Nutrition Flashcards
What occurs when there is Vitamins A, D E or K deficiency?
A- Colour Blindness
D- Osteomalacia/
Rickets
E- Anaemia /neuropathy
?malignancy/IHD
K- Defective
clotting
What occurs when there is Vitamins A, D excess?
A- Exfoliation Hepatitis
D- Hyper-calcaemia
How do you test ADEK?
Serum
Serum
Serum
PTT
What are the fat soluble vitamins?
ADEK
What are the water soluble vitamins?
B vitamins
Vit C
What is B1 Deficiency?
Beri-Beri
Neuropathy
Wernicke Syndrome
What is B2 Deficiency?
Glossitis
What is B6 Deficiency?
Dermatitis/ anaemia
What is B12 Deficiency?
Pernicious anaemia
What is B9 Deficiency?
Megaloblastic anaemia
Neural tube defect
What is B3 Deficiency?
Pellagra
What does Vit C deficiency cause?
Scurvy
What does Vit C excess cause?
Renal stones
What does B6 excess cause?
Neuropathy
How do you test for B1 levels?
RBC
transketolase
How do you test for B2 levels?
RBC
glutathione reductase
How do you test for B6 levels?
RBC AST activation
How do you test for B12 levels?
B12 serum
How do you test for B9 levels?
RBC folate
How do you test for Vit C?
Plasma levels
What does Iron (1) excess and (2) deficiency cause?
1 Hypochromic anaemia
2 Haemochromatosis
FBC/ ferritin/ iron/ TIBC
What does Copper (1) excess and (2) deficiency cause?
1 Anaemia
2 Wilson’s
Copper/ caeroplasmin
What does Fluoride (1) excess and (2) deficiency cause?
1 Dental caries
2 Fluorosis
What does iodine deficiency cause?
Goitre/ hypothyroid
What does zinc deficiency cause?
Dermatitis
How doe we spend energy?
Resting energy expenditure
Exercise
Thermogenesis
Facultative T
Where do we get most of our dietary energy from?
In the west? Fat apparently
How is energy regulated? (Draw out diagram)
What is body composition?
- Normal weight individual
- 98% O2, C, H, Na, Ca
- 60-70% H2O, 10-35% fat, 10-15% protein, 3-5% minerals
- Variation body composition considerable, variation in LBM less
What are the weight classes?
Weight
Body mass index
- weight/height2
- 25-30 kg/m2 overweight
- >30 kg/m2 obese
- >40 kg/m2 morbidly obese
waist hip ratio
What are the problems associated with obesity?
Is waist circumference a risk for CHD?
Yes
Why do we need protein?
- INTAKE 84gm men, 64gm women
- Utility
–Indispensable (e.g. leucine)
–“conditionally” indispensable (e.g. Cysteine)
–Dispensable (e.g. alanine)
- Protein synthesis/breakdown/oxidation
- Assessment
–N excretion and balance
–Tracer techniques
What are Lipids?
- Polyunsaturated fatty acid (PUFA) include essential fatty acids (EFA)
- Dietary fat determines LDL-C
saturated fat inc [chol]
PUFA dec [chol]
• incr. [HDL] associated reduced IHD risk
(women, alcohol, obesity)
What does pancreatic lipase do?
Pancreatic lipase is usually secreted by the pancreas and transferred to the duodenum to participate in the hydrolysis and digestion of fat, cholesterol esters, and fat-soluble vitamins.
Maybe watch this bit for info
Why are carbohydrates important?
- 40-80% total energy intake
- Polymerisation into sugars, oligosaccharides and polysaccharides
- 80 % complex 20 % simple
- NSP - non-starch polysaccharides
In which diseases are metabolites implicated?
- Cardiovascular disease
- Obesity
- Alcoholism
- T2DM
- Pregnancy
- Most malignancy
- Many GI conditions
What may indicate metabolic syndrome?
Fasting glucose >6 mmol/l
HDL- Men <1.0, Women <1.3
HTN- BP>135/80
Waist circumference- Men>102, women > 88
Microalbumin/ insulin resistance
What is the treatment of obesity?
- Exclude endocrine cause
- Exclude complications of obesity
- Educate
- Diet and exercise
- Medical therapy (Orlistat, GLP-1 agonist)
- Surgical therapy
What happens if a 100kg loses 10kg?
- Psychological benefit
- PCOS
- Oesophagitis
- CHD
- Osteoarthritis
- Liver function
- Pregnancy
- Mortality 20% down
- 0.9mmHg per kg down
- HbA1c 1.5% down
- Risk of DM 40% down
- LDL 15% down
- HDL 8% up
What are the bariatric procedures?
IS bariatric surgery good?
- Resolution/improvement of T2DM
- Resolution/improvement of hypertension
- Improved lipid profile
- Resulting in overall reduction in cardiac risk
- Resolution of obstructive sleep apnoea
- Resolution of PCOS and improved fertility
- Reduced cancer related deaths
- Regression of non-alcoholic fatty liver disease
- Reduced mortality
What is marasmus?
- Shrivelled
- Growth retarded
- Severe muscle wasting
- No s/c fat
What is Kwarshiorkor?
- Oedematous
- Scaling/ulcerated
- Lethargic
- Large liver, s/c fat
- Protein deficient
To predict risk of myocardial infarction and decide of possible benefit of HMG-CoA reductase inhibition (statin therapy), you would:
- Measurement of body mass index and waist circumference
- Measurement of serum leptin concentration
- Measurement of resting energy expenditure
- Measurement serum polyunsaturated fat concentration
- Measurement of total plasma cholesterol and/or low density lipoprotein cholesterol concentration
- Oral ferrous sulphate
- Oral Folic acid
- Oral vitamin K
- Parenteral thiamine (Pabrinex)
0 Reducing saturated fat and increasing mono or polyunsaturated fat in diet
Watch lecture
To assess the degree of obesity and resultant cardiovascular risk, you would:
- Measurement of body mass index and waist circumference
- Measurement of serum leptin concentration
- Measurement of resting energy expenditure
- Measurement serum polyunsaturated fat concentration
- Measurement of total plasma cholesterol and/or low density lipoprotein cholesterol concentration
- Oral ferrous sulphate
- Oral Folic acid
- Oral vitamin K
- Parenteral thiamine (Pabrinex)
0 Reducing saturated fat and increasing mono or polyunsaturated fat in diet
watch lcture
To reduce risk of Wernicke’s encephalopathy in alcoholic patient admitted to hospital
- Measurement of body mass index and waist circumference
- Measurement of serum leptin concentration
- Measurement of resting energy expenditure
- Measurement serum polyunsaturated fat concentration
- Measurement of total plasma cholesterol and/or low density lipoprotein cholesterol concentration
- Oral ferrous sulphate
- Oral Folic acid
- Oral vitamin K
- Parenteral thiamine (Pabrinex)
0 Reducing saturated fat and increasing mono or polyunsaturated fat in diet
Watch lecture
To advise a patient on a method of reducing plasma cholesterol:
- Measurement of body mass index and waist circumference
- Measurement of serum leptin concentration
- Measurement of resting energy expenditure
- Measurement serum polyunsaturated fat concentration
- Measurement of total plasma cholesterol and/or low density lipoprotein cholesterol concentration
- Oral ferrous sulphate
- Oral Folic acid
- Oral vitamin K
- Parenteral thiamine (Pabrinex)
0 Reducing saturated fat and increasing mono or polyunsaturated fat in diet
Watch lecture
To reduce risk of neural tube defect in woman seeking advice before pregnancy, with a previous pregnancy complicated by spina bifida in the infant.
- Measurement of body mass index and waist circumference
- Measurement of serum leptin concentration
- Measurement of resting energy expenditure
- Measurement serum polyunsaturated fat concentration
- Measurement of total plasma cholesterol and/or low density lipoprotein cholesterol concentration
- Oral ferrous sulphate
- Oral Folic acid
- Oral vitamin K
- Parenteral thiamine (Pabrinex)
0 Reducing saturated fat and increasing mono or polyunsaturated fat in diet
Watch lecture
