Test 2 - Nutrition Flashcards
Minerals and vitamins
1
Q
chemical elements in the body
A
more than 50
2
Q
role of chemical elements in our body
A
- growth
- repair
- maintenance of vital body functions
3
Q
groups of major chemical elements in the body
A
- major minerals
- trace elements
- trace contaminants
4
Q
Major minerals
A
calcium phosphorous sodium potassium magnesium
5
Q
trace elements- requirement
A
less than few mg per day
6
Q
trace elements -
A
iron iodine flourine zinc copper cobalt chromium manganese molybednum selenium nickel tin silicon vanadium
7
Q
trace contaminants
A
lead mercury barium boron aluminium
8
Q
vegetarian diet- (deficient minerals
A
bioavailability of iron and zinc is less because of the presence of phytates
9
Q
interference with proper mineral absorption
A
- phytic acid
2. large amount of dietary fibers
10
Q
calcium % in the body weight
A
1.5-2%
11
Q
calcium in average adult
A
1200g
12
Q
% of total calcium which is in bones
A
98%
13
Q
amount of calcium in blood
A
10 mg/dl
14
Q
requirement of calcium by developing foetus
A
30g
15
Q
dynamic equilibrium between blood and bone calcium is maintained by
A
- vit D
- parathryoid hormone
- calcitonin
16
Q
functions of ionised calcium
A
- formation of bone and teeth
- coagulation of blood
- contraction of muscle (cardiac, etc)
- milk production
- relay of electrical and chemical messages from the membrane surface to biochemical machinery inside
- membrane integrity
- enzyme and hormone metabolism
17
Q
sources of calcium
A
- milk
- milk products
- eggs
- fish
18
Q
calcium in one litre of cow’s milk
A
1200mg
19
Q
calcium in one liter of human milk
A
300 mg
20
Q
milk calcium form
A
calcium caseinogenate (easily assimilated by body)
21
Q
dietary source of calcium
A
- green leafy vegetables
- cereals
- millets (ragi, especially )
22
Q
limiting factor in absorption of calcium from green leafy vegetables -
A
oxalic acid in spinach, amaranth form insoluble complex with calcium (oxalate) - interferes with the absorption
23
Q
what food is VERY deficient in calcium
A
rice
24
Q
limiting factor in absorption of calcium from cereals-
A
cereals have phytic acid that forms insoluble compound with calcium (phytate) - interfere with calcium absorption
25
fruit with calcium
sitaphal
26
calcium in water
200 mg/day
27
% absorption of dietary calcium
20-30 % of dietary calcium intake is absorbed
28
calcium absorption is increased by
vit D
| body needs regulate calcium absorption
29
calcium absorption is decreased by
1. phytates
2. oxalates
3. fatty acids
(body needs regulate calcium absorption)
30
calcium related disorders
no clear cut diseases on low calcium intake
| no deleterious effects/ benefits on prolonged excessive intakes
31
RDA calcium - adult
600 mg intake
32
role of phosphorous
1. formation of bone and teeth
| 2. part of ATP - role in all metabolisms
33
adult phosphorous content
400-700g (mostly in bones and teeths)
34
phosphorous in vegetables in combination with
phytins
35
boavailability of vegetable phosphorous
40-60 %
36
phosphrous requirement / P:Ca ratio
1. infancy- 1:1.5
| 2. all other age groups - 1:1
37
sodium in body- location
all body fluids
38
sodium content of the body
100 g
39
source of sodium
1. added as NaCl in foods
40
excretion of sodium
1. sweat
| 2. urine (controlled by kidney)
41
depletion of sodium -
1. muscular cramps
42
requirement of sodium
1. depends on age, climate, occupation
| 2. 5 g per day - on average for adult
43
amount of sodium with hypertensive tendencies
>10 mg
44
potassium in adult human body
250 g
45
role of potassium in body
1. vasoactive
2. increase blood flow
3. sustain metabolic needs of the body
4. K supplements - lower blood pressure
46
release of potassium is by (cell)
endothelial cells
47
desirable Na:K ratio in diet
1:1 (in mmol)
48
magnesium - in body (location)
1. bones
| 2. all cells
49
amount of magnesium in the body
25 g (half of it is in the skeleton)
50
role of magnesium
1. metabolism of calcium and potassium
51
magnesium deficiencies are seen in
1. chronic alcoholism
2. toxemia of pregnancy
3. cirrhosis of liver
4. protein energy malnutrition
5. malabsorption syndromes
52
magnesium deficiency symptoms
1. irritability
2. tetany
3. hyperreflexia
4. sometimes - hyporeflexia
53
vitamin E- other name
tocopherol
54
vitamin E
group of fat soluble vitamins
55
most potent vitamin E
alpha tocopherol
56
vitamin E sources
1. vegetable oil
2. sunflower oil
3. cotton seed
4. egg yolk
5. butter
57
vitamin E - normal plasma level
08-1.4 mg per 100 ml
58
vitamin E requirement
0.8 mg of vit E per gram of essential
59
daily intake of vitamin E- on average is
8-10 mg
60
vit E - toxicity - in vitro
cytotoxic to lymphocytes
61
vitamin E - function
antioxidant
62
forms of vitamin K
K1
| K2
63
vitamin K1 - source
fresh green vegetables (dark green ones)
| some fruits
64
amount of vitamin K in cow's milk
60 mcg /L
65
amount of vitamin K in human milk
15 mcg/L
66
vitamin K2
synthesised by intestinal bacteria
67
intervention by long term antibiotics
1. suppress intestinal bacteria
| 2. cause vit K2 deficiency
68
storage of vitamin K
liver
69
role of vitamin K
1. stimulate coagulation factor production
| 2. stimulate release of coagulation factors
70
vitamin K deficiency
1. prothrombin content of blood is decreased
| 2. blood clotting time is prolonged
71
daily vitamin K requirement
0.03 mg/kg for adult
72
infant vit K deficiency- causes
1. minimal stores of prothrombin
| 2. lack of established intestinal flora
73
infant vit K deficiency - prophylaxis
single
im
vit K (menadione sodium bisulphite - 0.1 -0.2 mg
or 0.5 mg of vit K1)
74
vitamin B1- name/ solubility
thiamine (water soluble)
75
role of vitamin B1
1. essential for utilisation of carbohydrates
2. thiamine pyrophosphate - coenzyme of co-carboxylase - activate transketolase
3. transketolase - enzyme in direct oxidative pathway of glucose
4.
76
thiamine deficiency
1. accumulation of pyruvic and lactic acids in tissues and body fluids
77
sources of thiamine
1. whole grain cereals
2. wheat
3. gram
4. yeast
5. pulses
6. oil seeds and nuts (ground nut esp)
7. meat, fish eggs, vegetables, fruits (smaller amt.)
8. milk (in infants)
78
thiamine source in indian people
cereals (rice, wheat) - 60--85% of total intake
79
thiamine loses - in rice
1. during milling
2. washing
3. cooking
80
rice advice
eschew highly polished rice and eat parboiled or under milled rice
81
thiamine loses in vegetables and fruits
on prolonged storage
82
thiamine is lost in
1. milled rice
2. long stored vegetables and fruits
3. toast
4. baking soda cooked food material
83
deficiency of vitamin B1
1. ber beri
| 2. wernicke's encephalopathy
84
forms of beri beri
1. dry (peripheral neuritis)
2. wet (cardiac)
3. infantile (2-4 months old infants of thiamine deficient mother with peripheral neuropathy)
85
wernicke's encephalopathy
```
in chronic alcoholic/ people who fast
opthalmplegia
polyneuritis
ataxia
mental deterioration
```
86
frank beri beri cases - epidemiology
coastal states - andhra (where people eat polished rice)
87
prevention of beriberi
1. educating people to eat well balanced mixed diet with thiamine rich foods (parboiled and undermilled rice)
2. stop alcohol
3. supplementation of high risk group (eg. lactating mothers)
4. varied diet/ better economic conditions
88
RDA thiamine
30 mg
89
what if we give >30 mg of thiamine in diet
it is lost in urine
90
thiamine supplements are given in
1. patients on regular hemodialysis
91
thiamine prophylaxis is given to
1. patient with persistent vomiting
2. prolonged gastric aspiration
3. patient on long fasts
92
vitamin B2 - name
riboflavin
93
vitamin B2 - role
1. cellular oxidation
2. integrity of mucocutaneous structure
3. co-factor in a number of enzymes involved in metabolism : co-enzyme for glutathione reductase
4. antioxidant activity
5. metabolism of vitamin B6, niacin, vitamin K
94
riboflavin sources
1. milk
2. egg
3. liver, kidney
4. green leafy vegetables
5. meat and fish
Germinated
6. whole and milled cereals
7. pulses
95
main source of ribolflavin in indian diet
cereals (whole and milled) and pulses
96
deficiency of riboflavin
```
1. angular stomatitis in malnourished children
suggestive
2. cheilosis
3. glossitis
4. nasolabial dyssebachia
```
97
hyporiboflavinosis
1. impaired neuromotor functions
2. impaired wound healing
3. susceptibility to cataract
4. impaired utilisation of pyridoxine
98
body stores of riboflavin
not present
99
riboflavin RDA
0.6 mg per 1000 kcal of energy
100
vitamin b3
niacin or nicotinic acid
101
niacin - role
1. metabolism of carbohydrates, fats and proteins
2. normal functions of
- skin
- intestine
- nervous system
102
precursor of niacin
Tryptophan
103
metabolites of niacin
methylated
1. N- methyl nicotinamide
2. N- methyl pyridones
104
sources of niacin
1. liver
2. kidney
3. meat
4. poultry
5. fish
6. legumes
7. ground nut
105
sources of Tryptophan
milk proteins
106
Tryptophan required to make 1 mg of niacin
60 mg
107
unavailable bound niacin
in cereals
108
deficiency of niacin
1. pellagra - diarrhea, dementia, dermatitis
2. glossitis
3. stomatitis
4. mental changes
- depression
- irritability
- delirium
109
dermatitis due to niacin deficiency
1. bilaterally symmetrical
| 2. on sun exposed surface (back of head, lower legs, face and neck)
110
susceptibility of pellagra in population dependent on
maize diet
| jowar ( sorghum vulgare)
111
cause of pellagra
amino acid imbalance with excess of leucine
112
role of leucine in pellagra
excess leucine interfere with conversion of Tryptophan into Niacin
113
prevention of pellagra
1. good mixed diet (milk, meat)
2. avoid total maize and sorghum dependence
3. give modern knowledge anf opportunities
114
niacin - RDA
6 mg / 1000 kcal of energy
115
forms of b6
1. pyridoxine
2. pyridoxal
3. pyridoxamine
116
role of vitamin b6
1. metabolism of amino acids, fats and carbohydrates
117
sources of pyridoxine
1. milk
2. liver
3. meat
4. egg yolk
5. fish
6. whole grain cereals
7. legumes
8. vegetables
118
pyridoxine deficiency
1. peripheral neuritis
119
antagonist of pyridoxine
isoniazid
| give 10 mg / day in patients receiving isoniazid
120
RDA pyridoxine
adults - 2 mg / day
| pregnancy and lactation - 2.5 mg / day
121
vitamin b5
pantothenic acid
122
niacin metabolites excretion
in urine
123
pantothenic acid - RDA
10 mg
124
pantothenic acid - body levels/ form
18-35 mg / 100 ml
| as coenzyme A in cells
125
source of pantothenic acid
all foods
126
NPU egg
100
127
role of pantothenic acid
1. normal adrenal cortex functioning and corticosteroids biosynthesis
128
daily excretion of pantothenic acid
3 mg in urine
129
dietary antioxidants
1. nutrients
| 2. non nutrients
130
nutrient antioxidants
1. vitamin E
2. vitamin C
3. beta carotene
4. selenium
131
non- nutrient antioxidants
1. plant phenols
2. flavonoids
3. caffeine
4. coumarins
5. benzyl isothiocyanate
6. ferrulic, gallic and ellagic acid
7. super oxide dismutase
8. catalase superoxide mutase
9. coenzyme Q
10. glutathiones
132
role of antioxidants
1. reduce the effect of ROS and nitrogen species that causes oxidation damage
133
reactive oxygen species- causes
1. ageing
| 2. diet/ nutrient related chronic disorders due to ROS exposure
134
sources of antioxidants
1. tea and wine
2. vegetables
3. fruits
4. legumes
5. spices
6. cereals
135
evidence for the protective role of antioxidants in
1. fruits
| 2. vegetables
136
ROS - role
accumulate with age
1. damage the biomolecules
2. affect enzyme processes
3. affect the genetic machinery
137
diseases caused by ROS
1. cardiovascular
2. cataract
3. cancer
4. diabetes
5. neurodegenerative disorders
6. age related masculopathies
138
sources of ROS
1. endogenous - neutrophils etc, during tissue metabolism
| 2. exogenous
139
RDA antioxidants
500-600 gm/d
- prevent damage
- cause repair
140
high risk of oxidative damage is in
1. geriatric groups
2. premature infants
3. those doing strenous activities
4. smokers
5. alcoholics
6. exposed to environmental pollutants
7. chronic infections
141
Molybdenum - excessive
bony deformities
142
molybdenum - deficiency
1. esophageal and mouth cancers
143
first selenium deficiency reported in
1961/ 67
144
selenium in kwashiorkor
significant weight increase
145
selenium deficiency is seen in
protein energy malnutrition
146
selenium deficiency + vit E deficiency
decrease antibody production
147
chromium content of body
<6 mg
148
chromium - role
1. role in insulin and carbohydrate funtion
| unusual glucose tolerance curve that responds to chromium
149
cobalt - role
1. present preformed in B12
2. helps in capture of iodine by gland for thyroid hormone production
3. interact with iodine and affect its utilisation
150
cobalt deficiency causes
goitre
151
cobalt-iodine ratio - role
in pathogenesis of goitre
152
amount of copper in body
100-150 mg
153
hypocupermia is seen in
1. nephrosis
2. wilson's disease
3. infants fed cow's milk
4. protein energy malnutrition
154
deficiency of copper
1. neutropenia
155
hypercupermia
1. excessive intake of copper - food cooked in copper vessel
2. severe acute and chronic infections
- hodgkin's disease
- severe anemia
- haemochromatosis
- myocardial infarction
- hyperthyroidism
156
RDA copper
2 mg per day
157
folic acid names
recommended name - folate
alternative name - folacin
pharmaceutical preparation - folic acid
158
forms of folates
1. free form
| 2. bound form
159
absorption of free folate
rapid - from proximal part of small intestine
160
role of folic acid
1. synthesis of nucleic acid
| 2. normal development of blood cells in marrow
161
folic acid - etymology
folia (latin)- leaf
162
sources of folic acid
1. liver
2. meat
3. dairy product
4. eggs
5. milk
6. fruits
7. cereals
8. leafy vegetable
163
overcooking of food
folic acid is destroyed
164
deficiency of folic acid in babies
given milk food subjected to heat sterilization
165
causes of deficiency of folic acid
increased demand
1. pregnancy
2. lactation
3. taking folate antagonist
- alcohol
- pyrimethamine
- cotrimoxazole
166
deficiency of folic acid causes
1. megaloblastic anemia
2. glossitis
3. cheiilosis
4. gastrointestinal disturbances
- diarrhea
- distension
- flatulence
5. infertility
6. sterility
7. abortion
8. congenital malformations
167
diagnosis of folate deficiency
microbiological assay
measuring folate levels
- serum
- red blood cell
168
body stores of folate
5-10 mg
169
requirement of folate - conditions
1. rapid cell multiplication
- growth
- pregnancy
170
folates supplementations in pregnancy
1. decrease the incidence of low birth weight babies
| 2. increase weight of infants
171
healthy adults - folate intake values recommended by ICMR(2010)
200 mcg per day
172
pregnancy - folate intake values recommended by ICMR(2010)
500 mcg per day
173
lactation - folate intake values recommended by ICMR(2010)
300 mcg/ day
174
children - folate intake values recommended by ICMR(2010)
80- 120 mcg / day
175
vitamin B12 - structure
complex organo metallic compound with cobalt
176
therapeutic preparation of vitamin B12
cyanocobalamine
177
role of vita B12
1. synthesis of DNA
| 2. synthesis of fatty acids in myelin
178
deficiency of B12
1. megaloblastosis
2. megaloblastic anemia (pernicious anemia)
3. demyelinating neural lesions in spinal cord
4. infertility in animal species
179
physiological absorption of B12 - require
intrinsic factor released from stomach
180
absorption of B12 occurs at
terminal ileum
181
sources of Vitamin B12
1. liver
2. kidney
3. meat
4. fish
5. eggs
6. milk
7. cheese
8. colon bacteria
182
vitamin B12 - heat stability
heat stable
183
storage of Vit B12
liver - 2mg
| other body parts- 2 mg
184
B12 stores - lasts for
1-3 years
185
B12 deficiency in india
sub- clinical
| >30% - in adults and children
186
reason for B12 deficiency
large proportion of population depends on vegetable diet
187
normal adults - vitamin b12 intake values recommended by ICMR(2010)
1 mcg per day
188
pregnancy - vitamin b12 intake values recommended by ICMR(2010)
1.2 mcg per day
189
lactating - vitamin b12 intake values recommended by ICMR(2010)
1.5 mcg per day
190
infants and children - vitamin b12 intake values recommended by ICMR(2010)
0.2 mcg per day
191
Vitamin C- heat sensitivity
most
192
animals that require Vitamin C
1. man
2. monkey
3. guinea pig
193
vitamin C - name
ascorbic acid
194
vitamin C - solubility
water soluble
195
functions of vitamin C
1. potent anti oxidant - tissue oxidation
| 2. synthesis of collagen
196
collagen - content of the body
25% of total body proteins
197
functions of collagen
1. provide supporting matrix for blood vessels and connective tissue
2. bones and cartilage require collagen
3. reduce ferric iron to ferrous iron (facilitates absorption of iron from vegetables)
4. inhibits nitrosamine formation by the intestinal mucosa
5. unporved - common cold and infection remedy
198
vitamin C deficiency causes
1. local hemorrhages
2. easy fractures
3. scurvy (swollen and bleeding gums)
4. sub cutaneous, bruising and bleeding into the skin or joints
5. delayed wound healing
6. anemia
7. weakness
199
sources of vitamin C
1. fresh fruits
2. green leafy vegetables
3. traces in fresh meat and fish (sometimes cereals)
4. germinating pulses
5. root s and tubers (small amt.)
6. amla
7. guavas
200
Amla - amount of vitamin C
600 mcg/100g
201
Guava - amount of vitamin C
212 mcg/100g
202
lime - amount of vitamin C
63 mcg/100g
203
orange - amount of vitamin C
30 mcg/100g
204
tomato - amount of vitamin C
27 mcg/100g
205
germinated pulses - bengal gram - amount of vitamin C
16 mcg/100g
206
cabbage - amount of vitamin C
124 mcg/100g
207
amaranth - amount of vitamin C
99 mcg/100g
208
cauliflower - amount of vitamin C
56 mcg/100g
209
spinach - amount of vitamin C
28 mcg/100g
210
brinjals - amount of vitamin C
12 mcg/100g
211
potatoes - amount of vitamin C
17 mcg/100g
212
radish - amount of vitamin C
15 mcg/100g
213
RDA vitamin C adults
40 mg per day
214
normal body content of vitamin C
5 g
215
most abundant element in nature
flourine
216
form of fluorine
combined ( because of it's high reactivity )
217
fluoride content in body
1. bones
2. teeth
96 %
218
fluorine - function
1. mineralisation of bones
| 2. formation of dental enamel
219
sources of fluorine
1. drinking water
2. sea fish
3. cheese
4. tea
220
indian water supply - fluorine content
0.5 mg /L
221
fluorine content of water in fluorosis endemic areas
3-12 mg/L
222
deficiency of fluorine
1. dental caries
223
excessive fluorine due to prolonged ingestion
1. dental fluorosis
| 2. skeletal fluorosis
224
Recommended levels of fluorides in water in india
0.5- 0.8 mg /L
225
Recommended levels of fluorides in water in temperate countries
1-2 mg/L
226
zinc is a component of how many enzymes?
> 300 enymes
227
function of zinc
1. metabolism of glucides and proteins
2. immunity function - regulate skin barrier and gene regulation of lymphocytes
3. synthesis of insulin by pancreas
228
zinc - location in body
all tissues
229
zinc plasma levels - healthy adults
96 microg per 100 ml
230
zinc plasma levels - healthy children
89 microg per 100 ml
231
zinc content of average adult body
1.4-2.3 g
232
deficiency of zinc
1. growth failures
2. sexual infantilism in adoloscents
3. loss of taste
4. delayed wound healing
5. abortion
6. congenital malformations like, anencephaly
milder deficiency
7. low birth weight
8. intrauterine growth retardation
9. preterm delivery
233
low zinc levels are seen in which diseases
1. liver diseases
2. pernicious anemia
3. thalassemia
4. myocardial infarction
234
causes of zinc deficiency
1. lack of animal food intake
2. high dietary phytate
3. inadequate food intake
4. increased fecal loses (diarrhea)
235
acute persistant diarrhea
ORS with zinc
1. reduce duration of illness
2. increase survival
236
mcg
microgram (recommended symbol in the United States when communicating medical information is mcg.)
237
role of zinc
1. decrease incidence of clinical attacks of malaria in children
2. antioxidation
238
source of zinc
1. animals- meat, milk, fish
| 2. vegetables (less)= bio availability (due to phytates)
239
RDA of zinc in men
12 mg per day
240
RDA of zinc in women
10 mg per day
241
RDA of zinc in children
10 mg per day
242
RDA of zinc in infants
5 mg per day
243
Zinc demands are increased in
1. growing children
2, pregnant women
3. lactating women
244
total human body iron content
3-4 g (60-70 % in Hb)
245
storage iron content
1-1.5 g
246
iron content in each gram of hemoglobin
3.34 mg of iron
247
functions of iron
1. formation of hemoglobin - binding of oxygen to blood cellls
- oxygen transportation
- cell respiration
2. brain development and function
3. regulation of body temperature
4. muscle activity
5. catecholamine metabolism
6. immunity - t cell and antibodies formation
7. formation of myoglobin, cytochrome, catalase, enzyme systems
248
sources of iron - forms
1. haem iron
2. non haem iron
cooking in iron vessel - provides iron
249
which iron form is better absorbed
heme iron
250
heme iron source
1. liver
2. meat
3. poultry
4. fish
251
heme iron - absorption
1. better absorption
| 2. also helps in absorption of non heme iron from foods eaten at the same time
252
iron content of breast milk
<0.2 mg/dl
253
non- heme iron sources
1. cereals
2. green leafy vegetables
3. legumes
4. nuts
5. oil seeds
6. jaggery
7. dried fruits
254
substances decreasing the bioavailability of non heme iron
1. phytates (bran)
2. oxalates (vegetables)
3. carbonates
4. phosphates (egg yolk)
5. dietary fibers
6. milk
7. egg
8. tea (tannin)
255
absorption of iron - location
1. duodenum
2. upper small iintestine in ferrous state
(according to body needs)
256
absorption of iron - factors influencing
1. body reserve of iron
2. presence of inhibitors in diet
3. presence of promoters
257
total human body iron content
3-4 g (60-70 % in Hb)
258
storage iron content
1-1.5 g
259
iron content in each gram of hemoglobin
3.34 mg of iron
260
functions of iron
1. formation of hemoglobin - binding of oxygen to blood cellls
- oxygen transportation
- cell respiration
2. brain development and function
3. regulation of body temperature
4. muscle activity
5. catecholamine metabolism
6. immunity - t cell and antibodies formation
7. formation of myoglobin, cytochrome, catalase, enzyme systems
261
sources of iron - forms
1. haem iron
2. non haem iron
cooking in iron vessel - provides iron
262
which iron form is better absorbed
heme iron
263
heme iron source
1. liver
2. meat
3. poultry
4. fish
264
heme iron - absorption
1. better absorption
| 2. also helps in absorption of non heme iron from foods eaten at the same time
265
iron content of breast milk
<0.2 mg/dl
266
non- heme iron sources
1. cereals
2. green leafy vegetables
3. legumes
4. nuts
5. oil seeds
6. jaggery
7. dried fruits
267
substances decreasing the bioavailability of non heme iron
1. phytates (bran)
2. oxalates (vegetables)
3. carbonates
4. phosphates (egg yolk)
5. dietary fibers
6. milk
7. egg
8. tea (tannin)
268
absorption of iron - location
1. duodenum
2. upper small iintestine in ferrous state
(according to body needs)
269
absorption of iron - factors influencing
1. body reserve of iron
2. presence of inhibitors in diet
3. presence of promoters
4. disorders of duodenum and jejunum
270
promoters of iron absorption
1. ascorbic acid (foods containing it)
| 2. pregnancy state
271
disorders of duodenum and jejunum
1. coeliac disease
| 2. tropical sprue
272
iron absorption from habitual indian diet
<5% of dietary intake
273
transportation of iron is in the form of
plasma ferritin
274
storage of iron
in liver
spleen
bone marrow,
kidney
275
characteristic feature of iron metabolism
conservation - when red blood cells break down, the iron from it utilized to make newer red blood cells
276
total daily iron loss of adult
1 mg
277
total loss during one menstruation
12.5 mg
278
routes of iron loss
1. hemorrhages
- pysiological - mesntruation, childbirth
- pathological - hookworms , malaria, hemorrhoids, peptic ulcers
2. basal losses - excretion through urine, sweat and bile and desquamated surface cells
3. use of IUD
279
loss of blood because of IUD is
increases by 35- 146% of average monthly loss
280
loss of blood because of hormonal contraceptive
decreases by 50 %
281
iron deficiency - stage 1
1. decreased iron stores - no detectable abnormalities
282
iron deficiency stages
3
283
iron deficiency - stage 2
1. intermediate/ latent iron deficiency
| 2. stores are exhausted but anemia hasn't occurred
284
iron deficiency stage 2 is diagnosed by
1. measuring serum ferritin levels
| 2. transferrin levels decreased to 15 %
285
normal transferrin level
30%
286
iron deficiency stage 2 - status in india
prevalent
287
iron deficiency stage 3
decreased hemoglobin synthesis and circulating concentration
288
end result of iron deficiency
nutritional anemia (syndrome caused by malnutrition)
289
deficiency of iron causes
1. nutritional anemia
2. impaired cell mediated immunity
3. diminished work performance
4. reduced resistance to infection
5. morbidity
6. mortality
290
diagnosis of anemia according to WHO expert group
anemia or deficiency should be considered to exist when hb is below certain levels the value of which depends on the group you belong to
291
adult males - cut off point for diagnosis of anemia
13 g/dl (venous blood)
292
adult females - non pregnant - cut off point for diagnosis of anemia
12 g/dl (venous blood)
293
adult females , pregnant - cut off point for diagnosis of anemia
11 g/dl (venous blood)
294
children - 6 months to 6 years - cut off point for diagnosis of anemia
11 g/dl (venous blood)
295
children 6 to 14 years - cut off point for diagnosis of anemia
12 g/dl (venous blood)
296
cut off point for diagnosis of anemia - MHCH %
34
297
MHCH below 34 in iron deficiency anemia
cells are hypochromic
298
11-10 g/dl iron
early anemia
299
<10 g/ dl of iron
marked anemia
300
evaluation of iron status - parameters
1. hemoglobin concentration
2. serum iron concentration
3. serum ferritin concentration
4. serum transferrin saturation
301
hemoglobin concentration as a measure of iron status
1. insensitive index of nutrient depletion
2. no value if anemia isn't severe (as anemia only occurs when iron deficiency is very severe but
because iron deficiency can occur without severe anemia)
302
serum iron concentration normal
0.80 - 1.80 mg/L
303
serum iron concentration in iron deficiency
< 0.5 mg/L
304
serum ferritin
1. most sensitive
| 2. reflects size of iron stores in the body
305
ferritin levels in absence of stored iron
<10 mcg/L
306
serum transferrin -
should be above 16%
307
iron requirements
1. rapid expansion of tissues, and red mass
- pregnancy
- childhood
- adoloscence
308
iodine - type of nutrient
essential micro nutrient
309
role of iodine
1. thyroid hormone formation T3 (3 iodines), T4 (4 iodine atoms)
2. normal growth and development
310
body content of iodine
50 mg
311
blood iodine level
8-12 mcg /dl
312
source of iodine
1. seas fish
2. sea salt
3. cod liver oil
4. milk, meat, vegetables, cereals
5. fresh water - (1-50 mcg/L)
313
source of iodine
food - 90%
water - 10%
availability of iodine depends on the soil content which varies from geographical area to area so the deficiency is geochemical in nature
314
goitrogens
1. chemicals
2. leads to goitre development
3. interfere with iodine utilization by thyroid gland
315
sources of goitrogens
1. brassica - cabbagee, cauliflowers
316
goitrogens - example
1. cyanoglycosides
| 2. thiocynates
317
deficiency of iodine
1. goitre
2. hypothyroidism
3. retarded physical development
4. impaired mental function
5. increased abortion and still birth rates
6. neurological cretinism - deaf-mutism
7. myxoedematous cretinism - dwarfism and severe mental retardation
318
IDD
iodine deficiency disorders (earlier called endemic goitre) - all effects of iodine deficiency that can be prevented by correcting the said deficiency
319
spectrum of IDD with levels of severity
1. goitre - grade I, II, III, Multinodular
2. hypothyroidism - variable severity
3. subnormal intelligence, delayed motor milestones, mental deficiency, hearing and speech defects- variable severity
4. stabismus (squint) - unilaterla, bilateral; nystagmus
5. spasticity (extra pyramidal) - muscle wekaness in legs, arms, trunk
- neuromuscular weakness - diplegia, quadriplegia
6. endemic cretinism - hypothyroid, neurological
7. intrauterine death - spontaneous abortion, miscarriage
320
IDD
1. grave problem
| 2. socio economic significance
321
RDA adults
150 mcg
322
RDA - pregnancy (WHO)
250 mcg
323
epidemiological assessment of iodine deficiency
1. necessary before starting iodization programme
| 2. surveillance of goitre control programmes
324
indicators of iodine deficiency
1. prevalence of goitre
2. prevalence of cretinism
3. urinary iodine excretion
4. measurement of thyroid function by determination of serum levels of T4 (more sensitive indicator than T3) and pituatary thyrotropic hormone (TSH)
prevalence of neonatal hypothyroidism
325
objective of goitre control programmes
1. increase iodine intake
326
most important indicator for surveillance
urinary excretion
327
most sensitive indicator of environmental iodine deficiency
neonatal hypothyroidism
