SM_144b: Nutrition

Question 1

Vitamins are ____

Answer 1

Vitamins are organic compounds involved in the release of energy from carbohydrates, fats, and proteins

• Natural component of foods: usually present in minute amounts
• Do not yield energy themselves
• Cannot substitute for each other
• Are not synthesized by the body in amounts adequate to meet physiological needs

Question 2

Most nutrients are absorbed in ____

Answer 2

Most nutrients are absorbed in the first 100-150 cm of the small intestine

Question 3

____ is a common dietary therapy in patients with eosinophilic esophagitis

Answer 3

Six food elimination diet is a common dietary therapy in patients with eosinophilic esophagitis

Question 4

Describe nutrient deficiencies in eosinophilic esophagitis

Answer 4

Nutrient deficiencies in eosinophilic esophagitis

Question 5

Celiac disease is an ____ with a ____ haplotype, environmental trigger of ____, and autoantigen of ____

Answer 5

Celiac disease is an autoimmune related enteropathy with a positive DQ2/DQ8 haplotype, environmental trigger of gluten, and autoantigen of tissue transglutaminase

(gluten-free diet is the treatment)

Question 6

In a patient with celiac disease, villi ____, so ____

Answer 6

In a patient with celiac disease, have been damaged by inflammation, so fewer nutrients pass into the bloodstream

Question 7

Medical nutrition therapy of celiac disease involves ____

Answer 7

Medical nutrition therapy of celiac disease involves strict, lifelong gluten free diet

• Eliminate all grains containing wheat, rye, and barley

Question 8

Nutritional complications of celiac disease include ____, ____, ____, ____, ____, and ____

Answer 8

Nutritional complications of celiac disease include iron deficiency anemia, lactose intolerance, osteopenia / osteoporosis, folate deficiency, and B12 deficiency

Question 9

People with IBD, especially Crohn’s disease have low serum levels of ____, ____, ____, and ____

Answer 9

People with IBD, especially Crohn’s disease have low serum levels of iron, B6 / B12, Vitamin D and A, and Zn

Question 10

Zinc deficiency presents as ____, ____, ____, ____, ____, ____, and ____

Answer 10

Zinc deficiency presents as impaired growth, hypogonadism, skin rashes, diarrhea, immune deficiency, hair loss, and anorexia

• Zinc-containing proteins catalyze reactions and have structural and regulatory roles

Question 11

Summarize the role of nutrients in various disorders

Answer 11

Role of nutrients in various disorders

Question 12

Nutrients at risk in normal digestion are ____, ____, and ____

Answer 12

Nutrients at risk in normal digestion are iron, B vitamins, and fat soluble vitamins (A and D)

Question 13

Weight loss GI surgery can result in ____

Answer 13

Weight loss GI surgery can result in iron deficiency

Question 14

Iron deficiency presents with ____, ____, and ____

Answer 14

Iron deficiency presents with hypochromic microcytic anemia, pica, and koilonychia

Question 15

Microcytic hypochromic anemia may result from ____

Answer 15

Microcytic hypochromic anemia may result from iron deficiency

Question 16

Koilonychia (spoon nails) are seen in ____

Answer 16

Koilonychia (spoon nails) are seen in iron deficiency

Question 17

Vitamin D deficiency results in ____ and ____

Answer 17

Vitamin D deficiency results in rickets and osteomalacia

• Function: regulation of Ca and P metabolism in the bone, intestine, and kidney
• Receptors: Vitamin D receptor is present in many cells, Vitamin D affects gene transcription and appears to have a role in cellular proliferation / differentiation

Question 18

Describe biosynthesis and metabolism of Vitamin D

Answer 18

Biosynthesis and metabolism of Vitamin D

Question 19

Vitamin D deficiency presents with ____ and ____

Answer 19

Vitamin D deficiency presents with bony abnormalities (rickets in children, osteomalacia in adults) and muscle weakness/ pain

Question 20

This is ____ due to ____

Answer 20

This is rickets / osteomalacia due to Vitamin D deficiency

Question 21

In LMICs, ____ is the leading cause of preventable blindness in children

Answer 21

In LMICs, Vitamin A deficiency is the leading cause of preventable blindness in children

Question 22

Vitamin A deficiency presents with ____, ____, and ____

Answer 22

Vitamin A deficiency presents with night blindness, conjunctival changes (Bitot spots), and corneal ulceration

• Vitamin A assists with vision and gene expression / cellular differentiation

Question 23

These are ____ caused by ____

Answer 23

These are Bitot’s spots caused by Vitamin A deficiency

• Buildup of keratin - Vitamin A deficiency and drying up of cornea

Question 24

Rice fortified with ____ reduces infant mortality and prevents blindness

Answer 24

Rice fortified with Vitamin A reduces infant mortality and prevents blindness

(recommended to consume 700 ug/day)

Question 25

Thiamine (B1) deficiency results in ____ and \_\_\_\_

Answer 25

Thiamine (B1) deficiency results in beriberi and Wernicke-Korsakoff syndrome * Thiamine diphosphate is a cofactor for a number of enzymes involved in carbohydrates and amino acid catabolism, neurotransmitter formation, and DNA formation including alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase, and transketolase

Question 26

Three forms of beriberi are \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 26

Three forms of beriberi are wet (cardiac), dry (nervous), and Wernicke-Korsakoff (cerebral)

Question 27

Wet beriberi presents with \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 27

Wet beriberi presents with high output heart failure, cardiomegaly, pitting edema, and neuropathy * Mechanisms: peripheral vasodilation, increased cardiac output, kidneys sense volume change (fluid retention), and edema leading to cardiac fall out (tachycardia and venous pressure)

Question 28

Dry beriberi presents with ____ consisting of \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 28

Dry beriberi presents with peripheral neuropathy consisting of foot / wrist drop, loss of deep tendon reflexes, loss of sensation of vibration and joint position, and parasthesias

Question 29

Cerebral beriberi (Wernicke-Korsakoff syndrome) presents with \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 29

Cerebral beriberi (Wernicke-Korsakoff syndrome) presents with ataxia, confusion, impaired memory, confabulation, disordered eye motility, and neuropathy

Question 30

Riboflavin (B2) deficiency presents with \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 30

Riboflavin (B2) deficiency presents with weakness, sore red tongue (magenta tongue), angular stomatitis and cheliosis, and scaly dermatitis

Question 31

Niacin (B3) deficiency results in \_\_\_\_

Answer 31

Niacin (B3) deficiency results in pellagra

Question 32

Magenta tongue and angular stomatitis and cheilosis occur in ____ deficiency

Answer 32

Magenta tongue and angular stomatitis and cheilosis occur in riboflavin (B2) deficiency

Question 33

Folate (B9) deficiency presents with ____ and \_\_\_\_

Answer 33

Folate (B9) deficiency presents with megaloblastic anemia and increased risk of NTDs in kids

Question 34

Vitamin B12 deficiency presents with \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_, and \_\_\_\_

Answer 34

Vitamin B12 deficiency presents with * Megaloblastic anemia * Glossitis * Neuropathy * Parasthesias in feet * Ataxia * Memory impairment * Personality changes

Question 35

Megaloblastic anemia can result from ____ or ____ deficiency

Answer 35

Megaloblastic anemia can result from folate (B9) or cobalamin (B12) deficiency (large immature and dysfunctional RBCs in the bone marrow)

Question 36

\_\_\_\_ may mask symptoms of megaloblastic anemia but not fix the underlying neurological damage

Answer 36

Folic acid supplementation without B12 may mask symptoms of megaloblastic anemia but not fix the underlying neurological damage

Question 37

Ritualistic ice eating occurs in ____ which results from ____ deficiency

Answer 37

Ritualistic ice eating occurs in pica which results from iron deficiency

Question 38

\_\_\_\_ comes from shellfish, meat, nuts, legumes, and dairy products

Answer 38

Zinc comes from shellfish, meat, nuts, legumes, and dairy products

Question 39

\_\_\_\_ comes from meat, poultry, fish, legumes, tofu, and fortified cereal

Answer 39

Iron comes from meat, poultry, fish, legumes, tofu, and fortified cereal

Question 40

\_\_\_\_ comes from fatty fish (e.g. salmon, tuna, mackarel), cod liver oil, fortified foods (e.g. milk, soy milk), and egg yolks

Answer 40

Vitamin D comes from fatty fish (e.g. salmon, tuna, mackarel), cod liver oil, fortified foods (e.g. milk, soy milk), and egg yolks

Question 41

Preformed ____ (retinoids) come from liver, eggs, and dairy products \_\_\_\_ carotenoids (beta-carotene) come from green leafy vegetables, orange and red fruits and vegetables

Answer 41

Preformed Vitamin A (retinoids) come from liver, eggs, and dairy products Provitamin A carotenoids (beta-carotene) come from green leafy vegetables, orange and red fruits and vegetables

Question 42

\_\_\_\_ comes from legumes, yeast, pork, and whole grains

Answer 42

Thiamine (B1) comes from legumes, yeast, pork, and whole grains

Question 43

\_\_\_\_ comes from fortified cereal, milk, eggs, and oily fish

Answer 43

Riboflavin (B2) comes from fortified cereal, milk, eggs, and oily fish

Question 44

\_\_\_\_ comes from meat, fish, legumes, peanuts, cereal, coffee, and tea

Answer 44

Niacin (B3) comes from meat, fish, legumes, peanuts, cereal, coffee, and tea

Question 45

\_\_\_\_ comes from fortified cereal, legumes, greens, and orange juice

Answer 45

Folic acid (B9) comes from fortified cereal, legumes, greens, and orange juice

Question 46

\_\_\_\_ comes from animal products such as seafood, meat, poultry, and dairy products

Answer 46

Vitamin B12 comes from animal products such as seafood, meat, poultry, and dairy products