Introduction to nutrition

Question 1

Fat soluble vitamins

Answer 1

AD(1,2,3)EK

Question 2

Water soluble vitamins

Answer 2

B 1,2,3,5,6.
Folic Acid
Biotin
Vit C

Question 3

Vit B1 (Thiamin Absorption) and excretion

Answer 3

Jejunum and ileum

Biliary and urinary

Question 4

Vit B1 deficiency

Answer 4

Beri Beri

Wernicke-Korsakoff syndrome

Question 5

Effect of thiamin on metabolic intermediates

Answer 5

Increased Pyruvate

Increased Lactate

Decreased Ace-CoA for TCA

Question 6

Wet beri beri

Answer 6

High output heart failure

peripheral vaso-dilation
biventricular failure
edema

brought on by physical exertion and increased carbohydrate intake

Question 7

Dry beriberi

Answer 7

Peripheral neuropathy of distal extremities

Both sensory and motor impariement

Occurs with little physical exertion and decreased caloric intake

Question 8

Wernicke’s Encephalopathy

Answer 8

Confusion
Oculomotor dysfunction
Gait ataxia

Acute syndrome -treat with thiamine to prevent death

Question 9

Korsakoff Syndrome

Answer 9

Chronic neurological condition

Impaired short term memory and confabulation

normal cognition

Question 10

Roboflavin is involved in

Answer 10

Beta oxidation

AA oxidation

TCA cycle

Erythrocyte integrity

Conversion of tryptophan to niacin

Question 11

Absence of riboflavin causes 2 Cs

Answer 11

Cheilosis

Corneal vascularization

Glossitis

Anemia due to red blood cell lysis

Question 12

Niacin deficiency

Answer 12

Pellagra

Question 13

Vit B6 involved in

Answer 13

AA metabolism

Question 14

Vit B6 deficiency

Answer 14

Convulsions
Hyperirritability
Dermatitis
Glossitis

Question 15

Excess intake of Vit B6

Answer 15

Sensory neuropathy that is not resolved when toxicity is corrected–was use in womens clinics in the past. ( Large doses)

Question 16

Vit B12 functions

Answer 16

Involved in conversion of homocysteine to methionine

Rearrangement of methylmalonyl CoA to Succinyl Co-A

Question 17

B12 deficiency causes (lab values)

Answer 17

high homocysteine and high malonyl Co-A

Question 18

Folic acid deficiency causes (lab values)

Answer 18

High homocysteine and normal malonyl Co-A levels.

Question 19

Vit B12 deficiency deficiency causes

Answer 19

Glossitis , posterior column findings with proprioception and vibratory sense

Question 20

Slide about Cobalamin

Answer 20

Vit B12 digested

HCl and IF are secreted

B12 bound to R (to stabilize it) in low pH

B12, IF, R go to duodenum , R is degraded

IF bind to B12

Complex moves to ileum and bind to IF-B12 receptor on enterocytes

Complex taken up by enterocytes

IF degraded, B12 freed

B12 is bound to transcobalamin II forming TCII/B12 complex

Complex moves to basolateral side of enterocyte into circulation , stored in liver and made available for B12 dependent enzymes.

Question 21

B12 deficiency

Answer 21

Megaloblastic anemia
Elevated MCV
Hypersegmented Neutrophils

Question 22

Causes of B12 def

Answer 22

Pernicious anemia (body can’t use B12 properly , mostly due to absence of IF)

Diet

Surgery

Crohn’s

Pancreatic disease (can’t digest off of R binder)

Question 23

Clinical signs of B12 deficiency

Answer 23

Neuropathy: symmetrical parenthesis and ataxia, loss of proprioception and vibration sense.

Question 24

Folic acid required for

Answer 24

erythropoiesis

Question 25

Folic acid roles

Answer 25

responsible for conversation of once carbon metabolism DNA synthesis , purine metabolism , thymidylate synthase

Question 26

Folic acid and enterohepatic cycle

Answer 26

Methylation occurs in duodenum Absorption in jejunum, transferred to liver and excreted in bile back to the duodenum.

Question 27

Signs of folic acid deficiency

Answer 27

Glossitis , macrocytic anemia

Question 28

Causes of folate deficiency

Answer 28

Diet, Meds, Malabsorption, Liver dysfunction

Question 29

Medications decrease absorption of dietary folate

Answer 29

Methotrexate , Phenytoin, Trimathoprin

Question 30

Clinical symptoms of folate deficiency

Answer 30

Megaloblastic anemia -- indistinguishable from B12 megaloblastic anemia.

Question 31

Vit C absorption and regulation

Answer 31

small intestines and kidneys

Question 32

Vit C def

Answer 32

Scurvy ``` impaired wound healing g defective tooth formation deficient osteoblast and fibroblast function swollen gums bruising anemia ```

Question 33

Marasmus

Answer 33

Cachexia - seen in chronic diseases such as cancer , COPD, CHF, Anorexia Nervose, HIV/AIDS.

Question 34

Kwashiorkor

Answer 34

Occurs mainly in setting of acute , life threatening illnesses and stress such as trauma , sepsis , ARDS, Ischemic pancreatitis ** Aggressive treatment is needed unlike in marasmus.

Question 35

Diagnostics for Kwashiorkor and Marasmus

Answer 35

Kwashiorkor- Serum albumin less than 2.8 and at least either, edema , poor wound healing, easy hair pluckability Marasmus - less than 3 mm tricep skin fold. Mid arm muscle circumference less than 15 cm.

Question 36

Energy need equation

Answer 36

BEE- EE of a healthy person at rest before eating or activity .

Question 37

EE=

Answer 37

BEE+Activty +Met Demand+ TEF

Question 38

Protein estimation per day

Answer 38

1.2 - 1.5 grams per kg body weight

Question 39

Major feeding routes

Answer 39

oral , peripheral vein, tube, central vein