GI case Flashcards
Healthy Diet: (2)
A diet containing:
- An appropriate balance of food groups to obtain appropriate nutrients
- The right amount of energy to maintain an energy balance
Energy requirements:
- Man
- Woman
- 2,500 calories a day
- 2,000 calories a day
Overweight/Obesity statistics among adults:
- 7/10 men are overweight/obese
- 6/10 women are overweight/obese
Obesity definition:
- Generally a result of energy intake being greater than energy expenditure
- Determined by Body Mass Index (BMI), 30 or higher
BMI classifications:
- Underweight
- Normal
- Overweight
- Obese
- Morbidly obese
- < 18.5
- 18.5-24.9
- 25-29.9
- 30-39.9
- > /= 40
Obesity Aetiology: (7)
Many potential factors:
- Psychological
- Cultural
- Psychiatric
- Environmental factors
- Genetics
- Medications
- Endocrine disorders
Obesity consequences:
- A modifiable risk factor for disease
Obesity: treatment options
- Lifestyle changes
- Pharmacotherapy
- Bariatric surgery
Consequences of malnutrition:
- Literally everything is negatively effected
Malnutrition in hospital
- Significant proportion of patients admitted to hospitals, care homes and mental health units are at risk of malnutrition
Functions of the liver and gallbladder: (3)
- Metabolism
- Synthetic function
- Biliary circulation
Liver metabolism: carbohydrates (3)
- Description
- 2 functions
- Liver is an ‘altruistic’ organ - releases glucose into the blood stream
- Glycogen storage
- Gluconeogenesis
Liver metabolism: proteins
- Transamination: Aminotransferases break the amino acid down to glutamic acid
- Oxidative deamination produces carboxylic acid and ammonia (which needs to be removed)
Aminotransferases:
- Location
- Indication
- Clinical
- Should be in the hepatocytes, not the bloodstream
- Large quantities in bloodstream indicates hepatocyte damage
- ALT monitored clinically for hepatocyte damage
Urea cycle:
- Removes ammonia from the liver
- May be affected by liver damage
Hyperammonaemia
Elevated levels of ammonia. Mostly caused by a defect in the urea cycle, causes: - Confusion - Excessive sleepiness - Hand tremors - Coma
Hyperammonaemia:
- Excess ammonia in the blood stream
- May be seen in urea cycle disorders, other inborn metabolic errors and liver failure
Liver metabolism: lipids
- Essential in lipid metabolism
- Liver problems may disrupt lipid levels (cholesterol, triglyceride)
Synthetic function of the liver: albumin:
- % of plasma proteins
- Maintains:
- Also acts as:
- Makes up 50% of plasma proteins
- Main factor in maintaining osmotic pressure
- Also acts as a carrier protein: calcium, bilirubin
Hypoalbuminaemia:
- Definition
- Cause
- Effect
- Low levels off albumin in the blood
- Caused by liver disease, nephrotic syndrome, malnutrition and burns
- causes Peripheral oedema
Liver disease and bleeding: (3)
- Clotting factors synthesised in the liver
- Cholestasis: malabsorption of Vitamin K
- Decreased platelet count
Biliary system:
- Globin route
- Haem route
Breaks down old/damaged RBCs:
- First into Haem and globin (protein)
- Globin broken down to amino acids
- Haem is then broken down to Biliverdin and iron by Haemoxygenase
- Biliverdin to bilirubin via biliverdin reductase
Biliary system:
- Globin route
- Haem route
Spleen breaks down old/damaged RBCs:
- First into Haem and globin (protein)
- Globin broken down to amino acids
- Haem is then broken down to Biliverdin and iron by Haemoxygenase
- Biliverdin (soluble) to bilirubin (non-soluble) via biliverdin reductase
Conjugation of bilirubin:
- Bilirubin transported to liver bound to albumin
- Bilirubin taken up by the liver via facilitated diffusion: conjugated to glucuronic acid
- Conjugated bilirubin released into bile