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Biochemistry I/II > Lecture 25: Malnutrition > Flashcards

Lecture 25: Malnutrition Flashcards

1
Q

___ is the science that studies the interaction between nutrients, and other substances in food in relation to maintenance, growth, reproduction, health, and disease of an organism

A

Nutrition

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2
Q

___ is defined as a disease state in which an organism is not receiving required nutrients for it to be able to grow and reproduce

A

Malnutrition

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3
Q

___is a disease state in which an organism is not consuming the minimum amount of various nutrients and/or enough calories for growth and reproduction. Also known as protein-energy malnutrition (PEM)

A

Undernutrition

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4
Q

_____is a disease state in which an individual’s diet results in serious protein deprivation, but still significant caloric intake (carbohydrate-based diets)

A

Kwashiokor

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5
Q

What are the clinical symptoms of Kwashiokor?

A

-Immune system compromised
-NO significant muscle wasting/loss of fat
-Edema (stomach)
-Poor wound healing
-Stunted growth
-Loss of hair/pigment
-Fatty liver
-Decreased serum albumin

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6
Q

Marasmus is a disease state in which an individual’s _____ is greater than the individual’s protein deprivation

A

caloric deprivation (restriction; starvation conditions)

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7
Q

What are the symptoms of Marasmus (chronic state)?

A

-Anemia
-No edema
-Low mortality
-Extreme muscle wasting (cachexia) and extreme loss of body fat
-Immune system preserved

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8
Q

What is an example of non-adaptive malnutrition?

A

Kwashiokor
(high mortality pathological state)

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9
Q

True or False: individuals with Marasmus display anemia and edema

A

False - individuals with Marasmus display anemia but NOT edema

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10
Q

____ is a disease state in which an individual’s caloric deprivation is greater than the individual’s protein deprivation

A

Marasmus

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11
Q

True or False: Extreme muscle wasting and extreme loss of body fat (cachexia) are seen in Kwashiorkor

A

False - extreme muscle wasting and extreme loss of body fat (cachexia) are seen in Marasmus

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12
Q

How are the albumin levels of patients with Marasmus compare to those with kwashiorkor?

A

Albumin levels are normal in people with Marasmus
Albumin levels are elevated in people with Kwashiorkor

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13
Q

True or False: The immune system is compromised in patients with marasmus

A

False - The immune system is compromised in patients with Kwashiorkor

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14
Q

Cachexia is an adaptive response to ____

A

undernourishment

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15
Q

True or False: Marasmus is a low mortality pathological state

A

True

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16
Q

Under starvation conditions, individuals will lose ___ mass to adjust to reduced energy intake. The body uses ___ acids as a source of energy.

A

muscle; amino

17
Q

One physiological response to starvation is decreased energy expenditure (also known as: BMR_ due to decreased energy ___, decreased body __. This can lead to lethargy.

A

intake; mass

18
Q

Physiological fasting triggers oxidation of _____ and ___ to provide energy

A

oxidation of fatty acids and ketosis

19
Q

What mediates the physiological response to starvation?

A

Endocrine systems (insulin, glucagon, thyroid, adrenal)
Hematological changes (hemoglobin)

20
Q

True or False: During starvation conditions, insulin will be high and glucagon will be low

A

False
There will be low insulin levels and high glucagon levels (mediates breakdown of fats, proteins, breakdown of glycogen)

21
Q

True or False:
During starvation conditions, (adrenal glands) epinephrine will become elevated while thyroid hormone will decline

A

True

22
Q

True or False: During starvation conditions, individuals may develop anemia

A

True

23
Q

Glycogen can be broken down into ____ while protein can be broken down into amino acids, which can be used for the process of ____ in the liver.

A

glucose; gluconeogenesis

24
Q

During starvation conditions, adipose tissue can be broken into free fatty acids. These can either provide energy (muscle) or make ___ in the liver and provide energy to brain and muscle

A

ketones

25
Q

How does the physiological response to starvation change when starvation is acute (1-3 days) vs. chronic (10-15 days)?

A

Under chronic conditions:
-more ketogenesis in liver to supply brain and muscle w ketones
-more break down of fat

Under acute condtions:
-gluconeogenesis predominates in liver
-brain is supplied w glucose
-muscle broken down to get amino acids for gluconeogenesis

26
Q

How can you calculate BMI?

A

BMI = 703 x (weight)/(height)^2

27
Q

BMI less than 25 is considered ___ weight while over 25 is considered ___

A

normal; overweight

28
Q

BMI greater than 30 indicates ___ while BMI greater than 40 indicates ___

A

obesity; morbid obesity

29
Q

If patient is older than 70 years of age, has BMI greater than 20.5, is critically ill, or had a reduced food intake in past week, you should screen them for _____

A

malnutrition

30
Q

True or False: Albumin, Pre-Albumin, Tranferrin, and CRP are made in the liver

A

True

31
Q

Can you use albumin as nutritional marker in patient with infection/inflammation or liver/renal failure?

A

No

32
Q

Why could someone who is malnourished have normal looking albumin levels?

A

Dehydration

33
Q

What is a good clinical marker for malnutrition?

A

Albumin (unless inflammation/infection/kidney or liver failure)

34
Q

How do you treat PEM?

A

1) slow increase in food intake (enteral or parenteral)
2) slow increase in protein intake
3) monitor/reintroduce electrolytes
4) avoid re-feeding syndrome (hypophosphatemia)

35
Q

____syndrome is re-introduction of nutrients in a malnourished individuals trigger the synthesis of proteins, fats, and glycogen, which depletes the serum of potassium, magnesium, and phosphorus (hypophosphatemia)

A

Re-feeding Syndrome

36
Q

What can be the consequences of malnutrition?

A

cardiac, pulmonary, and neurological consequences (can be fatal!)

Biochemistry I/II (23 decks)

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