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JazGI > Dietary issues > Flashcards

Dietary issues Flashcards

1
Q

Physical exercise and fibre decrease the risk of ___ cancer

A

colorectal cancers`

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2
Q

vegetables and fruits decrease the risk of ____(3) cancers

A

mouth-larynx
oesophagus
stomach

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3
Q

red and processed meat increases the risk of ___ cancer

A

colorectal

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4
Q

salt increases the risk of ____ cancer

A

stomach

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5
Q

alcohol increases the risk of _____(4) cancers

A

mouth-larynx
oesophagus
liver
colorectal

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6
Q

increased body fatness increases the risk of ___ (3) cnacers

A

oesophagus
gall bladder
colorectal

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7
Q

Neural centre for monitoring body weight =

A

hypothalamus

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8
Q

lesioning ventromedial hypothalamus =>

A

obesity

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9
Q

leisioning lateral hypothalamus =>

A

Lateral = Leanness

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10
Q

Feeling of fullness =

A

satiation

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11
Q

length of time from 1 meal until the next

A

satiety

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12
Q

CCK is secreted from ______ in the ___
release is proportional to intake of __+__
causes afferents to be sent to ___ and get satiation

A

I / enteroendocrine cells in duodenum and jejunum
lipids and protein
NTS -> hindbrain stimulated

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13
Q

mucosal L cells in GI tract release this rapidly post-meal =>
stimulates the ___

A

PYY3-36
decreases gastric motility, emptying and food intake (satiety signal)
hypothalamus

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14
Q

GLP-1 is released from ___ due to ingestion
It causes __
stimulates ___

A

L cells
decreased gastric emptying and intake of food
NTS andhypothalamus

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15
Q

Satiety signal released from oxyntic cells of small intestine post-meal =

A

OXM - oxyntomodulin

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16
Q

Obestatin is a ___ signal released from ____ which may antagonise ghrelin

A

satiety

stomach/small intestine cells

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17
Q

Satiety+satiation signals =

A 
CCK
PYY3-36
GLP-1
Oxyntomodulin
Obestatin
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18
Q

Hunger signal =

A

ghrelin

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19
Q

Ghrelin is released from ___
it __ before meals and ___ after
___ fat utilisation
__+__ increase ghrelin

A

oxyntic cells in the stomach
increases before and decreases after meals
decreases fat utilisation
hypoglycaemia and fasting

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20
Q

`++_ stim. hypothalamus to increase food intake in adiposity -ve feedback

A

glutamate, GABA, opioids

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21
Q

__ stim hypothalamus to decrease food intake in adiposity -ve feedback

A

monoamines

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22
Q

Hormones whose levels are proportional to fat stores

they tell hypothalamus to __+_

A

leptin and insulin

decrease intake and increase energy expediture

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23
Q

If have a lack of ___ or ___ receptors then have an unrestrained appetite => obesity
are also __,__+__

A

leptin

hyperglycaemic, hyperinsulinaemic and insulin resistant

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24
Q

Roles of leptin = (6)

A 
food intake/expenditure/fat deposition
peripheral glucose homeostasis/insulin sensitivity
maintainenc of immune and reprod. system
angio+tumouri-genesis
bone formation
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25
There are lots of insulin receptor in the ___ in the brain
hypothalamus
26
Adiponectin goes to the ___ and ___ food intake
hyothalamus | decreases
27
food reward has a role in ___ pathways in the brain | same pathway areas that are affected by ___
dopamine | substance abuse
28
Orlistat (Xenical/Alli) is for: mechanism= side effects:
diet-induced obesity inhibits pancreatic lipas to less tri absorption cramping, vomiting and need ADEK supplements
29
Diet induced obesity => ___ resistance | due to ___/___
leptin defective transport of leptin to brain altered signal transduction after leptin receptors
30
malnutrition definition
deficiency, excess or imbalance of E, protein + other nutrients => measurable adverse effects
31
diagnosis of malnutrition is by
anthropometry eg. MUAC, BMI, grip strength | biochem: low albumin, transferrin, vitamin and urinary creatinine
32
factors for needing nutritional support
BMI less than 18.5 more than 10% unintentional wt loss in 3-6 months BMI less than 20 with more than 5% unintentional wt loss in 3-6 months eaten/will eat little or nothing for more than or equal to 5days decreased absorptive capacity/increased nutritional needs
33
enteral tubes are not given if patient has:
lower GI obstrction, prolonged intestinal ileus severe d/v high enterocutaneous fistula intestinal ischaemia
34
Refeeding syndrome =
fatal shifts in fluids and electrolytes and organ + metabolic regulation dysfunction due to rapid start of refeeding after period of undernutrition more common in enteral/parenteral feeding
35
Refeeding syndrome pathology: increased protein and glycogen synthesis uses up (5) this causes
glucose, K+, thiamin, Mg2+, PO4- hypokalaemia/magnesaemia/phosphataemia thiamin deficiency salt and H2O retention
36
refeeding syndrome can cause
arrhythmias | altered consciousness, seizures, respiratory failure, CV collapse
37
prevent refeeding syndrome by:
start on 50% of required and increase feeding monitor electrolytes adjust fluids supplement vitamins
38
easy bruising is a sign of which vitamin deficiency
C/K
39
___ is an autorecessive form of impaired zinc uptake need ___ signs =
acrodermatitis enteropathica supplements alopecia perioral and acral rash
40
glossitis and angular stomatitis are signs of which deficiency
vitamin B/iron
41
Koilonychia is a sign of __ deficiency or __ problems
iron | thyroid
42
Baseline investigations for malabsorption =
FBC, coagulation, LFTs, albumin, Ca2+/Mg2+, stool culture => endoscopy, barium imaging, CT, MRI
43
Calcium is absorbed from the gut by __ and ___
passively - paracellularly - whole length of small intestine | actively (mainly) - transcellularly - due to low concn in lumen
44
active transport of Ca2+ is regulated by ___+_
calcitriol - hormonally active product of vit D3 | PTH (increases calcitriol)
45
apical channel involved in Ca2+ absorption in the gut and its expression is increased by ___
TRPV6 | calcitriol
46
in the enterocytes Ca2+ is bound to ___ and so decreases free Ca2+ and maintains driving force for Ca2+ absorption
calbindin D
47
2 basolateral membranes involved in Ca2+ absorption =
Ca2+ATPase/PMCA1 (increased expression caused by calcitriol) | Na/Ca exchanger/NCX
48
Females or males absorb more iron
females
49
form of iron that is absorbable
ferrous (Fe2+)
50
form of iron that is ingested and is converted to ___ by ___
ferric (Fe3+) by HCl and vitamin C is converted to ferrous (Fe2+)
51
apical membrane transported for gut Fe2+ absorption coupled to ___ and reduced by __ eg. __
DMT1 H+ transport HFE mutations eg. hereditary haemochromatosis
52
apical membrane transporter that absorbs Hb
Hb carrier protein 1 - Hb oxidase transports Hb in and then is changed to Fe2+
53
enzyme that changes iron to stored state (___) =
apoferratin converts ferrous to ferritin
54
Basolateral membrane transporter of iron in gut | negatively regulated by ___ from ___ when Fe levels are high = major control of absorption
feroportin hepcidin hormone liver
55
cobalamin=
vitamin B12
56
When B12 is ingested salivary glands secrete ___ and it binds to B12 when ___ releases B12 from protein it was bound to. Parietal cells release ___ ___ digest ___ to release B12 which then binds to ___ and is absorbed in terminal ileum by ___
``` salivary = haptocorin HCl releases Parietal = intrinsic factor Pancreatic proteases digest haptocorin binds to intrinsic factor endocytosis ```
57
Water soluble vitamins =
Vitamin B (not 12) Vit C Vit H
58
Vitamin H =
biotin
59
ascorbate =
vit C
60
folate = | Na independant/dependant absorption
Vitamin B9 | independant
61
Vitamin H and C are Na independant/independant absorption
Na dependant
62
fat soluble vitamins need __+__ for asorption | They are incorporated into___
bile salts and intaact intestinal mucosa | mixed micelles > passive transport in enterocytes > chylomicrons/VLDL>lymphatics
63
Guidelines for alcohol consumption
no more than 14 units per week | ideally spread over 3 or more days
64
Wernicke-Korsakoff syndrome is due to a lack of ___ caused by __
Vitamin B1 - thiamine | alcoholism
65
Alcohol is broken down in the liver by __+__
cytochrome p450 2E1 | alcohol dehydrogenase
66
___ grades cirrhosis and is based on ascites, encephalopathy, PT, bilirubin and albumin
Childs A/B/C
67
MELD score grades cirrhosis based on _+_+_
INR, bilirubin, creatinine
68
In alcoholic hepatitis AST:ALT ratio = AST = bilirubin =
AST: ALT is more than 1.5 AST less than 500 bilirubin more than 80
69
__+_ Alcoholic hepatitis scores are used for prognostic scoring
Maddrey's and Glasgow
70
Limit of alcohol to pass for drink driving
50mg
71
How to calculate alcohol units in a drink =
(volume(ml)xAlcohol%) / 1000
72
Globus sensation =
feeling of something stuck in throat
73
Malingering =
make up illness for own gain eg. benefits/drugs
74
factitious disease =
only want to occupy "sick" role - not for personal gain
75
Diagnosis of typical anorexia nervosa
significant self-induced wt. loss / failure to gain wt in a child BMI less than 17.5 Skinny ideal Endocrine abnormalities
76
Restricting type of anorexia nervosa =
not binge eating/purging type
77
No endocrine abnormalities are seen in patients with ___ nervosa
bulimia
78
Anorexia and bulimia nervos are more common in F/M and by how much?
F 10:1
79
Anorexia/bulimia nervosa patients are made inpatients if:
suicide risk more than 5yrs of condition co-morbidity - depression, extreme social isolation

JazGI (26 decks)

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