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Mechanisms of Disease > Nutritional Diseases - Gustafson > Flashcards

Nutritional Diseases - Gustafson Flashcards

1
Q

Primary malnutrition

A

Not enough of a nutrient in the diet to meet the needs of a healthy person

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2
Q

Secondary malnutrition

A

Malabsorption, urinary wasting, or excessive need for a particular nutrient

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3
Q

What is a leading cause of morbidity and mortality?

A

Undernutrition

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4
Q

Most effective cure?

A

Prevention
Good public health measures
Vector control
tons of other shit

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5
Q

Zoonotic disease

A

Jumped into the human species

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6
Q

What are a few diseases that are re-emerging due to climate change?

A

Malaria, dengue fever

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7
Q

What is a poison?

A

Too much of any thing, dosage

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8
Q

Xenobiotics

A

Exogenous chemicals in the environment

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9
Q

What is toxicology?

A

Study of poisons

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10
Q

What do Phase I reactions involve?

A

This is phase I of metabolism of poisons
Hydrolysis
Reduction
Oxidation

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11
Q

What do Phase II reactions involve?

A 
Phase 2 of the metabolism of poisons
Glucuronidation
Sulfation
Methylation
Conjugation
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12
Q

What does carbon monoxide bind to?

A

Hemoglobin

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13
Q

What happen with CO poisoning?

A

Colorless odorless gas, light headiness, confusion, vertigo, mental status changes

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14
Q

What part of parasites (children) susceptible to lead?

A

Brains

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15
Q

Lead in the body does what?

A

Inhibits ferrochelatase, forming ringed sideroblasts, microcytic hypochromic anemia, punctate basophilic stippling of the red cells

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16
Q

Toxicology generally deals with?

A

Substance of abuse, environmental or employment exposure to toxic substances

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17
Q

Is too much of a good thing bad?

A

Yes

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18
Q

Is too little of a good thing bad?

A

Yes

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19
Q

Are we going to be able to answer Gustafson’s questions from left field?

A

Probably not.

But press on, fearless med student, press on.

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20
Q

BMI is an indication of?

A

Nutritional status

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21
Q

What are some things that can lead to too little food/vitamins we need?

A

Poor
Infections
Acute or chronic disease such as cancer or HIV
Improper education about nutrition
Anorexia, bulimia or other psychosocial concerns
Aging and associated chronic conditions

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22
Q

What are 7 lab tests to evaluate nutritional status?

A 
Body weight and height
Ability to perform ADL
BMI
Skin fold thickness
Muscle mass
Albumin
Transferrin
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23
Q

Marasmus

A

Weight 60% below the normal age sex and height voluse
Emaciated appearance to the patient - dry starvation
Deficiency is in total calories
Ravenously hungry
Muscles are wasted, where there is little or no edema

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24
Q

What is deficient in marasmus?

A

Total calories

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25
Kwashiorkor
``` "wet starvation" Too little protein in the diet Low serum albumin --> edema Fatty liver Mentally dull ```
26
In kwashiorkor where are the protein reserves lost first?
Visceral proteins
27
Is weight normal with marasmus or kwashiorkor?
Kwashiokor
28
What is the flag sign?
In Kwashiorkor | Without tyrosine to make melanin, the hair cannot pigment, so becomes stripped
29
3 Key features of anorexia nervosa?
Refusal to maintain a healthy body weight An intense fear of gaining weight A distorted body image
30
What characterizes bulimia nervosa?
Frequent episodes of binge eating followed by frantic efforts to avoid gaining weight
31
4 Fat soluble vitamins are?
A D E K
32
What are the 9 water soluble vitamins?
``` Vit B1 - thiamine Vit B2 - riboflavin Vit B6 Vit B12 Niacin Vit C Folate Pantothenic acid Biotin ```
33
Vit A important for what two things?
Phototransduction | Maintenance of epithelial differentiation
34
Too little Vit A
Squamous metaplasia/hypkeratosis
35
Too much Vit A
De-differentiation of squamous epithelium
36
What cause lead to Vit A deficiency?
Poverty Fat malabsorption - intestinal or biliary obstruction Weird diets Amateur vegetarians -more common in poor nations, can combat by giving supplement every 6 months
37
Bitot's spots
Extra keratin on the eye
38
Squamous metaplasia of the eye causes
Xerophthalmia - dry eyes
39
Vit A deficiency leads to?
Night blindness because retinal rod pigments can't be renewed Squamous metaplasia of columnar epithelia in airways and urothelium - makes respiratory inf, esp measles more of a problem and cited as cause of an increased rate of kidney stones
40
If you eat polar bear liver what can happen?
1. You can get your ass thrown in a psych ward for being a freak 2. Vit A toxicity
41
Can you eat so many carrots that you overdose on Vit A?
Nope
42
Pts who have Vit A toxicity present with?
Increased intracranial pressure
43
Two common def with Vit D?
Rickets in children | Osteomalacia in adults
44
What does costochondral junction in vit D def look like?
New osteoid does not calcify well, chondrocytes don't line up normally
45
Best dietary sources of Vit D?
Enriched dairy products Oily fish - mackerel (mmmmm) Shiitake mushrooms grown under UV light
46
``` Levels of 25-hydroxyvitamin D Toxic? Normal? PTH elevated and treat? WHO says deficient? ```
150 ng/dL 80 ng/dL 30-40
47
What kind of idiots overdose on Vit D? What can they develop?
Those that abuse supplements | Kidney stones
48
2 pts with Vit E deficiency?
Preemies | Pts with fat malabsorption
49
What problems did preemies have that we overcame with Vit E supplementation?
Hemolytic disease
50
What does Vit K allow us to do?
g-carboxylation of glutamic acid to make clotting factors II, VII, IX, X, C and S
51
What causes Vit K deficiency
Preemies Babies generally - esp milk only babies Fat malabsorption Functional def - liver failure, coumadin Rx
52
Are anti-vaxxers smart folk?
Fuck. No
53
What can happen if 100 anti-vaxxers refuse the vit K injection for their baby after birth?
1 of them will have a brain hemorrhage from Vit K def | PVL - periventricular leukomalacia
54
What can cause Vit B1 (thiamine) def?
Crackpot diets Starvation/alcoholic binge After bariatric surgery
55
If you give a glucose IV to someone who's thiamine deficient, you can ppt what?
Wernicke's
56
Korsakoff's
Thiamine def in young children
57
What can cause Vit B3 (niacin)?
Dietary - poverty, monotonous grain based diet, alcoholism, anorexia Others - carcinoid tumors, malabsorption, taking isoniazid, hartnup disease
58
What is Pellagra? What is it from?
``` From niacin (B3) def Starts as a sunburn-like rash, then becomes a flaky, hyper pigmented rash esp where there's sun exposure ```
59
What are the 4 D's of pellagra?
Dermatitia, diarrhea, dementia (psychoses), death
60
When is pantothenic acid (B5) def seen? 1 symptom?
Mixed deficiencies in wartime/famine | Painful paresthesias in lower legs - burning feet
61
What does Vit B6 (pyridoxine) do?
Shuttles amino groups
62
When are Vit B6 levels low?
non-supplementing vegetarians
63
When is Folic acid (Vit B9) low? What does it do?
Shuttles methyl groups | Junk food diet, alcoholics, pregnancy, phenytoin users, malabsorption
64
Folic acid famously causes?
Megaloblastic anemia
65
Folic acid supplementation can help with?
NTDs | Cleft palate/lip
66
What is Vit C important for? Def called?
Is the oxidizer to maintain collagen | Scurvy
67
What causes scurvy?
``` Lack of Vit C -long sea voyages poverty crackpot diets alcoholic binges some dialysis pts ```
68
What is a scurvy rash?
Petechiae around hair follicles | Coiled corkscrew hairs
69
Why is scurvy painful?
First arthralgia and joint effusions | Then bleeds, including under periosteum
70
What major things cause iron def?
Diet - non-meat-eaters, milk only babies Extra need - menses, preggo, blood donors Those with GI/GU bleeds Malabsorption - esp celiacs
71
What is the most commonly detected nutritional problem in US today?
Iron def
72
What can cause hypchromic, microcytic anemia?
Iron def
73
Koilonychia
Wavy nails | from iron def?
74
What is zinc required for?
Basic enzymes like carbonic anyhdrase and alk phis. Animal proteins most abundant, breast milk is low
75
Acrodermatitis enteropathica
Dermatitis around mouth and anus and on extremities With thinning of the hair and diarrhea Assoc with zinc def Manage with high doses of oral zinc
76
Copper def? Associated with?
Preemies, starvation, zinc enthusiasts | Anemia, body deformities (if long standing in kids) and depigmentation
77
Mencke's disease
Kinky hair | Inborn error of metabolism
78
Keshan disease
Selenium def | In 1969 bureaucrat forgot to add selenium to the fertilizer, making more hearts vulnerable to coxsackievirus
79
What do we need iodine for?
Lots of shit | But also to make thyroid hormone
80
Number one cause of preventable mental retardation worldwide?
Iodine def
81
Iodine def goiters
The thyroid gland undergoes hyperplasia under the influence of high hTSH
82
Magnesium def
Not enough green in your diet | Not clear if there is a def
83
Obesity
Increased body fat, excess body weight
84
Overweight BMI
25-30
85
Obese BMI
> 30
86
Leptin
Tells up to stop eating
87
What is the fat burner that guards against obesity
Adiponectin
88
Consequences of obesity
Type II DM, insulin resistance and hyperinsulinemia

Mechanisms of Disease (8 decks)

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