Chapter 8 - Nutritional disorders Flashcards
Which is the only dietary fuel for RBCs?
Glucose.
And because RBCs lack mitochondria, they use only anaerobic glycolysis to generate ATP
Tell me one virus infection that causes temporary destruction of brush border, with a consequent diarrhea and disaccharidases’ insufficiency
Rotavirus
Transaminases remove amine groups from AAs to form …
α-ketoacids
Long-chain free FAs are the major source of energy for all cells except … and …
RBCs and Brain tissue
Where is glycogen stored?
Muscle and liver
What do micelles contain?
- MGs
- FAs
- fat soluble vits
- CH esters
Which apolipoprotein is required for fomation and secretion in blood of chylomicrons?
apoB48
In marasmus, pathogenesis of loss of subcutaneous fat
Decrease in leptin stores in adipose-> stimulates hypothalamic-pituitary axis -> release of CORT-> lipolysis
Which disorder carries the highest death rate of all psychiatric disorders?
Anorexia nervosa
Hypoestrinism has what effect on bones?
Osteoporosis.
Esteogen normally: (+) osteoblastic activity
(-) osteoclastic activity
What is the most probable cause of death in a girl with anorexia nervosa?
Ventricular arrhythmia usually related to hypokalemia from laxative abuse
Diarrhea can cause hypomagnesemia, which can cause decreased synthesis and release of which hormone?
Parathyroid hormone
How can one distinguish hypercarotenemia with jaundice?
In hypercarotenemia the scleras are white
In which disease macrophages in granulomas synthasize 1-α-hydroxylase, synthesizing vitD and producing hypervitaminosis D?
Sarcoidosis
Which CYP enzyme of P450 system is a 25-hydroxylase?
production of 25-OH vitD
CYP27A1
VitE also called…
tocopherol or tocotrienol
Breast milk is deficient in vitamins … and …
D and K
Other name of vitK
Phytomenadione
Phylloquinone
Phytonadione
Warfarin or heparin provides immediate anticoagulation?
Heparin. Prothrombin has the longest half-life. Warfarin requires at least 3-4 days before all functional prothrombin has disappeared. (previously γ-carboxylated factors are still present)
So patients are initially placed on both heparin and warfarin.
Which is the MC vit deficiency ni the USA?
Folate deficiency.
Which deugs can cause folate deficiency?
Phenytoin
Sulfonamides
Methotrexate
Cigarette smoking can cause vitamin … deficiency
vit C
Deficiency in which vitamin can cause combined iron and folate deficiency?
VitC
For which 3 enzymes is copper a cofactor?
- ferroxidase (binds iron to transferrin)
- lysyl oxidase (cross-linking of collagen and elastic tissue)
- tyrosinase (melanin synthesis)
Clinical findings in copper deficiency
- Microcytic anemia
- Aortic dissection
- Poor wound healing
Total serum copper in Wilson disease is increased or decreased?
Decreased because of decreased ceruloplasmin.
Increased serum free copper, increased urine copper.
Chromium is a component of … and a cofactor for …
Glucose tolerance factor -> maintains normal serum glucose
Insulin-> fascilitates the binding of glucose to adipose and muscle GLUTs
Clinical findings in chromium deficiency
- Impaired glucose tolerance
2. Peripheral neuropathy
Clinical findings in selenium deficiency
- Muscle pain and weakness
2. Dilated cardiomyopathy
Which is the only bile acid that is not reabsorbed in the terminal ileum?
Lithocholic acid.
It may have a causative role in producing colorectal cancer.
Insoluble fiber would eliminate the lithocholic acid that would have contact with the bowel mucosa.
Symptoms of calcium deficiency
- Tetany
2. Osteoporosis
Symptoms of phosphorus deficiency
Decreased ATP causes :
a. Muscle weakness: rhabdomyolysis with myoglobinuria
b. Hemolytic anemia
Symptoms of sodium deficiency
- Mental status abnormalities (cerebral edema-> water shifts into cells by osmosis)
- Convulsions
Symptoms of potassium deficiency
- Muscle weakness (cannot repolarize muscle)
2. Polyuria (renders collenting ducts resistant to ADH)
Symptoms of magnesium deficiency
- Hypocalcemia with tetany (acquired hypoparathyroidism due to impaired PTH secretion and resistance it target tissue)
- Tachycardia
Symptoms of calcium excess
- Kidney stones (calcium oxalate and phosphate)
- Metastatic calcification (eg nephrocalcinosis)
- Polyuria (due to calcification of renal tubule BMs)
Symptoms of phosphorus excess
- Hypocalcemia (increased P drives Ca2+ into bone and soft tissue)
- Hypovitaminosis D (inhibits activity of 1-α-hydroxylase)
Symptoms of sodium excess
- Mental status abnormalities (intracellular shrinkage of neuroglial cells and neurons)
- Convulsions
Symptoms of potassium excess
Heart stops in diastole (treat with calcium gluconate)
Symptoms of magnesium excess
- Neuromuscular depression (decreased DTRs, muscle weakness)
- Bradycardia
