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CMOD-Block 2 Path > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Contrast Primary and Secondary Nutrition.

A

Primary Nutrition - nutritional necessities are missing from the diet

Secondary/Conditional Malnutrition - intake is adequate but malnutirition results from:

  • malabsorption
  • Impaired Utilization or Storage
  • Excess Losses
  • Increased Requirements
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2
Q

What are 3 general causes of secondary malnutrition?

A
  • G.I. diseases
  • Chronic Wasting Diseases
  • Acute Critical Illness
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3
Q

Compare and contrast Marasmus and Kwashiorkor with respect to:

  • Cause of Deficiency
  • Appearance
  • Effect on Tissues
A

Kwashiorkor

  • Protein Loss > Caloric Loss
  • VISCERAL compartment depleted
  • Swollen Appearance
  • Edema secondary to Hypoalbuminemia, BONE Marrow Defects

Marasmus

  • Skeletal Muscle (SOMATIC compartment is affected)
  • Appear Emaciated overall
  • ANEMIA, Little Effect on Serum Albumin
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4
Q

T or F: people with both Kwashiokor and Marasums suffer from immune deficiencies and vitamin deficiencies.

A

True

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5
Q

Between a person with Kwashiorkor and Marasmus, which is more likely to experience lactose intolerance?

A

Kwashiorkor is often associated with Lactose Intolerance

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6
Q

What type of malnutrition is commonly experienced by cancer patients?
- Primary or Secondary?

A
  • Cachexia

- This is a secondary protein effect

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7
Q

What are some common deficiencies seen in anorexia patients?
- of these deficiencies, which is most likely to kill them?

A 
Decreased Bone Density (low Ca2+ and Phosphate)
Electolyte abnormalities (low K+) 
Low Estrogen Levels (amenorria) 
Anemia (B12 deficiency?)
Hypoalbuminemia (low protein)

Low K+ (HYPOKALEMIA) will likely kill them causing Heart Problems

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8
Q

What are the major risk factors to someone who is Bulimic?

A
  1. Electrolyte Imbalences - Low K+ will cause Arrhythmias
  2. Gastric or Esophageal Rupture
  3. Pulmonary Aspiration of Gastric Contents
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9
Q

What radiological features are apparent on a patient who has rickets?

A
  • Curved Bones (curved outward)

- Blurred Growth Plate

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10
Q

What is the principle histological Feature in both ricketts and osteomalacia?

A

Excess of Unmineralized Bone Matrix (Osteoid)

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11
Q

How can Sarcoidosis cause Hypercalcemia?

A

Sarcoidosis - Macrophage Activation to Attack foreign material = GRANULOMA formation

  • In about 10% of Sarcoidosis Macrophages, which HAVE 1-alpha Hydroxylase for beginning Vit. D synthesis turn this enzyme on
  • Vit. D. causes Increased intestinal absorption of Ca2+ and Increased Bone Turnover
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12
Q

Under normal circumstances where is Vitamin D typically converted to its most active form and by what enzyme?

A

Converted to most active form in the KIDNEY

Enzyme:
Alpha1-Hydroxylase

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13
Q

What are the 4 main steps in Vitamin D metabolism?

  • Locations
  • enzymes
  • binding proteins
A
  1. Absorption in gut or Synthesis in Skin
  2. Vit. D binds to Alpha1-GLOBULIN and is transported to the liver
  3. Liver Converts Vit. D => 25-Hydroxyvitamin D via 25-Hydroxylase
  4. Kidney Converts Vit. D => 1,25-Hydroxyvitamin D via Alpha1-Hydroxylase
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14
Q

Deficiency in what vitamin is closely linked to metaplasia?

A

Vitamin A

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15
Q

What are some of the results of Vitamin A deficiency?

A
  1. Xeropthalmia (dry eye)
  2. Keratomalacia (softening of the cornea)
  3. Corneal Ulceration
  4. Blindness
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16
Q

What causes the impaired wound healing seen in scurvy?

A

Vitamin C is a co-factor for Prolyl and Lysyl Hydroxylases which are needed to CROSS-LINK collagen

  • Collagen is essential to wound healing
17
Q

What are the normal, overweight, and obese cutoffs for BMI?

A 
Normal = 18.5-22.5 kg/m^2
Overweight = 25-30 kg/m^2
Obese = 30 kg/m^2
18
Q

What is Central obesity?

A

Central Obestity = Visceral Obestity

  • Fat accumulates around the trunk an din the mesentery around the viscera

**Associated with a much higher risk of disease

19
Q

What does the LEP gene code for?

  • what is the function of this gene product?
  • Where is it released?
A

LEP codes for LEPTIN

Function:
DECREASES food intake
INCREASES energy expenditure

Origin:
- Released from Adipose Tissue

20
Q

What is the effect of Ghrelin?

- Where is it released?

A

Stimulate Appetite

Origin:
- Stomach

21
Q

What is the effect of PYY?

- Where is it released?

A

Delayed Satiety Signal

Origin:
- Intestines

22
Q

What should you think anytime you hear of postmenopausal bleeding from an obese woman?

A
  • ENDOMETRIAL CARCINOMA
  • Symptomatic Leiomyomata
  • Edometrial Sarcoma
23
Q

On gross examination how would you differentiate a benign uterine tumor from a cancerous one?

A
  • Benign Tumors typically have well defined Edges

- Cancer has less well defined edges

24
Q

What is a Leiomyoma?

- Histological Features?

A
  • Benign Smooth Muscle Cells

Histo Features:

  • Bundles of Smooth mm. cells point out at angles
  • Low Mitotic Rate CIGAR shaped nuclei (normally colored and sized nuclei)
  • Hemorrhagic Necrosis
25
Q

What does Endometrial Adenocarcinoma look like?

A

Disorganized Cells with Back to Back Glands Diving Down into the Myometrium

26
Q

What Aspect of Obesity accounts for Increased Rate of heart disease (outside of hypertriglyceridemia)?

A
  • Increased Markers of Inflammation
27
Q

What are the characteristics of the typical gallstone patient?

A

Fat
Female
Forty
Flatulent

28
Q

What cancers are more common in overweight men?

A

Esophageal
Thyroid
Colon
Kidney

29
Q

What cancers are more common in overweight women?

A

Esophageal
Endometrium
Gallbaldder
Kidney

30
Q

What is the precursor to Vitamin A?

A

ß-carotene

31
Q

Where is Vitamin A stored?

A

Liver

32
Q

What symptoms are caused by Getting too much Vitamin A in the diet?

A
  • Dizziness
  • Vomiting
  • Stupor

***Symptoms like this could be confused with a brain tumor

33
Q

What are the 4 fat soluble vitamins?

- how are these absorbed?

A
  • A, D, E, K = Fat Soluble

- Chylomicrons are needed to Absorb these

34
Q

What disease is caused by Vitamin D deficiency in kids?

- Adults?

A

No Vit. D:
Kids = Rickets
Adults = Osteomalacia

35
Q

Where in the kidney is Calcium Absorbed?

A

Distal Tubules

36
Q

What is the MC4R receptor?

- what happens if you get a mutation in this gene?

A

Leptin Receptor

  • Massive Obesity Results from failure of the MC4R Leptin receptor to form
37
Q

What endogenous mediator do scientists believe might link Obesity to cancer and why?

A
  • Insulin-Like Growth Factor (ILGF)

- It may Prevent cell Death, thus promoting Cancer

38
Q
  • *Group the following Based on their Function and state the function.
  • POMC (pro-opiomelanocortin)
  • AgRP (agouti-Related Peptide)
  • NPY (Neuropeptide Y)
  • CART (Cocaine and Amphetamine Regulation Transcript)
A

POMC and CART - Neurons that Stimulate Neurons that:

  • Function to Increase Energy Output
  • Promote Weight Loss

NPY/AgRP - Neurons that Stimulate Neurons that:
- Promote Food Intake and Weight Gain

CMOD-Block 2 Path (22 decks)

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