Csd Ii Exam I Flashcards

Front 1

what two parameters determine an individual's blood pressure?

Back 1

cardiac output x stroke volume

Front 2

what two parameters determine an individual's cardiac output?

Back 2

stroke volume x heart rate

Front 3

what elevated parameters is elevated blood pressure/hypertension due to?

Back 3

cardiac output and/or peripheral resistance

Front 4

what percentage of hypertension is considered primary or essential hypertension?

Back 4

98%

Front 5

is a higher risk associated with elevated systolic or diastolic blood pressure?

Back 5

systolic

Front 6

what are five routine laboratory tests that are used to evaluate a person for hypertension?

Back 6

(1) urinalysis
(2) CBC
(3) BMP
(4) lipid profile
(5) ECG

Front 7

At what level of blood pressure do you want to keep someone with uncomplicated hypertension below?

Back 7

140/90

Front 8

At what level of blood pressure do you want to keep someone who has hypertension with diabetes mellitus?

Back 8

130/80

Front 9

At what level of blood pressure do you want to keep someone who has hypertension with renal impairment?

Back 9

130/80

Front 10

At what level of blood pressure do you want to keep someone with high risk hypertension?

Back 10

130/80

Front 11

About how much does blood pressure decrease with weight loss?

Back 11

5-20 mm Hg/10 kg

Front 12

About how much does blood pressure decrease when someone adopts the DASH eating plan?

Back 12

8-14 mm Hg

Front 13

About how much does blood pressure decrease when someone goes on a 2 g Na diet?

Back 13

2-8 mm Hg

Front 14

About how much does blood pressure decrease with 150 mins/wk of physical activity?

Back 14

4-9 mm Hg (only if HR is elevated)

Front 15

About how much does blood pressure decrease with moderation of alcohol comsumption?

Back 15

2-4 mm Hg

Front 16

this type of hypertension is when it is poorly controlled and the person is on three drugs including a diuretic

Back 16

resistant

Front 17

this type of hypertensive state requires immediate blood pressure reduction to prevent or limit target organ damage

Back 17

hypertensive emergency

Front 18

this type of hypertensive state benefits from reducing blood pressure within a few hours

Back 18

hypertensive urgency

Front 19

this type of hypertension seen in pregnant women is high blood pressure present before pregnancy or diagnosed before the 20th week of gestation

Back 19

chronic

Front 20

this type of hypertension seen in pregnant women is increased blood pressure that occurs in pregnancy (after the 20th week) and is accompanied by edema, proteinuria, or both

Back 20

preeclampsia

Front 21

what three types of drugs are contraindicated for pregnant women?

Back 21

ACE inhibitors, angiotensin II receptor blockers, and direct renin inhibitors

Front 22

what drug is commonly recommended for women diagnosed with hypertension during pregnancy?

Back 22

methyldopa

Front 23

what blood pressure level should you use as a guide to determine if blood pressure is too high?

Back 23

180/100

Front 24

suffix meaning to create, produce

Back 24

-genesis

Front 25

suffix meaning to break down

Back 25

-lysis

Front 26

highly-branched polysaccharide composed of glucose subunits; major carbohydrate storage form in humans

Back 26

glycogen

Front 27

synthesis of glycogen, predominantly in the liver and skeletal muscle

Back 27

glycogenesis

Front 28

breakdown of glycogen to glucose

Back 28

glycogenolysis

Front 29

formation of glucose by the liver or kidneys from pyruvate, lactate, glycerol, or amino acids

Back 29

gluconeogenesis

Front 30

metabolic pathway that breaks down glucose to two molecules of pyruvate (aerobically) or two molecules of lactate (anaerobically)

Back 30

glycolysis

Front 31

synthesis of triacylglycerol

Back 31

lipogenesis

Front 32

breakdown of triacylglycerol, the primary energetic storage for of lipids

Back 32

lipolysis

Front 33

production of ketones, predominantly in the liver

Back 33

ketogenesis

Front 34

any of the three compounds created by acetyl CoA which are water soluble cellular fuels normally exported by the liver; used by the brain in situations of starvation

Back 34

ketone body

Front 35

what are the three ketone bodies?

Back 35

(1) acetoacetate
(2) hydroxybutyrate
(3) acetone

Front 36

an acid containing a ketone group (-CO-) in addition to the acid group(s)

Back 36

ketoacid

Front 37

product of fatty acid metabolism that accumulates in blood during starvation and in severe untreated diabetes; acetoacetic acid, acetone or B hydroxybutyric acid (also called ketone body)

Back 37

ketone

Front 38

plasma pH <7.35 accompanied by the accumulation of ketone bodies in the body tissues and fluids

Back 38

ketoacidosis

Front 39

high blood glucose concentration

Back 39

hyperglycemia

Front 40

low blood glucose concentration

Back 40

hypoglycemia

Front 41

normal blood glucose concentration

Back 41

euglycemia

Front 42

what is the role of glucose in the human body?

Back 42

provides energy for the body's cells

Front 43

what are some of the consequences of low blood glucose (hypoglycemia)?

Back 43

anxiety
shakiness
mental confusion
sweating
later, at risk for seizures

Front 44

what are some of the consequences of high blood glucose (hyperglycemia)?

Back 44

increased respiration
fruity smell
diabetic coma
ketoacidosis

Front 45

this type of diabetes is an autoimmune destruction of pancreas beta cells; caused by hyposecretion

Back 45

type I

Front 46

this type of diabetes is slow onset, and subtle; caused by hyporesponsiveness

Back 46

type II

Front 47

what are the three major organs involved in the metabolism of carbohydrates, proteins, and fat?

Back 47

(1) liver
(2) adipose cells
(3) skeletal muscle

Front 48

what is the major hormone used to lower blood glucose?

Back 48

insulin

Front 49

control of the flow of fuels in or out of the major organs that matabolize fuels is via what two mechanisms?

Back 49

(1) hormones
(2) autonomic nervous system

Front 50

what hormones are used to control blood glucose?

Back 50

insulin, glucagon, epinephrine, norepinephrine, cortisol, and growth hormone (insulin is the only one that lowers, the rest raise)

Front 51

this metabolic functional state is a state of plenty and occurs when ingested nutrients are being absorbed into the blood; anabolic pathways predominate, resulting in maitaining body proteins, and store energy molecules in the form of fat or glycogen

Back 51

absorptive state

Front 52

this metabolic functional state, the state of fasting, occurs when no nutrients are absorbed from the gastrointestinal system; the major goal of this state is to spare glucose for the nervous system; metabolic pathways stimulated during this state are catabolism of carbohydrates, fat, and proteins

Back 52

postabsorptive state

Front 53

what are the two major hormones of the absorptive state?

Back 53

insulin and growth hormone

Front 54

about 2/3 of ingested CHO is this plant polysaccharide

Back 54

starch

Front 55

about 1/3 of ingested CHO is in the form of these two disaccharides

Back 55

sucrose and lactose

Front 56

the majority of ingested CHO is digested and absorbed where?

Back 56

the upper 20% of the small intestine

Front 57

approximately __% of ingested CHO are absorbed

Back 57

98%

Front 58

digestion of CHO begins in the mouth where what enzyme begins to break down starch?

Back 58

salivary amylase

Front 59

salivary amylase begins to break starch down into what type of CHO?

Back 59

disaccharides and short branches chains of glucose

Front 60

what are three types of disaccharides?

Back 60

(1) sucrose
(2) lactose
(3) maltose

Front 61

in the small intestine, what enzyme digests starch into disaccharides and short branched chains of glucose?

Back 61

pancreatic amylase

Front 62

sucrose, lactose, maltose and glucose are further digested by these enzymes located in the border of GI epithelial cells into monosaccharides

Back 62

luminal enzymes

Front 63

what are the three monosaccharides that the disaccharides and branched chains of glucose are broken down into in the GI tract?

Back 63

(1) glucose
(2) galactose
(3) fructose

Front 64

this glucose transporter gets glucose into the skeletal muscle cells

Back 64

Glut 4

Front 65

this glucose transporter on the basal membrane transports monosaccharides out of the G1 epithelial cells into the interstitial space; it is also found in the liver, pancreas, and kidney

Back 65

Glut 2

Front 66

how does glucose enter the beta cells of the pancreas?

Back 66

via facilitated transport through the Glut-2 transporter

Front 67

the metabolism of glucose is coupled with an influx of what and a section of what?

Back 67

calcium, insulin

Front 68

this is a key anabolic hormone for many tissues in the body to promote glucose uptake into skeletal muscle cells and adipocytes

Back 68

insulin

Front 69

this is the preferred energy source for the body's cells; it can be fully oxidized to ATP

Back 69

glucose

Front 70

what is the key pathway for the breakdown of glucose in the body?

Back 70

glycolysis

Front 71

what are the two fates of glucose when it enters the liver?

Back 71

(1) liver glycogen
(2) becomes triglycerides that are packaged into VLDLs and enter the circulation

Front 72

what are the two fates of glucose when it enters the muscle?

Back 72

(1) muscle glycogen
(2) oxidized for energy

Front 73

what is the fate of glucose when it enters the adipocytes?

Back 73

triglycerides

Front 74

what is the alternative mechanism (other than insulin) that is used to promote glucose entry into muscle cells?

Back 74

muscle contraction

Front 75

what are the two main responses to exercise (in relation to glucose)?

Back 75

(1) increased glucose transport
(2) after exercise effect: promotes insulin sensitivity and glycogen storage

Front 76

this is a transmembrane receptor that possesses tyrosine kinase activity on the muscle cells and adipocytes

Back 76

insulin receptor

Front 77

this is a protein that is involved in glucose transport; its inhibition allows glut-4 transporter translocation

Back 77

AS160

Front 78

this protein phosphorylates AS160, therefore allowing glut4 translocation; also stimulates glycogenesis

Back 78

Akt

Front 79

this is a glucose transporter that facilitates glucose diffusion in response to insulin signaling or muscle contraction

Back 79

Glut-4

Front 80

this kinase acts as a fuel sensor; when activated, it favors catabolic pathways and stimulates production of 2 ADP--> ATP + AMP

Back 80

AMPK (AMP activated kinase)

Front 81

the brain accounts for approximately __ % of the consumption of glucose when the body is at rest

Back 81

60

Front 82

a total of about __ g of glucose is consumed per day

Back 82

120

Front 83

the brain is sensitive to lowered blood glucose, therefore, below __ mg/dL you will see signs and symptoms of hypoglycemia

Back 83

70

Front 84

blood glucose levels below __ mg/dL is a serious situation (can be life-threatening)

Back 84

40

Front 85

during situations of starvation, the brain utilizes __

Back 85

ketones

Front 86

what are the three major fuels for muscles?

Back 86

(1) carbohydrates
(2) fats
(3) ketones

Front 87

during resting conditions, muscle preferentially utilizes what for energy?

Back 87

fatty acids

Front 88

glycogen can be converted into what molecule during muscle contraction to meet the energy demands of the muscle?

Back 88

glucose-6-phosphate

Front 89

this cycle is when pyruvate can be converted into lactate or alanine, which are then transported by the circulation to the liver where it uses them to produce glucose

Back 89

Cori cycle

Front 90

these molecules are synthesized within the adipocytes from fatty acids, glycerol, and glucose

Back 90

triglycerides

Front 91

this enzyme catalyzes the breakdown of triglycerides to fatty acids and glycerol

Back 91

lipase

Front 92

a major stimulus for the release of fatty acids is the level of what molecule that is a metabolite of glucose?

Back 92

glycerol-3-phosphate

Front 93

the liver stores about __-__ kcals of glycogen

Back 93

400-450 (100 g)

Front 94

during this phase, the liver takes of glucose and promotes glycogenesis

Back 94

absorptive

Front 95

during this phase, the liver releases glucose through the metabolic processes of glycogenolysis and gluconeogenesis

Back 95

post absorptive

Front 96

during periods of excess triglycerides, the liver synthesizes these molecules

Back 96

VLDLs

Front 97

during periods of low fuel availability, the liver converts fatty acids into what?

Back 97

ketones

Front 98

the liver meets its own energy requirements through the production of what from amino acids?

Back 98

ketoacids

Front 99

about how much glucose is containe din the plasma?

Back 99

3g or 12 kcal

Front 100

where is the major glycogen storage in the body?

Back 100

muscle glycogen

Front 101

what is the body's upper limit for glycogen storage?

Back 101

15 g/kg body mass

Front 102

what is the body's upper limit of glycogen storage for a 70 kg male?

Back 102

1050 g; about 4200 kcal

Front 103

what is the body's upper limit of glcogen storage for a 56 kg female?

Back 103

840 g; about 3360 kcal

Front 104

on the average normal diet, what are muscle glycogen stores?

Back 104

400 g (1600 kcal)

Front 105

the digestion of proteins begins in the stomach, where the secretion of __ is converted into __ in the presence of H?

Back 105

pepsinogen; pepsin

Front 106

what cells in the stomach secrete pepsinogen?

Back 106

chief cells

Front 107

__% of ingested protein is absorbed as amino acids?

Back 107

99%

Front 108

in the small intestines, peptide fragments are converted into what molecules?

Back 108

oligopeptides (3-8 amino acid residues)

Front 109

in the small intestines, what enzyme converts peptide fragments into oligopeptides?

Back 109

pancreatic enzymes (trypsin, chymotrypsin, elastase, carboxypeptidase)

Front 110

what enzymes in the stomach allow oligopeptides to be digested into amino acids or short peptides of 2 or 3 amino acids?

Back 110

intestinal brush boarder peptidases

Front 111

what are the three major fates of absorbed proteins?

Back 111

(1) amino acids enter the body cells and are used for synthesis of proteins
(2) amino acids enter the liver where they can be oxidized for energy or used to synthesize liver proteins
(3) some amino acids are converted into ketoacids

Front 112

what are the three major fates of the ketoacids?

Back 112

(1) converted into urea for excretion by kidney
(2) can enter the Krebs cycle for oxidation
(3) can be converted into fatty acids

Front 113

what is another name for dietary fat?

Back 113

chylomicron

Front 114

which enzyme in the circulation releases free fatty acids and monoglycerides from dietary fat that can enter the body's cells?

Back 114

lipoprotein lipase

Front 115

fat digestion and absorption occurs almost entirely in what organ?

Back 115

the small intestine

Front 116

about __% of ingested fat is absorbed

Back 116

95%

Front 117

What are six functions of calcium in the body?

Back 117

(1) muscle contraction
(2) role in action potential
(3) second messenger
(4) exocytosis of messengers (neurotransmitter, insulin)
(5) major bone mineral
(6) blood clotting

Front 118

where is the majority of total body calcium found (98.8%)?

Back 118

bones

Front 119

about how much calcium is combined with plasma proteins and is non-diffusible through the capillary membrane?

Back 119

41%

Front 120

about how much calcium is combined with plasma ECF and anionic substances?

Back 120

9%

Front 121

about how much calcium is ionized and can freely diffuse through the capillary membrane?

Back 121

50%

Front 122

what is the average calcium level in the human body?

Back 122

9.4 mg/dL (normal range-9.0-10.5)

Front 123

what are three functions of phosphate?

Back 123

(1) major bone mineral
(2) acid-base buffer system
(3) phosphorylation of proteins

Front 124

about how much phosphate is found as bone mineral?

Back 124

85%

Front 125

about how much phosphate is found in cells?

Back 125

14-15%

Front 126

about how much phosphate is found in the ECF?

Back 126

less than 1%

Front 127

inorganic phosphate comes in what two forms?

Back 127

HPO4- and H2PO4-

Front 128

which form of phosphate is contained in higher concentration in the ECF?

Back 128

HPO4

Front 129

what is the average total quantiity of inorganic phosphorus in the body?

Back 129

4 mg/dL

Front 130

this is a decrease in the ECF concentration of calcium that causes neuromuscular excitability; this results in a condition of tetany

Back 130

hypocalcemia

Front 131

the decrease in calcium allows easy initiation of action potentials through an increase in the permeability to this ion

Back 131

sodium

Front 132

this is an increase in the ECF concentration of calcium, which depresses the nervous system and muscle activity; serious cardiac arrhythmias may occur if it becomes too high

Back 132

hypercalcemia

Front 133

what are the three major hormones in the body that control calcium and phosphate balance?

Back 133

(1) parathyroid hormone
(2) Vitamin D3
(3) calcitonin

Front 134

what organ is considered the major calcim reservoir in the body?

Back 134

bone

Front 135

bone is composed of an organic matrix composed largely of what type of fibers?

Back 135

collagen

Front 136

what is the homogenous ground substance in bone made of?

Back 136

fluid and proteoglycans

Front 137

what is the primary crystalline bone salt found in the bone matrix?

Back 137

hydroxyapatite

Front 138

what cells are responsible for deposition of bone?

Back 138

osteoblasts

Front 139

active osteoblasts secrete what enzyme?

Back 139

alkaline phosphatase

Front 140

what are mature osteoblasts embedded in the bone matrix called?

Back 140

osteocytes

Front 141

bone absorption occurs by activation of what type of cells?

Back 141

osteoclasts

Front 142

about how much calcium that is presented to the GI tract gets excreted?

Back 142

90%

Front 143

about how much of the filtered calcium gets reabsorbed

Back 143

99%

Front 144

what is the major site for the adjustment of the final amount of reabsorption of calcium?

Back 144

late distal tubule

Front 145

the C cells of this gland secrete calcitonin

Back 145

thyroid

Front 146

what stimulates the release of parathyroid hormone by the parathyroid gland?

Back 146

a decrease in calcium concentration in the circulation

Front 147

this hormone functions to stimulate the release of exchangeable calcium, proliferation of osteoclasts, increase absorption, increased renal absorption of calcium and excretion of phosphate, and secretion of vitamin D3

Back 147

parathyroid hormone

Front 148

some studies have shown that this hormone will decrease osteoclastic absorption of calcium and shift the balance of absorption vs. deposition towards more deposition; possibly decreases the formation of osteoclasts

Back 148

calcitonin

Front 149

what are four other hormones that increase bone mass?

Back 149

(1) insulin
(2) Growth hormone/IGF-1
(3) estrogen
(4) testosterone

Front 150

what are three hormones that can decrease bone mass?

Back 150

(1) parathyroid hormone
(2) cortisol (at high levels)
(3) thyroid hormone (at high levels)

Front 151

decreased parathyroid hormone leads to this problem, which leads to decreased EFC calcium; tetany is a serious concern with this

Back 151

hypoparathyroidism

Front 152

an increase in the concentration of parathyroid hormone leads to this condition, which causes increased osteoclastic activity

Back 152

hyperparathyroidism

Front 153

this type of hyperparathyroidism occurs due to oversecretion of PTH and is usually caused by a tumor

Back 153

primary

Front 154

this type of hyperparathyroidism is caused by increased secretion of PTH secondary to derangements in calcium balance (i.e. kidney failure, vitamin D deficiency)

Back 154

secondary

Front 155

this disease is generally due to a lack of vitamin D3 in the diet of children; both the plasma levels of calcium and phosphate are decreased and the compensatory rise in PTH cause sincreased bone absorption and thus weakened bones; new bone is formed but it is not properly calcified

Back 155

rickets

Front 156

this is improper mineralization of the new bone matrix in adults; may be due to calcium, vitamin D, or phosphate deficiency

Back 156

osteomalacia

Front 157

this disease occurs when renal failure leads to decreased secretion of vitamin D3 and therefore decreased absorption of calcium

Back 157

renal rickets

Front 158

this is the loss of bone mass, diminished organic bone matrix

Back 158

osteoporosis

Front 159

what are five possible causes of osteoporosis?

Back 159

(1) protein malnutrition
(2) lack of physical activity
(3) postmenopausal lack of estrogen
(4) old age
(5) Cushing's syndrome (Excess cortisol)

Front 160

what are three things that could cause a vitamin D deficiency?

Back 160

(1) lack of sunlight
(2) poor nutrition
(3) dietary restrictions

Front 161

these are chemical substances that are necessary for the life and growth of an organism

Back 161

nutrients

Front 162

what are four functions of nutrients?

Back 162

(1) normal cellular function
(2) cellular repair
(3) growth and development
(4) immunity

Front 163

what are the six types of macro and micronutrients?

Back 163

(1) proteins
(2) CHO
(3) fat
(4) vitamins
(5) minerals
(6) water

Front 164

the inadequate usage of a nutrient to sustain normal biochemical function

Back 164

malnutrition

Front 165

what is the common cause of malnutrition?

Back 165

a cellular imbalance between the supply of nutrients and the body's demand for them

Front 166

what is a deficiency of protein called?

Back 166

kwashiorkor

Front 167

what is a deficiency of energy called ?

Back 167

marasmus

Front 168

what is a deficiency of iron called?

Back 168

anemia

Front 169

what can vitamin A defiency cause?

Back 169

night blindness, or full blindness later

Front 170

what is vitamin C defiency called?

Back 170

scurvy

Front 171

what is thiamin deficiency called?

Back 171

beriberi

Front 172

what can a calcium deficiency cause?

Back 172

osteoporosis

Front 173

what can a vitamin D deficiency cause?

Back 173

rickets, osteoporosis

Front 174

what can an iodine deficiency cause?

Back 174

goiter

Front 175

what can a folate deficiency cause?

Back 175

neural tube defects in a fetus

Front 176

children who are poorly malnourished suffer up to __ days of ilness each year

Back 176

160

Front 177

the triceps skinfold thickness is an indicator of what in the body?

Back 177

subcutaneous fat

Front 178

the mid upper arm circumference is an indicator of what in the body?

Back 178

muscle mass

Front 179

some common symptoms of this disease include edema of the abdomen and extremities, decreased muscle mass, enlarged and fatty liver, inadequate growth, lethargy, flaky skin, vomiting, and diarrhea

Back 179

kwashiorkor

Front 180

what six laboratory values will be decreased in a child who is diagnosed with kwashiorkor?

Back 180

(1) serum albumin
(2) plasma glucose
(3) plasma amino acids
(4) potassium
(5) magnesium
(6) serum cholesterol

Front 181

a moderate protein energy malnutrition is considered a loss of __-__% of body weight

Back 181

10-20

Front 182

a severe protein energy malnutrition is considered a loss of greater than __% of body weight

Back 182

20%

Front 183

this type of protein energy malutrition is a result of insufficient intake of protein and energy

Back 183

primary

Front 184

this type of protein energy malnutrition is a result of complications of diseases and other illnesses that impair the body's ability to absorb nutrients

Back 184

secondary

Front 185

these things that are found in human breastmilk can help kill bad gut bacteria in the baby and keep the good ones around

Back 185

oligosaccharides

Front 186

this is an energy dense lipid paste very similar to peanut butter, but wth added vitamins, and minerals, powdered milk, vegetable oil, and sugar

Back 186

ready to use therapeutic food (RUTF)

Front 187

these are esesntial organic substances in the body that control body processes (cofactors in enzymatic reactions)

Back 187

vitamins

Front 188

what are the 8 water soluble vitamins?

Back 188

(1) thiamin (B1)
(2) riboflavin (B2)
(3) niacin (B3)
(4) pyridoxine (B4)
(5) cobalamin (B12)
(6) ascorbic acid (C)
(7) folate
(8) pantothenic acid

Front 189

what are the four fat soluble vitamins?

Back 189

A, D, E, and K

Front 190

what are the six essential inorganic minerals needed for the body?

Back 190

(1) iodine
(2) sodium
(3) chloride
(4) calcium
(5) potassium
(6) magnesium

Front 191

what are the two trace elements/minerals found in the body?

Back 191

iron and zinc

Front 192

this is the most common nutrition disorder in the world and is a lack of iron

Back 192

anemia

Front 193

what is a diet component that can help increase iron absorption?

Back 193

vitamin C (ascorbic acid)

Front 194

what are two diet components that can decrease iron absorption?

Back 194

oxalates in spinach and tannins in tea

Front 195

this is a diffuse enlargment of the thyroid gland caused by a deficiency of iodine

Back 195

goiter

Front 196

this is a congenital abnormality that is an irreversible form of mental retardation that can be caused by severe iodine deficiency

Back 196

cretinism

Front 197

what are the two types of neural tube defects that can be caused by a lack of folic acid in the diet?

Back 197

(1) spina bifida
(2) anencephaly

Front 198

what are some common consequences of a thiamine (B1) deficiency?

Back 198

(1) cerebral ataxia (neuropathic beriberi)
(2) cardiac beriberi (congestive heart failure)
(3) wenicke korsakoff syndrome (confusion and psychosis)

Front 199

what can a deficiency of fluoride cause?

Back 199

dental caries

Front 200

what can an excess of fluoride cause?

Back 200

fluorosis (crippling bone disease)