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
