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MET 2 > Micronutrients > Flashcards

Micronutrients Flashcards

1
Q

Define micronutrients

A

Essential compounds required in small amounts in the diet

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2
Q

What is the role of micronutrients in adults

A

Maintaining homeostasis

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3
Q

What is the role of micronutrients in paeds

A

Energy suppluy

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4
Q

What does RDA stand for

A

Recommended dietary allowance

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5
Q

Name four vitamins that are fat soluble

A

A, D, E and K

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6
Q

Can fat soluble vitamins be stored

A

Yes

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7
Q

Which type of vitamins (fat soluble vs water soluble) can be toxic

A

Fat soluble (water soluble excess lost in urine)

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8
Q

Name four water soluble vitamins

A

B, folate, biotin, C

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9
Q

Do water soluble or fat soluble vitamins usually act as coenzymes

A

Water soluble

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10
Q

Name some causes of decreased vitamin intake in developed countries

A
  • Alcohol dependency
  • Small bowel disease
  • Vegans
  • Elderly with poor diet
  • Anorexic people
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11
Q

What deficiencies are common in alcohol dependency

A

Vitamin B

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12
Q

What causes of decreased intake vitamin deficiency can cause vitamin B9 deficiency

A

Small bowel disease
Elderly with poor diet
Anorexia

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13
Q

What are vegan usually deficient in

A

Vitamin B

Vitamin B12

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14
Q

What can cause decreased absorption vitamin deficiency in the developed world

A

Ileal disease
Liver and biliary tract disease
Intestinal bacterial growth
Oral antibiotics

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15
Q

What are the 3 things that most commonly cause all deficiencies in the developed world

A

Fat malabsorption
Alcoholism
Liver disease

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16
Q

What factors can contribute to vitamin A deficiency

A

Infection, measles, protein energy malnutrition

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17
Q

Clinical features of vitamin A deficiency

A

Xerophthalmia

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18
Q

Contributing factors to vitamin D deficiency

A

Ageing

Lack of sunlight exposure

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19
Q

Clinical features of vitamin D deficiencies

A

Rickets

Osteomalacia

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20
Q

Contributing factor to vitamin E deficiency

A

Antibiotic use

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21
Q

Clinical feature of vitamin E deficiency

A

Peripheral neuropathy

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22
Q

Cause of vitamin K deficiency

A

Antibiotic use

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23
Q

Clinical feature of vitamin K deficiency

A

Coagulopathy

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24
Q

Cause of vitamin C deficiency

A

Smoking

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25
Q

Clinical features of vitamin C deficiency

A

Scurvy

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26
Q

What is the clinical feature of B1 deficiency

A

beri beri

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27
Q

What is the clinical feature of B2 deficiency

A

Angular stomatitis

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28
Q

What is the clinical feature of b3 deficiency

A

Pellagra

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29
Q

What is the clinical feature of b6 deficiency

A

Neuropathy

Anaemia

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30
Q

What is the clinical feature of b12

A

Anaemia

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31
Q

What is the clinical feature of b9 deficiency

A

Anaemia

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32
Q

Define trace elements

A

Dietary minerals necessary in minute quantities for the normal function of organism

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33
Q

What happens when you are calcium deficient

A
  • Osteoporosis
  • Paresthesia
  • Muscle spasms
34
Q

What happens if you have a phosphorus deficiency

A
  • Bone pain
  • Pseudofractures
  • Proximal muscle weakness
  • Rickets
  • Short stature in children
35
Q

What happens if you have an iron deficiency

A

Anaemia

36
Q

What happens if you have selenium deficiency

A

Cardiomyopathy

37
Q

What happens if theres a zinc deficiency

A 
Growth retardation
Alopecia
Dermatitis
Diarrhoea
Congenital malformations
38
Q

What happens if there’s a copper deficiency

A

Growth retardation

39
Q

Define refeeding syndrome

A

Severe electrolyte disturbance and metabolic abnormalities in patients undergoing refeeding whether orally, enterally, paraenterally

40
Q

What are the long term consequences of refeeding syndrome

A

Pulmonary oedema, confusion, coma, cardiac failure and death

41
Q

What metabolic changes happen during chronic malnutrition

A

Low insulin, high glucagon and cortisol
Gluconeolysis, gluconeogenesis, protein catabolism
Depletion of electrolytes, proteins, fats minerals and vitamisn

42
Q

What is secreted when refeeding occurs after chronic malnutrition

A

Insulin

43
Q

What is the effect of insulin on protein and glycogen synthesis

A

Increases

44
Q

Describe what happens in refeeding at a cellular level

A
  • Increased glucose uptake
  • Increased phosphorus, magnesium and potassium
  • Increased thiamine use
45
Q

How do the levels of electrolytes change after refeeding

A 
Hypophosphataemia
Hypokalaemia
Hypomagnesaemia
Thiamine deficiency 
Sodium and water retention
46
Q

Neurological complications of refeeding syndrome

A

Convulsions, delerium, ataxia

47
Q

Cardiovascular complications of refeeding syndrome

A

Hypotension, arrythmias, heart failure

48
Q

How should refeeding syndrome be managed

A

Aggresive electrolyte replacement
Nutrional supplementation
Treat underlying medical problem

49
Q

What are the main functions of iron

A

Oxygen transport
Myoglobin function in skeletal muscle
Absorbed in small bowel

50
Q

Signs and symptoms of excess iron

A 
Lethargy and fatigue
Abdominal and joint pain
Reduced libido
Bronzing of skin
Diabetes
Cirrhosis
51
Q

Other than sunlight deficiency, what can cause vitamin D deficiency

A

Obesity
Smoking
Alcohol
Exercise

52
Q

Signs and symptoms of osteomalacia

A 
Reduced bone strength
Increase in bone fracture
Bone pain
Bending of bones
Muscle weakness
Waddling gait
53
Q

Name 3 groups of people who require more vitamin D

A

Pregnant/ breastfeeding women
People with low sun exposure
Age >65 years

54
Q

What can happen as a result of thiamine deficiency

A

Wernickes Encephalopathy and Korsakoff’s psychosis

55
Q

What is another name for vitamin B1

A

Thiamine

56
Q

Where is thiamine absorbed

A

Jejunum

57
Q

What is vitamin B1 involved in

A
  • Involved in glycolysis and krebs cycle
  • Involved in BCAA metabolism
  • Involved in pentose phosphate cycle metabolism
58
Q

When is vitamin B1 deficiency most commonly seen

A
  • Malignancy

- Alcoholism

59
Q

Signs and symptoms of thiamine deficiency

A

Cognitive impairment
Cognitive impairment
Muscle weakness

60
Q

What is another name for thiamine deficiency

A

Beri beri

61
Q

Symptoms of dry beri beri

A

Symmetric peripheral neuropathy

62
Q

What are the symptoms of shoshin beri beri

A

Fulminant cardiac failure

Lactic acidosis

63
Q

What are the symptoms of wet beri beri

A

Cardiac symptoms such as enlarged heart, tachycardia, high output ccf, peripheral oedema
Peripheral neurititis

64
Q

What are the symptoms of Wernicke’s encephalopathy

A

Horizontal nystagmus
Ophthalmoplegia
Cerebellar ataxxia

65
Q

Define Wernicke-Korsakoff syndrome

A

Mental impairment with additional loss of memory and a confabulatory psychosis

66
Q

What is another name for vitamin b3

A

Niacin

67
Q

Where is niacin absorbed

A

Jejunum

68
Q

What does niacin form

A

NAD and NADP which act as hydrogen acceptors in many oxidative reactions

69
Q

What can cause niacin deficiency

A

Vegetarian diets

Alcoholism

70
Q

What is Hartnup’s disease

A

Congenital defect of intestinal and kidney absorporption of tryptophan leading to vit b3 deficiency

71
Q

How does carcinoid syndrome lead to vitamin b3 deficiency

A

Increased conversion of tryptophan to serotonin

72
Q

Signs and symptoms of early pellagra/ b3 deficiency

A 
Loss of appetite
Generalised weakness
Irritability
Abdominal pain
Vomiting
Bright red glossitis
73
Q

Signs and symptoms of late pellegra

A 
Casals necklace
Vaginitis
Oesophagitis
Diarrhoea
Depression
Seizures
74
Q

What is Casals necklace

A

Skin rash particularly in areas expsoed to sunlight

75
Q

What are the signs and symptoms of pathologically high b3 levels

A

Flushing
Glucose intolerance, macular oedema and cysts
Fulminant hepatitis

76
Q

Describe how vitamin B12 is absorbed in the body

A

Dissassociated from proteins in stomach
Complexes with intrinsic factor in small intestine
Absorbed via specific receptors in terminal ileum

77
Q

What % of B12 is absorbed and what is excreted

A

40% absorbed

60% excreted

78
Q

Common causes of b12 deficiency

A

Inadequate intake
Disorders of terminal ileum
Defective release of cobalamin from food
Inadequate IF productive

79
Q

What are the forms of haematological b12 deficiency

A

Megaloblastic anaemia

Neutropaenia and thrombocytopaenia

80
Q

Neurological symptoms of b12 deficiency

A

Sensory disturbance, gait abnormalities, memory loss and disorientation

81
Q

Gastrointestinal symptoms of b12 deficiency

A

Beefy red glossitis
Malabsorption and diarrhoea
Anorexia

MET 2 (32 decks)

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