Week 8 Part2

Question 1

FUNCTIONS of Vit E

Answer 1

-antioxidant
 Scavenger of the free radicals
 Free radicals: Destroy the phospholipids (cell membrane- so there is loss of
function of the cell membrane)
 Once the cell membrane is destroyed it destroys the function of cells/ organs etc. Two cells most vulnerable to free radicals: (1) neurons- made of cell and axons/
dendrites so there is lots of cell membrane (2) RBCs
 In the case of Vit E deficiency there is damage of neurons and RBCs

Question 2

(1) nervous system pathology for vit. E

Answer 2

-degeneration of axons in the posterior columns of the spinal cord The posterior horns are for sensation
 So if there is damage, you will get tingling and numbness.
-loss of nerve cells in DRG’s
-myelin degeneration of sensory axons in peripheral nerves.
 Can also cause numbness and tingling
-degenerative change in the spinocerebellar tract
 Ataxia will occur

Question 3

SIGNS AND SYMPTOMS for vit. E

Answer 3

• absence of tendon reflexes
• ataxia
• dysarthria (people wont talk properly)
• loss of position and vibration sense (because spinocerebellar tract is affected)-loss of pain sensation (because the DRGs are affected)

Question 4

(2) pathology of erythrocytes for vit. E

Answer 4

-more susceptible to destruction by free radicals
-anemia in premature infants.
 No one knows why
 RBCs suffer but practically, this isn’t seen in mature people, just infants.

Question 5

-vit E: inhibits

Answer 5

atheroma formation in atherosclerosis (through reducing the oxidation of LDL)
 Narrows the lumen wall
 Vit E inhibits this
 This is theoretical, but it is not proven yet clinically.

Question 6

-vit E works well with

Answer 6

vit C and selenium
They work against the free radicals togetherThey are scavengers of free radicals.
Without vit E, selenium is not very useful.
Selenium is a micro element.

Question 7

Vit K

Answer 7

another fat soluble vitamin which plays an important role in blood coagulation

• clotting factors are produced in liver under influence of vit K.
• this is called vitamin coagulation (C was already taken, so they use the german word for coagulation which starts with a K)

Question 8

FUCNTIONS: of vit. K

Answer 8

A. –Koagulation (coagulation)

B.- osteocalcin

Question 9

–Koagulation (coagulation)

Answer 9

Formation of clothing factors 7,9,10
 As well as prothombin (clotting factor 2)
-it also participates in some things independent from clotting factors:

Question 10

osteocalcin

Answer 10

The function of this is to promote calcification of bones

So it vit K participates in bone tissue formation by forming osteocalcin.

Question 11

DEFICIENCIES: of vit. K

Answer 11

-bleeding diathesis
 No coagulation because clotting factors aren’t produced enough by the liver
 This is especially important in newborn babies: hemorrhagic disease of
newborn.
 The most dangerous is bleeding into the brain tissue: parenchymal hemorrhage.
 This disease is typical of vit K deficiency due to non production of vit K by their nongut flora.

Question 12

NIDUS

Answer 12

-formation in vit A and B6 deficiency -epithelial cells live 120 days
-because of deficiencies of vit A and B6, the lifespan of epithelial cells is shorter: 30 days
-every 30 days there is sloughing of epithelial cells.
-this means that more epithelial cells are being sloughed off and join together and form a
nidus- around which kidney stones can be formed. / urinary stone.

Question 13

Protein energy
malnutrition
(PEM)

Answer 13

-PEM refers to a range of clinical syndromes characterized by an inadequate dietary
intake of proteins and calories to meet the body’s needs

Common in third world countries.

Common in Africa
-may be a lack of proteins and calories or may be a lack of one of them

Question 14

TWO COMPARTMENTS OF PROTEINS IN OUR BODY

Answer 14

(1) -somatic protein compartments (proteins are located in the muscles)
(2) - visceral protein compartment ( protein is found predominately in the liver)(liver uses protein for its fxn)(albumin)

Question 15

MALNOUISHED.

Answer 15

less then 80% of the weight on the table

Question 16

MARASMUS

Answer 16

loss of weight more then 60% of normal weight from the tables
-lack of energy (calories) and protein
-decreases weight
1.-growth retardation
2.-loss of muscles.
-they use carbs, then fat, then proteins for energy
3.-there is loss of the somatic compartment of proteins so they get loss of muscles.
4.-serum albumin level is not affected.

There is depletion of somatic compartment, but not visceral compartment.
5.- extremities are emaciated
6.- large head because the body has lost its mass
7.- anemia
8.- multivitamin deficiency

Lack of nutrition leads to vitamin malnutrition
9.- immune deficiency
People will die

Question 17

kwashiorkor

Answer 17

-only lack of proteins, but good energy
-named in African which means first- second.
 The babies are weaned early in Africa
 So they give the baby a lot of carbs and not a lot of protein
-much more dangerous and serious then marasmus.

1.- loss of visceral protein compartment
 With hypo-albuminemia
 This loss of albumins in the blood means there is loss of oncotic pressure in BVs.
Blood will move to the tissues which has higher oncotic pressure and blood fluid
escapes from BVs into the tissues generalized edema (oncotic pressure deals
with proteins- movement of fluid from low oncotic pressure, to high oncotic
pressure) (lack of albumins in food lack in blood decreased oncotic pressure in BVs called hypoalbuminemia)
-the patient will have extra weight from fluid accumulation in the tissues.

2.-hair changes
 African children have black curly hair. They get loss of colour.
 Alternating band of pale and darker hair
 Straightening of curly hair
3.- skin lesions
 Zone of hyperpigmentation
 Areas of desquamation, hypopigmentation (black alternates with lighter colours of
the skin)
 FLAKY PAINT APPEARANCE of the skin** (kwashiorkor)- this is
hypopigmentation and hyperpigmentation. (less amount of black amounts of skin) 4.- fatty liver
 Liver steatosis due to protein malnutrition
 Accumulation of too much free fatty acids which would normally join with protein
5.- hepatomegaly
 Due to 4. Will cause cirrhosis
6.- apathy, listelessness, anorexia
7.- defects in immunity
 They are prone to infection
 They have anemia because there isn’t enough components of food (B12 is in animal food)
 A secondary infection will develop
 There are changes in the intestinal mucosa- atrophy of intestinal mucosa and lack
of vlili in the intestines. (process of digestion is impaired)
 Non production of enzymes for carb digestion: so these children can not tolerate
milk.

Question 18

Micro element
pathology
Trace elements(deficiency)

Answer 18

Iron - hypochromic, microcytic anemia
Iodine - hypothyroidism-goiter
Selenium - keshan disease - myopathy, congestive cardiomyopathy
Copper - muscle weakness -hypopigmentation
Zinc - a distinctive rash, acrodermatitis enteropathica-anorexia, diarrhea
-growth retardation
-hypogonadism, infertility
-impaired wound healing
-impaired night vision
-impaired immune function
-depressed mental function

Question 19

-MICRO ELEMENTS DEFINITION

Answer 19

the chemical elements whose normal concentration isless then one microgram in one gram of wet soft tissue

Question 20

Nutritional disorders

Answer 20

Anorexia nervosa (AN)
bulimia

Question 21

Anorexia nervosa (AN)

Answer 21

-affects women
-is self- induced starvation, resulting in marked weight loss
-in all patients with AN there is: (MANIFESTATIONS)
 1. Amenorrhea (absence of menstruation, a sign of pregnancy)
 Due to lack of gonadotropin- releasing hormone, luteinizing, and follicle stimulating hormone
 2. Signs typically of hypothyroidism:
 cold intolerance
 constipation
 bradycardia (decreases heart rate)
 skin is dry and scaly.
 Osteoporosis (this occurs more in women so this is a double bang due to endocrine problems) (this is a result of decreased estrogen production of abnormalities of the endocrine system)
 3. Cardiac arrhythmia
 4. Hypokalemia (decreased concentration of potassium)
 because people aren’t eating enough food.
-breast does not diminish in size, this is how we differentiate from other disorders (it isused for differential diagnosis)

Question 22

bulimia

Answer 22

-is a condition in which the patient binges on food and they induce vomiting
-this is a serious disease
-results in
 1. amenorrhea
 develops in only 50% of the women
 but irregular menstruation occurs
 2. Hypokalemia can die due to cardiac arrhythmia
 3. Aspiration pneumonia
 inhalation of stomach contents, the stomach contents goes into pharynx and in
inspiration, the vomit might go into the lung tissue
 this is very dangerous type of pneumonia- there is infection and inflammation and chemical damage of the lung tissue and tracheal bronchial tree because acid
shouldn’t be there.
 May result in strangulation
 This is a problem for alcoholics
 4. Esophageal and cardiac rupture.  damage of esophagus due to vomiting
 rupture means that food gets into mediastinum and you cant clean that out
 rupture of heart due to increased pressure when vomiting.

Question 23

Vit E aka ALFO TOCOPHEROL

Answer 23

-this is a collective name of Vit E consisting of four trocopherols and fourtocotrienols.
Found in many foods