ChemPath: Nutrition Flashcards by Sajed Mangoo

State the manifestation of Vitamin A (retinol) deficiency.

Colour blindness

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State the manifestation of Vitamin D (cholecalciferol) deficiency.

Osteomalacia/rickets

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State the manifestation of Vitamin E (tocopherol) deficiency.

Anaemia, neuropathy

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State the manifestation of viatmine K (phytomenadione) deficiency.

Defective clotting

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State the manifestation of Vitamin B1 (Thiamine) deficiency.

Beri-beri

Neuropathy

Wernicke syndrome

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State the manifestation of Vitamin B2 (riboflavin) deficiency.

Glossitis

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State the manifestation of Vitamin B6 (Pyridoxine) deficiency.

Dermatitis, anaemia

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State the manifestation of Vitamin B12 (cobalamin) deficiency.

Pernicious anaemia

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State the manifestation of Vitamin C deficiency.

Scurvy

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State the manifestation of Folate deficiency.

Megaloblastic anaemia, NTD

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State the manifestation of Vitamin B3 (niacin) deficiency.

Pellagra

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State the manifestation of an excess of Vitamin A.

Exfoliation, hepatitis

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State the manifestation of Vitamin D excess.

Hypercalcaemia

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State the manifestation of Vitamin B6 excess.

Neuropathy

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State the manifestation of Vitamin C excess.

Renal stones

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Which tests are used for the following vitamin derangements?

Vitamin K
Vitamin B1
Vitamin B2
Vitamin B6
Folate

Vitamin K = PT
Vitamin B1 = RBC transketolase
Vitamin B2 = RBC glutathione reductase
Vitamin B6 = RBC AST activation
Folate = RBC folate

What are the two forms of Beri-beri? Describe them.

Wet - characterised by cardiovascular disease (patients have oedema and other features of heart failure)
Dry - characterised by neurological disease (may have Wernicke’s syndrome)

What are the main features of pellagra?

Dementia
Diarrhoea
Dermatitis

State the manifestations of the following deficiencies in trace elements.

Iron
Iodine
Zinc
Copper
Fluoride

Iron - anaemia
Iodine - goitre, hypothyroidism
Zinc - dermatitis
Copper - anaemia
Fluoride - dental caries (NOTE: excess causes fluorosis)

What is the recommended division between fats, carbohydrates and proteins in a normal diet?

Carbohydrate: 50%

Fats: 33%

Protein: 17%

Describe the adiponectin levels in obese people.

Reduced - this leads to insulin resistance

NOTE: insulin causes a slight increase in satiety and thermogenesis

What are the effects of leptin, ghrelin and PYY?

Leptin - anti-hunger hormone
Ghrelin - hunger hormone
PYY - satiety hormone produced by the intestines

What waist circumference is associated with increased risk in men and women?

Men > 94 cm (major risk > 102 cm)

Women > 80 cm (major risk > 88 cm)

Define and give an example of:

Indespensable protein
Conditionally indispensable protein
Dispensable protein

Indespensable protein = cannot be made in the body and must be obtained from the diet e.g. leucine
Conditionally indispensable protein = can by synthesised at certain stages in your life (e.g. very young, pregnancy) e.g. cysteine
Dispensable protein = can be produced by the body
- There are 6: alanine, aspartic acid, asparagine, glutamic acid, serine and selenocysteine

Name two techniques that can be used to assess protein levels.

Nitrogen excretion and balance Tracer techniques

Describe the relationship between dietary fat and LDL levels.

High dietary saturated fat leads to high LDLs

Describe the effect of alcohol and obesity of lipid levels.

Alcohol increases HDLs Obesity lowers HDLs

How are triglycerides absorbed in the intestines?

As monoglycerides

By what process does pancreatic lipase break down fatty acids?

Hydroxylation

What proportion of dietary carbohydrates should be complex?

80%

What is another name for dietary fibre?

Non-starch polysaccharides

What are the five features that constitute metabolic syndrome?

* Fasting glucose \> 6 mmol/L * HDL \< 1 (men) or \< 1.3 (women) * Waist circumference \> 102 (men) \> 88 (women) * Hypertension \> 135/80 * Microalbumin/insulin resistance

Outline the treatment options for obesity.

* Exclude endocrine causes (e.g. hypothyroidism) * Screen for complications of obesity * Educate * Diet and exercise * Medical: orlistat, GLP-1 injections * Surgery

Name and describe three types of bariatric surgery.

1. **Adjustable Band** - a silicone ring is put around the top of the stomach. It is connected to a port that is placed in the adipose tissue near the stomach. A needle can be inserted into the port and fluid inserted or withdrawn to make the band tighter or looser (NOTE: the band can erode through the mucosa) 2. **Roux-en-Y Gastric Bypass** - the stomach is made much smaller and the second part of the small intestine is connected to the small stomach. This means that most of the stomach and duodenum is bypassed. It can cause rapid resolution of T2DM. 3. **Duodenal-Jejunal Sleeve** - inserted via endoscope, allows food to bypass the duodenum so that it doesn't mix with bile salts (can only stay in for 1 year) 4. **Sleeve Gastrectomy**

Name and describe two types of protein energy malnutrition.

**Marasmus:** * Cased by low dietary intake of carbohydrates, lipis and protein * Shrivelled * Growth retardation * Severe muscle wasting * NO subcutaneous fat **Kwashiorkor:** * Caused by protein deficiency * Oedematous * Scaling/ulcerated * Lethargic * Large liver * Subcutaneous fat