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YEAR 5: Chemical Pathology > ChemPath: Nutrition > Flashcards

ChemPath: Nutrition Flashcards

1
Q

Which vitamins are fat solube?

A

A,D,E,K

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2
Q

State the manifestation of Vitamin A (retinol) deficiency.

A

Colour blindness

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3
Q

State the manifestation of Vitamin D (cholecalciferol) deficiency.

A

Osteomalacia/rickets

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4
Q

State the manifestation of Vitamin E (tocopherol) deficiency.

A

Anaemia, neuropathy
(?malignancy/IHD)

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5
Q

State the manifestation of viatmine K (phytomenadione) deficiency.

A

Defective clotting

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6
Q

State the manifestation of Vitamin B1 (thiamine) deficiency.

A
  • Beri-beri
  • Neuropathy
  • Wernicke syndrome
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7
Q

State the manifestation of Vitamin B2 (riboflavin) deficiency.

A

Glossitis

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8
Q

State the manifestation of Vitamin B6 (Pyridoxine) deficiency.

A

Dermatitis, anaemia

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9
Q

State the manifestation of Vitamin B12 (cobalamin) deficiency.

A

Pernicious anaemia (megaloblastic anaemia)

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10
Q

State the manifestation of Vitamin C (ascorbate) deficiency.

A

Scurvy

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11
Q

State the manifestation of vitamin B9 (folate) deficiency.

A
  • Megaloblastic anaemia
  • Neural Tube Defects
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12
Q

State the manifestation of Vitamin B3 (niacin) deficiency.

A

Pellagra

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13
Q

State the manifestation of an excess of Vitamin A.

A

Exfoliation, hepatitis

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14
Q

State the manifestation of Vitamin D excess.

A

Hypercalcaemia

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15
Q

State the manifestation of Vitamin B6 excess.

A

Neuropathy

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16
Q

State the manifestation of Vitamin C excess.

A

Renal stones

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17
Q

Which tests are used for the following vitamin derangements?

  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin C
  • Vitamin B12
A

Serum levels

18
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
19
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)
20
Q

What are the main features of pellagra?

A

3 D’s

  • Dementia
  • Diarrhoea
  • Dermatitis
21
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
22
Q

What does excess of the following mineral cause

  • Iron
  • Copper
  • Fluoride
A
  • Iron - haemochromatosis
  • Copper - Wilson’s
  • Fluorosis (white/brown speckles on teeth - not harmful)
23
Q

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

A

Carbohydrate: 50%

Fats: 33%

Protein: 17%

24
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

25
Q

What are the effects of leptin, ghrelin and PYY? Where are they produced

A
  • Leptin - satiety hormone (white adipose tissue)
  • Ghrelin - hunger hormone (brain)
  • PYY - satiety hormone (intestines)
26
Q

Where do ghrelin, PYY, and leptin act on?

A

Hypothalamus

27
Q

How is BMI calculated?
What are the cut offs for

  • Overweight
  • Obese
  • Morbidly obese
A

BMI = weight/height^2

  • Overweight = 25-30
  • Obese >30
  • Morbidly obese >40
28
Q

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

A

Men > 94 cm (major risk > 102 cm)

Women > 80 cm (major risk > 88 cm)

29
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 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
30
Q

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

A

Nitrogen excretion and balance

Tracer techniques

31
Q

Describe the relationship between dietary fat and LDL levels.

A

High dietary saturated fat leads to high LDLs

32
Q

Describe the effect of alcohol and obesity of lipid levels.

A

Alcohol increases HDLs

Obesity lowers HDLs

33
Q

How are triglycerides absorbed in the intestines?

A

As monoglycerides

34
Q

By what process does pancreatic lipase break down fatty acids?

A

Hydroxylation

35
Q

What proportion of dietary carbohydrates should be complex?

A

80%

36
Q

What is another name for dietary fibre?

A

Non-starch polysaccharides

37
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
38
Q

Outline the treatment options for obesity.

A
  • Exclude endocrine causes (e.g. hypothyroidism)
  • Screen for complications of obesity
  • Educate
  • Diet and exercise
  • Medical: orlistat, GLP-1 agonist
  • Surgery
39
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
40
Q

Name and describe two types of protein energy malnutrition.

A

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

YEAR 5: Chemical Pathology (27 decks)

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