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Preventive and social medicine > Test 1 - Nutrition > Flashcards

Test 1 - Nutrition Flashcards

1
Q

nutrition

A

science of food and it’s relationship with health

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2
Q

nutrients - role

A

body growth
development
maintenance

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3
Q

nutrient/ food factor

A

specific dietary constituent

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4
Q

dietetics

A

planning of meal for:
well
sick

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5
Q

good nutrition:

A

maintain nutritional status - enable
growth
good health

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6
Q

five sections of nutrition

A 
dietary constituents
nutritional requirement
assessment of nutritional status
nutritional problems in public health
nutritional programme in india
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7
Q

vitamins and essential amino acids discovered by

A

1950

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8
Q

roots of nutrition

A

physiology

biochemistry

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9
Q

international activities in field of nutrition initiated by

A

League of nations
FAO
WHO
UNICEF

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10
Q

nutrition is associated with

A 
infection
immunity
fertility
maternal health
family health
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11
Q

science of nutrition

A

laboratory testing

epidemiology

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12
Q

concepts of nutrition epidemiology

A
  1. epidemiological assessment of nutritional status of communities
  2. nutritional surveys
  3. dietary surveys
  4. nutritional surveillance
  5. nutritional and growth monitoring
  6. nutritional rehabilitation
  7. nutritional indicators
  8. nutritional intervention
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13
Q

use of epidemiological factors in

A
  1. elucidation of disease
  2. aetiology
  3. identification of risk factors for disease
    planning and evaluation of nutritional programmes
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14
Q

cornerstone of socio-economic development

A

nutrition

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15
Q

nutritional factors affects

A
  1. education
  2. demography
  3. agriculture
  4. rural development
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16
Q

how to tackle nutritional problems

A

intersectoral and integrated approach of sectors of development

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17
Q

8 elements of primary health care (HEALTH FOR ALL)

A
  1. food supply and promotion of proper nutrition
  2. education about prevailing health problems and how to control and prevent them
  3. adequate supply of water and basic sanitation
  4. maternal and child health and family planning
  5. immunization against infectious disease
  6. prevention and control of endemic disease
  7. treatment of common infections
  8. essential drugs
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18
Q

HEALTH FOR ALL

A

monitored by nutritional indicators

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19
Q

how to promote health and nutritional status of families and communities

A
  1. integrate nutrition in primary health care systems

2. formulate national dietary goals

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20
Q

classification of foods - ways

A
  1. by origin
  2. by chemical composition
  3. predominant function
  4. nutritive values
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21
Q

classification of food by origin

A
  1. animal origin

2. plant origin

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22
Q

classification of food by chemical composition

A
  1. proteins
  2. carbohydrates
  3. minerals
  4. fats
  5. vitamins
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23
Q

classifications of food by predominant function

A
  1. body building foods
  2. energy giving food
  3. protective food
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24
Q

body building food

A
  1. milk
  2. meat
  3. poultry
  4. fish
  5. eggs
  6. pulses
  7. nuts
  8. oil seeds
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25
Q

energy giving foods

A
  1. cereals
  2. sugars
  3. roots and tubers
  4. fats
  5. oils
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26
Q

protective food

A
  1. vegetable
  2. fruits
  3. milk
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27
Q

classification by nutritive values

A
  1. cereals and millets
  2. pulses (legumes)
  3. vegetables
  4. nuts and oilseeds
  5. fruits
  6. animal foods
  7. fats and oils
  8. sugar and jaggery
  9. condiments and spices
  10. miscellaneous foods
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28
Q

nutrients

A

organic and inorganic complexes in the food - have specific function

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29
Q

number of nutrients

A

about 50

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30
Q

types of nutrients

A
  1. macronutrients

2. micronutrients

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31
Q

macronutrients are also called

A

proximate principles (because they form the bulk of food)

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32
Q

examples of macronutrients

A

proteins, carbohydrates and fats

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33
Q

In india - contribution of protein in total energy intake

A

10-15 per cent

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34
Q

In india - contribution of fats in total energy intake

A

15- 30 per cent

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35
Q

In india - contribution of carbohydrate in total energy intake

A

50-80 percent

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36
Q

Micronutrients

A

vitamins and minerals

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37
Q

Micronutrients- etymology

A

because these are required in small amounts (fraction of a milligram to several grams)

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38
Q

Protein - derivation

A

that which is of first importance

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39
Q

proteins - chemical structure

A

complex, organic, nitrogenous (carbon, hydrogen, nitrogen (16%), oxygen and sulphur- phosphorus, iron, etc)

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40
Q

protein % of body

A

20%

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41
Q

Amino acids

A

make up protein (required for synthesis of tissue protein)

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42
Q

number of amino acids needed by the body

A

20

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43
Q

essential amino acids -number

A

9

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44
Q

essential amino acids- definition

A

amino acids that the body cannot synthesize in amounts corresponding to its needs and therefore they are obtained from the dietary proteins

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45
Q

essential amino acids - names

A

leucine, isoleucine, methionine, lysine, phenylalanine, threonine, vaine, tryptphan, histidine (PVT TIM HALL)

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46
Q

non essential amino acids

A

alanine, arginine, asparagine, glutamic acid, cysteine, aspartic acid, glutamine, glycine, proline, serine

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47
Q

arginine

A

essential during development stage

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48
Q

tryptophan

A

forms niacin

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49
Q

methionine

A

methyl group donor- synthesis of

  1. choline
  2. folates
  3. nucleic acids
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50
Q

amino acids essential for premature babies

A

cysteine and tyrosine

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51
Q

biologically complete protein

A

those which contain all the essential amino acids in amounts corresponding to human needs

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52
Q

quality of proteins depend on

A

pattern of amino acid
(pattern of amino acids of milk and egg are considered most suitable for humans and therefore these proteins are of superior quality)

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53
Q

functions of proteins

A
  1. repair and maintenance of body tissue
  2. body building (especially in infants and small children)
  3. maintenance of osmotic pressure
  4. synthesis of certain substances like antibodies, plasma proteins, coagulation factors, hormones, enzymes, hemoglobin
  5. supply energy when calorie intake is inadequate - 4 kcal per gram
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54
Q

protein energy malnutriton - features

A

CMI and bactericidal activity of leucocytes is lowered

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55
Q

dietary source of proteins

A
  1. animal source (complete proteins)

2. vegetable source

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56
Q

best food protein

A

egg protein

  • high biological value
  • high digestibility
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57
Q

reference protein- in nutritional studies

A

egg protein

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58
Q

main source of proteins in india

A

cereals and pulses - because they are cheap and easily available

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59
Q

cereal proteins are deficient in

A

lysine and threonine

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60
Q

pulse proteins are deficient in

A

methionine

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61
Q

limiting amino acids

A

if a diet is inadequate in any essential amino acids, the protein synthesis cannot proceed beyond the rate at which that amino acid is available. that amino acid is called the limiting amino acid

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62
Q

supplementary action of proteins

A

combination of food eaten together (example rice and dhal)

  • their protein content supplement each other
  • provide nutrition comparable to animal proteins (in respect of essential amino acids)
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63
Q

advantages of supplementary action of proteins - for vegetarians

A

he can get

  • high grade proteins
  • at low cost
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64
Q

protein metabolism

A

-not stored like fats
- replaced everyday
- break down and utilization occurs
turnover rate varies from tissues to tissues
- 1-2% of body protein replacement per day
- pattern of specific protein and amount of protein - maintained constant

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65
Q

evaluation of proteins

A
  • amount of amino acids
  • digestibility
  • suitability
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66
Q

parameters for evaluation of proteins

A
  • estimation of biological value
  • digestibility coefficient
  • protein efficiency ratio
  • net protein utilization
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67
Q

net protein utilization

A

product of biological value and digestibility coefficient divided by 100

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68
Q

net protein utilization - definition

A

it is the

  • proportion of ingested protein
  • that is retained in the body
  • under specified condition
  • for the maintenance and growth of the body tissue
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69
Q

essentiality of nutrient is measured by the -

A

growth

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70
Q

tests to assess state of protein nutrition

A
  1. arm muscle circumference
  2. creatinine height index
  3. serum albumin and tranferrin
  4. total body nitrogen
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71
Q

best measure of state of protein nutrition

A

serum albumin concentration

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72
Q

liver’s ability to sythesise protein measured by

A

serum albumin and serum transferrin levels

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73
Q

indian medical council of medical research

A

recommends the daily requirement of nutrients

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74
Q

Fats - solid at

A

20 degrees celsius

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75
Q

oils -

A

liquid at 20 degrees C

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76
Q

Fats and oils -

A

concentrated source of energy

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77
Q

classification of fats

A
  1. simple lipids (triglycerides)
  2. compounds (phospholipids)
  3. derived (cholesterols)
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78
Q

fats that can be synthesised endogenously

A

triglyceride

cholesterol

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79
Q

fat storage

A

99% in adipose tissues as triglyceride

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80
Q

adipose tissue - % of body weight

A

10-15%

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81
Q

1 kg of adipose tissue =

A

7700 kcal of energy

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82
Q

fatty acids + glycerol

A

formed by fat hydrolysis

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83
Q

types of fatty acid

A
  1. saturated (hydrogenated)

2. unsaturated - have double bonds

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84
Q

saturated fatty acids

A

in animal fats

lauric, palmitic, stearic acids

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85
Q

unsaturated fatty acids

A
  1. monounsaturated

2. polyunsaturated

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86
Q

monounsaturated fatty acids

A

oleic acid

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87
Q

polyunsatured fatty acids

A

in vegetable oils

alpha-linolenic, linoleic acids

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88
Q

essential fatty acids

A
  1. linoleic acid- most important
  2. linolenic
  3. arachidonic acid
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89
Q

coconut and plam oils

A

saturated fatty acids

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90
Q

fish oils -

A

poly and mono unsaturated fatty acids

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91
Q

high medium chain SFA -

A

coconut, palm kernels, butter ghee

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92
Q

high SFA

A

palmolein

93
Q

high MUFA and moderate LA

A

ground nut, rice bran, sesame

94
Q

high LA

A

cotton seed, corn, safflower, sunflower

95
Q

LA and ALA

A

soyabean, canola, mustard, flax seed

96
Q

high TFA -

A

vanaspati

97
Q

linoleic acid-

A

vegetable oils

  1. safflower
  2. corn oil
  3. sunflower
  4. soyabean
  5. sesame
  6. groundnut
  7. mustard
  8. palm
  9. cocunut
98
Q

arachidonic acid

A

meat, eggs, milk

99
Q

linolenic acid

A

soyabean oils

leafy greens

100
Q

eichosapentaenoic acid

A

fish oils

101
Q

essential fatty acids -

A

linoleic, linolenic, arachidonic, eichosapentaenoic acid

102
Q

animal fats

A

saturated - ghee, butter, cheese, eggs, fat of meat and fish

103
Q

cord liver oil and sardine - sat/unsat?

A

Saturated

104
Q

vegetable fats

A 
plant seeds 
ground nut
mustard
sesame
coconut
105
Q

other sources - invisible fats

A

cereals
pulses
nuts
vegetables

106
Q

invisible fats

A

not visible to naked eye (in cereals and pulses)

- contribute to the major portion of fat intake

107
Q

visible fats

A

separated from their natural sources- ghee (from milk), cooking oil (from seeds)

108
Q

visible fat - measurement

A

easy to estimate the daily intake

109
Q

good source of unsaturated fatty acids

A

edible plant products

110
Q

cereals, millets and oil seeds

A

linoleic

111
Q

soyabean, mustard, flaxseeed

pulses, legumes, green leafy

A

linoleic and ALA

112
Q

cholesterol source

A

animal foods like butter, ghee, whole milk cream, fatty cheese, fatty meats

113
Q

high saturated fatty acid source

A

animal foods like butter, ghee, whole milk cream, fatty cheese, fatty meat

114
Q

trans fatty acid - natural source

A

animal foods like, butter, ghee, whole milk cream, fatty cheese, and fatty meat

115
Q

long chain PUFA

A

lean meat, poultry meat

116
Q

eggs - fat content

A
  1. cholesterol
  2. LA
  3. ALA
  4. DHA (docosahexanoic acid)
117
Q

fish - fat content

A

PUFA

118
Q

visible fats

A

vegetable oils
ghee
vanaspati

119
Q

commercial food is prepared in which fats?

A

vanaspati - PHVO

120
Q

fats - function - calorie needs

A
  1. high energy foods
  2. 9 kcal per gram
  3. protein sparer
  4. vehicle for fat soluble vitamins
  5. support viscera
  6. insulation against cold
  7. palatability
121
Q

fats -non calorie roles

A
  1. body growth
  2. structural integrity of cell membrane
  3. reduce platelet adhesiveness
  4. reduce serum cholesterol and LDL
  5. PUFA- forms prostaglandins
  6. cholesterol - component of membrane and nervous tissue, form steroid hormones and bile acids
122
Q

hydrogenation of vegetable oils

A
  1. under optimum temperature
  2. under optimum pressure
  3. presence of catalyst
  4. VANASPATI is formed (semi solid - solid fat)
  5. unsaturated fatty acids are converted into saturated fatty acids
  6. EFA is reduced
123
Q

vanaspati - fortification

A

vit D -175 IU per 100 gm

vit A - 2500 IU per 100 gm

124
Q

advantage vanaspati

A
  1. ghee like consistency

2. keeping quality good even in humid climate

125
Q

trans fatty acids

A
  1. formed by partial hydrogenation of polyunsaturated fatty acids - also remove the critical double bonds of EFA - hence harmful
  2. geometrical isomers of cis unsaturated fatty acids with saturated fatty acid like configuration
126
Q

trans fatty acids - shelf life

A

increased

127
Q

trans fatty acid - pathogenic potential

A
  1. atherogenic
  2. risk of CAD increased
  3. increase LDL
  4. decrease HDL
128
Q

trans fatty acid- elimination

A

years

129
Q

refining of oils

A

treatment with steam, alkali etc.

130
Q

refined and deodourized oil - advantage

A
  1. improves taste and quality
  2. remove free fatty acid
  3. remove rancid materials
131
Q

diseases of disturbances of fat metabolism

A
  1. obesity
  2. phrenoderma
  3. CAD
  4. cancer
  5. others like kwashiorkor
132
Q

obesity (fat and disease)

A

30% increase in adipose tissue

133
Q

phrenoderma- pathology- (fat and disease)

A

EFA deficiency

  1. rough dry skin
  2. horny papular erruptions- posterior, lateral aspects of limbs and back, buttocks
134
Q

phrenoderma - treatment

A

linseed, safflower oil along with B complex

135
Q

CAD - (fat and disease)

A

> 40% fats in the diet

especially saturated fats

136
Q

cancer- (fat and disease)

A

colon cancer

breast cancer

137
Q

kwashiorkor ? (fat and disease)?

A

skin lesions like in EFA deficiency

138
Q

WHO/FAO expert group pf diet, nutrition and prevention of chronic diseases - endorse

A

qualitative composition of fats in diet - significant role in CVD pathogenesis

139
Q

WHO/FAO expert consultation of fats and fatty acids on 2008 Geneva, Switzerlands

A

reviewed

  1. scientific evidence on nutrient intake values for total fats and fatty acids
  2. assessed the risk to adequate growth, development and maintenance of health
  3. provided recommendations to different groups
140
Q

WHO/FAO expert consultation of fats and fatty acids- consultations and recommendations

A
  1. energy balance is critical to maintain healthy body weight and ensuring optimal nutrient intake
  2. 6% PUFA recommendation - lower LDL, cholesterol, and CHD risk; increasing HDL
  3. n-3 PUFA - prevent CHD- other degenerative diseases of aging
  4. no need to recommend specific n-6- n-3 ratio or LA to ALA ratio - consdiering both of them are in recommended doses
  5. attention for - replacement of TFA
141
Q

replacing SFA with PUFA/MUFA

A

decrease LDL
decrease total/ HDL ratio
decrease CHD risk

142
Q

replacing SFA with carbohydrate

A

decrease LDL, HDL

143
Q

replacing SFA with TFA

A

decrease HDL

increase total/HDL ratio

144
Q

replacing carbohydrates with MUFA

A

increases HDL

145
Q

minimum intake levels of LA

A

2.5% E

146
Q

minimum intake levels of of ALA

A

0.5 % E

147
Q

choice of cooking oil

A
  1. limit butter/ghee use
  2. avoid PHVO/ use its replacment
  3. correct combination of oils
148
Q

oil containing LA + oil containing both LA and ALA

A
  1. groundnut/sesame/rice bran/cottonseeds +mustard/rapeseed
  2. groundnut/sesame/rice bran/cottonseeds + canola
  3. groundnut/sesame/rice bran/cottonseeds + soyabean palmolein + soyabean
  4. safflower/sunflower + palm oil/ palmolein + mustard/rapeseeds
149
Q

oil containing high LA + oil containing moderate to low LA

A
  1. sunflower/safflower + palmolein/palm oil/olive

2. sunflower/safflower + ground nut/sesame/rice bran/ cotton seeds

150
Q

frying oil - home- single

A

high thermal stability - palm oil/palmolein, sesame, rice bran, cotton seeds

151
Q

frying oil- commerical - blends

A

palm oil/palmolein, sesame, rice bran, cotton seeds

152
Q

RDA fats - takes in account

A
  1. total fat
  2. individual fatty acids
  3. health promoting non glyceride components
  4. age group and condition like foetus, pregancy, lactation, energy deficiency and non communicable diseases
153
Q

main source of energy

A

carbohydrate (4 kcal per gram)

154
Q

functions of carbohydrate

A
  1. source of energy
  2. oxidation of fats
  3. aa synthesis
155
Q

sources of carbohydrate

A

sugar, starch, cellulose

156
Q

starch source

A
  1. cereals
  2. roots
  3. tubers
157
Q

sugars - types

A

monosacchride

disaccharide

158
Q

carbohydrate reserve

A

500g

159
Q

sources other than carb reserve for glucose homeostasis

A

protein, glycerol

160
Q

glycaemic index

A

AUC - area under two hour blood glucose response curve following 50 g test carbohydrate as a % of AUC of the standard (white bread/glucose)

161
Q

sugar

A

soluble

easily assimilate

162
Q

high glycaemic foods

A

readily digestible

absorbable sugar

163
Q

low glycaemic foods

A

foods favouring slow release and absorption of sugar in small intestine (reduced peak, prolonged action)

164
Q

low GI- 55 and less

A 
most fruits and vegetables
whole grains
pasta
beans
lentils
165
Q

medium GI -

A

56-69
sucrose
basmati rice
brown rice

166
Q

high GI

A 
70 or more 
corn flakes
jasmine rice
baked potatoes
white bread
candy bars
syrupy foods
167
Q

dietary fibers

A
  • remnants
  • of edible parts of plants
  • and analogous carbohydrates
  • that are resistant to digestion and absorption in the human small intestine
  • with complete or partial fermentation in the human large intestine
168
Q

dietary fibers - examples

A
  1. oligosaccharides
  2. polysacchrides
  3. lignin
  4. organic acid (butyric acid)
  5. polyols (sorbitol)
169
Q

dietary fibers- function

A
  • laxative - softening, increased bulk, frequency, regularity
  • blood cholesterol and glucose attenuation
  • promotes interactions between nutrients
  • changes pattern of bacterial colonies and thus, the fermentative products
  • favours satiety
  • increses transient time in the gut
  • substrate for organic acids and nutraceuticals in gut
170
Q

dietary fibers - classification

A

source - cereal, vegetable, fruits

solubility in water- soluble (partially/ fully), insoluble

171
Q

part of energy from resistance starch made available by

A

bacterial fermentation

172
Q

digestibility of dietary fibers depend on

A
  • physiochemical and structural properties of the fiber
  • process used for digestion
  • enzymes
173
Q

dietary/ crude fiber - old concept

A

all that was insoluble in boiling water, dilute acid and alkali

  • has digestibility
  • can hold water
174
Q

dietary fibers - advantages

A
  • decrease CAD (bind to bile salt- decrease its reabsorption - decrease cholesterol)
  • pectin and gum - reduce post prandial glucose in blood
175
Q

most effective gum

A

fenugreek seed - 40% gum - reduce cholesterol and glucose

176
Q

disadvantage of fibers

A

may decrease vitamin and mineral (Ca, Mg, Iron, Zn) absorption

177
Q

vitamins

A

essential nutrients

  • fat soluble- A, D, E, K
  • water soluble
178
Q

vitamin A- constitute of

A

retinol pre-formed v

beta carotene - pro-v - converted to retinol in intestinal mucosa

179
Q

retinol term introduced in (for vitamin A-1 - crystalline form)

A

1960

180
Q

international units for vitamin A

A
  1. 3 micro gram of retinol

0. 55 micro gram of retinol palmitate

181
Q

1mcg of retinol

A

1 Retinol equivalent

182
Q

1 mcg of beta carotene

A

0.167 mcg of Retinol equivalent

183
Q

1 mcg of other carotenoids

A

0.084 mcg of Retinol equivalent

184
Q

1 Retinol equivalent =

A

3.333 IU of vitamin A

185
Q

functions of vitamin A

A
  • retinal pigment- vision in dim light
  • glands and epithelial tissue functioning
  • growth esp. skeletal
  • anti-infective
  • may protect from bronchial cancer
186
Q

vitamin A - sources

A

animal- retinol

palnt - carotene

187
Q

retinol in

A
  • liver
  • eggs
  • butter
  • cheese
  • whole milk
  • fish
  • meat
  • FISH LIVER OILS (used as supplement - richest source)
188
Q

carotene

A
  • spinach
  • amaranth
  • green, yellow fruits
  • carrots
189
Q

conversion of carotene to retinol

A

hindered in malnourishment and diarrheal diseases

190
Q

storage of vitamin A -

A

retinol palmitate - in liver - reserve 6-9 months

191
Q

retinol is toxic - how is it transported in blood

A

by binding to a retinol binding protein (produced by liver)

192
Q

vitamin A deficiency causes -

A

xeropthalmia - dry eye

  • night blindness
  • conjunctival xerosis
  • bitot’s spot
  • corneal xerosis
  • keretomalacia
193
Q

night blindness

A

failure to dark adaptation

194
Q

conjunctival xerosis

A
  • conjuctiva - dry, non wettable, muddy, wrinkled (normal is smooth and shiny)

EMERGING LIKE SAND BANKS AT RECEDING TIDES when child ceases to cry

195
Q

bitot’s spots

A
  • triangular
  • pearly white or yellowish, foamy, either side of cornea
  • bilateral
196
Q

corneal xerosis

A

cornea - dry, dull, non wettable, eventually opaque

ulceration, corneal scar

197
Q

keratomalacia

A

liquefaction of cornea

- cornea is soft - may brust

198
Q

extra ocular manifestation of vitamin A deficiency

A
  • child mortality
  • infections
  • follicular hyperkeratosis
  • anorexia
  • growth retardation
199
Q

treatment - vitamin A deficiency

A

200,000 IU or 110 mg of vitamin A orally on two successive days
- vitamin A given to children with corneal ulcers (regardless of vit A deficiency diagnosis)

200
Q

prevention of vitamin A deficiency

A
  • nutrition education
  • improving diet
  • reducing frequency and severity of associated conditions
201
Q

National institute of nutrition at hyderabad - intervention against nutritional blindness (immunisation against xeropthalmia)

A

100,000 IU to children between the age of 6 months to 1 year -
200,000 IU 6 monthly to children between the age of 1 - 6 years -

202
Q

Assessment of vitamin A deficiency

A
  • population survey (6 months to 6 years - special risk groups)
  • clinical and biochemical criteria
203
Q

criteria for assessing xeropthalmia

A 
night blindness 
bitot's spots
corneal xerosis/ corneal ulceration/ keratomalacia
corneal ulcer
serum retinol less than 10 mcg/dl
204
Q

prevalence of xeropthalmia features in preschool and children upto 6 years

A 
night blindness - >1 %
bitot's spots- > 0.5%
corneal xerosis/ corneal ulceration/ keratomalacia - > 0.01%
corneal ulcer - > 0.05%
serum retinol less than 10 mcg/dl- >5%
205
Q

RDA of vitamin A

A

adults- 600 mcg

> 50% from animal sources

206
Q

conversion ratio of carotene to retinol

A

1:8 - current

older - 1:4

207
Q

RDA - retinol - man

A

600 mcg

208
Q

RDA - retinol - woman

A

600 mcg

209
Q

RDA - retinol - pregnancy

A

800 mcg

210
Q

RDA - retinol- lactation

A

950 mcg

211
Q

RDA - retinol - infant

A

350 mcg

212
Q

RDA - retinol 1-6 years

A

400 mcg

213
Q

RDA - retinol - 7-9 years

A

600 mcg

214
Q

RDA - retinol - 10- 17 years

A

600 mcg

215
Q

Vitamin A (retinol) toxicity

A
  • nausea
  • vomiting
  • anorexia
  • sleep disorders
  • skin desquamation
  • enlarged liver
  • papillar edema
  • teratogenic
216
Q

Vitamin D forms

A
  • calciferol (ergosterol from plants)

- cholecalciferol (animal, fish, liver oils) - also made by body (UV lights - five mins per day)

217
Q

Vitamin D storage

A

in fat deposits

liver

218
Q

vitamin D - active metabolites

A

25 HCC
1,25 DHCC

bound to proteins

219
Q

target tissue of vitamin D

A

bone

intestine

220
Q

vitamin D

A

kidney hormone

- not required in diet

221
Q

vitamin D function

A
  • promotes Ca and phosphorous gut absorption
  • reabsorbs phosphates from kidney
  • variable effect on Ca (kidney)
  • bone mineralisation, reabsorption, collagen maturation
  • growth
222
Q

sources

A 
sunlight (UV light act on 7DHC of skin) 
foods- liver, egg yolk, butter, cheese, some fish, fish liver oil 
human milk 
- fortified
milk
margarine
vanaspati 
infant food
223
Q

deficiency

A
  1. rickets

2. osteomalacia

224
Q

prevention

A
  1. nutritional education
  2. sunlight exposure
  3. prophylaxis with vitamin D
  4. fortification
225
Q

daily requirement

A

ICMR

400 IU or 10 mcg - in case of minimal exposure

226
Q

toxicity - due to hypercalcemia

A 
nausea
vomiting
anorexia 
thirst
drowsiness
cardiac arrhythmias
renal failure 
coma
227
Q

rickets

A 
vitamin D deficiency
6 months - 2 years - affected age group
- hypocalcemia
1. growth failure
2. bone deformity- curved legs, deformed chest, harrison's sulcus, rickety rosary, kyphoscoliosis 
3. muscular hypotonia 
4. tetany
5. convulsions 
- elevated ALP
- milestones like walking and teething - delayed
228
Q

osteomalacia

A

vitamin D deficiency
in women
esp pregnant or lactating

Preventive and social medicine (13 decks)

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