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MALABSORPTION AND MALNUTRITION Flashcards

1
Q

what is malnutrition?

A

insufficient dietary intake to meet metabolic requirements

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2
Q

what is malabsorption?

A

a disorder of the digestive tract resulting in the inability to utilise appropriate dietary intake

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3
Q

what is kwashiorkor?

A

a severe malnutrition particularly of protein - presents as oedema

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4
Q

what are the 2 main types of protein-energy malnutrition?

A

kwashiorkor and marasmus

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5
Q

what is marasmus?

A

total dietary lack - presents as growth failure, apathy, diarrhoea, hepatomegaly, oedema, muscle wasting, anaemia, stomatitis

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6
Q

what tends to cause malnutrition in the developed world?

A

anorexia
neglect
dysphagia
increased metabolic demands e.g. pregnancy

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7
Q

what can a vitamin B6 deficiency cause?

A

neuropathy

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8
Q

what can a vitamin B1 deficiency cause?

A

cardiomyopathy and encephalopathy

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9
Q

what can a vitamin B2 deficiency cause?

A

stomatitis

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10
Q

what can a vitamin B3 (niacin) deficiency cause?

A

pellagra

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11
Q

what is pellagra?

A

triad of dermatitis, dementia, and diarrhea and can result in death (4Ds)

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12
Q

whatcan a B12 defiicneyc cause?

A

megaloblastic anaemia, neuropathy, dementia

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13
Q

what can a vitamin d deficiency cause?

A

osteomalacia

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14
Q

what can a vitamin c deficiency cause?

A

scurvy

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15
Q

what can a vitamin k deficiency cause?

A

coagulopathy

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16
Q

what are oligosaccharides?

A

carbohydrates existing as 3-9 monosaccharides in a chain

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17
Q

what are polysacchardies?

A

carbohydrates existing as 10+ carbohydrates in a chain

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18
Q

what are examples of monosaccharides?

A

glucose, fructose, galactose

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19
Q

what are examples of disaccharides?

A

lactose, sucrose and maltose

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20
Q

what is lactose formed of?

A

glucose and galactose

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21
Q

what is sucrose formed of?

A

fructose and glucose

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22
Q

what is maltose formed of?

A

2 glucose

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23
Q

whats an example of a poysaccharide?

A

starch

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24
Q

what are dietary fibres and why are they important?

A

carbohydrates that intestinal enzymes cant break down so they onyl get broken down a little by gut bacteria and end up as bulk matter in the stool
they slow the rate of absorption of simple sugars to help maintain healthy blood glucose
increase stool weight to prevent constipation
some like beta-glucan are good for heart health

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25
outline how carbohydrates are digested?
mechanically by chewing mouth - amylase breaks down starch and glycogen, pancreatic amylase yields disaccharides maltase/sucrase/lactose found on brush border wall which yield monosaccharides these can then cross the gut lining
26
what transporter does glucose use to cross into an enterocyte and then into the blood stream?
SGLT1 with 2Na+ and then GLUT2
27
what transporter does galactose use to cross into an enterocyte and then into the blood stream?
SGLT1 with Na+ and then GLUT2
28
what transporter does fructose use to cross into an enterocyte and then into the blood stream?
GLUT5 and then GLUT2
29
what transporter does lactose use to cross into an enterocyte and then into the blood stream?
SGLt1 and then GLUT2
30
what are the 3 groups of amino acids?
non-essential - we make them conditionally essential - we make them in a healthy body essential - we cant make them
31
outline how proteins are digested?
HCL in the stomach makes the amino acid chain more accessible to enzymatic action pepsin cleaves it into small oligopeptide chains pancreatic proteolytic enzymes are release inactivated, get activated and then digest peptides further tripeptides, dipeptides and amino acids can be taken up into hepatocytes and the trigger- and di-peptides are converted to amino acids here via pepsidases
32
what are the 4 inactive endopeptidases, their enzymes and their active forms?
trypsinogen - activated by enteropeptidase to form trypsin chymotripsinogen - activated by trypsin to form chymotrypsin proelastase - activated by trypsn to form elastase procarboxypeptidase - activated by trypsin to form carboxypeptidase
33
whats the molecular transporter than moves peptides into enterocytes?
PepT1
34
why are fats important?
they are a source of energy, help absorbe fat-soluble vitamins and can be converted to prostaglaninds which can help cells communicate
35
how long is a short chain fatty acid?
2-5 carbons
36
how long is a medium chain fatty acid?
6-12 carbons
37
how long is a long chain fatty acid?
13+ carbons
38
outline fat digestion?
lingual lipase and mastication start fat breakdown gastric lipase further breaks down these triglycerides bile salts emsulify lipids which allows digestion by pancreatic lipase = fatty acids and monoglycerides = formation of micelles monoglycerides and fatty acids are absorbed in the jejunum but bile salts remain in the lumen to go back to the liver (Enterohepatic Circulation) fatty acids and monoglycerides will be packaged up in the enterocytes to form mature chylomicrons which can then be transported into the intestinal lymphatics
39
what are micelles composed of?
fatty acids, monoglycerides, bile salts, cholesterol - all coated by phospholipids
40
what are the pancreatic lipolytic enzymes for triglycerides and what are they broken down into?
colipase and lipase - fatty acids and monoglycerides
41
what are the pancreatic lipolytic enzymes for phospholipase A2 and what are they broken down into?
fatty acids and lysolecithin
42
what are the pancreatic lipolytic enzymes for cholesterol esterase and what are they broken down into?
fatty acids and cholesterol
43
what are the fat soluble vitamins?
A D E K
44
what are the water soluble vitamins
B complex C B12
45
what secretes lingual lipases?
ebners glands
46
outline the vagus nerves role in enzymatic digestion
vagus nerve releases ACh which then releases histamine. Presence of food in the stomach stimulates gastrin release. vagal activity/gastric distention/gastrin/histamine act on parietal cells to inceas H+ release and intrinsic factor
47
where is pepsinogen released from? what triggers this? what does it do?
chief cells gastrin ans vagus nerve breaks down proteins in food during digestion
48
what stimulates the gallbladder to release bile
cholecystokinin
49
what can alkalise the chyme?
bicarbonate release
50
what is Lymphangiectasia?
pathological dilation of the lymph vessels
51
what are some examples of infections of the lumen of the small intestine?
``` Giardiasis tb ancylostoma tropheryma whippelii cryptosporidium isospera ```
52
what tends to cause bacterial overgrowth?
``` jejunal diverticulosis blind loops formed in surgery obstructions motility disorders hypochlorydia in the elderly ```
53
whats the consequence of terminal ileal surgery?
bile salt and B12 malabsorption
54
what are the consequences of B12 malabsorption?
``` megaloblastic anaemia peripheral neuropathoes optic atrophy dementia subacute cord degenration ```
55
what are examples of intrahepatic biliary disease?
gall stones
56
what are examples of extrahepatic biliary disease?
pancreatic tumour
57
whats a consequence of biliary disease
malsborption of vitamins ADEK
58
what are examples of diseases of the pancreas?
pancreatitis tumours obstructing pancreatic duct zollinger ellison syndrome
59
what are the sympotms of malabsorption syndromes?
diarrhoea, bloating, flatulance, unintentional weight loss and nutritional deficiencies
60
symptoms of vit A deficiency?
night blindness eye dryness corneal ulcerations thickened skin
61
symptoms of vit D deficiency?
rickets | osteomalacia
62
symptoms of vit E deficiency?
ataxia impaired proprioception and vibration sensation haemolytic anaemia
63
symptoms of vit K deficiency?
increased bleeding
64
symptoms of fat malabsorption?
causes steatorrhea - fatty, floating, voluminous and terrible smelling stools
65
signs of protein malabsorption?
diarrhoea | oedema
66
signs of carbohydrate malabsorption?
watery diarrhoea
67
signs of iron malabsorption?
microcytic anaemia
68
signs of folate malabsorption?
macrocytic anaemia
69
what are the 2 types of cholestasis?
hepatocellular (impairment of bile formation) | obstructive

xB15W1 (9 decks)

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