enviro - nutrition Flashcards
highly susceptible groups to nutritional diseases
1) poor ppl
2) alcoholics
3) acute and chronic illness: basal metabolic rate may be increased
4) dieters- anorexia or bulimia
what does SAM stand for?
severe acute malnutrition
two types of SAM?
1) maramus - SOMATIC protein compartment represented by skeletal muscles affected
2) Kwashiorkor - affects VISCERAL protein compartment in the visceral organs
SAM is casued by?
inadequate dietary intake f protein and total calories to meet the body’s needs
PEM stands for?
protein energy malnutrition
define maramus
less than 60% of normal body weight
- growth retardation
- loss of muscle mass
- anemia*****
- immunodeficiency
define Kwashiorkor
excessive protein deprovation
- weight is 60-80% of normal
- generalized or dependent edema
- –pronounced abdomin
- “flaky paint’ lesions**
- hair abnormalities
- enlarged, fatty liver
- muscle atrophy
- defects in immunity and secondary infection
if you see a pronounced abdomen, what PEM disease is it?
Kwashiorkor
the severe form of PEM/SAM is known as?
cachexia; weakness and wasting of the body
cachexia is associated with?
cancer
define anorexia nervosa?
self induced; similar to PAM/SEM
- amenorrhea
- cold intolerance, constipation, skin and hair changes
- —cold cuz no cushion!
- decreased one density
- cardiac arrhythmia may lead to sudden death
clinical symptoms of anorexia nervosa are similar to?
protein energy malnutrition starvation (PEM/SAM)
define amenorrhea
an abnormal absence of menstruation
define bulimia
willful vomiting after large intake of calories
- binge eating (typically of carbs) followed by induced vomiting
- *if female, 50% have amenorrhea
T or F… bulimics maintain normal weight?
true
clinical problems with bulimia
- electrolyte imbalances
- aspiration of gastric juices
- esophageal rupture
- erosion of teeth
T or F… dentists are commonly the first to notice bulimia
true
what are the fat soluble vitamins?
A D E K
- readily stored in body
- poorly absorbed in some GI disorders
T or F… single vitamin deficiencies are common
FALSE
-deficiency may be primary or secondary
Vitamin A is transported and stored in?
retinal! (retinal ester)
**primarily stored in liver = 90%
vitamin A functions (4 things)
- maintains normal dark vision via rhodopsin synthesis
- promotes differentiation of mucous secreting cells
- enhancement of immunity and cancer prevention
- photo protective and antioxidant functions
clinical signs of vitamin A deficiency?
What two organs commonly affected?
1) night blindness
2) xerophthalmia (dry eye)
3) squamous metaplasia predisposes to secondary pulmonary infections and desquamation of keratin debris in the urinary tract leads to renal and urinary bladder stones
- –lungs and bladder
4) impaired immunity
vitamin D is a ____ hormone
steroid hormone
vitamin D function
functions to maintain normal plasma levels of calcium and phosphorous (needed for bone)
vitamin D source
- diet: fish and grains
* endogenous: UV light converts 7-dehydrocholesterol (skin) to Vit D3
vitamin D is obtained?
90% of required Vit D can be obtained endogenously
vitamin D metabolism= conversion to active forms in ____ and _____?
liver and kidney
The state of vitamin D deficiency in children is called ____? In adults is called ______?
- children = rickets
* adults = osteomalacia
basic derangement of vitamin D is an excess of?
excess of non-mineralized bone matrix
rickets symptoms
- excessive cartilage malformations lead to eventual skeletal deformations
- frontal bossing and ‘squared head’
- rachitic rosary
- pigeon breast
- lumbar lordosis and bowed legs
define rachitic rosary
excess cartilage at costochondral junction aka bony necklace caused by Vit D deficiency
*sign of rickets
osteomalacia symptoms
- weak bone with gross fracture or micro fracture
- excess of osteoid (unmineralized bone)
- differentiate from osteopenias such as osteoporosis
Vitamin E functions? (3 things)
- Free radical scavenger
- Protects against oxidation-induced tissue damage
- Acts along with selenium in the maintenance of cell (neuronal) membranes
Vitamin E is found?
Abundant in vegetables, grains, and nuts
Vitamin E deficiency affects?
peripheral nerves and may increase RBC fragility
Vitamin K is required for?
clotting
Vitamin K is needed for the activity of what clotting factors?
clotting factors II, VII, IX, and X (prothrombin complex)
Vitamin K sources?
- Endogenous -gut microflora
* Exogenous -necessary
T or F…. Vitamin K is not recycled
FALSE
*** Vitamin K is recycled in the liver
Vitamin K deficiency consequences?
- -Bleeding diathesis in neonates
- -Intracranial hemorrhage
Name a drug that acts as a Vitamin K antagonist?
Warfarin (aka coumadin)
**prevents clotting
another name for Thiamine?
Vitamin B1
high risk groups for Thiamine/Vitamin B1 deficiency?
Seen in populations highly dependant on refined foods (polished rice)
Thiamine/Vitamin B1 Deficiency Syndromes
1) Polyneuropathy (dry beriberi)
2) Cardiovascular syndrome with edema (wet beriberi)
3) Wernicke -Korsakoff syndrome
describe Wernicke -Korsakoff syndrome?
** lesions target what?
- Wernicke’s encephalopathy–acute phase (neurological disorder = confusion, unsteady, eye movement)
- Korsakoff’s psychosis–Chronic phase; mental illness; permanent damage to memory
- **CNS lesions -target thalamus and hypothalamus
- Seen mostly in chronic alcoholics in USA
alcoholics commonly get what disease?
Wernicke -Korsakoff syndrome from a Thiamine/Vitamin B1 Deficiency
another name for Riboflavin?
Vitamin B2
Riboflavin/Vitamin B2 deficiency
- Associated with other nutritional deficiencies. Low consumption of milk, chronic alcoholism, or chronic diarrhea.
- Angular cheilitis
- Glossitis -shiny, red-blue tongue
- Eye changes
- Dermatitis
define Glossitis
shiny, red-blue tongue
*commonly seen in Riboflavin/Vitamin B2 deficiency
define Angular cheilitis
common inflammatory condition affecting the corners of the mouth or oral commissures
*commonly seen in Riboflavin/Vitamin B2 deficiency
another name for Vitamin B3?
Niacin
An inability to absorb Niacin/Vitamin B3 or amino acid TRYPTOPHAN may cause?
pellagra
define pellagra
a disease characterized by scaly sores, mucosal changes and mental symptoms
Nicotinic Acid is associated with?
Niacin/Vitamin B3
skin seizure is another name for what disease
pellagra
what are the 3 D’s of pellagra?
- Dermatitis
- Diarrhea
- Dementia (neuron degeneration)
define Dermatitis
Flakey skin
* Pellagra may actually be a complex disorder involving thiamine, riboflavin and other nutrients
sources of Vitamin C?
milk, fruits, and vegetables
functions of Vit C?
1) Collagen synthesis
2) Vascular integrity and elasticity
Deficiency disease of Vit C called?
scurvy
define scurvy and its symptoms
- can be seen in USA, mainly in autistic kids
- -Much more dramatic in children
- Skeletal changes in children similar to rickets
- Membranes and endochondral bone formation is disrupted
- Bowed legs
- corkscrew hair
scurvy can secondarily cause?
1) bacterial periodontal infection
2) hemorrhage
- - Periungual aka warts
- - Gingival swelling and bleeding
scurvy primarily affects what part of the mouth?
gingiva
T or F… Vit C deficiency is common?
***Give example of diet
FALSE
- Unusual except in very strict or unusual diets
- The original “Zen macrobiotic diet” induced some cases and deaths from scurvy
corkscrew hair is associated with with Vit deficiency?
Vit C
hair probs are seen in what diseases?
Vit C deficiency, and SEM/PAM (Kwashiorkor) and anorexia
zinc is a ___ element
trace elements
zinc is needed in what amount?
Less than 1 ug/gm of wet tissue
Zinc deficiency symptoms
1) Acrodermatitis enteropathica
- -distinctive rash around mouth and anus
2) Infertility
3) Growth retardation
define Obesity
Increased accumulation of body fat above a particular standard
** BMI > 30 kg/m (normal < 25 kg/m)
BMI is calculated how?
Weight in kilograms divided by the square of your height in meters
define Central obesity
fat accumulation primarily in trunk (abdomen)
does central or general obesity have higher risks of diseases?
Central obesity has higher risk of many diseases than general obesity
T or F… obesity has a major genetic component
true
List diseases obese people are at high risk of getting?
1) Diabetes -type II
2) Hypertriglyceridemia and low HDLs = increased risk of coronary artery disease
3) Cholelithiasis -gall stones
4) Hypoventilation syndrome (Pickwickian syndrome) -respiratory abnormalities
5) Osteoarthritis -due to wear and tear of joints
6) Increased risk of stroke and cancer
define Cholelithiasis
formation of gall stones
Hypertriglyceridemia and low HDLs increases your risk of ______ disease?
coronary artery disease
Atherosclerosis can be postponed by reducing _____ intake?
saturated fat intake
You can replace saturated fats in your diet with?
unsaturated fats (fish, poly and mono-unsaturated vegetable oils)
fix Hypertension by?
decreasing sodium intake, exercise, medication
Garlic may help what organ?
heart
fiber helps what organ?
colon, reduced diverticulosis of colon
Sodium nitrite (and nitrates via transformation to nitrosamines and nitrosamides) may promote what cancers?
gastric and pancreatic cancers
High animal fat with low fiber may promote?
colonic cancer
What are Theoretical Anticarcinogens?
Vitamin C, E, A and selenium (antioxidants)
what causes sudden death in anorexic ppl?
cardiac arrhythmia
zinc deficiency and lead toxicity both have negative affects on?
reproductive system (causes infertility)
