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AT CHEMPATH > ChemPath: Nutrition > Flashcards

ChemPath: Nutrition Flashcards

1
Q

State the manifestation of Vitamin A (retinol) deficiency.

A

Colour blindness

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2
Q

State the manifestation of Vitamin D (cholecalciferol) deficiency.

A

Osteomalacia/rickets

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3
Q

State the manifestation of Vitamin E (tocopherol) deficiency.

A

Anaemia, neuropathy

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4
Q

State the manifestation of viatmine K (phytomenadione) deficiency.

A

Defective clotting

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5
Q

State the manifestation of Vitamin B1 (Thiamine) deficiency.

A

Beri-beri

Neuropathy

Wernicke syndrome

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6
Q

State the manifestation of Vitamin B2 (riboflavin) deficiency.

A

Glossitis

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7
Q

State the manifestation of Vitamin B6 (Pyridoxine) deficiency.

A

Dermatitis, anaemia

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8
Q

State the manifestation of Vitamin B12 (cobalamin) deficiency.

A

Megaloblastic anaemia
e.g. Pernicious anaemia

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9
Q

State the manifestation of Vitamin C deficiency.

A

Scurvy

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10
Q

State the manifestation of Folate deficiency.

A

Megaloblastic anaemia
Neural tube defect in pregnancy

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11
Q

State the manifestation of Vitamin B3 (niacin) deficiency.

A

Pellagra

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12
Q

State the manifestation of an excess of Vitamin A.

A

Exfoliation, hepatitis

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13
Q

State the manifestation of Vitamin D excess.

A

Hypercalcaemia

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14
Q

State the manifestation of Vitamin B6 excess.

A

Neuropathy

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15
Q

State the manifestation of Vitamin C excess.

A

Renal stones

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16
Q

Which tests are used for the following vitamin derangements?

  • Vitamin K
  • Vitamin B1
  • Vitamin B2
  • Vitamin B6
  • Folate
A
  • Vitamin K = PT
  • Vitamin B1 = RBC transketolase
  • Vitamin B2 = RBC glutathione reductase
  • Vitamin B6 = RBC AST activation
  • Folate = RBC folate
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17
Q

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

A
  • Wet - characterised by cardiovascular disease (patients have oedema and other features of heart failure)
  • Dry - characterised by neurological disease (may have Wernicke’s syndrome)
18
Q

What are the main features of pellagra?

A

B3 deficiency, 3Ds
* Dementia
* Diarrhoea
* Dermatitis
Ultimately death

19
Q

State the manifestations of the following deficiencies in trace elements.

  • Iron
  • Iodine
  • Zinc
  • Copper
  • Fluoride
A
  • Iron - anaemia
  • Iodine - goitre, hypothyroidism
  • Zinc - dermatitis
  • Copper - anaemia
  • Fluoride - dental caries (NOTE: excess causes fluorosis)
20
Q

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

A

Carbohydrate: 50%

Fats: 33%

Protein: 17%

21
Q

Describe the adiponectin levels in obese people.

A

Reduced - this leads to insulin resistance

NOTE: insulin causes a slight increase in satiety and thermogenesis

22
Q

What are the effects of leptin, ghrelin and PYY?

A
  • Leptin - anti-hunger hormone
  • Ghrelin - hunger hormone
  • PYY - satiety hormone produced by the intestines
23
Q

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

A

Men > 94 cm (major risk > 102 cm)

Women > 80 cm (major risk > 88 cm)

24
Q

Define and give an example of:

  1. Indespensable protein
  2. Conditionally indispensable protein
  3. Dispensable protein
A
  1. Indespensable protein = cannot be made in the body and must be obtained from the diet (9 essential amino acids) e.g. leucine
  2. Conditionally indispensable protein = can by synthesised at certain stages in your life (e.g. very young, pregnancy) e.g. cysteine
  3. Dispensable protein = can be produced by the body
    • There are 6: alanine, aspartic acid, asparagine, glutamic acid, serine and selenocysteine
25
Q

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

A

Nitrogen excretion and balance
Tracer techniques

Note: usually use clinical assessment though

26
Q

Describe the relationship between dietary fat and LDL levels.

A

High dietary saturated fat leads to high LDLs

27
Q

Describe the effect of alcohol and obesity of lipid levels.

A

Alcohol increases HDLs

Obesity lowers HDLs

28
Q

How are triglycerides absorbed in the intestines?

A

As monoglycerides

29
Q

By what process does pancreatic lipase break down fatty acids?

A

Hydroxylation

30
Q

What proportion of dietary carbohydrates should be complex?

A

80%

31
Q

What is another name for dietary fibre?

A

Non-starch polysaccharides

32
Q

What are the five features that constitute metabolic syndrome?

A
  • Fasting glucose > 6 mmol/L
  • HDL < 1 (men) or < 1.3 (women)
  • Waist circumference > 102 (men) > 88 (women)
  • Hypertension > 135/80
  • Microalbumin/insulin resistance
33
Q

Outline the treatment options for obesity.

A
  • Exclude endocrine causes (e.g. cushings, acromegaly, hypothyroidism)
  • Screen for complications of obesity
  • Educate
  • Diet and exercise
  • Medical: orlistat, GLP-1 injections (semaglutide/ozempic)
  • Surgery
34
Q

Name and describe three types of bariatric surgery.

A
  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
35
Q

Name and describe two types of protein energy malnutrition.

A

Marasmus:

  • Caused by low dietary intake of carbohydrates, lipids and protein

Kwashiorkor:

  • Caused by protein deficiency. Seen in times of famine
36
Q

What 2 hormones does white adipose tissue produce? Describe their actions

A

Adiponectin - if reduced, leads to insulin resistance (in obese people)
Leptin - anti-hunger hormone

37
Q

List clinical features of marasmus (4)

A

Carb, fat and protein deficiency

  • Shrivelled
  • Growth retardation
  • Severe muscle wasting
  • NO subcutaneous fat
38
Q

List clinical features of kwashiorkor (4)

A

Protein deficiency

  • Oedematous
  • Scaling/ulcerated
  • Large liver
  • Subcutaneous fat present
39
Q

Compare and contrast unsaturated and saturated fats

A

Unsaturated fat:
- Includes PUFA and essential fatty acids, which is good for you
- Also can be called cis fat
- Note unsaturated fat also includes trans fat -> the worst for you, trans = H bond in different plane, is a marker of CVD

Saturated fats:
No double bonds, bad for you

40
Q

List the fat-soluble and water-soluble vitamins

A

Fat-soluble: ADEK
(stored in adipose so rare to be deficient in developed world)

Water-soluble: B1, B2, B3, B6, B9, B12, C

AT CHEMPATH (24 decks)

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