Term
| What causes the diarrhea characteristic of Kwashiorkor? |
|
Definition
| villous atrophy of the small intestine |
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|
Term
| Loss of visceral protein compartment is characteristic of what type of malnutrition? |
|
Definition
|
|
Term
| Loss of somatic protein compartment is characteristic of what type of malnutrition? |
|
Definition
|
|
Term
| What types of illnesses cause a marasmus-like secondary malnutrition? |
|
Definition
| chronic illnesses like cancer and chronic lung disease |
|
|
Term
| What types of illnesses cause a Kwashiorkor-like secondary malnutrition? |
|
Definition
| acute catabolic illnesses like burns, trauma, and sepsis |
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Term
| What are the symptoms of cachexia? |
|
Definition
| extreme weight loss, fatigue, muscle wasting, and anemia |
|
|
Term
| What are the cachetic agents produced by tumors: |
|
Definition
| PIF (proteolysis-inducing factor) and LMF (lipi-mobilizing factor) |
|
|
Term
| How do you calculate BMI? |
|
Definition
| weight in kg/height in meters squared |
|
|
Term
| What's a normal BMI? At what BMI is a patient determined to have malnutrition? |
|
Definition
normal is 18.5 to 25 kg/m2
<16kg/m2 is considered malnutrition |
|
|
Term
| Besides decreased weight, what are the other possible symptoms of anorexia nervosa? |
|
Definition
| amenorrhea, hypothyroidism, decreased bone density, anemia, hypokalemia |
|
|
Term
| Besides weight loss, what are other dangers associated with bulimia? |
|
Definition
| hypokalemia (and other electrolyte imbalances) leading to cardiac arrhythmia, pulmonary aspiration of gastric contents, and esophageal and gastric rupture |
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|
Term
| List the fat soluble vitamins. |
|
Definition
|
|
Term
| What are the functions of vitamin A? |
|
Definition
| maintainence of specialized epithelial linings, component of visual pigment maintianing vision in reduced light, enhancing immunity to infections |
|
|
Term
| What are the dietary sources of vitamin A? |
|
Definition
| animal derived (liver, fish, eggs, milk) and yellow and leafy green vegetables (carrots, squash, spinach) |
|
|
Term
| What are the characteristic eye changes associated with vitamin A deficiency? |
|
Definition
| Bitot's spots, corneal ulcer, and keratomalacia |
|
|
Term
| T/F Vitamin A deficiency can cause kidney stones. |
|
Definition
| True, without vitamin A you don't have normal ciliated columnar epithelium in the kidney leading to pelvic keratinization which can lead to stones or possibly cancer |
|
|
Term
| Headache, vomiting, stupor, and papilledema (basically, symptoms of a brain tumor) can actually be due to what nutrition issue? |
|
Definition
|
|
Term
| Weight loss, nausea, vomiting, mucosal dryness, bone and joint pain, hepatomegally with fibrosis and increased bone resorption and osteoporosis can be indicative of what type of malnutrition? |
|
Definition
| chronic toxicity of vitamin A |
|
|
Term
| Which viatmin promotes calcium and phosphate absorption in the small intestine? |
|
Definition
|
|
Term
| What are the dietary sources of vitamin D? |
|
Definition
| deep sea fish, plants and grains |
|
|
Term
| What enzymatic reactions occur to make vitamin D active. |
|
Definition
| D-25-hydroxylase in the liver converts vitamin D to 25-OH-D which is converted by alpha-1-hydroxylase in the kidney into 1,25(OH)2D |
|
|
Term
| What are the signs of Rickets? |
|
Definition
| craniotabes, frontal bossing and squaring of head, rachitic rosary, pigeon breast, Harrison's groove, lumbar lordosis, and bowing of the legs |
|
|
Term
| In children, vitamin D deficiency presents as ________. In adults vitamin D deficiency presents as ______. |
|
Definition
|
|
Term
| T/F Leg bowing is a common HPI for osteomalacia. |
|
Definition
| False, in osteomalacia you have weak bones vulnerable to gross or microfractures (esp in the vertebral bodies and femoral necks) |
|
|
Term
| What are the effects of hypervitaminosis D? |
|
Definition
Initially: hypercalcemia with weakness and headaches
Later: renal stones and clacifications, ectopic calcification |
|
|
Term
| T/F Vitamin E is an anti-oxidant. |
|
Definition
|
|
Term
| Which circumstances put patients at risk for vitamin E deficiency? |
|
Definition
| TPN, intestinal malabsorption, low birth weight infants, abetalipoporteinemia |
|
|
Term
| What is the effect of vitamin E deficiency on the body? |
|
Definition
degeneration of axons in posterior column of spinal cord
loss of nerve cells in the DRG
vtamin E deficient RBCs are more susceptible to oxidative stress and have a shorter half life |
|
|
Term
| What dietary problem causes decreased tendon reflexes, ataxia, dysarthria, loss of position and vibration sense, loss of pain sensation, muscle weakness, impaired vision, anemia, and disorders of eye movement? |
|
Definition
|
|
Term
| What does the body use vitamin K for on the molecular level? |
|
Definition
| as a cofactor for a liver microsomal carboxylase which converts glutamyl residues to gamm-carboxyglutamates |
|
|
Term
| How does Warfarin/coumadin work? |
|
Definition
| Warfarin blocks the action of vitamin K by preventing it from being recycled via the enzymes vitamin K epixide reductase and Vitamine K reductase |
|
|
Term
| Vitamin K is important for the action of which clotting factors? |
|
Definition
| II, VII, IX, and X as well as proteins C and S |
|
|
Term
| T/F Vitamin K can influence bone clacification. |
|
Definition
| True! it influences bone calcifcation through gamma-carboxylation of osteocalcin |
|
|
Term
| Vitamin K deficiency occurs in what clinical situations? |
|
Definition
| severe fat malabsorption (like in cystic fibrosis!), antibiotic use, newborns (because of low liver reserves, undeveloped bacterial flora and low levels of K in breast milk), coumarin anticoagulants |
|
|
Term
| Which vitamin is given as a routine prophylaxis for newborns? |
|
Definition
| vitamin K to prevent bleeding diathesis |
|
|
Term
| Vitamin B1 is also called ______. |
|
Definition
|
|
Term
| What are the three major functions of vitamin B1? |
|
Definition
| synthesis of ATP, cofactor in the pentose phosphate pathway, maintains neural membranes and normal nerve conduction |
|
|
Term
| Vitamin B1 (thiamine) deficiency is common in what patient population? |
|
Definition
|
|
Term
|
Definition
| vitamin B1 deficiency that results in neuropathy |
|
|
Term
|
Definition
| B1 deficiency that causes cardiac failure |
|
|
Term
| What is Wernicke-Korsakoff syndrome? |
|
Definition
| Vitamin B1 deficiency that results in Wernicke encephalopathy and Korsakoff psychosis as well as degernation, atrophy and hemorrhage of the mamillary bodies |
|
|
Term
| What is Wernicke encephalopathy characterized by? |
|
Definition
| opthalmoplegia, nystagmus, ataxia of gait and stance and mental function abnormalities |
|
|
Term
| What is Korsakoff psychosis characterized by/ |
|
Definition
| impairment of remote recall (retrograde amnesia), inability to acquire new information, and confabulation |
|
|
Term
| What is vitamin B2 also called? |
|
Definition
|
|
Term
| What is the biological function of riboflavin? |
|
Definition
| oxidation-reduction reactions |
|
|
Term
| What patient population is at risk for deficiency in riboflavin? |
|
Definition
| alcoholics, patients with chronic infections, advanced cancer, or other debilitating diseases. OR patients who avoid dairy products |
|
|
Term
| What are the characteristics of riboflavin deficiency? |
|
Definition
| cheiolosis, glossitis, kertitis and corneal ulceration, and greasy, scaling dermatitis over nasolabial folds |
|
|
Term
| Niacin is an essential component of what important biological molecules? |
|
Definition
|
|
Term
| What are the characteristics of Niacin deficiency? |
|
Definition
| dermatitis, diarrhea and dementia |
|
|
Term
|
Definition
| niacin deficiency, seen in people who eat only corn |
|
|
Term
| What is the other name for vitamin B6? |
|
Definition
|
|
Term
| Pyridoxine deficiencies are usually secondary to what conditions? |
|
Definition
| drug use (isoniazid, estrogens, and penicillamine), alcoholics (acetaldehyde enhances degradation) and pregnancy (due to increased demand) |
|
|
Term
| What are the manifestastions of pyridoxine deficiency? |
|
Definition
| no characteristic clinical symptoms but can manifest as seborrheic dermatitis, cheilosis, glossitis, or perpheral neuropathy |
|
|
Term
| What is the function of vitamin B12 on a molcular level? |
|
Definition
| converts 5-methyltetrahydrofolate to tetrahydrofolate |
|
|
Term
| What situations can lead to vitamin B12 deficiency? |
|
Definition
| dietary deficiency in extreme vegetarianism and infection by the parasitic fish tapeworm Diphyllobothrium latum |
|
|
Term
| Where is vitamin B12 absorped? |
|
Definition
|
|
Term
| Pernicious anemia is generally due to... |
|
Definition
| lack of secretion of intrinsic factor which prevents absorption of vitamin B12 in the ileum |
|
|
Term
| What is the molecular function of folate? |
|
Definition
| cofactor in nucleic acid synthesis |
|
|
Term
| What situations cause folate deficiency? |
|
Definition
| poor diet (folate is found in leafy veggies, liver, beans, nuts, and whole-wheat flour) |
|
|
Term
| Pregnancy increases your requirement for folate by ____. |
|
Definition
|
|
Term
| Which drugs act as folate antagonists? |
|
Definition
| chemotherapeutic agents (methotrexate, 6-mercaptopurine, and cyclophosphamide) |
|
|
Term
| Which drugs interfere with folate absorption and metabolism? |
|
Definition
| oral contraceptives, anticonvulsants, ethanol, and cigarette smoking |
|
|
Term
| What causes a megaloblastic anemia? |
|
Definition
|
|
Term
| If a patient comes in with megaloblastic anemia it is important to give them both folate and B12 supplements (even if you suspect folate deficiency) because... |
|
Definition
| vitamin B12 deficiency can cause subacute combined degeneration of the spinal cord that is not corrected by folate administration and potentially irreversible |
|
|
Term
| What vitamin is important for the synthesis of collagen? |
|
Definition
|
|
Term
| Which populations in developed countries are at risk for vitamin C deficiency? |
|
Definition
| the elderly (tea and toast diet), alcoholics, and infants on milk only diets |
|
|
Term
| Why did sailors have to be at sea for a LONG time (months) before they developed scurvy? |
|
Definition
| rate of catabolism of vitamin C is slow so it takes months to develop deficinecy states |
|
|
Term
| What are the symptoms of scurvy? |
|
Definition
| hemorrhage, skeletal changes (bowing of long bones and depression of sternum), swollen bleeding gums and tooth loss, impaired wound healing |
|
|
Term
| What part of the GI tract absorbs Iron? |
|
Definition
|
|
Term
| What situations can cause iron deficiency? |
|
Definition
| blood loss (blood donors, GI bleed), menstruating women, infants fed only milk, strict vegetarian diets, rapidly growing children, pregnant women, people who eat iron binding substances |
|
|
Term
| Nutritional deficiency in what promotes pica? |
|
Definition
|
|
Term
| What type of anemia is iron deficiency anemia? |
|
Definition
| hypochromatic, microcytic anemia |
|
|
Term
| What deficiency can present as acrodermatitis enteropathica, anorexia with diarrhea, growth retardation, impaired wound healing, hypogonadism with diminished reproduction capacity, altered immune function, impaired night vision (altered vitamin A metabolism), depressed mental function, and congenital malformations? |
|
Definition
|
|
Term
| Zinc deficiency is seen in what situations? |
|
Definition
| children who eat clay (which binds zinc), TPN unsupplemented with zinc, rare genetic syndrome |
|
|
Term
| Selenium deficiency symptoms are... |
|
Definition
| myopathy (rarely cardiomyopathy) |
|
|
Term
| Iodine deficiency presents as... |
|
Definition
| goiter, hypothyroidism, cretinism |
|
|
Term
| Copper deficiency presents as... |
|
Definition
| muscle weakness, neurologic defects, hypopigmentation, and abnormal collagen cross-linking |
|
|
Term
| What BMI counts as overweight? |
|
Definition
|
|
Term
| What BMI counts as obese? |
|
Definition
|
|
Term
| Metabolic syndrome is characterized by.. |
|
Definition
| visceral/intraabdominal adiposity, insulin resistance, hyperinsulinemia, glucose intolerance, hypertension, hypertriaglyceridemia, low HDL cholesterol |
|
|
Term
| What are common complications of obesity? |
|
Definition
| non-alcholic fatty liver disease, gallstones, osteoarthritis |
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