Hartnup disease - mechanism - clinical signs - treatment

- Defective tryptophan transport --> no nicotinamide/NAD production - 3D - Treat with niacin supplement

Cystinuria - Mechanism - Clinical signs - Treatment

- defective absorption of Arg, Lys, Cys, ornithine - cystine stones in kidney, ureter, bladder - fluids, penicillamine

GSH synthetase deficiency - cause - clinical signs - treatment

- genetic - oxoprolinuria, GSH in urine - deliver bicarb to blood

Glutothionuria - mechanism - clinical signs

- deficient g-glutamyltranspeptidase (GGP) - excess GSH in urine

Essential FA deficiency - mechanism - clinical signs - treatment

- oleic acid elongates and accums in body with no function - dermatitis and growth retardation - linoleic acid (linolenic acid and arachidonic acid alleviate symptoms)

Micro and Macronutrients Flashcards by Mimi Tan

Protein digestion in stomach?

Pepsinogen cleaved to pepsin at pH5 (secreted from stomach)

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Protein recommendation daily?

0.8 g/kg

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Protein digestion in duodenum?

cholecystokinin secreted –> secrete pancreatic zymogens
secretin releases bicarb (helps cholecystokinin)
Enteropeptidase cleaves trypsinogen which cleaves everything else

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Pancreatic zymogens

trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase

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Protein digestion in small intestine?

aminopeptidasee cleaves

metalloendopeptidase

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Hartnup disease

mechanism
clinical signs
treatment

Defective tryptophan transport –> no nicotinamide/NAD production
3D
Treat with niacin supplement

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Cystinuria

Mechanism
Clinical signs
Treatment

defective absorption of Arg, Lys, Cys, ornithine
cystine stones in kidney, ureter, bladder
fluids, penicillamine

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GSH and associated diseases

Glutathione: antioxidant (protects against FR)

GSH synthetase deficienccy and glutothionuria

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GSH synthetase deficiency

cause
clinical signs
treatment

genetic
oxoprolinuria, GSH in urine
deliver bicarb to blood

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Glutothionuria

mechanism
clinical signs

deficient g-glutamyltranspeptidase (GGP)

- excess GSH in urine

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Essential AA

FILM (phe, ile, leu, met)
TV (thr, val)
WHKR (trp, his, lys, arg)

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Biological value
% absorbed for synthesis
DietN-UrinN-fecalN / dietN-fecalN

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NPU

Net protein utilization
% for synthesis (neglecting absorption)
DietN-urinN-fecalN / dietN

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PER

Protein efficiency ratio

weight gain / weight protein ingested

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Digestibility

Food N absorbed

Food N - fecal N / food N

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Chemical score

compare to egg protein

mg essential AA/g / mg essential AA/Egg g

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PDCAAS

Measures limiting EAA

mg EAA/g / mg of prot req pattern

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Sparing effects

Protein quality: nutrients filling roles of otherrs

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PEM (what does it stand for and give examples)

Protein energy malnutrition
Kwashiorkor
Marasmus

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Types of carbs

Available and unavailable (soluble and insoluble)

unavailable provides bulk

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Example of insoluble fiber? Soluble fiber? noncarb fiber?

Insoluble- cellulose
Soluble- pectins
noncarb- lignin

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glycemic index vs load

index gives ability of carb to raise blood glucose (high GI linked with diabetes

load is GI multiplied by (carb in a gram)/100

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Essential fats?

Omega 3 and 6

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Essential FA deficiency

mechanism
clinical signs
treatment

oleic acid elongates and accums in body with no function
dermatitis and growth retardation
linoleic acid (linolenic acid and arachidonic acid alleviate symptoms)

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What does trans fat interfere with?

delta 6 desaturasee | catalyzes arachidonic acid production

What is an omega 3 fatty acid

linolenic acid

Six exchange groups-

fruit, veg, starch, milk, meat, fat

Vit A oxidation states

Retinal (aldehyde) (+NADH--> retinol; +NAD+ ---> retinoic acid) Retinol (alcohol) Retinoic acid

Vit D and Ca2+ regulation

Low serum Ca2+ --> PTH --> increase calcitriol --> input to plasma from kidney, intestinal mucosa, bones Excess Ca2+ --> increase calcitonin from thyroid --> store excess to bones

In addition to PTH, what increases calcitriol from parathyroid?

low phosphate levels

What are the toxic minerals

CSF did moly and arsenic | copper, selenium, fluoride, molybdenium, arsenic

Function of selenocysteine

antioxidant (active site for glutathione perioxidase) regulate thyroid fxn immune response

Keshan disease - cause - clinical symptom

- selenium deficiency | - cardiomyopathy

Kashin-Beck disease - cause - clinical sign

- selenium deficiency | - deforming arthritis

Myxodematous cretinism - cause - clinical sign

- selenium deficiency | - MR

Active form of vit D

1,25 hydroxycholecalciferol (calcitriol)

symptoms of vit A deficiency

xerophthalmia; skin lesions/infection, infertility, night blindness

symptoms of vit A toxicity

liver problems, birth defects

Diseases of vit D deficiency

rickets | osteomalacia

symptoms of vit D toxicity

anorexia, atherosclerosis, cardiac myopathy

Active form of vit E

alpha tocopherol

function of vit E

antioxidant (PUFA)

Symptoms of vit E deficiency

infertility anemia muscular dystrophy nerve damage

vit K function

carboxylation of glutamate | important for blood clotting and bone metab

B1 deficiency

Thiamin | Beriberi; wernicke korsakoff

B1 active form

(Thiamin) | TPP

B2 deficiencyy

(riboflavin) | cracked stuff

Active form of B2

(riboflavin) | FMN, FAD

B3 active form

(Niacin) | NAD, NADP

B3 deficiency

pellagra (3D) | same as tryptophan deficiency

Biotin deficiency

Dermatitis (avidin from egg whites prevents absorption)

Pantothenic acid active form

CoASH

B12 activity

(cobalmin) Met synthetase Methylmalonyl CoA mutase (MCM)

Folic acid active form

THF acid

Folic acid activity

Met synthetase | 1 Carbon transfer

B12 deficiency

megaloblastic anemia | nerve damage

Folic acid deficiency

megaloblastic anemia | neural tube devo

B6 active form

(Pyridoxine) | pyridoxal phosphate

B6 deficiency symptoms

cracked stuff

Antibodies might cause what vitamin deficiency?

B12 (cobalmin)

Which vitamin is not a real vitamin?

Vit D (steroid prohormone)

Which vitamins are produced by bacteria?

Vit K (k2), biotin, b12

What vit deficiency is similar to enzymatic disease?

B3 and hartnup disease (both lack tryptophan -->NAD) (cause pellagra 3D)

g-glutamyltranspeptidase

deficient in glutothionuria (excess GSH in urine)

glutathione

GSH- antioxidant, protects againt FR

lignin

noncarb fiber

Delta 6 desaturase

catalyzes arachidonic acid (blocked by trans fat)

PTH

parathyroid hormone: increases calcitriol when Ca2+ plasma level is low

glutothione perioxidase

antioxidant; active site is selenocysteine

Chronic stress -->

Corticotropin releasing factor (CRF) from hypothalamus --> ACTH release from pituitary --> glucorticoid release from adrenal cortex --> gene expression

Effect of increased glucocorticoids

(chronic stress) - increased lipolysis, increased lipase expression - increased muscle protein degradation - increased gluconeogenesis in liver

Alcohol metabolism

1. convert to acetylaldehyde via ADH 2. to acetate 3. to acetyl coA generates NADH

Heavy drinking activates?

MEOS: microsomal ethanol oxidizing system requires NADPH and generates ROS what causes liver failure

Excess NADH from alcohol causes-->

1. lactic acidosis (increased pyruvate)) 2. lactate blocks gluconeogensis --> hypoglycemia 3. accum G3P--> hyperlipidemia 4. block TCA --> ketoacidosis

Nutrient requirement patterns over life cycle?

High fat requirement % in infancy/toddler Higher caloric need when young Lower protein requirement % (ut high relative to body weight) when young