[P] Week 5: Environmental and Nutritional Disease - Part 1 Flashcards
What are the two dieatary Insufficiency?
- Primary Malnutrition
- Secondary Malnutrition
DIETARY INSUFFICIENCY
- It is commonly seen in chronically ill patients, elderly, or bed-ridden patients.
- Bed-ridden or hospitalized malnourished patients have an increased risk of infection, sepsis, impaired wound healing, and death after surgery
Secondary Malnutrition
DIETARY INSUFFICIENCY
What are the most obvious signs of secondary malnutrition?
- Depletion of subcutaneous fat in the arms, chest wall, shoulders, or metacarpal regions.
- Wasting of the quadriceps and deltoid muscles.
- Ankle or sacral edema.
Condition that lead to primary ort secondary malnutrition
- Poverty
- Acute and chronic illnesses with increased catabolism.
- Chronic alcoholism
- Ignorance and failure of diet supplementation
- Self-imposed dietary restrictions
- Other causes may also be GIT diseases and malabsorption syndromes, genetic diseases, and inadequate total parenteral nutrition (TPN).
Malnutrition is defined as the consequence of inadequate intake of protein and calories to meet the body’s needs.
Severe Acute Malnutrition (SAM)
SAM is formerly known as the?
Protein Energy Malnutrition
The WHO defines severe acute malnutrition (SAM) as a state characterized by a weight for height ratio that is ____ standard deviations below the normal range
three (3)
What are the Determination of State of Malnourishment
- Body Mass Index (BMI)
- Skinfold Thickness
- Measurement of Serum Proteins
DETERMINATION OF STATE OF MALNOURISHMENT
Computed using both the height and weight of person and then comparing it to a standardized chart
Body Mass Index (BMI)
DETERMINATION OF STATE OF MALNOURISHMENT
Classification:
- underweight
- Normal
- Overweight
- Obese
A. Below 18.5
B. 18.5 to 24.9
C. 25 to 29.9
D. Above 30
ABCD
In/de -crement of 5
DETERMINATION OF STATE OF MALNOURISHMENT
Measures fat stores and muscle mass.
Skinfold thickness
DETERMINATION OF STATE OF MALNOURISHMENT
Measurement of serum proteins (albumin, transferrin, and others) can provide an estimate of the adequacy of the visceral protein compartment.
Measurement of serum protein
What are the type of Severe Acute Malnutrition
- Marasmus
- Kwashiorkor
TYPES OF SEVERE ACUTE MALNUTRITION
- Develops when the diet is severely lacking in calories.
- Weight falls to 60% of normal for sex, height, and age.
- Growth retardation and loss of muscle mass and subcutaneous fat as a result of catabolism and depletion of the somatic protein compartment
Marasmus
TYPES OF SEVERE ACUTE MALNUTRITION
Manifestations include:
- Emaciated extremities
- Head appearing too large for the body
- Anemia
- Multivitamin deficiencies
- Defects in T cell immunity making them prone to infections
Marasmus
TYPES OF SEVERE ACUTE MALNUTRITION
- Occurs when protein deprivation is relatively greater than
the reduction in total calories. - Marked protein deprivation is associated with severe loss of the visceral protein compartment, and the resultant hypoalbuminemia gives rise to generalized or dependent
EDEMA.
Kwashiorkor
TYPES OF SEVERE ACUTE MALNUTRITION
- Characteristic skin lesions with alternating zones of hyperpigmentation, desquamation, and hypopigmentation, giving a “flaky paint” appearance.
- Hair changes includes loss of color or alternating bands of pale and darker colors, straightening, fine texture, and loss of firm attachment to the scalp.
Kwashiorkor
TYPES OF SEVERE ACUTE MALNUTRITION
- Other findings include:
o enlarged fatty liver
o apathy
o listlessness
o loss of appetite - This is the most common form of severe acute malnutrition among African children who have been fed a carbohydrate-rich diet.
Kwashiorkor
Enumerate the Eating Disorders
- Anorexia Nervosa
- Bulimia
EATING DISORDERS
- self-induced starvation, resulting in marked weight loss.
- It has the highest death rate of any psychiatric disorder.
Anorexia Nervosa
EATING DISORDERS
- Binge eating is the norm.
- They eat large amounts of food, principally carbohydrates, which are ingested, followed by induced vomiting.
- The problem here is that the stomach acid can go up to the esophagus and teeth, which can cause an injury.
Bulimia
VITAMIN DEFICIENCIES
important to maintain normal vision, regulation of cell growth an ddifferentiation, and regulation of life and metabolism
Vitamin A
VITAMIN DEFICIENCIES
name given to a group of related compounds that include retinol, retinal, and retinoic acid, which have similar biologic activities
Vitamin A
VITAMIN DEFICIENCIES
Sources of this vitamins comprise of:
- dairy
- oats
- carrots
- bread
- sweet potatoes.
Greatest sources include
- beef kidneys
- liver
- cod liver oil
- chicken liver
Vitamin A
VITAMIN DEFICIENCIES
Vitamin A deficiency occurs worldwide either as a
consequence of?
primary malnutrition or secondary to conditions that cause malabsorption of fats
VITAMIN DEFICIENCIES
Vitamin A deficiency manifestation:
- Xeropthalmia
- Xerosis conjunctiva
- Bitot spots
- Keratomalacia
A. dryness of the conjunctiva
B. buildup of keratin debris in small
opaque plaques
C. dry eyes - most devastating change
D. softening & destruction of the
cornea
- C
- A
- B
- D
VITAMIN DEFICIENCIES
Vitamin A is also good for skin. However, excessive use, such as using too many ____ and ____ treatments can lead to toxicity.
retinol products and isotretinoin
VITAMIN DEFICIENCIES
- Made from sunlight exposure.
- The major function is the maintenance of adequate levels of calcium and phosphorus to support metabolic functions.
Vitamin D
VITAMIN DEFICIENCIES
Vitamin D deficiency is called what in children and adult?
Children - Rickets
Adults - Osteomalacia
VITAMIN DEFICIENCIES
Vitamin D Deficiency
Manifestations include:
- Craniotabes (infants)
- Frontal bossing, squared appearance to the head (infants)
- Rachitic rosary (beading of the ribs)
- Pigeon breast deformity
- Lumbar lordosis
- Bowing of legs
VITAMIN DEFICIENCIES
In children, hypervitaminosis D may take the form?
metastatic calcifications of soft tissues such as the kidney
VITAMIN DEFICIENCIES
In adults, hypervitaminosis D it causes?
bone pain and hypercalcemia
VITAMIN DEFICIENCIES
The toxic potential of vitamin D is so great that in sufficiently large doses, it is a?
potent rodenticide
VITAMIN DEFICIENCIES
Prolonged exposure to normal sunlight does not produce
an excess of vitamin D, but ____ of orally administered vitamin can lead to hypervitaminosis
Megadoses
VITAMIN DEFICIENCIES
Vitamin C is also known as?
Ascorbic Acid
VITAMIN DEFICIENCIES
A deficiency of water soluble vitamin C leads to the development of?
Scurvy
characterized principally by bone disease in growing children and by hemorrhages and and healing defects in children & adults.
VITAMIN DEFICIENCIES
A person who has scurvy will have ____ when they brush their teeth
bleeding gums
VITAMIN DEFICIENCIES
TOF
The popular notion that megadoses of vitamin C protect against the common cold, or at least allay the symptoms, has not been borne out by controlled clinical studies
T
familliarize the table for virtamins and trace elements thank yew
facts
defined as an accumulation of adipose tissue that is of sufficient magnitude to impair health
Obesity
Obesity is associated with several of the most important diseases of humans, including ?
- Type 2 diabetes,
- dyslipidemia
- cardiovascular disease
- hypertension
- cancer
CLINICAL CONSEQUENCES OF OBESITY
- Insulin resistance & hyperinsulinemia
- Hypertriglycidemia & low HDL cholesterol levels
- Nonalcoholic fatty liver disease
- Cholelithiasis (gallstones)
- Obstructive sleep apnea
- Predisposing factor for osteoarthritis
- Increased incidence of certain cancers in overweight people, including cancers of the esophagus, thyroid, colon, and kidney in men and cancers of the esophagus, endometrium, gallbladder, and kidney in women
TOF
Diet is linked to cancer
TRUE
With respect to carcinogenesis, three aspects of the diet are of major concern, what are those?
- The context of exogenous carcinogens
- The endougenous syntehesis of carinigens from dietary components
- The lack of protective factors like vitamins C & E, betacarotene, and selenium
DIET AND CANCER
The context of exogenous carcinogens
It is involved in the development of hepatocellular carcinoma.
Aflatoxin