Nutrition Flashcards
Marasmus can be caused by
here in the US
COPD
HF
Neoplasm
AIDS
Metabolic Syndrome attributes
Elevated: abd circ, BP, TG, FBG
Low HDL cholesterol
Metric calc of BMI
Kg/Meters(squared)
Increased abd circ is
> 102cm in men
>88cm in women
Increased waist/hip ratio
> 1.0 in men
>0.85 in women
Orlistat and OTC Alli MOA
MOA: work in the GI tract by inhibiting lipase thereby reducing fat absorption
Orlistat and OTC Alli SE
- increased diarrhea, gas, cramping
- poss decrease in absorption of fat soluble vitamins
SSRI used for obesity
Lorcaserin
Bariatric surgery is accepted in pt’s with
BMI >40 or 35 with comorbidities
Most popular Bariatric surgery and complication rate
Roux-en-Y
Up to 40% complication rate
Peritonitis, abdominal wall hernia, ulcer, infection.
Roux-en-Y nutritional deficiencies
Nutritional deficiencies - B12, Folate, Calcium, Vit D
Gastric Banding comp and outlook
fewer short term comp, lower wight loss than others
Sleeve gastrectomy being used more often-
Removal of 75% of the _______.
More weight loss than _______.
stomach.
banding.
Requirements of fat soluble vitamins
- Require digestion and absorption of dietary fat
- Require a carrier system for transport in the blood
- The body accumulates stores of these vitamins so deficiencies develop more slowly
Vitamin A- foods
Dairy, eggs, liver, meats, fish oils (polar bear(big game) liver/organs)
Vitamin A- precursor
Beta-Carotene from yellow and green veges
Vitamin A- Deficiency
MC cause of blindness in dev countries.
- Night blindness is earliest sx,
- Other sx: xerosis, Bitot spots, corneal ulceration or necrosis, perforation, endophthalmitis and blindness.
Usual cause of Vit A deficiency
Fat malabsorption or laxative abuse in the elderly or poor diet
Vit A- Tx
oral replacement + ongoing supp with Beta-carotene
Vit A- Toxicity (b-carotene)
Excess intake of b-carotene results in staining of the skin yellow-orange.
-Sclera remain white, ddx from jaundice
Vit A- Causes of Toxicity (vit a)
Excess intake of vit A
- Chronic toxicity after high doses over >3months
- Acute toxicity can result from drug overdoses or consumption of predator organs, especially liver
S/S of Vit A toxicity
N/V Abd pain HA Papilledema Lethargy
Vitamin D- actions
increases absorption of calcium in the intestine and increases reabsorption of ca in the renal tubules
Vit D- Causes of deficiency
increasingly as a result of diminished exposure to sunlight;
also malnutrition or malabsorption
Meds- Orlistat, cholestyramine, some older anticonvulsants
Vit D- Deficiency causes bone….
rickets in children
osteomalacia in adults
Vit D- Tx
increase sunlight (if no underlying condition) oral supp
Vit E- Foods
Vegetable oils, cereals, dairy, wheat germ, eggs
Vit E- fxn
Prevents oxidation rxn on cell walls
Vit E- Deficiency is caused by…
Malabsorption; also CF/Inborn errors of metabolism
Vit E- Deficiency S/S
Flexia Disturbance of gait Decreased proprioception and vibration Ophthalmoplegia Retinal degeneration
Vit E- Tx
Large doses IV shown to improve the neurologic comp of errors of metabolism
Vitamin K- Foods
Leafy veges, fruits, seeds, intestinal bacteria
Vit K- fxn
Necessary for coag factors II, VII, IX, X
Vit K- Deficiency findings
Prolonged PT
Bruising or bleeding in GI tract, GU tract, Gingiva, Lungs, Joints and Brain
Vit K- Tx
ORal (slower, >1day) or IV (faster, <1day) replacement
Water Soluble Vit
B1-Thiamine B2-Riboflavin B3-Niacin B6-Pyridoxine Vitamin C B12-Cobalamin Folic Acid
