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PATH 406 > Nutrition: Part 1 > Flashcards

Nutrition: Part 1 Flashcards

1
Q

What is the definition of nutrient?

A

Molecule that is necessary for the health of an individual but is not made in adequate quantities by the individual

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2
Q

What is the definition of nutrition ?

A

A science that encompass all the interactions that occur between living organisms and food which provides nutrients and energy.

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3
Q

What is the definition of malnutrition?

A

Any condition resulting from an energy or nutrient intake either above or below that which is optimal
- It encompasses both undernutrition and over-nutrition/obesity

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4
Q

What are the 6 classes of nutrients?

A

Carbs
Lipids
Protein
Water
Vitamins
Minerals

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5
Q

What are the energy-yielding nutrients?

A

Carbs, lipids and protein

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6
Q

What are the organic nutrients? Provide general functions of each.

A

Carbs — energy, regulation
proteins — energy, structure, regulation
lipids — energy, structure, regulation
vitamin — regulation

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7
Q

What are the inorganic nutrients? Provide general functions of each.

A

Minerals — structure, regulation
Water — regulation

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8
Q

What are some examples of trace elements and what do they do?

A

Iron — carry oxygen to body cells
Iodine — thyroid hormones
fluoride — strong teeth

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9
Q

What are dietary reference intakes (DRI)?

A

A set of reference values for the intake of energy, nutrients, and food components that can be used for planning and assessing the diets of healthy people in the USA and Canada

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10
Q

What are the 4 different sets of reference values in DRIs?

A
  1. Estimated average requirement (EAR)
    — the intake level for a nutrient at which the needs of 50% of the population will be met
  2. Recommended dietary allowance (RDA)
    — a measure of the daily intake of a nutrient that is required to keep 97% of the population healthy
  3. Adequate intake (AI)
    — estimate of the nutrient intake required to keep a person healthy
  4. Tolerable upper intake level (UL)
    — amount of nutrient that may be taken without concern for adverse effects
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11
Q

What is the difference between absolute and relative deficiency?

A

Absolute is not enough nutrients being ingested in diet, relative means systemic needs change and are above what can be compensated for by dietary modification alone.

Ex. of relative deficiency ➔ cancer, severe trauma

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12
Q

What are the clinical subtypes of acute malnutrition?

A

Dependent on presence/absence of edema
1. Marasmus — malnutrition without edema
2. Kwashiorkor — malnutrition with edema

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13
Q

How can we assess nutrition?

A

ABCDE
A — Anthropometrics: mid-upper arm circumference (MUAC), weight-for-height Z score (WHZ)
B — Biochemical: lab measurements
- Albumin, prealbumin, transferrin, total lymphocyte count, Hb
C — Clinical: medical history, signs and symptoms
- Weight change, diet, GI symptoms
D — Dietary: intake
E — Environmental: food access, living condition, recent refugee/immigrant

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14
Q

Where is thiamine found (Vitamin B1)?

A

Yeast, legumes, pork, brown rice and cereals made from whole grains

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15
Q

What clinical phenotypes does thiamine deficiency cause?

A
  1. Beriberi (infantile and adult)
  2. Wernicke-Korsakoff syndrome
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16
Q

What is infantile beriberi caused by? What is the onset? Cardiac and neurologic symptoms?

A
  • Infants who are breastfed by women with a thiamine deficient diet
  • Onset 3 months - 2 yrs
  • Cardiac: cardiomegaly, tachycardia, cyanosis, dyspnea
  • Neurologic: agitation, vomiting nystagmus, seizure
17
Q

What are the 2 types of adult beriberi?

A

Dry — symmetrical peripheral neuropathy characterized by both sensory and motor impairments, mostly of the distal extremities

Wet — neuropathy plus cardiac involvement with cardiomegaly, cardiomyopathy, heart failure, peripheral edema and tachycardia

18
Q

What is Wernicke’s-Korsakoff syndrome?

A

Wernicke’s encephalopathy (WE)
- Acute, need immediate treatment
- Characterized by nystagmus, ophthalmoplegia, ataxia, and confusion
- Reported in chronic alcoholic and weight loss surgery

Korsakoff syndrome (KS)
- Chronic, consequence of WE
- Characterized by impaired short-term memory and confabulation with otherwise grossly normal cognition

19
Q

What symptoms are observed in niacin/nicotinic acid (Vitamin B3) excess?

A
  • Flushing
  • Nausea
  • Vomiting
  • Pruritus
  • Hives
  • Constipation
  • Elevated liver enzymes
  • Hepatitis
  • Niacin-induced myopathy
20
Q

Where is niacin found?

A

Yeast
Meats
Grains
Legumes
Corn treated with alkali
- corn has low-tryptophan content
- niacin found in corn is bound to other molecules which can not be well absorbed
Seeds

21
Q

Where can folate be found? What is it required for?

A

Found in cereals, liver, green leafy, vegetables, legumes, kidney beans

Required for biosynthesis of choline serine glycine, purines and pyrimidine (thymidine) — DNA synthesis — impt for cell division

22
Q

What is the biological half life of folate?

A

One month

23
Q

What is the RDA of folate?

A

Adults — 400 ug/day
Infants — 65-80 ug/day
Children — 150-400 ug/day

Requirement increase in pregnancy & lactation
- Pregnant women: 600 ug/day
- Lactating women: 500 ug/day

24
Q

What can folate deficiency cause? What are the lab findings?

A

Megaloblastic anemia — large abnormally nucleated cells (evident on blood smear)

Neurological symptoms ➔ rare
WBC and/or platelets ➔ myb low
RBC folate ➔ low
Serum homocysteine ➔ increased
MMA ➔ normal

Maternal deficiency-neural tube defect

25
Q

What is used to test for folate?

A

RBC folate test
- better than serum folate

26
Q

What may mask a vitamin B12 deficiency?

A

Folate excess

27
Q

Where is vitamin B12 (Cyanocobalamin) found? What is the function of Vit B12?

A

Animal products

Coenzyme for more than 12 different systems

28
Q

How is vit B12 absorbed?

A
  1. IF glycoprotein produced in stomach forms complex with B12, which is required for enterocyte entry
  2. B12 is stored in the liver and released to meet physiological demands
29
Q

What is the effect of Vit B12 on the TCA cycle?

A

B12 is a coenzyme for L-methylmalony-CoA mutase reaction to generate succinyl CoA (TCA cycle)
➔ decrease in B12 = increase in L-methylmalony-CoA mutase
➔ results in methylmalonic aciduria and metabolic ketoacidosis

30
Q

What are the clinical symptoms of Vit B12 deficiency?

A
  • megaloblastic anemia
  • neurologic injury
  • WBC and or platelets low
  • Vit B12 low
  • AutoAb to intrinsic factor (IF) present
  • increased serum homocysteine & MMA
31
Q

What is the role of laboratory testing in the assessment of nutritional status for
1. anemia
2. bone mineral status
3. malabsorption

A

Anemia — iron, folate, vit b12
Bone mineral status — Ca, Mg, Phosphorus
Malabsorption — fat soluble vitamins

PATH 406 (24 decks)

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