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PBD II Exam 1 > Environmental and Nutritional Diseases V > Flashcards

Environmental and Nutritional Diseases V Flashcards

1
Q

appropriate diet

A

sufficient energy
amino acids and FA building blocks
Vits and Minerals - coenzymes

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2
Q

primary malnutrition

A

missing component of diet

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3
Q

secondary malnutrition

A

adequate supply of nutrients

-but malabsorption, impaired storage, excess loss, etc.

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4
Q

causes of dietary insufficiency

A 
poverty
infection
acute/chronic illness
chronic alcoholism
ignorance
self-imposed diet restriction
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5
Q

PEM

A

protein energy malnutrition

-BMI < 16 kg/m2

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6
Q

chronic alcoholism

A

deficiency in vitamins

-thiamin, pyridoxine, folate, vit A

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7
Q

thiamine deficiency

A

in chronic alcoholics

-brain damage

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8
Q

malabsorption

A

non-tropical and tropical sprue

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9
Q

marasmus

A

depleted somatic compartment
decreased T cells - susceptible to viral infection

serum albumin normal

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10
Q

kwashiorkor

A

depleted visceral compartment

edema, skin, hair changes
-serum albumin decreased

fatty liver

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11
Q

cachexia

A

in aids and cancer patients

weight loss, fatigue, muscle atrophy, anorexia, edema, anemia

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12
Q

causes of cachexia

A

agents secreted by tumors

PIF

LMF > TNF and IL-6 > acute phase response > C reactive protein

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13
Q

PIF and pro-inflammatory cytokines

A

in cachexia patients

  • skeletal m breakdown
  • via NF-kappaB activation of ubiquitin pathway
  • degrade myosin heavy chain

MuRF1 and MAFBx - two muscle specific ubiquitin ligases

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14
Q

bulimia

A

more common than anorexia

amenorrhea less than 50%

sign - scars on hands - from gagging self

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15
Q

highest death rate of psych disorder

A

anorexia

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16
Q

concerns with bulimia and anorexia

A

hypokalemia***

muscle cramping, paralytic ileus, cardiac arrhythmia and arrest

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17
Q

anorexia

A

amenorrhea very common

also cold intolerance, bradycardia, constipation, skin and hair changes

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18
Q

fat soluble vitamins

A

ADEK

more readily stored in body

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19
Q

vitamin A

A

retinoids - family name

-retinol is chemical name

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20
Q

sources of pre-formed Vit A

A

liver, fish, eggs, milk, butter

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21
Q

provitamins for Vit A

A

carotenoids
-metabolized to Vit A

yellow and leafy green vegetables, carrots, squash, spinach

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22
Q

beta-carotene

A

efficiently converted to Vit A

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23
Q

Vit A metabolism

A

fat-soluble - to liver

  • stored in Ito cells
  • binds RBP (retinol binding protein) before release
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24
Q

function of Vit A

A

maintain vision
-rhodopsin in rods and iodopsins in cones

cell growth and differentiation
-mucus epithelium - to squamous metaplasia and then to keratinizing epithelium

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25
photon causes
11-cis retinal to 11-trans retinal
26
RAR/RXR
receptor for retinoic acid - increase growth receptors
27
Tx of skin disorders - acne and psoriasis
retinoids
28
vitamin A deficiency
night blindness epithelial squamous metaplasia and keratinzation -susceptible to pulmonary infection and bladder stones
29
eye changes in vit A deficiency
bitot spots corneal ulcers keratomalacia
30
Vit A toxicity
too much - long time ago - people ate livers acute - HA, dizzy, vomit, bulrry vision chronic - weight loss, anorexia, nausea, vomit, bone and joint pain
31
Vitamin D
maintenance of the calcium and phosphorus levels
32
Vit D deficiency in children
rickets
33
Vit D deficiency in adults
osteomalacia
34
source of Vit D
synthesis in skin | -sun conversion of 7-dehydrochoesterol > cholecalciferol (Vit D3)
35
Vitamin D metabolism
Vit D synthesized in skin - transport to liver (bound to DBP) - liver conversion to 25-hydroxycholecalciferol - kidney conversion to 1,25 hydroxycholecalciferol
36
regulation of 1,25 Vit D formation
PTH - increases hypophosphatemia -increases both activate alpha-1 hydroxylase** also negative feedback mechanism
37
effects of 1,25 Vit D
skeletal homeostasis stimulate intestinal Ca absorption stimulate Ca reabsorption in kidney increase RANKL - bone breakdown also effect on bone mineralization
38
Vit D deficiency
normal range - 20-100 ng/mL -deficiency > 20 children - rickets adult - osteomalacia elderly - increased bone loss and hip Fxs
39
nonambulatory rickets
head and chest stress - craniotabes - bones snap back - pigeon breast deformity - frontal bossing and squared head - rachitic rosary
40
ambulatory rickets
lumbar lordosis and bowed legs
41
vit D toxicity
metastastic calcification of soft tissues -children bone pain and hypercalcemia -adults
42
ascorbic acid
Vit C
43
Vit C deficiency
scurvy hemorrhage and healing defects in children and adults
44
Vit C sources
need all from diet (no endogenous production) milk, liver, fish, fruits, veggies
45
antimicrobial effect of Vit D
TLRs stimiulated increase vit D receptor expression and increase mitochondria CYP27B synthesis of catyhelicidin occurs (anti-microbial)
46
function of Vit C
activation of prolyl and lysyl hydroxylases from inactive precursors - providing for hydroxylation of procollagen also antioxidant - scavenge free radicals
47
Vit C deficiency
impaired collagen formation -impaired wound healing -bleeding tendency inadequate osteoid synthesis
48
beri beri
vit B1 deficiency (thiamine) alcoholics and africans can lead to wernicke/korsakoff syndrome
49
wernicke
vit B1 deficiency | -CNS - ataxia, ocular problems, dementia
50
korsakoff
vit B1 deficiency | -psych - amnesia
51
pellagra
vit B3 deficiency (niacin) -or of tryptophan 3 D's - dementia, dermatitis, diarrhea
52
riboflavin
Vit B2
53
zinc deficiency
rash around eyes, mouth, nose, anus anorexia/diarrhea growth retardation depressed mental function infertility
54
iron deficiency
hypochromic microcytic anemia
55
iodine deficiency
goiter | hypothyroidism
56
copper deficiency
muscle weakness | neuro defects
57
normal BMI range
18.5 - 25 kg/m2
58
obese BMI
> 30
59
overweight BMI
25-30
60
central and visceral adiposity
fat in abdomen and mesentery and organs | -higher risk for diseases
61
hypothalamic control of hunger
arcuate nucleus - POMC/CART - stop eating - NPY/AgRP - eat more
62
leptin
synthesized by fat cells stimulate POMC/CART -to stop eating
63
mutation in MC4R
massive obesity
64
thermogenesis
mediated by leptin
65
adiponectin
stimulates FA oxidation and decrease in fat mass produced by adipocytes
66
AdipoR1
adiponectin receptor in skeletal muscle
67
AdipoR2
adiponectin receptor in liver
68
adipose and inflammation
pro-inflammatory | -levels of C-reactive protein high
69
orexigenic
increased food intake
70
anorexigenic
decreased food intake
71
ghrelin
only gut hormone that increases food intake
72
PYY
from endocrine cell in ileum and colon -low during fasting, increase after eating decreased in individuals with prader willi syndrome (ch 15) reduce food intake and weight gain
73
amylin
secreted with insulin from pancreatic beta-cells | -reduces food intake and weight gain
74
activity of PYY and amylin
activate POMC/CART | -dont eat
75
metabolic syndrome
visceral or intra-abdominal adiposity, insulin resistance, hyperinsulinemia, glucose intolerance, HTN, low HDL
76
non-alcoholic fatty liver disease
in obese
77
cholelithiathis
gallstones | -6x more likely in obese patients
78
pickwickian syndrome
hypoventilation in obese individuals obesity with hypersomnolence as well
79
results of obesity
insulin resistance - DM II - hyperinsulinemia increased IGF-1
80
obese males and cancer
BMI > 25 | -associatd with increased adenocarcinoma of esophagus, thyroid, colon, kidney
81
obese females and cancer
BMI > 25 | -increased adenocarcinomas of esophagus, endometrium, gallbladder, kidney
82
mechanism of obesity and cancer
hyperinsulinemia and insulin resistance -increased IGF-1 mitogenic and anti-apoptotic also increased steroid hormones
83
adiponectin in obese
role in insulin sensitization low levels - lead to hyperinsulinemia and insulin resistance
84
aflatoxin
development in hepatocellular carcinomas and asia and africa -causes p53 mutations
85
nitrosamines and nitrosamides
formation of gastric carcinomas -formed in body from ingested nitrites and nitrates
86
colon cancer and diet
high animal fat intake with low fiber
87
fiber
increased intake related to decreased risk of colon cancer
88
poly-unsaturated fatty acids
in fish oils decrease in atherosclerosis
89
recommended diet
veggies, fruits, whole grains, olive and peanut oils, complex carbs, low in salt

PBD II Exam 1 (14 decks)

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