Chemical Pathology - Nutrition Flashcards
deficiency and excess of Vit A (retinol)
Def: colour blindess
Excess: exfoliation, hepatitis
test for it in the serum
deficiency and excess of Vit D (cholecalciferol)
Def: osteomalacia, rickets
Excess: hypercalcaemia
test for it in the serum
deficiency of Vit E (tocopherol)
anaemia, neuropathy, IHD
test for it in the serum
deficiency of Vit K (phyto-menadione)
defective clotting
test the PTT
deficiency of B1 (thiamin) and how to test for it
Def: Beri-Beri, Neuropathy, Wernicke syndrome
Test: RBC transketolase
deficiency of B2 (riboflavin) and how to test for it
Def: glossitis
Test: RBC glutathione reductase
deficiency and excessof B6 (rpyridoxine) and how to test for it
Def: dermatitis, anaemia
Excess: neuropathy
Test: RBC AST activation
deficiency of B12 (cobalamin) and how to test for it
Def: pernicious anaemia
Test: serum B12
deficiency and excess of Vit C and how to test for it
Def: scurvy
Excess: renal stones
Test: plasma
deficiency of Folate and how to test for it
Def: megaloblastic anaemia, neural tube defect
Test: RBC folate
deficiency of Niacin (B3)
pellagra
what are the fat soluble vitamins? where are they stored?
A,D,E,K
stored in adipose tissue
what are the types of Beri Beri?
B1/thiamine def
- Wet: characterised by CVD (oedema, HF)
- Dry: characterised by neurological disease
what is pellagra (niacin/B3 def) characterised by?
diarrhoea
dermatitis
dementia
death (if untreated)
deficiency and excess of iron? how to test?
Def: hypochromic anaemia
Excess: haemochromatosis
Test: FBC, Fe, Ferritin
deficiency of iodine? test?
Def: goitre, hypothyroid
Test: TFT
deficiency of zinc?
Def: dermatitis
deficiency and excess of iron? how to test?
Def: anaemia
Excess: Wilson’s
Test: Cu, caeroplasmin (copper-binding protein, is low in Wilson’s)
what does an ideal diet consist of?
50% carbs
33% fats
17% proteins
what hormones does white adipose tissue produce?
- adiponectin (dec in obese people = leads to insulin resistance)
- leptin (anti-hunger hormone)
what does insulin release after a meal result in?
- feeling of satiety
- increase in energy expenditure (thermogenesis)
what does ghrelin do?
hunger hormone
high before eating
what does PYY do?
satiety hormone
produced in intestines
PYY increase after eating a meal
what values of BMI represent obesity/ overweight?
25-30: overweight
>30: obese
>40: morbid obese
what definition of obesity is linked to CHD risk?
waist circumference
what are the different categories of amino acids?
- indispensable (cannot be made, needed from diet) e.g. leucine
- conditionally indispensable (needed at certain parts of life e.g. cysteine in pregnancy)
- dispensable (body can produce e.g. alanine)
how do you assess protein intake?
nitrogen excretion and balance
tracer techniques
what does pancreatic lipase do?
breaks down fatty acids by hydroxylation
what 5 features does the metabolic syndrome consist of?
- fasting glucose (>6.0mmol/l)
- HDL
- waist circumference
- HTN
- microalbumin, insulin resistance
obesity treatment
- exclude endocrine cauaes
- educate
- diet and exercise
- medical therapy (orlistat and GLP-1)
- surgical therapy
MOA of orlistat and GLP-1
orlistat = pancreatic lipase inhibitor GLP-1 = causes a feeling of satiety
3 forms of bariatric surgery
- adjustable band: silicone ring around top of stomach
- Roux-en-Y Gatric bypass: stomach made smaller, first part of duodenum and most of stomach is bypassed
- duodenal-jejunal sleeve: sleeve from pyloric sphincter to jejunum
what is marasmus and how does it present?
lack of intake of CHO, lipids and protein
Px: shrivelled, severe muscle wasting, growth retarded, no SC fat
what is kwashiorkor and how does it present?
protein def
Px: oedematous, lethargic, protein def, scaling/ulcerated, large liver, SC fat
