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Pathophys, GI LIver Cancer > Nutrition, Starvation > Flashcards

Nutrition, Starvation Flashcards

1
Q

3 basic stages of catabolism of food

A
  1. Break down all food/nutrients into basic monomers
  2. Convert all basic monomers into Acetyl CoA to
  3. Feed Citric Acid Cycle and gain energy
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2
Q

Fats break down into

A

Fatty Acids and Glycerol

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3
Q

Constructing molecules from smaller stuff

A

Anabolism

a block ANAnother block ANAnother block

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4
Q

3 stages of anabolism

A
  1. Precursors: amino acids, nucleotides, monosaccharides
  2. Use ATP (phosphorylation) to turn these precursors into activated forms
  3. Assemble activated precursors into complex molecules (polysaccharides, lipids, nucleic acids)
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5
Q

How many saccharides in complex carbs

A

3 OR MORE

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6
Q

Lipid energy vs carb energy

A

Lipids provide twice the amount of energy as an equal mass of carbs

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7
Q

What makes essential fatty acids so essential?

A

WE CAN’T MAKE THEM IN OUR BODIES SO WE HAVE TO EAT EM

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8
Q

name 2 essential fatty acids

A

Linoleic Acid

Linolinic Acid

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9
Q

Omega 3 foods ______ can help with these conditions_____

A

Sardines, salmon, walnuts, flax seeds

cardiovascular, fatigue, dry skin, joint pain

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10
Q

How many essential amino acids are there

A

NINE. THERE ARE 9. NEIN.

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11
Q

1 important essential amino acid you should know

A

TRYPTOPHAN

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12
Q

1 important “conditional” amino acids you should know

A

TYROSINE

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13
Q

What makes an amino acid “conditional” (like tyrosine?) AND WHEN DO YOU NEED THEM MOST

A

It can be made by the body, but not very efficiently

Need them most in illness, stress, poor nutrition

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14
Q

What fraction of calories should be from fat?

A

1/3

ONE THIRD FAT, ONE THIRD FAT, ONE THIRD FAT

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15
Q

HOW MUCH SALT / DAY, MAXIMUM?

A

< 2300 mg !! JEEEZ!

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16
Q

Describe the absorptive state

A

Anabolism exceeds catabolism

Driven by insulin

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17
Q

Which hormones are at work int he post absorptive state

A

3-5 hours after digestion of meal - FASTING

Increased Glucagon! Maintaining stable plasma glucose (70-110)

Decreased insulin!

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18
Q

Which cells are good at converting glucose into triglycerides

A

Liver cells and fat cells (adiposcytes)

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19
Q

Describe neuro-endo control of absorptive state

A

Insulin dominant, parasympathetic storage

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20
Q

Describe neuro-endo control of post absorptive

A

Glucagon dominant, sympathetic breakdown

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21
Q

SYmpathetic nervous system effect on blood glucose

A

Breaks down glycogen
Gluconeogenesis in liver
Break down fat (fat cells)

22
Q

Net result of cortisol in metabolism

A

increase plasma concentrations of
AMINO ACIDS
GLUCOSE
FREE FATTY ACIDS

23
Q

Growth hormone effects on metabolism

A

Similar to cortisol - get it out so you can use it

Opposite of insulin

24
Q

Why do cushiness patients have central obesity and muscle wasting?

A

They store fat in fat cells and CATABOLIZE PROTEINS (muscle tissues)

25
Total energy expenditure =
Internal heat produced + external work performed + energy stored
26
4 things that contribute to a lower BMR
1. Being female 2. Getting old 3. Not getting enough sleep 4. Fasting
27
How many calories = 1 lb?
3500 cals!
28
1 nutritional calorie = how many biochem calls?
1,000 biochem cals!
29
What immune active gene is associated w obesity
TLR-5 deficiency
30
Describe the normal function of leptin
High Leptin levels = less hungry, more busy | *triggers you to stop eating and start burning*
31
Describe process and effect of leptin desensitization
Consistently high levels of leptin, from high fat, leads to desensitization (to leptin) As a result, leptin does not trigger satiety - leads to more eating, and more conserving energy - positive feedback
32
Causes of secondary malnutrition
1. Loss of appetite (from cancer, infection) 2. BMR change (HIV, infection, fever) 3. Decreased nutrient absorption (GI stuff) 4. Parasites
33
Causes of primary malnutrition
Not enough food. protein-calorie
34
Protein-energy malnutrition at <1 year of age can lead to
Marasmus, permanently stunted growth
35
Symptoms of Marasmus
Dry skin loose folds of skin ``` Slow heart rate Low blood pressure Drowsiness Irritability Big appetite ```
36
What differentiates Kwashiorkor from Marasmus?
Marasmus is deficiency in ALL energy Kwashi is deficiency in PROTEIN - leads to EDEMA, SWOLLEN BELLY
37
What happens to blood glucose in starvation
Drops to 35-60mg/dl WITHOUT clinical symptoms!! WAAOOOWWW
38
Why do serum electrolytes stay stable in starvation/
RENAL CONSERVATION KICKS IN IMMEDIATELY
39
How long does it take for urine output to drop in starvation
1 week
40
At what point in starvation does negative nitrogen balance occur
First 5-7 days
41
At what point in starvation does negative nitrogen balance decrease significantly
1 month
42
In starvation, non-gluocse energy sources are used for all cells EXCEPT
RBCs WBCs CNS
43
What happens with serum albumin level in starvation
Albumin level is normal until LATE starvation
44
In starvation, what hormonal changes are responsible for the mobilization and oxidation of fat? (aka, releasing and making fat usable for energy - ketones, free fatty acids etc)
Insulin levels decrease Glucagon levels increase Coritsol and Growth Hormone stays the same
45
What kind of changes will lower the BMR in starvation?
Changes in Sympathetic Nervous System and Thyroid Hormone concentrations
46
In refeeding syndrome, decreased sodium excretion leads to what complications
Fluid retention in first few days Then leads to Pulmonary Edema and CHF
47
How does refeeding screw up the respiratory system
Starving person can't handle the Increased CO2 and O2 production because of respiratory muscle wasting
48
GI complaints with refeeding
Diarrhea, nausea, vomiting
49
Thiamine deficiency's role in referring syndrome
Thiamine is needed for carb metabolism, so when carbs are reintroduced without thiamine, you get weird thiamine deficiency symptoms (neuro, tachy, cardiomegaly)
50
Carb refeeding in B1 (thiamine) deficient patients can lead to
Wernick'es encephalopathy
51
What does weight gain > 1 kg in the first week of refeeding indicate?
Fluid retention
52
What electrolytes do you need more of in refeeding?
Additional phosphorus, potassium, magnesium and thiamin are required (anticipate that they will move intracellular very rapidly)

Pathophys, GI LIver Cancer (4 decks)

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