Nutritional Path II Flashcards
Primary and secondary malnutrition
Primary - nutrients missing from diet
Secondary - problems with absorption, excess loss, increased nee
Marasmus
caloric deprivation weight below 60% normal loss in subcutaneous tissue - skin is baggy anemia and vitamin deficiencies immune deficiency
Kwashiorkor
protein deprivation
associated with skin lesions, flaky skin, FATTY LIVER, swollen edema
spotty lesions
Anorexia nervosa
self starvation - amenorrhea, cold, bradycardia (low heart rate), constipation, dry skin, change/thinning of hair, decrease bone density, cardiac arrhythmia
hypokalemic
Bulimia
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
Vitamins
essential organic compounds required for growth and metabolism
Lipid soluble vitamins
A,D,E(Tocopherol),K
vitamins that are synthesized endoginously
D,K, biotin and niacin
T/F dietary supply of all vitamins is essential for health
True
Types of vitamins
lipid/fat and water soluble
Vitamin A
Retinol, retinol ester, retinal and retinoic acid
what is needed for absorption of lipid soluble vitamins?
Bile, pancreatic enzymes, and antioxidant activity in the food is rewuired for absorption
Vitamin A comes from?
Vegetables - Carotenoids (beta-carotene)
Animal derived foods - liver, fish, eggs, milk, butter, vegetables, carrots, squash, spinach
Storage of Vit A
more then 90% reserves stored in the liver
Functions of Vit A
normal vision in reduced light
potentiating the differentiation of specialized epithelial cells - like mucus secreting cells
enhancing immunity to infections
Vit A deficiencies
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
Vit D function
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
Sources of Vit D
endogenous synthesis in the skin (90%)
deep sea fish, plants, and grains
Rickets
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
Osteomalacia
Adults - vit d deficiency
Vit D toxicity
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
difference in storage of water soluble vs. fat soluble vitamins?
excess of fat soluble = stored in the liver
excess of water soluble = excreted in the urine
Vitamin C
Ascorbic Acid Water soluble Not synthesized endogenously in humans sources - milk and some animal products, abundant in fruits and veggies antioxidant properties
hydroxylation of collagen from
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
Vit C deficiency
Scurvy
Gingival swelling, hemorrhages, and secondary bacterial periodontal infections (common)
impaired wound healing and localization infections
Who has vit c deficiency?
elderly
live alone
alcoholics
periotneal dialysis and hemodialysis patients -
food faddists
infants maintained on formulas of evaporated milk without supplementation
Vit C toxicity
slight relief may be as a result of antihistamine actions of the ascorbic acid
uricosuria - large excretion in asorbic acid
Vit K defciency
May have troubles in some clotting factors as this vitamin plays a role in those pathways
pro-coagulant
exogenous carcinogen
Aflatoxin - important in development of hepatocellular carcinoma (mutation in the p53 gene)
aflotoxin
think hepatocellular carcinoma - p53 gene mutation
Nitrosamines and nitrosamides are?
endogenous synthesis of carcinogens
Nitrosamines and nitrosamides
gastric carcinomas (because induce gastric carcinomas in animals)
Colon cancer
high animal fat intake combined with low fiber intake
anticarcinogenic effects
Vitamins C and E, Beta- carotenes, and selenium - due to their antioxidant properties
Retinoic acid
promotes epithelial differentiation and reverses squamous metaplasia
SAM
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
cachexia
severe form of secondary malnutrition - often developing in chronically ill, older or bedridden patients and often seen in cancer patients
