Chapter 3: Biochemical Assessment Flashcards by isabelle _

Q

measurement of a nutrient and its metabolite in blood, feces, urine, or blood which has a relationship to nutritional status

A

biochemical assessment

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Q

considered as a more objective and precise approach than the other methods

A

biochemical assessment

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Q

biochemical assessment - types

measure levels of the nutrients in biological specimens on the assumption that such tests reflect the total body nutrient content or the nutrient store most sensitive to depletion

A

static biochemical tests

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Q

biochemical assessment - types

show the change of nutrient concentration in any given specimen which is most sensitive to nutritional change

A

static biochemical tests

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Q

biochemical assessment - types

measure the level rather than the function of a nutrient and provide information on the degree of deficiency of the particularly body pool sampled rather than the whole body status

A

static biochemical tests

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Q

biochemical assessment - types

changes in the activities of enzymes dependent on a specific nutrient or in the concentrations of specific blood components dependent on a given nutrient

A

functional biochemical tests

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Q

biochemical assessment - types

assess the consequence of the nutrient deficiency by measuring changes in the activities of a specific enzyme

A

functional biochemical tests

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Q

potential confounders of biochemical assessment

predictive values or cut-off point for a certain group, age, sex, ethnics, physiological state or environmental condition

A

reference/standards

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Q

potential confounders of biochemical assessment

contamination or lysis, time of collection, handling in certain temperature, exposed to sunlight, use of certain anticoagulant, method of configuration, sample storage, and transportation

A

specimen

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Q

commonly used specimen

(serum/plasma): protein, lipids, chon, vitamins, minerals

A

blood

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Q

commonly used specimen

preferred for most hematologic examinations

A

venous blood

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Q

commonly used specimen

gives different results compared to venous blood

A

capillary

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Q

commonly used specimen

reflects chronic status

A

erythrocyte

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Q

commonly used specimen

reflects acute nutrient status; age and size of the cell determine nutrient content

infection influences nutrients concentration in the cells

A

leucocyte

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Q

commonly used specimen

protein, vitamins, sodium, potassium, iodine, selenium, chromium

A

urine

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Q

commonly used specimen

readily available and non-invasive

A

urine

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Q

commonly used specimen

a pre-requisite when used as specimen to determine nutritional status

A

normal renal function

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Q

most preferred as concentration of nutrient metabolite is not equally distributed throughout the day

A

24-hr urine

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Q

influence of infection/inflammation on nutritional biomarkers

can cause immediate lower concentration of nutrient biomarkers due to increased micronutrient loss and decreased stores

A

infection or inflammation

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Q

influence of infection/inflammation on nutritional biomarkers

influences the concentration of serum retinol, carotenoids, pyridoxal phosphate, vitamin c, ferritin, zinc, or selenium

may not give a true indication of their status

A

subclinical infection

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Q

influence of infection/inflammation on nutritional biomarkers

recommended to include acute phase protein measurement when dealing with assessment of nut status

A

world health org

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Q

a condition in which there are no mobilizable iron stores and signs of a compromised supply of iron to tissues are noted

A

iron deficiency anemia

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Q

a condition where a lack of iron in the body leads to a reduction in the number of red blood cells, as reflected in low hemoglobin levels

A

iron deficiency anemia

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Q

is the gold standard for the quantitative determination of hemoglobin

A

cyanmethemoglobin

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hemoglobin determination involves collecting blood through finger prick, _____ of whole blood is pipetted directly into a tube containing 5 ml of cyanmethemoglobin solution

20 ul

is defines as hemoglobin concentration below a specified cut-off point, which can change according to the age, gender, physiological status, smoking habits, and altitude at which the population being assessed lives

enamia

WHO defines anemia in children under 5 y/o and pregnant as a hemoglobin concentration _____ at sea level

<110 g/l

hemoglobin values which anemia is likely to be present in populations at sea level - normal hemoglobin level 6 mos-6 y/o pregnant women

11.0 g/dL

hemoglobin values which anemia is likely to be present in populations at sea level - normal hemoglobin level 6.1-14 y/o females, >15 y/o (non-pregnant/non-lactating) lactating women

12.0 g/dL

hemoglobin values which anemia is likely to be present in populations at sea level - normal hemoglobin level males, >15 y/o

13.0 g/dL

classification of public health significance of anemia in populations on the basis of prevalence estimated from blood levels of hemoglobin severe

prevalence of anemia: >40.0%

classification of public health significance of anemia in populations on the basis of prevalence estimated from blood levels of hemoglobin moderate

prevalence of anemia: 20.0-39.9%

classification of public health significance of anemia in populations on the basis of prevalence estimated from blood levels of hemoglobin mild

prevalence of anemia: 5.0-19.9%

classification of public health significance of anemia in populations on the basis of prevalence estimated from blood levels of hemoglobin low

prevalence of anemia: <4.9%

is the lack of vitamin a in the body

vitamin a deficiency

occurs where diets contain insufficient vitamin a for meeting the needs for growth and development, physiological functions and illness

vitamin a deficiency

leading cause of blindness in children and increases the risk of disease and death from sever infections, may be aggravated by high rates of infection, esp. diarrhea and measles

vitamin a deficiency

blood concentrations of _____ in plasma or serum are used to assess subclinical vitamin a deficiency

retinol

a plasma or serum retinol concentration _____ umol/l indicates subclinical vitamin a deficiency in children and adults

<0.70 umol/l

indicate severe vitamin a deficiency

<0.35 umol/l

guidelines used for the interpretation of vitamin a biochemical data - ug/dL deficient

<10 ug/dL

guidelines used for the interpretation of vitamin a biochemical data - ug/dL low

10-19 ug/dL

guidelines used for the interpretation of vitamin a biochemical data - ug/dL acceptable

20-49 ug/dL

guidelines used for the interpretation of vitamin a biochemical data - ug/dL high

>50 ug/dL

guidelines used for the interpretation of vitamin a biochemical data - umol/L deficient

<0.35 umol/L

guidelines used for the interpretation of vitamin a biochemical data - umol/L low

0.35-0.69 umol/L

guidelines used for the interpretation of vitamin a biochemical data - umol/L acceptable

0.70-1.74 umol/L

guidelines used for the interpretation of vitamin a biochemical data - umol/L high

>1.75 umol/L

prevalence cut-offs to define vitamin a deficiency in a population and its level of public health significance mild

2 - <10%

prevalence cut-offs to define vitamin a deficiency in a population and its level of public health significance moderate

10- <20%

prevalence cut-offs to define vitamin a deficiency in a population and its level of public health significance severe

>20%

main indicator of iodine status in all age groups, because its measurement is relatively non-invasive and easy to perform

median iodine concentration

adequate iodine nutrition is considered to pertain when the median urinary iodine concentration is

100-199 ug/l

the indicator of iodine deficiency "elimination" is a median value of _____, that is, 50% of the sample should be above 100 ug/L and not more than 20% of the samples should be below

100 ug/L

urinary iodine excretion determination: urine collection field storage and transport

15 ml mid-stream

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: insufficient iodine status: severe iodine deficiency urinary iodine excretion (UIE): ? ug/L

<20 ug/L

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: insufficient iodine status: moderate iodine deficiency urinary iodine excretion (UIE): ? ug/L

20-49 ug/L

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: insufficient iodine status: mild iodine deficiency urinary iodine excretion (UIE): ? ug/L

50-99 ug/dL

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: adequate iodine status: optimal urinary iodine excretion (UIE): ? ug/L

100-199 ug/dL

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: more than adequate iodine status: risk of induced hyperthyroidism in susceptible groups urinary iodine excretion (UIE): ? ug/L

200-299 ug/dL

epidemiological criteria for assessment of iodine nutrition in a population based on median or range of urinary iodine concentrations in school-aged children (>6 y/o) iodine intake: excessive iodine status: risk of adverse health consequences urinary iodine excretion (UIE): ? ug/L

>300 ug/dL

guidelines for interpretation of serum 25-hydroxy vitamin D deficient

<50 mmol/mL

guidelines for interpretation of serum 25-hydroxy vitamin D insufficient

50 - <75 mmol/mL

guidelines for interpretation of serum 25-hydroxy vitamin D sufficient

>75 mmol/mL

suggested guidelines for public health concern for zinc deficiency low

<5%

suggested guidelines for public health concern for zinc deficiency moderate

5 - <10%

suggested guidelines for public health concern for zinc deficiency moderately high

9 - 20%

suggested guidelines for public health concern for zinc deficiency high

>20%

condition: nutrient: protein and energy

protein-energy malnutrition (kwashiorkor, nutritional marasmus)

condition: nutrient: vitamin a

xerophthalmia

condition: nutrient: thiamine (vitamin b1)

beriberi, wernicke's encelopathy

condition: nutrient: riboflavin

ariboflavinosis

condition: nutrient: niacin

pellagra

condition: nutrient: ascorbic acid (vitamin c)

scurvy

condition: nutrient: folate, vitamin b12

megaloblastic anemia

condition: nutrient: vitamin d

rickets, osteomalacia

condition: nutrient: iodine

iodine deficiency disorders, goiter, cretinism

condition: nutrient: zinc

zinc deficiency

condition: nutrient: iron

microcytic anemia

condition: nutrient: fluoride

dental caries

lab test: low total serum protein and very low serum albumin levels, low levels of digestive enzymes

kwashiorkor

lab test: low urinary hydroxyproline

marasmus

lab test: low serum vitamin a levels; altered relative dose response, changed cytology of conjunctival cells

xerophthalmia

lab test: low whole blood or erythrocyte transketolase, low urinary thiamine in 24-hr urine collections or per gram of creatinine, low thiamine in whole blood

beriberi, wernicke's encelopathy

lab test: raised levels of erythrocyte glutathione reductase, low urinary riboflavin levels in 24hr urine collections or per gram of creatinine

ariboflavinosis

lab test: low levels or urinary n-methyl-nicotinamide in 24hr urine collections or per gram of creatinine, low niacin in whole blood

pellagra

lab test: low leucocyte vitamin c; low serum ascorbate levels

scurvy

lab test: low hemoglobin, hyper segmentation of polymorphonuclear leucocytes, megaloblastic red blood cells, macrocytic red blood cells, low levels of serum folate

megaloblastic anemia

lab test: low plasma 25-hydroxycholecalciferol levels; increased plasma alkaline phosphatase

rickets, osteomalacia

lab test: low hemoglobin, low serum ferritin, low transferrin saturation, raised free erythrocyte protoporphyrin, hypochromic macrocytic red blood cells

microcytic anemia

lab test: low urinary iodine levels

goiter, cretinism, iodine disorders

lab test: decreased plasma zinc levels

zinc deficiency