Nutrition/ Endocrine Disorders

Question 1

What causes reduced body weight?

Answer 1

Mal-Nutrition

Thyroid dysfunction

Question 2

What causes increased body weight

Answer 2

Over-nutrition
In-utero under nutrition
Cortisol dysfunction

Question 3

What can malnutrition cause in kids?

Answer 3

Oedema (Kwashiorkor - excess watery fluid)

- Low plasma albumin concentration

Question 4

What are the 3 main causes of malnutrition on adults?

Answer 4

Anorexia Nervosa
Cancer cachexia (wasting syndrome)
Malabsorption / maldigestion

Question 5

What causes malabsorption?

Answer 5

Pancreatic insufficiency

• Chronic pancreatitis / cancer / cystic fibrosis
• Deficiency of pancreatic enzymes

Question 6

Explain Steatorrhea

Answer 6

• Increased fat in stool
  (more fat = more fluids, electrolytes + proteins in stool)
• Causes many deficiencies (Vitamin A, D, E + K are lipid soluble and can’t be absorbed)

Question 7

What is the function of thyroid hormones?

Answer 7

• Stimulate basal metabolic rate
• Enhance SNS
• Promote fat mobilisation / glucose catabolism

Question 8

Explain how thyroid hyper-secretion effects the body

Answer 8

Increases BMR

• Weight loss, fatigue, protuding eyeballs
• Increased heat (sweating)
• SNS: cardiac hyperexcitability (tachycardia, ectopic beats, weakened myocardium)
• Nervous excitability

Question 9

What is graves disease?

Answer 9

Autoimmune thyroid HS
- Antibodies mimic thyroid stimulating hormone (block receptors)
Causes: hypertrophy, hyperplasia, increased T3 (regulates metabolic temp/ rate), enlargement of gland

Question 10

How is Graves treated?

Answer 10

1. Anti-thyroid drugs. 2. Radioactive Iodine. 3. Subtotal Thyroidectomy (remove thyroid)

Question 11

What are some causes of obesity (before birth)

Answer 11

• Maternal obesity, smoking, stress

- Gestational diabetes

Question 12

What are some causes of obesity (in infancy)

Answer 12

• Short breastfeeding
• Formula Milk
• Maternal separation

Question 13

What are some adult causes of obesity?

Answer 13

• Diet / exercise
• Stress
• Endocrine disorders

Question 14

What is the function of cortisol?

Answer 14

• Regulates response to stress
• Increases gastric acid secretion
• Regulates metabolism (increases it)

Question 15

Explain Cushing’s Disease

Answer 15

• Hypercortisolism (not diurnal)
  Causes:
  Glucose: Weight gain, excess lipids in trunk/ face

Protein: Muscle + bone wasting, loss of collagen

Dampen immune response
Hyper-section of adrenal androgens
Gastric ulcer/ bleeding

Question 16

What causes cushings? (4 causes)

Answer 16

Increased ACTH
Hypothalamic / pituitary / adrenal tumour
Cortisone therapy
Ectopic cancer

Question 17

How does maternal smoking effect the fetus?

Answer 17

It causes placental small artery vasoconstriction (less blood flow)
- High risk of metabolic disorders + small birth weight

Question 18

What is thrifty-genotype?

Answer 18

Genes that promote fat deposition

Question 19

Name 3 examples of weight-loss technology

Answer 19

-Appetite pacemaker (maestro)
-Gastric balloon
Hydrogel therapeutics to treat obesity

Question 20

What are the diagnostic criteria for DM?

Answer 20

Random venous glucose: >11mM
Fasting: >7mM
OGTT (2Hr) >11.mM
HbA1c: >6.5%

Question 21

What are some risk factors for GDM?

Answer 21

• Ethnic group
• Family history
• High birth-weight baby, pregnancy loss
• Increase BMI + age
• Excessive weight gain
• PCOS

Question 22

What are some effects of hyperglycaemia?

Answer 22

• Thirsty
• Glucose in urine (glycosuria)
• Increased urination (polyuria)
• Weight loss
• Potentially: ketoacidosis

Question 23

What are some chronic complications of DM?

Answer 23

• Cardiovascular disease
• Retinopathy
• Renal failure
• Sensory neuropathy
• Foot ulcer (vascular)