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1st yr-Med 2022-2023 > GHM L1 > Flashcards

GHM L1 Flashcards

1
Q

Macronutriens

A
  • Fats
  • Carbohydrates
  • Proteins
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2
Q

Fat

A

Major constituent of membrane phospholipids
ESSENTIAL Precursors of eicosanoids

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3
Q

Eicosanoids

A
  1. Thromboxane
  2. Prostaglandins
  3. Prostacyclin
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4
Q

Carbs

A

ESSENTIAL Plant origin. Except lactose + small amount of glycogen

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5
Q

Essential

A

Something we cannot make ourselves

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6
Q

Amino Acids

A

Synthesising:

New proteins
Thyroid hormones
Neurotransmitters
Catecholamines

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7
Q

DIAGRAMS OF MACRONUTRIENTS

A

RECOGNISE THEM!!!!

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8
Q

What happens if we get too little fat in diet?

A

Fatty acids are essential
Failure in growth
Reproductive problems

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9
Q

What happens if we get too little carbs in diet?

A

Carbs not needed.

But, too little carbs leads to protein sparring effect.

This leads to acidosis. This where carbohydrate starvation leads to glycolysis to stop and lypolysis to start. This is to provide energy.

This leads to ketoacids being produced. This increases irrersible damage + acidity

Hypoglycemia - drop in blood sugar levels, fatigue

Muscle wasting - amino acids used up for energy

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10
Q

What happens if we get too little protein in diet?

A

Kwashiorkor

  • Very severe permananet intellectual disability
  • Severe oedema
  • Dermatitis
  • Liver enlargement
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11
Q

Marusmus

A

<60% of weight for age
Deficiency in calorie intake

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12
Q

Kwashiorkor

A

60-80% of weight for age
Oedema
Protein deficiecny

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13
Q

Marasmus Kwashiorkor

A

<60% of weight for age
Oedema

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14
Q

Underweight

A

60-80% of weight for age
No oedema

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15
Q

Malnutrition

A

Failure to thrive

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16
Q

Types of malnutrition

A
  1. Marasmus
  2. Kwashiorkor
  3. Marasmus Kwashiorkor
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17
Q

What happens if we get too much fat in diet?

A

CVD - Cardiovascular Disease

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18
Q

What happens if we get too much carbs in diet?

A

Diabetes Mellitus
Glucose Toxicity

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19
Q

What happens if we get too much protein in diet?

A
  • Some cancers
  • Calcium stones in Urinary Tract
    -Osteoperosis
    -Kidney disease
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20
Q

How can too much of all macronutrients cause obesity?

A

DIAGRAM L1

All macronutrients are eventually broken down into AcetylCoA

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21
Q

Body Fat %

A

New Born: 14% (male/female)
10 year old: male: 13% female: 19%
ADULT essential fat: male: 5% female: 13%
ADULY normal weight male: 15% female: 28%
Obese ADULT male: 25+ % female: 32+%

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22
Q

BMI (KG/M2)

A

<18.5: underweight
18.5-25: healthy
25-30: overweight
30-35: obese I
35-40: obese II
40>: OBESE III

23
Q

Why is obesity harmful?

A

Endocrinology (affects endocrine system) leading to:

-Diabetes Mellitus
-Polycistic Ovary Syndrome
-Infertility
-Menstrual Disorders

Gastrointestinal Problems:

-Fatty liver disease (2 types, AFLD, NAFDL)
-Non-alcoholic cirrhosis
-GERD
-Gall Stones

13 Cancers associated with being overweight + obesity

24
Q

Non-Alcoholic Fatty Liver Disease

A

Causes cirrhosis im liver
Linked to soft drinks
Linked to insulin resistance

TREATMENT:

Anti-diabetic medication
Diet
Exercise
Bariatric surgery

25
Q

Gall Stones

A

Crystallisation caused by excess cholestrol or lack of bile salts

Symptoms:

  • Pain when gall bladder contracts
  • Blockage of bile duct leading to bile retention
  • Jaundice
    -Secondary infection by intestinal bacteria

Risk Factors:

  • Obesity
    -Cirrhosis
    -Sickle cell disease

Treatment:

-Removal, dissolution, sonication of gallstones

Non-vegetarian have 9x higher incidence

26
Q

Gastro-oesophagul reflux disease (GORD)

A

Reflux of stomach contents from stomach into oesophagus. Causes pain + mucosl inflammation of oesophagus - oesophagitis

Causes heart burn (restrosternal burning pain) when lying down / after a meal

27
Q

Causes of GORD

A
  • Sleep apnoea
    -Gallstones (i.e. failure to neutralise the gallstones)
    -Obesity
    -Transient relaxations of lower oesophagul sphincter
28
Q

Non-pharmacological treatment for GORD

A

Ensure 2 hour gap between meal and sleep
Elavate head during sleep
Reduce Fat + alchohol intake

29
Q

What factors influence energy requirements

A
  1. Basal Metabolic Rate (KJ/Hour/Kg of body weight)
  2. Physical activity
  3. Growth, pregnancy, lactation
  4. Muscle mass
  5. Age BMR DECREASES WITH AGE
  6. Environmental temp
  7. Diet induced thermogenesis
30
Q

Metabolic Syndrome

A

Where a patient has:

  1. Cardiovascular disease
  2. Type 2 Diabetes
  3. High blood pressure
  4. NAFLD
  5. TOFI (thin outside, fat inisde)
31
Q

Metabolic Syndrome Causes

A

Glycogen metabolised in different ways
Fructose only metabolised in liver
Small amount of fructose, when its metabolised, is used to produce glycogen in liver
Large amounts of it is strored as fat therefore, too much fructose in diet can lead to metabolic syndrome
This leads to NAFLD and insulin resistance
Fructose safe to eat when in fruit / vegetables. The fibre is crucial.

32
Q

Satiety

A

Sensation of being full

33
Q

Hunger hormones

A
  1. Ghrelin
  2. Leptin
34
Q

Leptin

A

Supress appetite by inhibiting release of neuropeptide Y

Satiety is dependent on leptin + insulin
Leptin signals state (fullness) of fat stores:
-its plasma conc
-reflects size of fat stores

Insulin signals state (fullness) of carb stores

35
Q

Ghrelin

A

Appetite stimulant
When levels of leptin + insulin low, ghrelin + NPY released from stomach + hypothalamus

36
Q

Risk factors for obesity

A
  1. Less physical activity
  2. Heavy alcohol consumption
  3. Smoking cessation (quit smoking)
  4. Bad sleep
  5. Endocrine disorders (hypothyroidism)
  6. Genetic factors (thrifty genes)
  7. Drugs (steroids, anti-depressants)
  8. Immobilising diseases (restrict movement)
  9. Gut flora
37
Q

Weight Loss Diets

A
  1. Low Fat Diet
  2. Low Carb Diet
  3. Low Calorie Diet
38
Q

Low Fat Diet

A

Fat intake 15% of total calorie intake

  • reduces calorie intake
  • Reduces risk of CVD
  • Small weight loss
39
Q

Low Carb Diet

A

Carb intake 20% of total calories
More effective at reducing fat mass
More weight loss due to lower calorie intake

40
Q

Low calorie diet

A

800kcal or less calorie intake

  • Rapid, substantial weight loss in obese patients with T2D
    -increases insulin sensitivity

problems:

-gallstones
-constipation

however, indicated for obese patients where healh risk of obesity is worse than the diet itself

41
Q

Drugs for weight loss + obesity

A

LOSTI

Leptin - Does not work due to leptin resistance in obese patients

Orlistat - reduces fat absorption

Sibutramine - increases seratonin conc, decreases appetite, now withdrawn

Thyroid Hormone Treatment - Danger of death

Insulin - Danger of death, does not work due to insulin resistance in obese patients

42
Q

Surgey for weight loss

A

SSLR

Stomach banding
Stomach stapling
Liposuction
Resection of intestine

PROBLEM:

DIFFICULT AFTERCARE
HIGH RISK

43
Q

Too much Vitamin A

A
  1. Increased bone turnover (leads to osteoperosis + spontaneous bone fractures)
  2. Hair loss, mouth ulcers
44
Q

Too less Vitamin A

A
  1. Hyperkeratosis - abnormal thickening of outerlayer of skin
  2. Nightblindness
45
Q

Vitamin B1

A

Thiamine

46
Q

Too much Vitamin B1

A

Drowsiness

47
Q

Too less Vitamin B1

A
  • Wenricke-Korsakov Syndrome (pyschosis)
    -BeriBeri - affects peripheral nervous system, leads to problems walking, therefore, leads to paralysis
48
Q

Osteoporosis

A

Condition that weakens bones, makes them fragile + more likely to break

49
Q

Too much vitamin D

A
  • Calcium stones
    -Hypercalcemia
    -Bone pain
50
Q

Too less vitamin D

A
  • Osteoperosis
  • Rickets
    -Asthma + other inflammotry coniditions
51
Q

Vitamin C function

A

Collagen synthesis

52
Q

Too much Vitamin C

A

kidney stones

53
Q

Too little vitamin C

A

Scurvy

Mucous membrane bleeding
Open wounds
Lose gums
Lose teeth

death from bleeding

all of this = fatigue

1st yr-Med 2022-2023 (57 decks)

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