Nutrition Flashcards

1
Q
  1. Name the 4 main fat soluble vitamins
  2. What happens when there is a deficiency of each?
  3. What is the best test for each of them?
A

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

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2
Q
  1. Name the 3 main water soluble vitamins
  2. What happens when there is a deficiency and excess of each?
  3. What is the best test for each of them?
A
  • Folate deficiency causes macro anaemia
  • Potential dementia –> dermititis, diarrhoea, dementia and death = niacin deficiency
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3
Q

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?

A
  • 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
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4
Q

Describe the components of energy expenditure

A
  • REE - resting energy expenditure
  • Exercise
  • Thermogenesis
  • Faclutative T
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5
Q

Describe basic energy(or fat) homeostasis

A

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
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6
Q

What is the definition of obesity?

A

Body mass index:

  • 25-30kg/m2 = overweight
  • >30kg/m2 = obese
  • >40kg/m2 = morbidly obese

Waist: hip ratio

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7
Q
  1. What should protein intake be for men and women?
A
  • 84gm - men
  • 64gm - women
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8
Q

Describe what makes up metabolic syndrome

A
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9
Q

How should obesity be treated?

A
  • 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
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10
Q

What are the different bariatric surgery procedures?

A
  • Adjustable gastric band
  • Sleve gastrectomy
  • Gastric bypass/Roux-en-Y Gastric bypass
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11
Q

What are the health benefits fo bariatric surgery?

A
  • 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
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12
Q

Describe the clinical signs of Marasmus -undernourishment causing a child’s weight to be significantly low for their age.

A
  • Shrivelled
  • Growth retarded
  • Severe muscle wasting
  • No s/c fat
  • Lacking in protein, fat and carbohyrates
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13
Q

Describe the clinical signs of Kwashiorkor and what it is

A
  • 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
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14
Q

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)

A
  1. Measurement of total plasma cholesterol and/or LDL cholesterol concentration
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15
Q

For each Clinical scenario below, choose the SINGLE most likely

B. To assess the degree of obesity and resultant cardiovascular risk

A
  1. Measurement of body mass index and waist circumference
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16
Q

For each Clinical scenario below, choose the SINGLE most likely

C.To reduce risk of Wernicke’s encephalopathy in alcoholic patient admitted to hospital

A
  1. Parenteral thiamine (Pabrinex)
17
Q

For each Clinical scenario below, choose the SINGLE most likely

D. To advise a patient on a method of reducing plasma cholesterol

A

0 - Reducing saturated fat and increasing mono or polyunsaturated fat in diet

18
Q

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.

A
  1. Oral Folic acid