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Biochemistry > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

What are the essential components of diet?

A
  • Carbs
  • Proteins
  • Fats
  • Minerals
  • Water
  • Roughage
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2
Q

Function of Carbs?

A
  • Energy
  • Protein Sparer
  • Can be stored in times of exces
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3
Q

Function of Fats?

A
  • Heat and energy
  • Transporting fat soluble vitamins
  • Myelin Sheathe
  • Bile
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4
Q

What is the difference between essential and non-essential amino acids?

A

Essential amino acids must be derived from diet, whereas non-essential can be produced in the body

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5
Q

What foods contain all of the essential amino acids?

A
  • Meat
  • Fish
  • Eggs
  • Soya
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6
Q

What foods do not contain all of the essential amino acids?

A
  • Peas
  • Beans
  • Lentils
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7
Q

What is the function of dietary intake of water?

A
  • Assists in regulation of body temp
  • Major component of blood and tissue fluid
  • Component of urine and faeces
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8
Q

What is the function of dietary intake of roughage?

A

-Stimulates peristalsis and bowel movements

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9
Q

What are the types of protein energy malnutrition?

A
  • Kwashiorkor
  • Cachexia
  • Phthisis
  • Marasmus
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10
Q

What is Kwashiorkor?

A

Malnutrition due to diet deficient in protein

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11
Q

What is Cachexia?

A

Condition of abnormally low weight associated with chronic disease like cancer or AIDS

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12
Q

What is Phthisis?

A

any disease resulting in wasting of tissue

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13
Q

What is marasmus?

A

Severe wasting of infants

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14
Q

What are the symptoms of Kwashiorkor?

A
  • Oedema
    (Pitting)
  • Diarrhoea
  • Potbelly
    (Hepatomegaly)
  • Change in Hair and Nail
  • Desquamating Skin Rash
  • Decrease in linear growth
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15
Q

What are the two different categorisations Oedema can be split into?

A
  • Pitting/Non-pitting

- Local/General

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16
Q

What is the difference between local and general oedema?

A
  • Local is injury or inflammation

- General is heart or kidney failure

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17
Q

What is the difference between pitting and non-pitting oedema?

A
  • Pitting, when pressed indentation does not reform quickly

- Non-pitting, indentation reforms quickly

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18
Q

Where can general oedema occur?

A
  • Chest Cavity (Pleural Effusion)
  • Abdomen (Ascites)
  • Air Spaces (Pulmonary Oedema)
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19
Q

What is the mechanism of oedema?

A
  • Less protein means less amino acids means less albumin in the liver
  • Albumin is a carrier for fatty acids and maintains osmotic pressure
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20
Q

What are the three types of diarrhoea?

A
  • Osmotic
  • Secretory
  • Malabsorptive
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21
Q

What is osmotic diarrhoea?

A

Retaining water in lumen on GI tract

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22
Q

What is secretory diarrhoea?

A

Entereotoxin released by bacteria draws water into the lumen from cells

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23
Q

What is malabsorptive diarrhoea?

A

Reduced ability to digest and absorb nutrients

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24
Q

What type of diarrhoea is symptomatic of Kwashiorkor?

A

Malabsorptive

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25
Q

Why does Kwashiorkor cause malabsorptive diarrhoea?

A

-Decreased digestive enzymes and reduction in absorption in the pancreas and intensines, lowering the water potential in the lumen so water diffuses in by osmosis

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26
Q

What types of cells are there in the intestines and what do they secrete?

A
  • Goblet (Mucous)
  • Enteroendocrine cells (GLP-1)
  • Enterocytes (Absorptive cells)
  • Paneth cells (Bactericidal)
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27
Q

What 2 categories can the pancreas be divided into?

A

Endocrine and exocrine

28
Q

What hormones are secreted by the endocrine structure of the pancreas? (Islet of Langerhans)

A
  • Insulin
  • Glucagon
  • Somatostatin
  • Pancreatic Polypeptide
  • Ghrelin
29
Q

What are the exocrine structures in the pancreas?

A
  • Ductal Cells

- Acinar Cells

30
Q

What do acinar cells in the pancreas produce?

A

Digestive enzymes:

  • Lipase
  • Amylase, etc.
31
Q

What do the ductal cells of the pancreas do?

A

Connect to the pancreatic duct to pass the enzymes secreted by the acinar cells into the intestine

32
Q

What changes in hair occur in kwashiorkor?

A

Banded hair pattern of good/poor growth. Poor growth will be grey/blonde

33
Q

What changes in nails occur in kwashiorkor?

A

Finger clubbing, bloated fingernails/tips

34
Q

How does the desquamating skin rash work in kwashiorkor?

A

The stratum corneum layer of the epidermis is lost

35
Q

What is the mechanism of cachexia?

A

Hypercatabolism of fat and protein, mediated by cytokines which cause protein breakdown vie the Proteasome

36
Q

How do cytokines mediate protein breakdown via the Proteasome in Cachexia?

A

Proteins are tagged by Ubiquitin which are then sent to the proteasome for degradation

37
Q

What is Obesity?

A

Excessive accumulation of fat. BMI above 25.

38
Q

What is BMI formula?

A

Bodymass(kg)/Height(m)^2

39
Q

What are the causes of obesity?

A
  • higher food intake than energy expenditure
  • Genetic
  • Pathological
40
Q

What are cytokines?

A

Hormone-like substances that act in a paracrine fashion to mediate immune response

41
Q

What hormone is deficient in genetic obesity that is responsible for appetite control?

A

Leptin

42
Q

Why does a deficiency in Leptin lead to increased food intake?

A

Leptin inhibits NPY which reduces appetite and increases energy expenditure, so appetite/food intake increases while energy expenditure goes down

43
Q

What is genetic obesity caused by?

A

Homozygous mutation in the ob gene (ob/ob) causing no leptin to be produced

44
Q

What are the symptoms of Cushing’s Disease?

A
  • Moon Face
  • Thin Limbs
  • Truncal Obesity
  • Buffalo Hump
  • Stretch Marks
  • Muscle Wasting
  • Diabetes Mellitus
45
Q

What are the two causes of Cushing’s Disease?

A
  • Pituitary Adenoma

- Adrenal Tumour

46
Q

What is the function of the anterior pituitary gland?

A
  • Basophilic Cells secrete FSH, LH, ACTH and TSH

- Acidophilic cells secrete GH and prolactin

47
Q

What is the function of the posterior pituitary gland?

A

Release of Oxytocin and Vasopressin

48
Q

What does FSH do?

A

Females: Graafian follicle development
Males: Sperm production

49
Q

What does LH do?

A

Females: Stimulates ovulation
Males: Androgen production

50
Q

What does ACTH (Adrenocorticotropic Hormone) do?

A

Controls cortisol secretion in the adrenals

51
Q

What does TSH do?

A

Controls the thyroid gland

52
Q

What does prolactin do?

A

Stimulates milk production in females

53
Q

What does oxytocin do?

A

Stimulates uterine contraction

54
Q

What does vasopressin do?

A

Reabsorption of water into the kidney

55
Q

What are the two sections of the adrenal gland?

A

the Cortex and Medulla

56
Q

What is the cortex of the adrenal gland split into?

A
  • Zona Glomerulosa
  • Zona Fasiculata
  • Zona Reticularisa
57
Q

what hormones are secreted by the adrenal cortex?

A
  • Glucocorticoid
  • Mineralocorticoid
  • Sex Steroids
58
Q

What hormones are secreted by the adrenal medulla?

A

Epinephrine and Norepinephrine

59
Q

How does ACTH typically interact with the adrenal gland in healthy people?

A

Causes adrenal cortex to release cortisol (glucocorticoid), which causes negative feedback decreasing the rate of secretion of ACTH

60
Q

How does a pituitary adenoma cause cushings disease?

A

Increases ACTH, which increases cortisol, which cannot inhibit ACTH due to the tumour cells not being able to sense cortisol, causing constantly high cortisol (Hypercortisolaemia)

61
Q

How does increased cortisol from having an adrenal adenoma cause cushing’s disease?

A
  • Increased gluconeogenesis causing diabetes
  • Muscle wasting
  • Redistribution of fat to centre of body
62
Q

What is the clinical presentation of Cushing’s disease?

A
  • Obesity
  • Headaches due to stretching of dura matter in brain and spinal cord
  • Visual field defects due to adenoma pressing on optic chiasma
  • Hypercortisolaemia
63
Q

What are the health risks of obesity?

A
  • Increased risk of death from surgery
  • Insulin resistance and diabetes
  • Coronary heart disease
  • Gallstones
  • Arthritis
  • Varicose Veins and Haemorrhoids
64
Q

Why does obesity lead to increased risk of death from surgery?

A
  • Takes longer
  • Difficult to control anaesthesia
  • Reduced lung function due to fat in thoracic cavity
65
Q

Why does obesity lead to an increase in diabetes?

A

increased Fatty acids cause decrease in glucose uptake/utilisation in muscle

66
Q

Why does obesity lead to increased risk of arthritis?

A

Increased weight puts more stress on load bearing joints

67
Q

How does obesity increase haemorrhoid risk?

A

Increased intraabdominal pressure and decreased fibre intake leading to more straining during defecation

Biochemistry (7 decks)

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