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Block 1 test 2 > Introduction to nutrition > Flashcards

Introduction to nutrition Flashcards

1
Q

Fat soluble vitamins

A

AD(1,2,3)EK

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2
Q

Water soluble vitamins

A

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

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3
Q

Vit B1 (Thiamin Absorption) and excretion

A

Jejunum and ileum

Biliary and urinary

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4
Q

Vit B1 deficiency

A

Beri Beri

Wernicke-Korsakoff syndrome

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5
Q

Effect of thiamin on metabolic intermediates

A

Increased Pyruvate

Increased Lactate

Decreased Ace-CoA for TCA

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6
Q

Wet beri beri

A

High output heart failure

peripheral vaso-dilation
biventricular failure
edema

brought on by physical exertion and increased carbohydrate intake

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7
Q

Dry beriberi

A

Peripheral neuropathy of distal extremities

Both sensory and motor impariement

Occurs with little physical exertion and decreased caloric intake

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8
Q

Wernicke’s Encephalopathy

A

Confusion
Oculomotor dysfunction
Gait ataxia

Acute syndrome -treat with thiamine to prevent death

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9
Q

Korsakoff Syndrome

A

Chronic neurological condition

Impaired short term memory and confabulation

normal cognition

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10
Q

Roboflavin is involved in

A

Beta oxidation

AA oxidation

TCA cycle

Erythrocyte integrity

Conversion of tryptophan to niacin

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11
Q

Absence of riboflavin causes 2 Cs

A

Cheilosis

Corneal vascularization

Glossitis

Anemia due to red blood cell lysis

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12
Q

Niacin deficiency

A

Pellagra

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13
Q

Vit B6 involved in

A

AA metabolism

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14
Q

Vit B6 deficiency

A

Convulsions
Hyperirritability
Dermatitis
Glossitis

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15
Q

Excess intake of Vit B6

A

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

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16
Q

Vit B12 functions

A

Involved in conversion of homocysteine to methionine

Rearrangement of methylmalonyl CoA to Succinyl Co-A

17
Q

B12 deficiency causes (lab values)

A

high homocysteine and high malonyl Co-A

18
Q

Folic acid deficiency causes (lab values)

A

High homocysteine and normal malonyl Co-A levels.

19
Q

Vit B12 deficiency deficiency causes

A

Glossitis , posterior column findings with proprioception and vibratory sense

20
Q

Slide about Cobalamin

A

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.

21
Q

B12 deficiency

A

Megaloblastic anemia
Elevated MCV
Hypersegmented Neutrophils

22
Q

Causes of B12 def

A

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)

23
Q

Clinical signs of B12 deficiency

A

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

24
Q

Folic acid required for

A

erythropoiesis

25
Q

Folic acid roles

A

responsible for conversation of once carbon metabolism

DNA synthesis , purine metabolism , thymidylate synthase

26
Q

Folic acid and enterohepatic cycle

A

Methylation occurs in duodenum

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

27
Q

Signs of folic acid deficiency

A

Glossitis , macrocytic anemia

28
Q

Causes of folate deficiency

A

Diet, Meds, Malabsorption, Liver dysfunction

29
Q

Medications decrease absorption of dietary folate

A

Methotrexate , Phenytoin, Trimathoprin

30
Q

Clinical symptoms of folate deficiency

A

Megaloblastic anemia – indistinguishable from B12 megaloblastic anemia.

31
Q

Vit C absorption and regulation

A

small intestines and kidneys

32
Q

Vit C def

A

Scurvy

impaired wound healing g
defective tooth formation 
deficient osteoblast and fibroblast function 
swollen gums 
bruising 
anemia
33
Q

Marasmus

A

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

34
Q

Kwashiorkor

A

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.

35
Q

Diagnostics for Kwashiorkor and Marasmus

A

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.

36
Q

Energy need equation

A

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

37
Q

EE=

A

BEE+Activty +Met Demand+ TEF

38
Q

Protein estimation per day

A

1.2 - 1.5 grams per kg body weight

39
Q

Major feeding routes

A

oral , peripheral vein, tube, central vein

Block 1 test 2 (9 decks)

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