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Gut and Metabolism > GM Week 1 > Flashcards

GM Week 1 Flashcards

1
Q

Explain how proteins can be used as an energy source:

A

During digestion, amino acids are absorbed into the blood. Some of these are de-nitrogenated and the resulting ketoacids can be used as a source of ATP.

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2
Q

What’s the absorption pathway for lipids compared with carbohydrates:

A
  • lipids are packaged into chylomicrons, which travel through the lymphatic system, through the thoracic duct and into the circulation
  • carbohydrates travel directly through the hepatic portal vein and into the circulation from there
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3
Q

How is the RDA defined in relation to the EAR?

A
  • EAR (estimated average requirement) is defined as the daily requirement for the population median.
  • RDA is defined as 2 standard deviations from the EAR. It’s sufficient to meet 98% of the populations dietary needs.
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4
Q

How does the acceptable macronutrient distribution range change from childhood through adulthood?

A
  • The % of dietary fat needed decreases as you grow up
  • The % of dietary protein needed increases as you grow up
  • The % of dietary carbohydrates needed stays the same
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5
Q

SSx of pellagra:

A
  • Dementia, Dermatitis, Diarrhea

- Due to niacin deficiency

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6
Q

Results from vitamin B12 deficiency:

A

Megaloblastic anemia

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7
Q

Where in the GI tract is B12 absorbed

A

Only in the terminal ileum

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8
Q

Is it possible to distinguish between folate and B12 deficiencies based on blood panel results?

A

No

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9
Q

Results from vitamin A deficiency:

A
  • Night blindness
  • Xerophthalmia
  • Lower immunity
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10
Q

True or false: heme iron is absorbed better than iron from leafy vegetables or other non-animal sources.

A

True

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11
Q

SSx of copper deficiency:

A
  • Anemia
  • Cardiac enlargement
  • Neutropenia
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12
Q

Results from iodine deficiency:

A
  • Goiter

- Cretinism

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13
Q

What’s the only way to increase your metabolism?

A
  • Lifting weights

- Every pound of muscle burns roughly 50 calories at rest

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14
Q

What are the main restrictions on a renal diet?

A
  • Low phosphorus
  • Low sodium
  • Low potassium
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15
Q

What’s one indication for the ketogenic diet?

A

Intractable epilepsy

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16
Q

Most common allergens in children:

A

Milk, soy, eggs, wheat

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17
Q

What type of allergic reaction is eosinophilic esophagitis? What’s its most common cause?

A
  • Mixed IgE/non-IgE

- Milk

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18
Q

Common non-IgE mediated allergies:

A
  • Cow’s milk protein allergy
  • Celiac
  • FPIES (Food-Protein-Induced Enterocolitis Syndrome)
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19
Q

What’s the MOA for statin drugs?

A

Decrease production of cholesterol in the liver by interrupting its synthesis pathway.

20
Q

Most common serious side effect of statin drugs:

A
  • Myopathy

- Ranges from mild myalgia to rhabdomyolysis

21
Q

What other effects might statins have besides lipid level improvement?

A

May also have anti-inflammatory effects, improve endothelial function and reduce thrombus formation

22
Q

Which 3 statins have the most drug interactions, and why? Name a dietary interaction with these medications.

A
  • Atorvastatin, lovastatin and simvastatin
  • CYP3A4 metabolism
  • Interacts with grapefruit and alcohol
23
Q

What’s the major effect of niacin (nicotinic acid)?

A
  • Decreases triglyceride synthesis
  • Increases HDL by lowering HLD uptake in liver
  • Variable effect on LDL
  • No effect on mortality when added to statin therapy
24
Q

What does the mnemonic G PACMAN stand for?

What does it apply to?

A 
G = grapefruit     P = protease inhibitors
A = azoles           C = cyclosporine
M = macrolides   A = amiodarone
N = non-dihydropyridine CCP

Statin drug interactions

25
Q

What is the main difference between anorexics and bulimics?

A

Weight

26
Q

Populations at risk for redox reaction-type (thiamin, niacin, riboflavin, pantothenic acid) vitamin deficiencies:

A
  • Malabsorption syndromes

- Alcoholics

27
Q

Caused by folate deficiency:

A
  • Neural tube defects in infancy

- Megaloblastic anemia

28
Q

Thiamine (B1) essentials:

A
  • Redox reactions
  • No toxicity
  • Deficiency causes paresthesias, beriberi, WKS
  • High transketolase activity suggest deficiency
29
Q

Riboflavin (B2) essentials:

A
  • Redox reactions
  • No toxicity
  • Deficiency causes angular stomatitis, glossitis
  • Can measure in plasma, urine
  • Tx with meat, fish, dairy, or supplements
30
Q

Niacin (B3) essentials:

A
  • Redox reactions
  • Deficiency causes pellagra
  • Was more common in corn based diets
  • Most common symptom is flushing
  • Can be made from tryptophan
31
Q

Pyridoxine (B6) essentials:

A
  • Carboxylation/transamination reactions
  • Important for heme synthesis
  • Toxic in large doses (sensory neuropathy)
32
Q

Cobalamin (B12) essentials:

A
  • 1C metabolism
  • Important for DNA synthesis, erythropoiesis, methionine and SAM synthesis
  • Only reabsorbed in distal ileum, so disease there will lead to deficiency
  • Common with vegans, alcoholics
  • Megaloblastic anemia neuropathy
  • No toxicity
33
Q

Folate (B9) essentials:

A
  • 1C metabolism
  • Important for DNA synthesis/repair, erythropoiesis
  • Tea and toast diet, alcoholics
  • Megaloblastic anemia but without neuropathy
  • No toxicity
34
Q

Pantothenic acid (B5) essentials:

A
  • Severe malnourishment (famine and war)
  • Burning feet syndrome
  • No toxicity
35
Q

Biotin (B7) essentials:

A
  • Carboxylation/transamidation reactions
  • Important for histone modifications
  • Malnourishment, eating shitloads of egg whites
  • Maculosquamous dermatitis with chronic deficiency
  • No toxicity
36
Q

Vitamin C essentials:

A
  • Antioxidant, collagen synthesis
  • Deficiency causes malaise, scurvy if severe
  • SSx of scurvy includes hair and tooth loss, bruising, bleeding, death
  • Can cause GI upset, gas, stones, false +/- on guaiac, urine glucose
37
Q

Vitamin A essentials:

A
  • Gene regulation
  • Important for vision
  • Night blindness, xerophthalmia, lower immunity if deficient
  • Toxic over 50,000 IU/d x 3 mo
38
Q

Vitamin E essentials:

A
  • Areflexia, decreased proprioception and vibration, ophthalmoplegia if deficient
  • Deficiency common in adults with liver disease, biliary atresia, or cystic fibrosis in children
39
Q

Vitamin K essentials:

A
  • Deficiency mimics warfarin use
  • Found in leafy green vegetables
  • Toxicity can cause anemia
40
Q

Lorcaserin

A
  • Promotes release of satiety hormones
  • Contraindicated in pregnancy
  • AEs: hypoglycemia, decreased lymphocytes
41
Q

Orlistat:

A
  • Inhibits gastric and pancreatic lipases, so reduced fat absorption
  • Contraindicated in pregnancy, malabsorption syndrome
  • AEs: rectal leakage, steatorrhea
  • Interacts with warfarin, fat soluble vitamins, etc.
42
Q

Phentermine:

A
  • Similar to amphetamines
  • Interacts with MAO inhibitors
  • Contraindicated in pregnancy, CVD
43
Q

Side effects and contraindications of statins:

A
  • AEs: myopathy, diabetes, memory loss

- Contraindicated in patients with liver disease

44
Q

Bile acid sequestering agents: cholestyramine, colestipol

A
  • Bind bile acids, causing conversion of cholesterol to make more bile acids, as well as uptake of LDL
  • Contraindicated in hypertriglyceridemia
  • Add on therapy for hyperlipidemia
45
Q

Indications for niacin:

A

Hypertriglyceridemia

46
Q

Relative amounts of micronutrients needed per day:

A

Very little: most fat soluble vitamins, B7, B9, B12

A lot: electrolytes and minerals

Everything else: somewhere in the middle

Gut and Metabolism (3 decks)

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