Nutritional Path II

Question 1

Primary and secondary malnutrition

Answer 1

Primary - nutrients missing from diet

Secondary - problems with absorption, excess loss, increased nee

Question 2

Marasmus

Answer 2

caloric deprivation
weight below 60% normal
loss in subcutaneous tissue - skin is baggy
anemia and vitamin deficiencies
immune deficiency

Question 3

Kwashiorkor

Answer 3

protein deprivation
associated with skin lesions, flaky skin, FATTY LIVER, swollen edema
spotty lesions

Question 4

Anorexia nervosa

Answer 4

self starvation - amenorrhea, cold, bradycardia (low heart rate), constipation, dry skin, change/thinning of hair, decrease bone density, cardiac arrhythmia
hypokalemic

Question 5

Bulimia

Answer 5

binging then vomit 
laxatives/ diuretics 
electrolyte imbalance 
aspiration of gastric contents
esophageal and stomach rupture
can lead to cardiac arrythmia as well 

we can diagnose this with presence of the teeth

Question 6

Vitamins

Answer 6

essential organic compounds required for growth and metabolism

Question 7

Lipid soluble vitamins

Answer 7

A,D,E(Tocopherol),K

Question 8

vitamins that are synthesized endoginously

Answer 8

D,K, biotin and niacin

Question 9

T/F dietary supply of all vitamins is essential for health

Answer 9

True

Question 10

Types of vitamins

Answer 10

lipid/fat and water soluble

Question 11

Vitamin A

Answer 11

Retinol, retinol ester, retinal and retinoic acid

Question 12

what is needed for absorption of lipid soluble vitamins?

Answer 12

Bile, pancreatic enzymes, and antioxidant activity in the food is rewuired for absorption

Question 13

Vitamin A comes from?

Answer 13

Vegetables - Carotenoids (beta-carotene)

Animal derived foods - liver, fish, eggs, milk, butter, vegetables, carrots, squash, spinach

Question 14

Storage of Vit A

Answer 14

more then 90% reserves stored in the liver

Question 15

Functions of Vit A

Answer 15

normal vision in reduced light
potentiating the differentiation of specialized epithelial cells - like mucus secreting cells
enhancing immunity to infections

Question 16

Vit A deficiencies

Answer 16

Impaired vision
Xerophthalmia - dry eye 
Enamel irregularities
pulmonary infections
renal and urinary bladder stones
follicular or papular dermatosis
impairement of immunity 0 higher mortality rates from common infections like measles, pneumonia, and infectous diarrhea

SQUAMOUS METAPLASIA - as it plays a role in maintainance of specialized epithelium

Question 17

Vit D function

Answer 17

Intestinal absorption of calcium and phosphate
stimualtes calcium resorption in renal and distal tubules
collaborates with PTH to regulate blood calcium
promotes mineralization of bone and teeth

Question 18

Sources of Vit D

Answer 18

endogenous synthesis in the skin (90%)

deep sea fish, plants, and grains

Question 19

Rickets

Answer 19

Vit D deficiency
excess of unmineralized bone matrix
Disorganization of bone - so increase in pressure on bones? - bone adapts and there is bowing of the bones
calcium is not veing depositited correctly

Question 20

Osteomalacia

Answer 20

Adults - vit d deficiency

Question 21

Vit D toxicity

Answer 21

hypervitaminosis
in children - may take the form of metastatic calcification of soft tissues such as the kidney
in adults - causes bone pain and hypercalcemia

MOST TOXIC OF FAT SOLUBLE - excess of vit d - too much calcium deposition

Question 22

difference in storage of water soluble vs. fat soluble vitamins?

Answer 22

excess of fat soluble = stored in the liver

excess of water soluble = excreted in the urine

Question 23

Vitamin C

Answer 23

Ascorbic Acid
Water soluble
Not synthesized endogenously in humans 
sources - milk and some animal products, abundant in fruits and veggies
antioxidant properties

Question 24

hydroxylation of collagen from

Answer 24

vit c-ascorbic acid
hydroxylation maintains the integrity of the collagen
activation of proyl and lysyl hydroxylases from inactive pre cursore, allowing for the hydroxylation of procollagen

Question 25

Vit C deficiency

Answer 25

Scurvy
Gingival swelling, hemorrhages, and secondary bacterial periodontal infections (common)
impaired wound healing and localization infections

Question 26

Who has vit c deficiency?

Answer 26

elderly
live alone
alcoholics
periotneal dialysis and hemodialysis patients -
food faddists
infants maintained on formulas of evaporated milk without supplementation

Question 27

Vit C toxicity

Answer 27

slight relief may be as a result of antihistamine actions of the ascorbic acid
uricosuria - large excretion in asorbic acid

Question 28

Vit K defciency

Answer 28

May have troubles in some clotting factors as this vitamin plays a role in those pathways
pro-coagulant

Question 29

exogenous carcinogen

Answer 29

Aflatoxin - important in development of hepatocellular carcinoma (mutation in the p53 gene)

Question 30

aflotoxin

Answer 30

think hepatocellular carcinoma - p53 gene mutation

Question 31

Nitrosamines and nitrosamides are?

Answer 31

endogenous synthesis of carcinogens

Question 32

Nitrosamines and nitrosamides

Answer 32

gastric carcinomas (because induce gastric carcinomas in animals)

Question 33

Colon cancer

Answer 33

high animal fat intake combined with low fiber intake

Question 34

anticarcinogenic effects

Answer 34

Vitamins C and E, Beta- carotenes, and selenium - due to their antioxidant properties

Question 35

Retinoic acid

Answer 35

promotes epithelial differentiation and reverses squamous metaplasia

Question 36

SAM

Answer 36

severe acute malnutrition - state characterized by reduced height to weight ratio that is below 3 SD of the world health organization
two ends of the spectrum are marasmus (caloric deprivation) and kwashiorkor (protein deprivation is greater than the reduction in total calories

Question 37

cachexia

Answer 37

severe form of secondary malnutrition - often developing in chronically ill, older or bedridden patients and often seen in cancer patients