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xB15W1 > MALABSORPTION AND MALNUTRITION > Flashcards

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
Q

outline how carbohydrates are digested?

A

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

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26
Q

what transporter does glucose use to cross into an enterocyte and then into the blood stream?

A

SGLT1 with 2Na+ and then GLUT2

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27
Q

what transporter does galactose use to cross into an enterocyte and then into the blood stream?

A

SGLT1 with Na+ and then GLUT2

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28
Q

what transporter does fructose use to cross into an enterocyte and then into the blood stream?

A

GLUT5 and then GLUT2

29
Q

what transporter does lactose use to cross into an enterocyte and then into the blood stream?

A

SGLt1 and then GLUT2

30
Q

what are the 3 groups of amino acids?

A

non-essential - we make them
conditionally essential - we make them in a healthy body
essential - we cant make them

31
Q

outline how proteins are digested?

A

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
Q

what are the 4 inactive endopeptidases, their enzymes and their active forms?

A

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
Q

whats the molecular transporter than moves peptides into enterocytes?

A

PepT1

34
Q

why are fats important?

A

they are a source of energy, help absorbe fat-soluble vitamins and can be converted to prostaglaninds which can help cells communicate

35
Q

how long is a short chain fatty acid?

A

2-5 carbons

36
Q

how long is a medium chain fatty acid?

A

6-12 carbons

37
Q

how long is a long chain fatty acid?

A

13+ carbons

38
Q

outline fat digestion?

A

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
Q

what are micelles composed of?

A

fatty acids, monoglycerides, bile salts, cholesterol - all coated by phospholipids

40
Q

what are the pancreatic lipolytic enzymes for triglycerides and what are they broken down into?

A

colipase and lipase - fatty acids and monoglycerides

41
Q

what are the pancreatic lipolytic enzymes for phospholipase A2 and what are they broken down into?

A

fatty acids and lysolecithin

42
Q

what are the pancreatic lipolytic enzymes for cholesterol esterase and what are they broken down into?

A

fatty acids and cholesterol

43
Q

what are the fat soluble vitamins?

A

A
D
E
K

44
Q

what are the water soluble vitamins

A

B complex
C
B12

45
Q

what secretes lingual lipases?

A

ebners glands

46
Q

outline the vagus nerves role in enzymatic digestion

A

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
Q

where is pepsinogen released from? what triggers this? what does it do?

A

chief cells
gastrin ans vagus nerve
breaks down proteins in food during digestion

48
Q

what stimulates the gallbladder to release bile

A

cholecystokinin

49
Q

what can alkalise the chyme?

A

bicarbonate release

50
Q

what is Lymphangiectasia?

A

pathological dilation of the lymph vessels

51
Q

what are some examples of infections of the lumen of the small intestine?

A 
Giardiasis
tb
ancylostoma
tropheryma whippelii
cryptosporidium
isospera
52
Q

what tends to cause bacterial overgrowth?

A 
jejunal diverticulosis
blind loops formed in surgery
obstructions
motility disorders
hypochlorydia in the elderly
53
Q

whats the consequence of terminal ileal surgery?

A

bile salt and B12 malabsorption

54
Q

what are the consequences of B12 malabsorption?

A 
megaloblastic anaemia
peripheral neuropathoes
optic atrophy
dementia
subacute cord degenration
55
Q

what are examples of intrahepatic biliary disease?

A

gall stones

56
Q

what are examples of extrahepatic biliary disease?

A

pancreatic tumour

57
Q

whats a consequence of biliary disease

A

malsborption of vitamins ADEK

58
Q

what are examples of diseases of the pancreas?

A

pancreatitis
tumours obstructing pancreatic duct
zollinger ellison syndrome

59
Q

what are the sympotms of malabsorption syndromes?

A

diarrhoea, bloating, flatulance, unintentional weight loss and nutritional deficiencies

60
Q

symptoms of vit A deficiency?

A

night blindness
eye dryness
corneal ulcerations
thickened skin

61
Q

symptoms of vit D deficiency?

A

rickets

osteomalacia

62
Q

symptoms of vit E deficiency?

A

ataxia
impaired proprioception and vibration sensation
haemolytic anaemia

63
Q

symptoms of vit K deficiency?

A

increased bleeding

64
Q

symptoms of fat malabsorption?

A

causes steatorrhea - fatty, floating, voluminous and terrible smelling stools

65
Q

signs of protein malabsorption?

A

diarrhoea

oedema

66
Q

signs of carbohydrate malabsorption?

A

watery diarrhoea

67
Q

signs of iron malabsorption?

A

microcytic anaemia

68
Q

signs of folate malabsorption?

A

macrocytic anaemia

69
Q

what are the 2 types of cholestasis?

A

hepatocellular (impairment of bile formation)

obstructive

xB15W1 (9 decks)

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