variety of metabolic processes
inborn errors of metabolism
these are genetic errors caused by defects in specific proteins (enzymes) needed to break down some food parts
some of the symptoms are fatal and irreversible
inborn errors of metabolism
inborn errors of metabolism - mgmt
a simple procedure to find out if an infant has a congenital metabolic disorder that may lead to mental retardation or even death if left untreated
it is done immediately after 24 hrs from birth
newborn screening
inborn errors of metabolism - common diseases
a genetically inherited birth defect that causes an unwanted buildup of the amino acid phenylalanine in the blood
phenylketonuria (PKU)
the build-up of phenylketonuria results from the absence or deficiency of phenylalanine hydroxylase (PAH) that converts 1 amino acid, phenylalanine, to another amino acid, tyrosine
phenylketonuria
amino acid involved in phenylketonuria
phenylalanine
inborn errors of metabolism - common diseases
symptoms: mental retardation, lack of pigmentation, apathy, poor physical development, death
phenylketonuria
phenylketonuria - dietary mgmt
phenylalanine-restricted
inborn errors of metabolism - common diseases
refers to the failure to metabolize galactose into glucose because of the absence of galactose1-phosphate uridyl transferase
galactosemia
inborn errors of metabolism - common diseases
symptoms:
-lactose intolerance: vomiting and diarrhea after drinking milk
-growth failure
-liver enlargement
-neurologic disorder
galactosemia
galactosemia - dietary mgmt
-eliminate lactose
-low galactose
-use soy protein isolate formula
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