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MOD Midterm > Nutrtional Diseases > Flashcards

Nutrtional Diseases Flashcards

1
Q

What is primary malnutrition?

A

Either carb, fat or protein missing from the diet Or all missing

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2
Q

What is secondary malnutrition?

A

Malabsorption, impaired utilization or storage, or increased need

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3
Q

What is severe acute malnutrition (SAM)?

A

Previously known as protein energy malnutrition or PEM
Consequences of inadequate intake of proteins and calories or deficiencies in the digestion or absorption of proteins -> loss of fat and muscle tissue, weight loss, lethargy, generalized weakness

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4
Q

Which population is highly affected by PEM/SAM?

A

Residents of nursing homes

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5
Q

What are signs of secondary PEM?

A

Depletion of subQ fat in the arms, chest wall, shoulders or metacarpal regions
Wasting of the quadriceps and deltoid muscles
Ankle or sacral edema

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6
Q

What is marasmus?

A

Severe lack of calories
Leads to growth retardation and muscle loss
Serum albumin NL —> anemia, immune deficiency —> infections
Emaciated extremities

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7
Q

What is kwashiorkor?

A

Decreased protein more severe —> decrease in total calories
Hypoalbuminemia -> generalized or dependent edema, vit deficiency, immune def, secondary infections
Depletion of visceral protein compartment
Fatty liver

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8
Q

What are somatic proteins?

A

Protein in skeletal muscles —> marasmus

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9
Q

What are visceral proteins?

A

Protein in organs primarily the liver
Kwashiorkor
Albumin and transferring levels

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10
Q

What is anorexia nervosa?

A

Self induced starvation —> marked weight loss
Amenorrhea, decreased thyroid hormone, decreased bone density
Anemia, lymphopenia, hypoalbuminemia
Gelatinous transformation
Increased susceptibility to cardiac arrhythmia and sudden death due to hypokalemia

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11
Q

What is gelatinous formation?

A

Fat in BM, mucinous matrix material deposition

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12
Q

What is bulimia?

A

Binge/purge
More common than anorexia and better prognosis
Electrolyte imbalance (hypokalemia) —> cardiac arrhythmia

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13
Q

What is a complication of both anorexia nervous and bulimia?

A

Susceptibility to cardiac arrhythmia and sudden death due to hypokalemia

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14
Q

What are the functions of vitamin A?

A

A component of visual pigment
Maintenance of specialized epithelia
Maintenance of resistance to infection

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15
Q

What are the deficiency syndromes associated with vitamin A?

A

Night blindness, xerophthalmia, blindness
Squamous metaplasia
Vulnerability to infection particularly measles

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16
Q

What are the functions of vitamin D?

A

Facilitates intestinal absorption of Ca and phosphorus and mineralization of bone

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17
Q

What deficiency syndromes are associated with vitamin D?

A

Rickets in children

Osteomalacia in adults

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18
Q

What is the function of vitamin E?

A

Major antioxidant

Scavenges free radicals

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19
Q

What deficiency syndromes are associated with vitamin E?

A

Spinocerebellar degeneration

20
Q

What are the functions of vitamin K?

A

Cofactor in hepatic carboxylation of procoagulants including factors II, VII, Ix and X + protein C and S

21
Q

What deficiency syndromes are associated with vitamin K?

A

Bleeding diathesis

22
Q

What is the function of vitamin B1 (thiamine)?

A

Coenzyme in decarboxylation reactions

Causes dry and wet beriberi, Wernicke syndrome, Korsakoff syndrome

23
Q

What is the function of Niacin?

A 
Incorporated into NAD and NADP
Involved in redox reactions 
Causes pellagra (dementia, dermatitis, diarrhea)
24
Q

What are the functions of vitamin B6 (pyridoxine)?

A

Derivatives serve as coenzymes in many intermediary reactions
Can lead to cheliosis, glossitis, dermatitis, peripheral neuropathy

25
Q

What is the function of vitamin C?

A

Serves in many oxidation reduction reactions and hydroxylation of oxygen
Leads to scurvy, hemorrhages and healing defects

26
Q

Secondary deficiency of vitamin A can occur with fat malabsorption disorders such as what?

A

Celiac dz, Crohn’s dz, cystic fibrosis, Bariatric surgery, mineral oil laxative

27
Q

What is one of the earliest signs of vit A deficiency?

A

Night blindness

28
Q

Describe the epithelial/squamous metaplasia and keratinization that can occur with vitamin A deficiency

A

Xerophthalmia (dry eyes), Bitot spots (keratin), keratomalacia (cornea destruction) —> blindness
Squamous metaplasia of resp epithelium —> increased pulmonary infections
Squamous metaplasia of urinary tract —> desquamation of keratin predisposes to urinary bladder stones

29
Q

What is arcuate vitamin A toxicity?

A

HA, dizziness, vomiting, stupor and blurred vision
Confused with pseudotumor cerebri (increased intracranial pressure, HA and vision changes; aka iodopahtic intracranial HTN)

30
Q

What are the effects of rickets?

A

Frontal bossing, squared head, rachitic rosary, pigeon breast deformity, lumbar lordosis, bowing of the legs

31
Q

What is the major source of vitamin D?

A

Endogenous synthesis from a precursor, 7-dehydrocholesterol, in a photochemical reaction that requires solar or artificial UV light in the range of 390315 nm

32
Q

Humans are entirely dependent on the diet for which vitamin?

A

C

33
Q

What is the function of iron?

A

Essential component of Hb as well as several iron containing metalloenzymes

34
Q

What is the basis of an iron deficiency?

A

Inadequate diet

Chronic blood loss

35
Q

What are the clinical features for iron deficiency?

A

Hypochromic microcytic anemia

36
Q

What is the normal range for BMI?

A

18.5-25 kg/M2

37
Q

What BMI range is considered overweight?

A

Between 25 and 30

38
Q

Excess adiposity and excess body weight are associated with what?

A

Increased incidence of T2DM, dyslipidemias, CVD, HTN and cancer

39
Q

What is leptin?

A

Secreted by fat cells

It’s output is regulated by the adequacy of fat stores

40
Q

What is adiponectin?

A

Produced in adipose tissue

Has been called a fat burning molecule

41
Q

What is Ghrelin?

A

Produced in the stomach and is the only known gut hormone that increases food intake (orexigenic effect)

42
Q

Obesity is associated with what syndrome (other than metabolic)?

A

Hypoventilation syndrome also called pcikwickian syndrome
Hypersomnolence both at night and during the day, often associated with sleep apnea, polycythemia, and eventual right sided heart failure (cor pulmonale)

43
Q

Which cancers are associated with obesity?

A

Increased risk for cancers of esophagus, thyroid, colon and kidney in men
Cancers of esophagus, endometrium, gallbladder and kidney in women

44
Q

Insulin resistance leads to hyperinsulinemia, how can this contribute to cancer?

A

Hyperinsulinemia leads to increased free insulin like growth factor (IGF-1)
IGF-1 is a mitogen
IGF-1 receptor, IGFR-1 is highly expressed in many human cancers

45
Q

The proinflammatory state that is associated with obesity may itself be what?

A

Carcinogenic

46
Q

What is aflatoxin?

A

Can lead to hepatocellular carcinoma

Toxin produced in fungi found in agricultural crops such as maize, peanuts and tree nuts

MOD Midterm (8 decks)

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