Nutrition Flashcards
- Name the 4 main fat soluble vitamins
- What happens when there is a deficiency of each?
- What is the best test for each of them?
B1 takes a long time to come back, so tend to replace thymine anyway in suscpected individuals
B12 –> Pernicious anaemia, especially when patient has other autoimmune conditions
- Name the 3 main water soluble vitamins
- What happens when there is a deficiency and excess of each?
- What is the best test for each of them?
- Folate deficiency causes macro anaemia
- Potential dementia –> dermititis, diarrhoea, dementia and death = niacin deficiency
Name the 5 main trace elements?
What happens when there is a deficiency and excess of each?
What is the best test for each of them?
- Haemochromatosis - high ferritin levels, which can deposit in the gonads and cause fertility problems. Therefore, men can present with primary hypogonadism
- Ceruoplasmin –> low in Wilson’s as is a binding protein to copper
Describe the components of energy expenditure
- REE - resting energy expenditure
- Exercise
- Thermogenesis
- Faclutative T
Describe basic energy(or fat) homeostasis
Hypotholamaus recieves several signals either to use up fat or to store fat
- Ghrelin is released from the stomach and acts on the hypothalamus as a hunger hormone. Causes the hypothalamus to use energy by using white adipose tissue
- PYY is released when a big meal has been eaten from the small intestine and acts on the hypothalamus to cause satiety, which causes signals to WAT to store excess energy
- Leptin is released from white adipose tissue and acts as a satiety hormone
What is the definition of obesity?
Body mass index:
- 25-30kg/m2 = overweight
- >30kg/m2 = obese
- >40kg/m2 = morbidly obese
Waist: hip ratio
- What should protein intake be for men and women?
- 84gm - men
- 64gm - women
Describe what makes up metabolic syndrome
How should obesity be treated?
- Exclude endocrine cause
- Exclude complications of obesity
- Educate
- Diet and exercise
- Medical therapy (Orlistat, GLP-1 agonist) - Orlistat works on pancreatic lipase and stops the absorption of fat (by at least a 1/3)
- Surgical therapy - bariatric surgery - long term weight loss
What are the different bariatric surgery procedures?
- Adjustable gastric band
- Sleve gastrectomy
- Gastric bypass/Roux-en-Y Gastric bypass
What are the health benefits fo bariatric surgery?
- 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
Describe the clinical signs of Marasmus -undernourishment causing a child’s weight to be significantly low for their age.
- Shrivelled
- Growth retarded
- Severe muscle wasting
- No s/c fat
- Lacking in protein, fat and carbohyrates
Describe the clinical signs of Kwashiorkor and what it is
- Kwashiorkor is a lack of protein only - common in types of famine
Clinical signs:
- Oedematous
- Scaling/ulcerated
- Lethargic
- Large liver, s/c fat
- Protein deficient
For each Clinical scenario below, choose the SINGLE most likely
A. To predict risk of myocardial infarction and decide of possible benefit of HMG-CoA reductase inhibition (statin therapy)
- Measurement of total plasma cholesterol and/or LDL cholesterol concentration
For each Clinical scenario below, choose the SINGLE most likely
B. To assess the degree of obesity and resultant cardiovascular risk
- Measurement of body mass index and waist circumference
For each Clinical scenario below, choose the SINGLE most likely
C.To reduce risk of Wernicke’s encephalopathy in alcoholic patient admitted to hospital
- Parenteral thiamine (Pabrinex)
For each Clinical scenario below, choose the SINGLE most likely
D. To advise a patient on a method of reducing plasma cholesterol
0 - Reducing saturated fat and increasing mono or polyunsaturated fat in diet
For each Clinical scenario below, choose the SINGLE most likely
E. To reduce risk of neural tube defect in woman seeking advice before pregnancy, with a previous pregnancy complicated by spina bifida in the infant.
- Oral Folic acid
