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Preventive and social medicine > Test 2 - Nutrition > Flashcards

Test 2 - Nutrition Flashcards

Minerals and vitamins

1
Q

chemical elements in the body

A

more than 50

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2
Q

role of chemical elements in our body

A
  1. growth
  2. repair
  3. maintenance of vital body functions
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3
Q

groups of major chemical elements in the body

A
  1. major minerals
  2. trace elements
  3. trace contaminants
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4
Q

Major minerals

A 
calcium
phosphorous 
sodium
potassium
magnesium
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5
Q

trace elements- requirement

A

less than few mg per day

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6
Q

trace elements -

A 
iron
iodine
flourine
zinc
copper
cobalt
chromium 
manganese 
molybednum
selenium
nickel
tin
silicon
vanadium
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7
Q

trace contaminants

A 
lead
mercury
barium
boron
aluminium
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8
Q

vegetarian diet- (deficient minerals

A

bioavailability of iron and zinc is less because of the presence of phytates

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9
Q

interference with proper mineral absorption

A
  1. phytic acid

2. large amount of dietary fibers

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10
Q

calcium % in the body weight

A

1.5-2%

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11
Q

calcium in average adult

A

1200g

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12
Q

% of total calcium which is in bones

A

98%

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13
Q

amount of calcium in blood

A

10 mg/dl

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14
Q

requirement of calcium by developing foetus

A

30g

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15
Q

dynamic equilibrium between blood and bone calcium is maintained by

A
  1. vit D
  2. parathryoid hormone
  3. calcitonin
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16
Q

functions of ionised calcium

A
  1. formation of bone and teeth
  2. coagulation of blood
  3. contraction of muscle (cardiac, etc)
  4. milk production
  5. relay of electrical and chemical messages from the membrane surface to biochemical machinery inside
  6. membrane integrity
  7. enzyme and hormone metabolism
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17
Q

sources of calcium

A
  1. milk
  2. milk products
  3. eggs
  4. fish
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18
Q

calcium in one litre of cow’s milk

A

1200mg

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19
Q

calcium in one liter of human milk

A

300 mg

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20
Q

milk calcium form

A

calcium caseinogenate (easily assimilated by body)

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21
Q

dietary source of calcium

A
  1. green leafy vegetables
  2. cereals
  3. millets (ragi, especially )
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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

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23
Q

what food is VERY deficient in calcium

A

rice

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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

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25
Q

fruit with calcium

A

sitaphal

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26
Q

calcium in water

A

200 mg/day

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27
Q

% absorption of dietary calcium

A

20-30 % of dietary calcium intake is absorbed

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28
Q

calcium absorption is increased by

A

vit D

body needs regulate calcium absorption

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29
Q

calcium absorption is decreased by

A
  1. phytates
  2. oxalates
  3. fatty acids
    (body needs regulate calcium absorption)
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30
Q

calcium related disorders

A

no clear cut diseases on low calcium intake

no deleterious effects/ benefits on prolonged excessive intakes

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31
Q

RDA calcium - adult

A

600 mg intake

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32
Q

role of phosphorous

A
  1. formation of bone and teeth

2. part of ATP - role in all metabolisms

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33
Q

adult phosphorous content

A

400-700g (mostly in bones and teeths)

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34
Q

phosphorous in vegetables in combination with

A

phytins

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35
Q

boavailability of vegetable phosphorous

A

40-60 %

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36
Q

phosphrous requirement / P:Ca ratio

A
  1. infancy- 1:1.5

2. all other age groups - 1:1

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37
Q

sodium in body- location

A

all body fluids

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38
Q

sodium content of the body

A

100 g

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39
Q

source of sodium

A
  1. added as NaCl in foods
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40
Q

excretion of sodium

A
  1. sweat

2. urine (controlled by kidney)

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41
Q

depletion of sodium -

A
  1. muscular cramps
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42
Q

requirement of sodium

A
  1. depends on age, climate, occupation

2. 5 g per day - on average for adult

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43
Q

amount of sodium with hypertensive tendencies

A

> 10 mg

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44
Q

potassium in adult human body

A

250 g

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45
Q

role of potassium in body

A
  1. vasoactive
  2. increase blood flow
  3. sustain metabolic needs of the body
  4. K supplements - lower blood pressure
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46
Q

release of potassium is by (cell)

A

endothelial cells

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47
Q

desirable Na:K ratio in diet

A

1:1 (in mmol)

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48
Q

magnesium - in body (location)

A
  1. bones

2. all cells

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49
Q

amount of magnesium in the body

A

25 g (half of it is in the skeleton)

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50
Q

role of magnesium

A
  1. metabolism of calcium and potassium
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51
Q

magnesium deficiencies are seen in

A
  1. chronic alcoholism
  2. toxemia of pregnancy
  3. cirrhosis of liver
  4. protein energy malnutrition
  5. malabsorption syndromes
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52
Q

magnesium deficiency symptoms

A
  1. irritability
  2. tetany
  3. hyperreflexia
  4. sometimes - hyporeflexia
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53
Q

vitamin E- other name

A

tocopherol

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54
Q

vitamin E

A

group of fat soluble vitamins

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55
Q

most potent vitamin E

A

alpha tocopherol

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56
Q

vitamin E sources

A
  1. vegetable oil
  2. sunflower oil
  3. cotton seed
  4. egg yolk
  5. butter
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57
Q

vitamin E - normal plasma level

A

08-1.4 mg per 100 ml

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58
Q

vitamin E requirement

A

0.8 mg of vit E per gram of essential

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59
Q

daily intake of vitamin E- on average is

A

8-10 mg

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60
Q

vit E - toxicity - in vitro

A

cytotoxic to lymphocytes

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61
Q

vitamin E - function

A

antioxidant

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62
Q

forms of vitamin K

A

K1

K2

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63
Q

vitamin K1 - source

A

fresh green vegetables (dark green ones)

some fruits

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64
Q

amount of vitamin K in cow’s milk

A

60 mcg /L

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65
Q

amount of vitamin K in human milk

A

15 mcg/L

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66
Q

vitamin K2

A

synthesised by intestinal bacteria

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67
Q

intervention by long term antibiotics

A
  1. suppress intestinal bacteria

2. cause vit K2 deficiency

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68
Q

storage of vitamin K

A

liver

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69
Q

role of vitamin K

A
  1. stimulate coagulation factor production

2. stimulate release of coagulation factors

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70
Q

vitamin K deficiency

A
  1. prothrombin content of blood is decreased

2. blood clotting time is prolonged

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71
Q

daily vitamin K requirement

A

0.03 mg/kg for adult

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72
Q

infant vit K deficiency- causes

A
  1. minimal stores of prothrombin

2. lack of established intestinal flora

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73
Q

infant vit K deficiency - prophylaxis

A

single
im
vit K (menadione sodium bisulphite - 0.1 -0.2 mg
or 0.5 mg of vit K1)

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74
Q

vitamin B1- name/ solubility

A

thiamine (water soluble)

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75
Q

role of vitamin B1

A
  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.
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76
Q

thiamine deficiency

A
  1. accumulation of pyruvic and lactic acids in tissues and body fluids
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77
Q

sources of thiamine

A
  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)
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78
Q

thiamine source in indian people

A

cereals (rice, wheat) - 60–85% of total intake

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79
Q

thiamine loses - in rice

A
  1. during milling
  2. washing
  3. cooking
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80
Q

rice advice

A

eschew highly polished rice and eat parboiled or under milled rice

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81
Q

thiamine loses in vegetables and fruits

A

on prolonged storage

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82
Q

thiamine is lost in

A
  1. milled rice
  2. long stored vegetables and fruits
  3. toast
  4. baking soda cooked food material
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83
Q

deficiency of vitamin B1

A
  1. ber beri

2. wernicke’s encephalopathy

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84
Q

forms of beri beri

A
  1. dry (peripheral neuritis)
  2. wet (cardiac)
  3. infantile (2-4 months old infants of thiamine deficient mother with peripheral neuropathy)
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85
Q

wernicke’s encephalopathy

A 
in chronic alcoholic/ people who fast 
opthalmplegia
polyneuritis 
ataxia 
mental deterioration
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86
Q

frank beri beri cases - epidemiology

A

coastal states - andhra (where people eat polished rice)

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87
Q

prevention of beriberi

A
  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
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88
Q

RDA thiamine

A

30 mg

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89
Q

what if we give >30 mg of thiamine in diet

A

it is lost in urine

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90
Q

thiamine supplements are given in

A
  1. patients on regular hemodialysis
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91
Q

thiamine prophylaxis is given to

A
  1. patient with persistent vomiting
  2. prolonged gastric aspiration
  3. patient on long fasts
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92
Q

vitamin B2 - name

A

riboflavin

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93
Q

vitamin B2 - role

A
  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
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94
Q

riboflavin sources

A
  1. milk
  2. egg
  3. liver, kidney
  4. green leafy vegetables
  5. meat and fish

Germinated

  1. whole and milled cereals
  2. pulses
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95
Q

main source of ribolflavin in indian diet

A

cereals (whole and milled) and pulses

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96
Q

deficiency of riboflavin

A 
1. angular stomatitis in malnourished children
suggestive
2. cheilosis
3. glossitis
4. nasolabial dyssebachia
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97
Q

hyporiboflavinosis

A
  1. impaired neuromotor functions
  2. impaired wound healing
  3. susceptibility to cataract
  4. impaired utilisation of pyridoxine
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98
Q

body stores of riboflavin

A

not present

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99
Q

riboflavin RDA

A

0.6 mg per 1000 kcal of energy

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100
Q

vitamin b3

A

niacin or nicotinic acid

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101
Q

niacin - role

A
  1. metabolism of carbohydrates, fats and proteins
  2. normal functions of
    - skin
    - intestine
    - nervous system
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102
Q

precursor of niacin

A

Tryptophan

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103
Q

metabolites of niacin

A

methylated

  1. N- methyl nicotinamide
  2. N- methyl pyridones
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104
Q

sources of niacin

A
  1. liver
  2. kidney
  3. meat
  4. poultry
  5. fish
  6. legumes
  7. ground nut
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105
Q

sources of Tryptophan

A

milk proteins

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106
Q

Tryptophan required to make 1 mg of niacin

A

60 mg

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107
Q

unavailable bound niacin

A

in cereals

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108
Q

deficiency of niacin

A
  1. pellagra - diarrhea, dementia, dermatitis
  2. glossitis
  3. stomatitis
  4. mental changes
    - depression
    - irritability
    - delirium
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109
Q

dermatitis due to niacin deficiency

A
  1. bilaterally symmetrical

2. on sun exposed surface (back of head, lower legs, face and neck)

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110
Q

susceptibility of pellagra in population dependent on

A

maize diet

jowar ( sorghum vulgare)

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111
Q

cause of pellagra

A

amino acid imbalance with excess of leucine

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112
Q

role of leucine in pellagra

A

excess leucine interfere with conversion of Tryptophan into Niacin

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113
Q

prevention of pellagra

A
  1. good mixed diet (milk, meat)
  2. avoid total maize and sorghum dependence
  3. give modern knowledge anf opportunities
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114
Q

niacin - RDA

A

6 mg / 1000 kcal of energy

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115
Q

forms of b6

A
  1. pyridoxine
  2. pyridoxal
  3. pyridoxamine
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116
Q

role of vitamin b6

A
  1. metabolism of amino acids, fats and carbohydrates
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117
Q

sources of pyridoxine

A
  1. milk
  2. liver
  3. meat
  4. egg yolk
  5. fish
  6. whole grain cereals
  7. legumes
  8. vegetables
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118
Q

pyridoxine deficiency

A
  1. peripheral neuritis
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119
Q

antagonist of pyridoxine

A

isoniazid

give 10 mg / day in patients receiving isoniazid

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120
Q

RDA pyridoxine

A

adults - 2 mg / day

pregnancy and lactation - 2.5 mg / day

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121
Q

vitamin b5

A

pantothenic acid

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122
Q

niacin metabolites excretion

A

in urine

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123
Q

pantothenic acid - RDA

A

10 mg

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124
Q

pantothenic acid - body levels/ form

A

18-35 mg / 100 ml

as coenzyme A in cells

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125
Q

source of pantothenic acid

A

all foods

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126
Q

NPU egg

A

100

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127
Q

role of pantothenic acid

A
  1. normal adrenal cortex functioning and corticosteroids biosynthesis
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128
Q

daily excretion of pantothenic acid

A

3 mg in urine

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129
Q

dietary antioxidants

A
  1. nutrients

2. non nutrients

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130
Q

nutrient antioxidants

A
  1. vitamin E
  2. vitamin C
  3. beta carotene
  4. selenium
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131
Q

non- nutrient antioxidants

A
  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
Q

role of antioxidants

A
  1. reduce the effect of ROS and nitrogen species that causes oxidation damage
133
Q

reactive oxygen species- causes

A
  1. ageing

2. diet/ nutrient related chronic disorders due to ROS exposure

134
Q

sources of antioxidants

A
  1. tea and wine
  2. vegetables
  3. fruits
  4. legumes
  5. spices
  6. cereals
135
Q

evidence for the protective role of antioxidants in

A
  1. fruits

2. vegetables

136
Q

ROS - role

A

accumulate with age

  1. damage the biomolecules
  2. affect enzyme processes
  3. affect the genetic machinery
137
Q

diseases caused by ROS

A
  1. cardiovascular
  2. cataract
  3. cancer
  4. diabetes
  5. neurodegenerative disorders
  6. age related masculopathies
138
Q

sources of ROS

A
  1. endogenous - neutrophils etc, during tissue metabolism

2. exogenous

139
Q

RDA antioxidants

A

500-600 gm/d

  • prevent damage
  • cause repair
140
Q

high risk of oxidative damage is in

A
  1. geriatric groups
  2. premature infants
  3. those doing strenous activities
  4. smokers
  5. alcoholics
  6. exposed to environmental pollutants
  7. chronic infections
141
Q

Molybdenum - excessive

A

bony deformities

142
Q

molybdenum - deficiency

A
  1. esophageal and mouth cancers
143
Q

first selenium deficiency reported in

A

1961/ 67

144
Q

selenium in kwashiorkor

A

significant weight increase

145
Q

selenium deficiency is seen in

A

protein energy malnutrition

146
Q

selenium deficiency + vit E deficiency

A

decrease antibody production

147
Q

chromium content of body

A

<6 mg

148
Q

chromium - role

A
  1. role in insulin and carbohydrate funtion

unusual glucose tolerance curve that responds to chromium

149
Q

cobalt - role

A
  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
Q

cobalt deficiency causes

A

goitre

151
Q

cobalt-iodine ratio - role

A

in pathogenesis of goitre

152
Q

amount of copper in body

A

100-150 mg

153
Q

hypocupermia is seen in

A
  1. nephrosis
  2. wilson’s disease
  3. infants fed cow’s milk
  4. protein energy malnutrition
154
Q

deficiency of copper

A
  1. neutropenia
155
Q

hypercupermia

A
  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
Q

RDA copper

A

2 mg per day

157
Q

folic acid names

A

recommended name - folate
alternative name - folacin
pharmaceutical preparation - folic acid

158
Q

forms of folates

A
  1. free form

2. bound form

159
Q

absorption of free folate

A

rapid - from proximal part of small intestine

160
Q

role of folic acid

A
  1. synthesis of nucleic acid

2. normal development of blood cells in marrow

161
Q

folic acid - etymology

A

folia (latin)- leaf

162
Q

sources of folic acid

A
  1. liver
  2. meat
  3. dairy product
  4. eggs
  5. milk
  6. fruits
  7. cereals
  8. leafy vegetable
163
Q

overcooking of food

A

folic acid is destroyed

164
Q

deficiency of folic acid in babies

A

given milk food subjected to heat sterilization

165
Q

causes of deficiency of folic acid

A

increased demand

  1. pregnancy
  2. lactation
  3. taking folate antagonist
    - alcohol
    - pyrimethamine
    - cotrimoxazole
166
Q

deficiency of folic acid causes

A
  1. megaloblastic anemia
  2. glossitis
  3. cheiilosis
  4. gastrointestinal disturbances
    - diarrhea
    - distension
    - flatulence
  5. infertility
  6. sterility
  7. abortion
  8. congenital malformations
167
Q

diagnosis of folate deficiency

A

microbiological assay
measuring folate levels
- serum
- red blood cell

168
Q

body stores of folate

A

5-10 mg

169
Q

requirement of folate - conditions

A
  1. rapid cell multiplication
    - growth
    - pregnancy
170
Q

folates supplementations in pregnancy

A
  1. decrease the incidence of low birth weight babies

2. increase weight of infants

171
Q

healthy adults - folate intake values recommended by ICMR(2010)

A

200 mcg per day

172
Q

pregnancy - folate intake values recommended by ICMR(2010)

A

500 mcg per day

173
Q

lactation - folate intake values recommended by ICMR(2010)

A

300 mcg/ day

174
Q

children - folate intake values recommended by ICMR(2010)

A

80- 120 mcg / day

175
Q

vitamin B12 - structure

A

complex organo metallic compound with cobalt

176
Q

therapeutic preparation of vitamin B12

A

cyanocobalamine

177
Q

role of vita B12

A
  1. synthesis of DNA

2. synthesis of fatty acids in myelin

178
Q

deficiency of B12

A
  1. megaloblastosis
  2. megaloblastic anemia (pernicious anemia)
  3. demyelinating neural lesions in spinal cord
  4. infertility in animal species
179
Q

physiological absorption of B12 - require

A

intrinsic factor released from stomach

180
Q

absorption of B12 occurs at

A

terminal ileum

181
Q

sources of Vitamin B12

A
  1. liver
  2. kidney
  3. meat
  4. fish
  5. eggs
  6. milk
  7. cheese
  8. colon bacteria
182
Q

vitamin B12 - heat stability

A

heat stable

183
Q

storage of Vit B12

A

liver - 2mg

other body parts- 2 mg

184
Q

B12 stores - lasts for

A

1-3 years

185
Q

B12 deficiency in india

A

sub- clinical

>30% - in adults and children

186
Q

reason for B12 deficiency

A

large proportion of population depends on vegetable diet

187
Q

normal adults - vitamin b12 intake values recommended by ICMR(2010)

A

1 mcg per day

188
Q

pregnancy - vitamin b12 intake values recommended by ICMR(2010)

A

1.2 mcg per day

189
Q

lactating - vitamin b12 intake values recommended by ICMR(2010)

A

1.5 mcg per day

190
Q

infants and children - vitamin b12 intake values recommended by ICMR(2010)

A

0.2 mcg per day

191
Q

Vitamin C- heat sensitivity

A

most

192
Q

animals that require Vitamin C

A
  1. man
  2. monkey
  3. guinea pig
193
Q

vitamin C - name

A

ascorbic acid

194
Q

vitamin C - solubility

A

water soluble

195
Q

functions of vitamin C

A
  1. potent anti oxidant - tissue oxidation

2. synthesis of collagen

196
Q

collagen - content of the body

A

25% of total body proteins

197
Q

functions of collagen

A
  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
Q

vitamin C deficiency causes

A
  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
Q

sources of vitamin C

A
  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
Q

Amla - amount of vitamin C

A

600 mcg/100g

201
Q

Guava - amount of vitamin C

A

212 mcg/100g

202
Q

lime - amount of vitamin C

A

63 mcg/100g

203
Q

orange - amount of vitamin C

A

30 mcg/100g

204
Q

tomato - amount of vitamin C

A

27 mcg/100g

205
Q

germinated pulses - bengal gram - amount of vitamin C

A

16 mcg/100g

206
Q

cabbage - amount of vitamin C

A

124 mcg/100g

207
Q

amaranth - amount of vitamin C

A

99 mcg/100g

208
Q

cauliflower - amount of vitamin C

A

56 mcg/100g

209
Q

spinach - amount of vitamin C

A

28 mcg/100g

210
Q

brinjals - amount of vitamin C

A

12 mcg/100g

211
Q

potatoes - amount of vitamin C

A

17 mcg/100g

212
Q

radish - amount of vitamin C

A

15 mcg/100g

213
Q

RDA vitamin C adults

A

40 mg per day

214
Q

normal body content of vitamin C

A

5 g

215
Q

most abundant element in nature

A

flourine

216
Q

form of fluorine

A

combined ( because of it’s high reactivity )

217
Q

fluoride content in body

A
  1. bones
  2. teeth
    96 %
218
Q

fluorine - function

A
  1. mineralisation of bones

2. formation of dental enamel

219
Q

sources of fluorine

A
  1. drinking water
  2. sea fish
  3. cheese
  4. tea
220
Q

indian water supply - fluorine content

A

0.5 mg /L

221
Q

fluorine content of water in fluorosis endemic areas

A

3-12 mg/L

222
Q

deficiency of fluorine

A
  1. dental caries
223
Q

excessive fluorine due to prolonged ingestion

A
  1. dental fluorosis

2. skeletal fluorosis

224
Q

Recommended levels of fluorides in water in india

A

0.5- 0.8 mg /L

225
Q

Recommended levels of fluorides in water in temperate countries

A

1-2 mg/L

226
Q

zinc is a component of how many enzymes?

A

> 300 enymes

227
Q

function of zinc

A
  1. metabolism of glucides and proteins
  2. immunity function - regulate skin barrier and gene regulation of lymphocytes
  3. synthesis of insulin by pancreas
228
Q

zinc - location in body

A

all tissues

229
Q

zinc plasma levels - healthy adults

A

96 microg per 100 ml

230
Q

zinc plasma levels - healthy children

A

89 microg per 100 ml

231
Q

zinc content of average adult body

A

1.4-2.3 g

232
Q

deficiency of zinc

A
  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
Q

low zinc levels are seen in which diseases

A
  1. liver diseases
  2. pernicious anemia
  3. thalassemia
  4. myocardial infarction
234
Q

causes of zinc deficiency

A
  1. lack of animal food intake
  2. high dietary phytate
  3. inadequate food intake
  4. increased fecal loses (diarrhea)
235
Q

acute persistant diarrhea

A

ORS with zinc

  1. reduce duration of illness
  2. increase survival
236
Q

mcg

A

microgram (recommended symbol in the United States when communicating medical information is mcg.)

237
Q

role of zinc

A
  1. decrease incidence of clinical attacks of malaria in children
  2. antioxidation
238
Q

source of zinc

A
  1. animals- meat, milk, fish

2. vegetables (less)= bio availability (due to phytates)

239
Q

RDA of zinc in men

A

12 mg per day

240
Q

RDA of zinc in women

A

10 mg per day

241
Q

RDA of zinc in children

A

10 mg per day

242
Q

RDA of zinc in infants

A

5 mg per day

243
Q

Zinc demands are increased in

A
  1. growing children
    2, pregnant women
  2. lactating women
244
Q

total human body iron content

A

3-4 g (60-70 % in Hb)

245
Q

storage iron content

A

1-1.5 g

246
Q

iron content in each gram of hemoglobin

A

3.34 mg of iron

247
Q

functions of iron

A
  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
Q

sources of iron - forms

A
  1. haem iron
  2. non haem iron

cooking in iron vessel - provides iron

249
Q

which iron form is better absorbed

A

heme iron

250
Q

heme iron source

A
  1. liver
  2. meat
  3. poultry
  4. fish
251
Q

heme iron - absorption

A
  1. better absorption

2. also helps in absorption of non heme iron from foods eaten at the same time

252
Q

iron content of breast milk

A

<0.2 mg/dl

253
Q

non- heme iron sources

A
  1. cereals
  2. green leafy vegetables
  3. legumes
  4. nuts
  5. oil seeds
  6. jaggery
  7. dried fruits
254
Q

substances decreasing the bioavailability of non heme iron

A
  1. phytates (bran)
  2. oxalates (vegetables)
  3. carbonates
  4. phosphates (egg yolk)
  5. dietary fibers
  6. milk
  7. egg
  8. tea (tannin)
255
Q

absorption of iron - location

A
  1. duodenum
  2. upper small iintestine in ferrous state
    (according to body needs)
256
Q

absorption of iron - factors influencing

A
  1. body reserve of iron
  2. presence of inhibitors in diet
  3. presence of promoters
257
Q

total human body iron content

A

3-4 g (60-70 % in Hb)

258
Q

storage iron content

A

1-1.5 g

259
Q

iron content in each gram of hemoglobin

A

3.34 mg of iron

260
Q

functions of iron

A
  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
Q

sources of iron - forms

A
  1. haem iron
  2. non haem iron

cooking in iron vessel - provides iron

262
Q

which iron form is better absorbed

A

heme iron

263
Q

heme iron source

A
  1. liver
  2. meat
  3. poultry
  4. fish
264
Q

heme iron - absorption

A
  1. better absorption

2. also helps in absorption of non heme iron from foods eaten at the same time

265
Q

iron content of breast milk

A

<0.2 mg/dl

266
Q

non- heme iron sources

A
  1. cereals
  2. green leafy vegetables
  3. legumes
  4. nuts
  5. oil seeds
  6. jaggery
  7. dried fruits
267
Q

substances decreasing the bioavailability of non heme iron

A
  1. phytates (bran)
  2. oxalates (vegetables)
  3. carbonates
  4. phosphates (egg yolk)
  5. dietary fibers
  6. milk
  7. egg
  8. tea (tannin)
268
Q

absorption of iron - location

A
  1. duodenum
  2. upper small iintestine in ferrous state
    (according to body needs)
269
Q

absorption of iron - factors influencing

A
  1. body reserve of iron
  2. presence of inhibitors in diet
  3. presence of promoters
  4. disorders of duodenum and jejunum
270
Q

promoters of iron absorption

A
  1. ascorbic acid (foods containing it)

2. pregnancy state

271
Q

disorders of duodenum and jejunum

A
  1. coeliac disease

2. tropical sprue

272
Q

iron absorption from habitual indian diet

A

<5% of dietary intake

273
Q

transportation of iron is in the form of

A

plasma ferritin

274
Q

storage of iron

A

in liver
spleen
bone marrow,
kidney

275
Q

characteristic feature of iron metabolism

A

conservation - when red blood cells break down, the iron from it utilized to make newer red blood cells

276
Q

total daily iron loss of adult

A

1 mg

277
Q

total loss during one menstruation

A

12.5 mg

278
Q

routes of iron loss

A
  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
Q

loss of blood because of IUD is

A

increases by 35- 146% of average monthly loss

280
Q

loss of blood because of hormonal contraceptive

A

decreases by 50 %

281
Q

iron deficiency - stage 1

A
  1. decreased iron stores - no detectable abnormalities
282
Q

iron deficiency stages

A

3

283
Q

iron deficiency - stage 2

A
  1. intermediate/ latent iron deficiency

2. stores are exhausted but anemia hasn’t occurred

284
Q

iron deficiency stage 2 is diagnosed by

A
  1. measuring serum ferritin levels

2. transferrin levels decreased to 15 %

285
Q

normal transferrin level

A

30%

286
Q

iron deficiency stage 2 - status in india

A

prevalent

287
Q

iron deficiency stage 3

A

decreased hemoglobin synthesis and circulating concentration

288
Q

end result of iron deficiency

A

nutritional anemia (syndrome caused by malnutrition)

289
Q

deficiency of iron causes

A
  1. nutritional anemia
  2. impaired cell mediated immunity
  3. diminished work performance
  4. reduced resistance to infection
  5. morbidity
  6. mortality
290
Q

diagnosis of anemia according to WHO expert group

A

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
Q

adult males - cut off point for diagnosis of anemia

A

13 g/dl (venous blood)

292
Q

adult females - non pregnant - cut off point for diagnosis of anemia

A

12 g/dl (venous blood)

293
Q

adult females , pregnant - cut off point for diagnosis of anemia

A

11 g/dl (venous blood)

294
Q

children - 6 months to 6 years - cut off point for diagnosis of anemia

A

11 g/dl (venous blood)

295
Q

children 6 to 14 years - cut off point for diagnosis of anemia

A

12 g/dl (venous blood)

296
Q

cut off point for diagnosis of anemia - MHCH %

A

34

297
Q

MHCH below 34 in iron deficiency anemia

A

cells are hypochromic

298
Q

11-10 g/dl iron

A

early anemia

299
Q

<10 g/ dl of iron

A

marked anemia

300
Q

evaluation of iron status - parameters

A
  1. hemoglobin concentration
  2. serum iron concentration
  3. serum ferritin concentration
  4. serum transferrin saturation
301
Q

hemoglobin concentration as a measure of iron status

A
  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
Q

serum iron concentration normal

A

0.80 - 1.80 mg/L

303
Q

serum iron concentration in iron deficiency

A

< 0.5 mg/L

304
Q

serum ferritin

A
  1. most sensitive

2. reflects size of iron stores in the body

305
Q

ferritin levels in absence of stored iron

A

<10 mcg/L

306
Q

serum transferrin -

A

should be above 16%

307
Q

iron requirements

A
  1. rapid expansion of tissues, and red mass
    - pregnancy
    - childhood
    - adoloscence
308
Q

iodine - type of nutrient

A

essential micro nutrient

309
Q

role of iodine

A
  1. thyroid hormone formation T3 (3 iodines), T4 (4 iodine atoms)
  2. normal growth and development
310
Q

body content of iodine

A

50 mg

311
Q

blood iodine level

A

8-12 mcg /dl

312
Q

source of iodine

A
  1. seas fish
  2. sea salt
  3. cod liver oil
  4. milk, meat, vegetables, cereals
  5. fresh water - (1-50 mcg/L)
313
Q

source of iodine

A

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
Q

goitrogens

A
  1. chemicals
  2. leads to goitre development
  3. interfere with iodine utilization by thyroid gland
315
Q

sources of goitrogens

A
  1. brassica - cabbagee, cauliflowers
316
Q

goitrogens - example

A
  1. cyanoglycosides

2. thiocynates

317
Q

deficiency of iodine

A
  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
Q

IDD

A

iodine deficiency disorders (earlier called endemic goitre) - all effects of iodine deficiency that can be prevented by correcting the said deficiency

319
Q

spectrum of IDD with levels of severity

A
  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
Q

IDD

A
  1. grave problem

2. socio economic significance

321
Q

RDA adults

A

150 mcg

322
Q

RDA - pregnancy (WHO)

A

250 mcg

323
Q

epidemiological assessment of iodine deficiency

A
  1. necessary before starting iodization programme

2. surveillance of goitre control programmes

324
Q

indicators of iodine deficiency

A
  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
Q

objective of goitre control programmes

A
  1. increase iodine intake
326
Q

most important indicator for surveillance

A

urinary excretion

327
Q

most sensitive indicator of environmental iodine deficiency

A

neonatal hypothyroidism

Preventive and social medicine (13 decks)

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