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19 Cards in this Set
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- Back
- 3rd side (hint)
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The Absorption of B12
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1. Salivary Glands Secrete R protein haptocorrin which binds B12 to prevent acid denaturation in Stomach
2. stomach parietal cells (located midway down gastric pits) secrete intrinsic factor R factor binds B12 in stomach once released from food by Acid 3. Pancreatic proteases cleave R factor which is immediately bound by intrinsic factor (to prevent degredation in SI by pancreatic enzymes) 4. IF-B12 complex abosrbed in distal ileum by IF specific receptor |
#biochemistry #nutrition #gastrointestinal
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Haptocorrin
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R factor
secreted by salivary glands binds to B12 to prevent hydrolysis by gastric acidity degraded by pancreatic proteases (where IF binds to prevents proteolytic degradation of B12) |
#biochemistry #nutrition #gastrointestinal
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Elderly Patient with Anemia and negative Fecal Occult Blood
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Probably B12 deficiency 2° aging → gastric atrophy → [relative] achlorhydria → poor B12 release from eaten foods
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#biochemistry #nutrition #gastrointestinal #hematology
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Danger of appetite suppressants
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Fenfluramine or Phentermine
↑ 5-HT release ↑ risk pulmonary htn after 3 mo → sudden cardiac death |
#pathology #nutrition #pulmonology
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Phentermine
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appetite suppressent
↑ 5-HT release like fenfluramine ↑ risk pulmonary htn after 3 mo → sudden cardiac death |
#pathology #nutrition #pulmonology #drugs
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Fenfluramine
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appetite suppressant
↑ 5-HT release like phentermine ↑ risk pulmonary htn after 3 mo → sudden cardiac death |
#pathology #nutrition #pulmonology #drugs
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What is the main mechanism for regulating iron stores?
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Hepatically produced Hepcidin produced by liver binds ferroportin and causes its degradation
[Ferroportin is basolateral iron transporter on gut epithelium. No ferroportin → iron lost in gut shedding] Hepcidin prodxn ↑ w/ high [iron] or inflammation |
#nutrition #biochemistry #molecules
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Hepcidin
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Hepatically produced Hepcidin produced by liver binds ferroportin and causes its degradation
[Ferroportin is basolateral iron transporter on gut epithelium. No ferroportin → iron lost in gut shedding] Hepcidin prodxn ↑ w/ high [iron] or inflammation Main mechanism of iron regulation |
#nutrition #biochemistry #molecules
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Timeline for correcting B12 deficiency
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Immediate ↑ Reticulocyte Count, drops off again
slow ↑ hemoglobin |
#nutrition #hematology
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Vitamin K deficiency
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Bleeding
Extremely unlikely in adults as colonic bacteria produce vitamin K |
#pathology #nutrition
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B6 deficiency anemia
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required for first step of heme synthesis
microcytic hypochromatic B6 responsive anemia same morphology as X linked Sideroblastic Anemia, but B6 responsive |
#pathology #nutrition #hematology
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Neutral Aminoaciduria
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Hartnup Dz
Defective Neutral AA transporters in both Kidneys and Intestine Tryptophan is the only essential AA, necessary for (BH4 dpt) 5HT and (B6 dpt) Niacin synth mostly aSx, though som pts present with pelagra: Diarrhea (Photosensative) Dermatitis Dementia (Ataxia) These pts benefit from Niacin supplementation |
#pathology #geneticdzs #nutrition
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Ataxia + Photosensitive Skin Lesions + Loose stools
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Pellagra 2° to Niacin Deficiency
Diarrhea, Dermatitis, Dementia causes: Corn Based Diets Carcinoid Tumor (uses up all the 5HT) Hartnup Dz: defective transport of neutral AA's in intestine and nephrons → no Tryptophan absorption → no Niacin prodxn |
#pathology #nutrition #neoplasia #geneticdzs
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Pellagra
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Diarrhea,
(Photosenstive) Dermatitis Dementia (Ataxia) causes: Corn Based Diets Carcinoid Tumor (uses up all the 5HT) Hartnup Dz: defective transport of neutral AA's in intestine and nephrons → no Tryptophan absorption → no Niacin prodxn |
#pathology #nutrition #neoplasia #geneticdzs
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Tocopherol
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Vitamin E
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#nutrition #molecules
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Vitamin E molecule name
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Tocopherol
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#nutrition #molecules
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Vitamin E deficiency
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anti-oxidant which preserves cell membranes
most affected: neurons (large surface area) RBC's (poor antioxidant fnx) manifestation: Friederick's ataxia-like neuropathy w/ ataxi a & loss of proprioception and vibration + hemolytic anemia |
#pathology #nutrition #neurology #hematology
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Extremity Edema
↑ Cardiac Output ↓ Extremity Sensation |
Wet Beriberi
neuropathy + cardiac involvement usually high output CHF Thiamine deficiency |
#pathology #nutrition
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Wet Beriberi
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Wet Beriberi
neuropathic sensory-motor loss in distal extremities + cardiac involvement usually high output CHF Thiamine deficiency dry beriberi does not include Cardiac invovlement |
#pathology #nutrition
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