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