Obeesiteh & PCOS Flashcards

(45 cards)

1
Q

What is Kwashiorkor caused by?

A

protein deficiency (but adequate energy)

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2
Q

When is Kwashiorkor often seen?

A

often seen in weaning infants at birth of a sibling in areas where protein foods aren’t abundant
-can occur even in overweight

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3
Q

onset and protein levels of Kwashiorkor

A

may be abrupt onset and low albumin (edema, etc)

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4
Q

Marasmus caused by

A

deficiency of both protein and energy

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5
Q

Where is marasmus seen

A

in areas where not enough food available

-associated with fat and muscle wasting

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6
Q

onset, protein levels of marasmus

A

slower onset and albumin level may be normal

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7
Q

Kwashiorkor-like secondary protein-energy malnutrition

-associated with what?

A

hypermetabolic acute illness like trauma, burns, sepsis

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8
Q

Marasmus-like secondary protein-energy malnutrition

associated with what?

A

COPD, CHF, AIDS, cancer

-number of calories they’re taking in aren’t enough to keep up w/ energy expended from/by diseases

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9
Q

list of things that cause protein-energy malnutrition

A
  • not enough energy or protein ingested
  • increased nutrient losses
  • increased nutrient requirements by underlying illness
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10
Q

Refeeding in protein-energy malnutrition

A
  • ***must be slow and careful b/c mineral/electrolyte problems during referring
  • will need vitamin and mineral supplements
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11
Q

Main vitamin that should be supplemented?

A

Vitamin D

  • essential for bone mineralization
  • deficiency associated with increased risk for colorectal, breast, and prostate cancers
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12
Q

Thiamine deficiency usually associated with

A

alcohol

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13
Q

riboflavin deficiency usually because

A

of multiple vitamin deficiencies

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14
Q

niacin deficiency

A

usually alcohol related

  • niacin helpful for treating lipids
  • severe deficiency causes dermatitis, diarrhea
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15
Q

vitamin C deficiency

A

urban poor, elderly, renal failure

-scurvy, bleeding gums, edema

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16
Q

What two vitamins necessary for RBC division

and what if deficient

A

B12 and folate

macrocytosis if deficient

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17
Q

B vitamin deficiencies

A

mouth soreness, glossitis, weakness, irritability

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18
Q

B12 deficiency

A
  • Macrocytic anemia, neuropathy
  • B12 stores last a long time
  • Intrinsic factor protects is (schilling test to see if IF is reason for B12 deficiency)
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19
Q

Folate deficiency

A
  • usually dietary deficiency
  • **folate stores are short-lived so highly dependent on diet
  • macrocytic anemia without neurologic defects
20
Q

If B12 deficiency and supply folate, what happens?

A

macrocytic anemia will correct but neurological will become permanent

21
Q

Vit A deficiency and excess

A
  • Deficiency can cause blindness

- hypervitaminosis very toxic

22
Q

Vit D

-essential for what?

A

bone mineralization

23
Q

Vit E deficiency

A

usually due to malabsorption

24
Q

Vit E supplementation

A

causes more harm than good for CVD

25
D-xylose test
- tests for bacterial overgrowth in gut - we can't digest xylose but bacteria can - look for labeled Co2 when xylose broken down
26
underweight BMI range
less than 18.5
27
normal BMI range
18.5-24
28
overweight BMI range
25-29
29
Obese BMI range
>29 30+
30
Obesity causes increased risk for
- insulin resistance/diabetes - metabolic syndrome - CVD, stroke, MI - cancer - MS problems/arthritis
31
What does adiponectin do? | What happens when obese?
repairs vascular walls and regulates inflammation | -adiponectin decreases with obesity
32
Obesity is worse/ higher CVD risk if what?
higher level of inflammation within fat
33
Drugs indicated for chronic obesity treatment
Xenical/orlistat
34
short term weight loss drugs
amphetamines suppress appetite, other drugs with unintentional weight loss side effect
35
Types of Bariatric surgeries
1. Restrictive reduces stomach size for earlier satiety 2. Malabsorptive more effective, prevents nutrients from being absorbed 3. Combination also very effective- gastric bypass with some malabsorption
36
PCOS general definition
1. ovulatory dysfxn 2. hyperandrogenism (must exclude other causes like ovarian tumor, etc) 3. exclusion of other disorders 4. possible polycystic ovaries
37
Things usually present with PCOS
- usually overweight/obese - insulin resistance or hyperinsulinemia - elevated LH levels - hyperandrogenism from hyperinsulinemia - anovulation - strong family clustering - prevalence of metabolic syndrome higher than general population
38
PCOS Lab Findings
- elevated LH but normal FSH - increased testosterone - ***insulin resistance with compensatory hyperinsulinemia (key pathogenic factor in PCOS)
39
Clinical Features of PCOS
- acanthosis nigricans - acne - alopecia - amenorrhea or dysfxnl menses - central obesity - hirsutism
40
PCOS pts have increased risk of what CVD disease?
7-fold increased risk of MI
41
Best first-line treatment for PCOS
* lifestyle modification with diet & exercise | * *weight loss, low fat and low carb diet
42
What medicine to treat infertility in PCOS?
Clomiphene
43
How to treat complaints of PCOS?
- oligomenorrhea: estrogen-progestin therapy - hirsutism- estrogen progestin - anovulation/infertility: clomiphene
44
drug treatments for weight loss
- Orlistat fat blocker - amphetamines for short term appetite suppression - bariatric surgery
45
insulin sensitizing agents
- metformin (biguanide) and | - thiazolidinediones