Gi Exam 2: Gi Nutrition

Front 1

what are the nutritional effects of short bowel syndrome?

Back 1

jeujunum is primary site of absorption of CHO, pro, fat, and many vitamins --> may need parenteral nutrition, slowly advance to oral intake

Front 2

trouble seeing at night is associated with ___ deficiency

Back 2

vitamin A

Front 3

loss of appetite is associated with __ deficiency

Back 3

zinc

Front 4

ataxic gait is associated with __ deficiency

Back 4

vitamin E

Front 5

bruising easily is associated with __ deficiency

Back 5

vitamin K (and vitamin E)

Front 6

where are nutrients absorbed?

Back 6

all over! lots of redundancy in the bowel --> helps w/compensation after part of intestine has been removed. but there's especially a lot of absorption in the jejunum

Front 7

what are these 4 acronyms?: RDA, AI, UL, EAR

Back 7

recommended dietary allowance (amt needed to meet requirements in ~97% of population), adequate intake (amt most healthy people take in), tolerable upper intake level, estimated average requirement (amt needed to meet requirement in 1/2 of healthy population)

Front 8

current recommendations aim to minimize the harm from __ and ___.

Back 8

excess and deficiency

Front 9

fat-soluble vitamins

Back 9

A, D, E, K

Front 10

vitamin A has a # of functions. what are the 2 forms of vitamin A in the diet?

Back 10

retinoids (egg yolks, dairy) and carotenoids (orange/red veggies, dk green vegetables)

Front 11

how does vitamin a deficiency occur?

Back 11

slowly. it takes weeks and weeks to deplete vitamin A stores. slowly progresses from tissue vit A depletion --> poor growth and anemia --> night blindness --> xerophthalmia

Front 12

sx of vitamin A deficiency

Back 12

lots of them (very multifunctional nutrient). night blindness and other ocular problems, rough scaly skin, loss of appetite, reproductive problems

Front 13

causes of vit A deficiency

Back 13

GI/fat malabsorption disorders (e.g., celiac disease), inadequate intake, parasites, alcoholism

Front 14

name 2 specific sx of vitamin A deficinecy

Back 14

bitot's spots (foamy patches on conjunctiva) and follicular hyperkeratosis (goose bumps on skin)

Front 15

what is the sx of vitamin A toxicity?

Back 15

ORANGE SKIN, bone/muscle pain, cirrhosis, dry itchy skin, conjunctivitis

Front 16

what are the 2 forms of vitamin D that we get from consumption (not from the sun)

Back 16

D2 from plants and D3 from fish/egg yolks. *note: in most countries, vitamin D is supplemented in food sources b/c natural levels are low

Front 17

vitamin D __ is common in most US adults, but ___ is not so common.

Back 17

insufficiency is common, deficiency is uncommon. *note: RDA of vit D is controversial, lots of research

Front 18

what organ is required for vitamin D?

Back 18

many! small intestine, liver, kidney

Front 19

what is vitamin D deficiency?

Back 19

serum (OH) D values <20-25 nmol/L --> severe deficiency --> associated w/osteomalica and rickets (50 nmol/L is considered low). (again, there's debates that you need 75 nmol/L, need 50, etc.)

Front 20

who is at risk for vitamin D deficiency?

Back 20

exclusively breastfed infants, adults >50yrs (decreased ability to synthesize active form), anyone w/limited sun exposure, anyone w/milk allergies, strict vegetarians, fat malabsorptive d/o, alcoholics

Front 21

how do you get toxicity from vitamin D?

Back 21

taking too much supplement. NOT from sun exposure!

Front 22

vitamin E sources

Back 22

synthesized by plants, especially green ones (chloroplasts) vegetable oils, nuts, leafy greens, fortified cereals

Front 23

vitamin E deficiency sx

Back 23

neurological problems associated w/nerve degeneration in hands/feet (very rare)

Front 24

function of vitamin E

Back 24

potent ANTIOXIDANT, immune fcn, DNA repair

Front 25

vitamin E toxicity can occur in people who ___, and presents w/___

Back 25

vitamin E toxicity can occur in people who take SUPPLEMENTS, and presents w/increased BLEEDING and impaired blood coagulation

Front 26

who is at risk for vitamin E deficiency?

Back 26

malabsorption, genetic defects in alpha-tocopherol transfer protein, premature or VLBW infants, alcoholics

Front 27

vitamin K function

Back 27

blood coag, healthy bones

Front 28

sources of vitamin K (phylloquinone, menaquinone)

Back 28

dark leafy greens, broccoli, cabbages, small amts made in GI via bacterial synthesis

Front 29

clinical signs of vitamin k deficiency

Back 29

blood coag problems (bleeding, bruising), increased risk of fractures, life-threatening bleeding in newborns in/around brain

Front 30

all newborns should be given a ___ injection at birth

Back 30

vitamin K

Front 31

vitamin K may reduced __ of ___, thereby increasing ___

Back 31

effectiveness of anticoagulants like warfarin, increasing the risk of clotting (intake of foods high in vitamin K should be limited, and amts consumed daily should remain constant)

Front 32

name the water soluble vitamins

Back 32

vitamin C, B1 (thiamin), B3 (niacin)

Front 33

clinical signs of vitamin C deficiency

Back 33

scurvy --> bruising, gum and dental problems, dry hair (corkscrew hair) and skin

Front 34

vitamin B1 deficiency (thiamin)

Back 34

beriberi --> affects cardiovascular

Front 35

niacin (vitamin B3) deficiency

Back 35

pellagra --> sx are 4 Ds: diarrhea, dermatitis, dementia, death

Front 36

B6, B12, and folate are especially important in __

Back 36

pregnancy

Front 37

clinical signs of B6 deficiency

Back 37

dermatitis, glossitis, convulsions

Front 38

clinical signs of folic acid deficiency

Back 38

megaloblastic anemia, diarrhea, fatigue

Front 39

clinical signs of B12 deficiency

Back 39

megaloblastic anemia, peripheral nerve degeneration, glossitis

Front 40

folic acid can correct the ___ caused by ___ defieciency, but will not correct __.

Back 40

folate corrects ANEMIA caused by B12 deficiency, but will not correct the NERVE DAMAGE.

Front 41

function of iodine

Back 41

prevents goiters, important for thyroid fcn

Front 42

true or false: iodine deficiency isn't seen in the US any more.

Back 42

false. still seen in parts where people aren't using iodized salt.

Front 43

zinc deficiency in the US is seen in ___, zinc inadequacy is seen in ___

Back 43

deficiency in alcoholics, inadequacy in older adults (b/c food doesn't taste as good y)

Front 44

symptoms of lactose malabsorption

Back 44

increased gas, abdominal cramping, diarrhea --> result of inadequate lactase (can't metabolize)

Front 45

dx of lactose malabsorption

Back 45

lactose tolerance test (most common), lactose breath hydrogen test

Front 46

true or false: lactose intolerance is relatively rare in the US.

Back 46

false. prevalence is ~1 in 5 adults, more common in some group (e.g., AAs)

Front 47

tx of lactose malabsorption

Back 47

restrict milk + dairy. products such as lactaid may be helpful

Front 48

true or false: if you are lactose intolerant, drinking almond or soy milk is a good nutritional replacement.

Back 48

false. these do not usually provide protein, calcium, or vitamin D. (read the labels!)