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