Malnutrition Flashcards by Rosie Liddell

What does cholesterol form?

Steroids hormones

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What are the 2 roles of vitamins?

> cofactors involved in enzymatic reactions
(water soluble vitamins ONLY)

> antioxidants

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What is a syndrome?

a collection of symptoms that forms a distinct clinical condition

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What are the 4 examples of protein energy malnutrition?

Kwashior Kor
Cachexia
Phthitis
Marasmus

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What is the cause of Kwashior Kor?

Lack of protein in diet

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What are the symptoms of Kwashior Kor?

Oedema
Diarrhoea
Potbelly
Changes in hair + nails
Desquamating skin rash
Decrease in linear growth

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What is oedema?

Excessive accumulation of fluid in tissues

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What are the 2 types of oedema?

Which type of oedema occurs in Kwashior Kor?

> Pitting = press down, remove + v slowly springs back to original shape
Non-pitting

Pitting

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What are the 2 ‘areas’ oedema can occur?

Local
- e.g. after injury/inflammation

General
- more serious (can have heart/kidney failure)

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In which parts of the body can general oedema occur?

What are the names for these conditions?

> within chest cavity
= ‘plural oedema’

> abdomen
= ‘ascites’

> within alveoli
= ‘pulmonary oedema’

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What causes oedema?

Decrease in albumin

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Where is albumin produced?

What are its 2 roles?

Liver
from amino acids

Act as a carrier

Maintains colloid osmotic pressure
–> exerts attractive force that helps to keep water in blood

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How does a decrease in albumin lead to oedema in Kwashior Kor?

Reduction in protein intake
-> decreased amino acids
-> decrease in albumin produced
-> lower attractive force on water in blood
= water moves into interstitial space

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Define diarrhoea

Bowel movements of increased frequency, volume + liquidity

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What are the 3 types diarrhoea?

Which type of diarrhoea is involved in Kwashior Kor?

Osmotic
Malabsorptive
Secretory

Malabsorptive

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What is osmotic diarrhoea?

What can this be induced by?

When water is drawn out of cells into the lumen of the intestine

Chemicals
e.g. sorbitol in sugar-free sweets

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What is malabsorptive diarrhoea?

Reduced ability to digest/absorb nutrients
due to reduction in digestive enzymes (pancreas) + reduction in absorption (intestine)

> partially digested food enters the large intestine
-> stimulates diarrhoea

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How long do cells at the tip of villi in the small intestine live for?

How are they replaced?

2-3 days

By stem cells differentiating

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Through which 2 ‘mechanisms’ does partially digested food enter the large intestine?

Intestine

Pancreas

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What are the 6 types of cells in the small intestine?

Goblet cells
Enterocytes
Pit cells
Stem cells
Enteroendocrine cells
Paneth cells

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What do goblet cells do?

Secrete mucus:
> protects epithelium from stomach acid
> lubricates food

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What do paneth cells do?

Produce bactericidal lysozyme

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What do enterocytes do?

Absorptive

located at ends of villi

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What do enteroendocrine cells do?

Secrete hormones

–> Metabolic affects

What do pit cells do?

Secrete prostaglandins

What do stem cells do?

Replace the other cell types

What role does the intestine play in malaborsptive diarrhoea?

Insufficient amino acid uptake --> reduction in SA --> reduction in nutrient absorption = partially digested food in large intestine

What are the 2 functions of the pancreas?

Endocrine | Exocrine

What is the endocrine function of the pancreas?

``` Produces hormones: > insulin (by beta cells) > glucagon (alpha) > somatostatin (delta) > pancreatic polypeptide (PP) > ghrelin (episilon) ```

What are the exocrine functions of the pancreas?

Acinal cells - produce digestive enzymes e.g. amylase + lipase - -> secreted into ducts Ductal cells - transport to intestine

What role does the pancreas play in malaborptive diarrhoea?

Reduced amino acid intake --> can't produce digestive enzymes in pancreas --> reduces ability to digested food = partially digested food in large intestine

What causes potbelly?

Hepatomegaly | = enlarged liver

What changes occur in hair in Kwashior Kor?

Alternating bands of poor (light) + good (dark) growth

What changes occur in nails in Kwashior Kor?

Finger clubbing | = nail bed thickens

What happens if you have a desquamating skin rash?

Outer layers of epidermis sloughs off

What causes a desquamating skin rash?

Reduction in proteins that help keep strata together

What are the 6 layers of epidermis? What is the dermis made up of?

``` Strata corneum " leucidum " granulosum " spinosum " basale ``` Fibroelastic tissue

What is Cachexia?

Extreme weight loss/low body weight associated w/ cancer, AIDS + TB

What causes cachexia in cancer patients?

Hyper-catabolism of proteins + lipids in healthy cells by cytokines to supply cancerous cells --> converted into energy

What are cytokines?

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

What are the 3 categories of cell signalling?

Endocrine Autocrine Paracrine

What does the endocrine system do?

Secretes hormones into blood | - has effect far away from cell where it's produced

What does the autocrine system do?

Produces substances that have an effect on themselves

What does the paracrine system do?

Has an effect on a neighbouring cell

What are the 2 groups of cytokines? | Give examples.

Inflammatory cytokines: - Tumour necrosis factor alpha - TNF2 - Interleukin 6 Tumour-derived catabolic factor - Proteolysis inducing factor

What effect do Proteolysis inducing factors (PIF) have? How does death normally occur?

Initiate protein breakdown via proteasome pathway (Ubiquitin is bound to the protein = ticketing it for degradation) Through erosion of respiratory muscles

What are the chemical constituents of carbohydrates?

CH2O

What are the chemical constituents of fats?

C, H + O

What are the chemical constituents of proteins?

C, H, O, N, P + S

What is are the functions of fats?

>Provide heat + energy >Transport fat-soluble vitamins >Necessary for nerve sheath + formation of bile

What are the 2 groups of amino acids?

Essential - derived from diet Non-essential - produced by body

What are the functions of proteins?

Provide amino acids for: >Formation of cells, growth + repair >Synthesis of hormones >Synthesis of plasma proteins

What are the functions of water?

> regulation of body temp > major component of blood tissue fluid > formation of urine + faeces

What are the functions of roughage?

> adds bulk to diet | > stimulates peristalsis + bowel movements

What are the 2 types of vitamins? Group the vitamins

Water soluble : B1, B2, B6, B12, C, nicotinic acid, pantothenic acid, floats, biotin + choline Fat soluble: A, D, E + K

What are the 2 types of malnutrition?

Food deprivation e.g. protein energy malnutrition Psychiatric e. g. anorexia nervosa e. g. elderly - isolation or dementia

What is phthisis?

Any disease resulting in wastage of tissue

What is marasmus?

Severe wasting in infants