Nutrition Flashcards
Contrast Primary and Secondary Nutrition.
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
What are 3 general causes of secondary malnutrition?
- G.I. diseases
- Chronic Wasting Diseases
- Acute Critical Illness
Compare and contrast Marasmus and Kwashiorkor with respect to:
- Cause of Deficiency
- Appearance
- Effect on Tissues
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
T or F: people with both Kwashiokor and Marasums suffer from immune deficiencies and vitamin deficiencies.
True
Between a person with Kwashiorkor and Marasmus, which is more likely to experience lactose intolerance?
Kwashiorkor is often associated with Lactose Intolerance
What type of malnutrition is commonly experienced by cancer patients?
- Primary or Secondary?
- Cachexia
- This is a secondary protein effect
What are some common deficiencies seen in anorexia patients?
- of these deficiencies, which is most likely to kill them?
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
What are the major risk factors to someone who is Bulimic?
- Electrolyte Imbalences - Low K+ will cause Arrhythmias
- Gastric or Esophageal Rupture
- Pulmonary Aspiration of Gastric Contents
What radiological features are apparent on a patient who has rickets?
- Curved Bones (curved outward)
- Blurred Growth Plate
What is the principle histological Feature in both ricketts and osteomalacia?
Excess of Unmineralized Bone Matrix (Osteoid)
How can Sarcoidosis cause Hypercalcemia?
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
Under normal circumstances where is Vitamin D typically converted to its most active form and by what enzyme?
Converted to most active form in the KIDNEY
Enzyme:
Alpha1-Hydroxylase
What are the 4 main steps in Vitamin D metabolism?
- Locations
- enzymes
- binding proteins
- Absorption in gut or Synthesis in Skin
- Vit. D binds to Alpha1-GLOBULIN and is transported to the liver
- Liver Converts Vit. D => 25-Hydroxyvitamin D via 25-Hydroxylase
- Kidney Converts Vit. D => 1,25-Hydroxyvitamin D via Alpha1-Hydroxylase
Deficiency in what vitamin is closely linked to metaplasia?
Vitamin A
What are some of the results of Vitamin A deficiency?
- Xeropthalmia (dry eye)
- Keratomalacia (softening of the cornea)
- Corneal Ulceration
- Blindness
What causes the impaired wound healing seen in scurvy?
Vitamin C is a co-factor for Prolyl and Lysyl Hydroxylases which are needed to CROSS-LINK collagen
- Collagen is essential to wound healing
What are the normal, overweight, and obese cutoffs for BMI?
Normal = 18.5-22.5 kg/m^2 Overweight = 25-30 kg/m^2 Obese = 30 kg/m^2
What is Central obesity?
Central Obestity = Visceral Obestity
- Fat accumulates around the trunk an din the mesentery around the viscera
**Associated with a much higher risk of disease
What does the LEP gene code for?
- what is the function of this gene product?
- Where is it released?
LEP codes for LEPTIN
Function:
DECREASES food intake
INCREASES energy expenditure
Origin:
- Released from Adipose Tissue
What is the effect of Ghrelin?
- Where is it released?
Stimulate Appetite
Origin:
- Stomach
What is the effect of PYY?
- Where is it released?
Delayed Satiety Signal
Origin:
- Intestines
What should you think anytime you hear of postmenopausal bleeding from an obese woman?
- ENDOMETRIAL CARCINOMA
- Symptomatic Leiomyomata
- Edometrial Sarcoma
On gross examination how would you differentiate a benign uterine tumor from a cancerous one?
- Benign Tumors typically have well defined Edges
- Cancer has less well defined edges
What is a Leiomyoma?
- Histological Features?
- 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
What does Endometrial Adenocarcinoma look like?
Disorganized Cells with Back to Back Glands Diving Down into the Myometrium
What Aspect of Obesity accounts for Increased Rate of heart disease (outside of hypertriglyceridemia)?
- Increased Markers of Inflammation
What are the characteristics of the typical gallstone patient?
Fat
Female
Forty
Flatulent
What cancers are more common in overweight men?
Esophageal
Thyroid
Colon
Kidney
What cancers are more common in overweight women?
Esophageal
Endometrium
Gallbaldder
Kidney
What is the precursor to Vitamin A?
ß-carotene
Where is Vitamin A stored?
Liver
What symptoms are caused by Getting too much Vitamin A in the diet?
- Dizziness
- Vomiting
- Stupor
***Symptoms like this could be confused with a brain tumor
What are the 4 fat soluble vitamins?
- how are these absorbed?
- A, D, E, K = Fat Soluble
- Chylomicrons are needed to Absorb these
What disease is caused by Vitamin D deficiency in kids?
- Adults?
No Vit. D:
Kids = Rickets
Adults = Osteomalacia
Where in the kidney is Calcium Absorbed?
Distal Tubules
What is the MC4R receptor?
- what happens if you get a mutation in this gene?
Leptin Receptor
- Massive Obesity Results from failure of the MC4R Leptin receptor to form
What endogenous mediator do scientists believe might link Obesity to cancer and why?
- Insulin-Like Growth Factor (ILGF)
- It may Prevent cell Death, thus promoting Cancer
- *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)
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
