Chempath 24: Nutrition

Question 1

List 4 fat soluble vitamins ?

Answer 1

A - retinol
D - cholecalciferol
E - tocopherol
K - phytomenadione

Question 2

What does vitamin A defficiency cause ?

Answer 2

Colourblindness, poor night vision

Question 3

What does Vitamin D deficiency cause ?

Answer 3

Osteomalacia / Rickets

Question 4

What does vitamin E deficiency cause ?

Answer 4

Neuropathy

Anaemia

Question 5

What does Vitamin K deficiency cause ?

Answer 5

Haemorrhage/ defective clotting

Question 6

Which tests of coagulation can be used to test for Vitamin K deficiency ?

Answer 6

PT (initially elevated due to FVIIa deficiency

PTT (elevated in more severe deficiency when the intrinsic pathway is also affected)

Question 7

What does vitamin b12 (cobalamin) deficiency cause ?

Answer 7

Pernicious anaemia

Question 8

What does vitamin C (ascorbate) deficiency cause ?

Answer 8

Scurvy

Question 9

What does folate deficiency cause ?

Answer 9

Megaloblastic anaemia

Neural tube defects (if in pregnancy)

Question 10

What does Niacin (Vit B3) deficiency cause ?

Answer 10

Pellagra

Question 11

What does vitamin B1 (thiamin) deficiency cause ?

Answer 11

Beri-beri
Wernicke’s encephalopathy
Neuropathy

Question 12

What is the triad of Pellagra ?

Answer 12

Diarrhoea
Dermatitis
Dementia

(Later death)

Question 13

What is the difference between wet and dry beriberi ?

Answer 13

Wet

• Mainly affects cardiovascular system
• signs of heart failure (high output)
• SOB

Dry

• Mainly affects peripheral nervous system
• parasthesia
• paralysis
• confusion
• nystagmus
• Wernicke’s encephalopathy

Question 14

Which medication is given to alcoholics to prevent Wernicke’s encephalopathy ?

Answer 14

Pabrinex (Vitamin B)

Question 15

What does Iodine deficiency cause ?

Answer 15

Hypothyroidism

Goitre

Question 16

Which disease is associated with excess copper ?

Answer 16

Wilson’s disease

Question 17

What does Flouride deficiency cause ?

Answer 17

Dental caries

Question 18

What does Iron deficiency cause ?

Answer 18

A microcytic hypochromic anaemia

Question 19

What does leptin do ?

Answer 19

Increases satiety

produced by white adipose tissue

Question 20

What does ghrelin do ?

Answer 20

Increases hunger

Question 21

What does PYY do ?

Answer 21

Increases satiety

produced in the intestines

Question 22

Which hormone is released by white adipose and reduced in people with obesity ?

Answer 22

Adiponectin

reduced adiponectin - insulin resistance

Question 23

Give an example of an amino acid that cannot be synthesised by a foetus so is received via the placenta ?

Answer 23

Cysteine

Question 24

List 3 endocrine conditions that could cause obesity ?

Answer 24

Hypothyroidism
Cushing’s syndrome
Acromegaly

(Leptin receptor deficiency,)

Question 25

List 2 medical treatments of obesity ?

Answer 25

Orlistat- Inhibits pancreatic lipase so that fat is not absorbed well GLP-1 - a diabetic drug that also increases satiety

Question 26

List 3 bariatric surgery procedures ?

Answer 26

Gastric banding Sleeve Gastrectomy Roux-en-Y bypass - bypass the first part of the duodenum and most of the stomach

Question 27

What causes kwashiorkor ?

Answer 27

Protein deficiency | Bilateral pitting oedema, subcutaneous fat, hepatomegaly

Question 28

What causes Marasmus ?

Answer 28

Low dietary carbohydrate, lipid and protein intake | Starved looking child, shrivelled, growth retardation, muscle wasting, no subcutaneous fat

Question 29

What test can be used to confirm thiamine deficiency in Wernicke's encephalopathy ?

Answer 29

RBC transketolase

Question 30

Which disease presents with a characteristic pigmented rash known as "Casal's necklace"

Answer 30

Pellagra (vit B3 deficiency)

Question 31

Patient presents with dermatitis, dementia, diarrhoea and a pigmented rash around their neck in the shape of a necklace. Most likely diagnosis ?

Answer 31

Pellagra

Question 32

what are the water soluble vitamins

Answer 32

B1, B2, B6, B12, C, folate, B3

Question 33

what does a B2 (riboflavin) deficiency cause

Answer 33

glossitis

Question 34

what does a B6 (pyridoxine) deficiency cause

Answer 34

dermatitis/anaemia

Question 35

what do excess vitamins A and D cause

Answer 35

A - exfoliation hepatitis | D - hypercalcaemia

Question 36

what does excess vitamin B6 cause

Answer 36

neuropathy

Question 37

what does excess vitamin C cause

Answer 37

renal stones

Question 38

where are soluble vitamins stored

Answer 38

adipose tissue

Question 39

what are the trace elements

Answer 39

``` iron iodine zinc copper fluoride ```

Question 40

what does a zinc deficiency cause

Answer 40

dermatitis

Question 41

what does a copper deficiency cause

Answer 41

anaemia

Question 42

how can copper levels be measured

Answer 42

Cu | caeroplasmin

Question 43

what is the role of insulin release on satiety

Answer 43

released after eating | causes the feeling of satiety

Question 44

features of metabolic syndrome

Answer 44

increases the risk of obesity-related conditions ``` 1 - fasting glucose >6.0mmol/l 2 - HDL men <1, women <1.3 3 - hypertension BP>135/80 4 - microalbumin, insulin resistance 5 - waist circumference m>102, w>88 ```

Question 45

deficiencies in Crohns

Answer 45

B12 and fat soluble vitamin deficiency folate if on methotrexate calcium, phosphate, mg, zinc if high output/chronic diarrhoea

Question 46

deficiencies in coeliac disease

Answer 46

iron ADEK thiamine vitamin B6

Question 47

deficiencies in chronic liver disease

Answer 47

``` ADEK b12 selenium magnesium zinc folate ```

Question 48

deficiencies in chronic kidney disease

Answer 48

protein energy wasting syndrome

Question 49

deficiencies in pancreatic insufficiency

Answer 49

ADEK