Nutritional diseases Flashcards
Kwashiorkor
Protein starvation (seen with purely CHO diet)–> can’t make lipoproteins and fat accumulates in hepatocytes
–> visceral protein depletion, uncontrolled ascites and central edema secondary to hypoalbuminemia
More edema in legs than in arms
Marasmus
Weight falls to 60% of normal for age
Muscle wasting but serum albumin levels are normal or slightly reduced
Major complications of anorexia
Increased susceptibility to cardiac arrhythmia and sudden death from hypokalemia
Cachexia
State of profound loss of lean body mass and fat due to TNF
Molecular pathology of cachexia
TNF binds and induces NFKB to produce muscle specific ubiquitin ligases that target muscle for degradation
Vitamin A deficiency
- Xerophthalmia (dry eye)
- Ketatomalacia (softening of the cornea)
- Corneal ulcers
- Blindness
Vitamin D
- Maintains blood Ca2+ and PO4-
2. Stimulates osteoblasts to synthesize osteocalcin to deposit calcium during bone growth
Hypervitaminosis D
Bone pain and hypercalcemia (adults)
Hypercalcemia and metastatic calcification of soft tissue, especially kidneys (children)
Vitamin C deficiency
- Bleeding tendency in gums, skin, joints
2. Imparied wound healing
Leptin
Regulates metabolism
- Stimulates POMC/CART neurons to produce anorexigenic neuropeptides
- Inhibit NPY/AgRP neurons that make orexigenic neuropeptides
Peptide YY (PYY)
released post-prandially by endocrine cells in the ileum and colon as satiety signal
Ghrelin
Produced in the stomach and increases food intake
Insulin
Anabolic hormone that directs glucose in the muscle cells and adipocytes
Most likely cause of death in cachectic cancer patients
Respiratory muscle failure due to diaphragm atrophy
Vitamin A deficiency and squamous metaplasia
Causes problems in eye but also loss of mucociliary epithelium in airways predisposing to infection and keratin debris in urinary tract predisposing to stones
Risks associated with abdominal obesity
- Heart disease
- Diabetes
- Hypertension
- Dyslipidemia
Metabolic syndrome
- Daibetes
- Hypertension
- Dyslipidemia
- Abdominal obesity
- -> pro-inflammatory and pro-thrombotic state
Metabolic syndrome associated with elevated levels of
CRP, IL-1, IL-6, IL-18, TNF, and plasminogen activator inhibitor-1
Adiponectin
Anti-inflammatory cytokine produced by adipocytes –> enhances insulin sensitivity
Reduced in metabolic syndrome
Risk factors for cholelithiasis
- Female
- Forties
- Fertile
- Fat
Raynaud phenomenon
Exaggerated vascular response to cold with abnormal vasoconstriction
Leiomyoma
Benign tumor of smooth muscle cells
–> Spindle shaped cells with cigar-shaped nuclei organized into bundles
Gallstones are associated with what?
Acute pancreatitis with elevated amylase and lipase
Pt will sit with knees to chest to alleviate pain
How does obesity cause gallstones?
Adipocytes produce estrogen which increases hepatic uptake and synthesis of cholesterol
