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80 Cards in this Set
- Front
- Back
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A BMI of <16.5 –
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severely underweight
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A BMI OF <18,5
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UNDERWEIGHT
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A BMI OF 18.5-24.9
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NORMAL
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A BMI OF 25-29.9
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OVERWEIGHT
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A BMI OF 30-39.9
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OBESE
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BMI > 40
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SEVERLY OBESE
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WHAT ARE THE 2 PRIMARY PROTEIN ENGERY MALNUTRION
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MARASMUS
KWASHIORKOR |
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WHAT ARE THE CHARTERISTIC S OF MARASMUS
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1. CALORIE DEF.
2. AFFECTS SOMATIC PROTIEN COMPARTMETNS (PROTEINS IN THE SKELETAL MUSCLE) 3. LOSS OF SUBCOUN. FAT AND MUSCLE MASS... 4. MAINTAIN SERUM ALBUMIN 5. EMACIATED WEIGHT LOSS 6. IMMUNE DEF. <60% BODY WEIGHT ADUJSTUE FOR HEGHT AND SEX.. DECREASED MID ARM CIRCUMFERENC |
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WHAT ARE THE CHARCTERSTICS OF KWASHIORKOR...
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1. PROTEIN DEF...
2. AFFECTS VISCERAL PROTEIN COMPARTMENT. (PROTEINS IN THE SERUM AND VISCERA SUCH AS THE LIVER) 3. RALTIVE SPARING OF SUC. FAT AND MUSCLE MASS 4. LOW SERUM ALBUMIN... 5. PROTUBERANT ABDOMEN...FATTY HAEPATOMEGALY AND ASCITES 6. CHARACTERSIC SKIN LESOINS .....FLAKY PAINT.. FLAG SIGN... 7. IMMUNE DEF. |
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WHAT ARE THE SECONDAR PROTEIN-ENERGY MALNUT.
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1. CACHEXIA
2. CANCER, AIDS 3. CYTOKINES (TNF IL-6 IFN GAMMA) 4. CHRONIC GI DX |
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IF THE HIGH WAIST CIRCUMFERENCE: HIP CERCUFERENCE RATIO CORRESPONS TO ...
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CENTRAL OR VISCERAL OBESITY AND IS ASSOCIATED WITH A HIGHER RISK OF OBESITY-ASSOCIATED DISEASES
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WHAT ARE THE OBESITY ASSOCIATED HELATH COMPLICATOINS..
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Dbs
HTN Ather. CAD Met. Syn abdominal obesity, insulin rest. hypertriglemia, low serum HDL, HTN and CAD DVT Ischemic stroke Nonalcol. Fatty liver dx Hypoven. Obst. sleep apnea Osteoarthosis Cancers dementia |
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it is importatn to understand that obesity is a disorder of ...
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energy imbalance.. and the the energy imbalance is maintaine dby neruohumoral circits that include ..
1. Afferetn arm (adpiso tissue, Gi tract and Pancreaus) 2. Central sensor (HT) 3. Effector arm (feeding bhr, energy expendertaire) 4. Communicatoin via neruopeptides/hormones |
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When the you have enough energy stores the adipsoe tissue relase...
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leptin.. which activates the anorexigenic neurons and inhibits the orexigenic neurons
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when you have insuff. energy sources the stomach relaease
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Ghrelin... which active the orexigneic neurons and inhibits the anorexigenic neurons..
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what are the fxns of the orexigenic neurons..
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these are located in the HT... they release Neuropeptide Y and Agouti related peptide... then this cause the release of melanin-concentrating hormone which .... increase food intake and decrease energy expenditure
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what is the fxn of anorexigenc neurons
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in the HT... they casue the release of melanocyte stimulating hormone.. (cocaine, and amphetamine)... this cause the release of thyrotropin releasing hormone and cortio-releasing hormones.... which increase energy expendture and decrease food intake.
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4-5% of massive obesity is caused by mutations in the...
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in the
gene encoding melanocortin 4 receptor (MC4R), the receptor for melanocyte stimulating hormone1 |
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What are the fat solulbe vit.
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DEKA.
need bile for absortoin stored in the body casue toxciity when in excess |
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wate souble vit.
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Vit B, C,
dont need bile not stored except vit b12 usually dont casue toxciity |
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what are the fxns of vit. A
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Beta Carotein... photoprot. and anti oxident
retinal: chrompohore in the visual pigmetns Retinoic acid: cell growth and differentation Promtes immunity to infectoins |
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what are some of the clinical manifestions of vit A deficiency...
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Night Blindness( ealry manfeistatoin)
Xerophthalmia squamous metaplasia of res. and urothelial muc follicuar dermatosis immune def. |
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pseduotumor cerebir can occur in what vit def...
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Vitamin A
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one of the souces of Vit A is the ...
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liver
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Acute toxicity of VIt. A
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think all the manfestions are due to increase ICP
HA/Irritable/vomiting/ stupor/papilloedema. |
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Chronic toxicit of Vit A
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N/V, WL
lipdryness peeling of skin hyperostosis with bone pain hepatomeg. with hepatic fibrosis |
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what acne medication is counterindacted in preg. b/c of vit A
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Isotretinoin
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what are some of the terto. effects of vit. a toxciity
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Cleft palate
o Cardiovascular defects o Renal defects o Limb defects o Thymic agenesis o Embryonic lethality |
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Vit D2
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ergocalciferol- derived from erogosteral
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Vit d3
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cholecalciferol... made in skin from 7dehydroscholesterol on exposure to UVB
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both ergocalidroxlation and cholecalciferal under go 25 hydroxlation in the liver to form.
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25-hydroxyvit. d
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25 hydroxyvit D undergoes 1-hydroxylation in kidney to from ...
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1, 25 hydroxlation.. calcitriol..
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What are Vit D fxns..
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intestinal absorption of Ca and phosphours..
mobilization of Ca from bone PTH depended distal renal tubular reabsorption. |
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Vit d defiency leads to...
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Excess unmineralized osteoid
o Rickets in children o Osteomalacia in adults |
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Clinical manfestaion of rickets are.
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Assocatied with Vit D def.
Craniotabes • Frontal bossing • Delayed closure of cranial sutures • Rachitic rosary • Pectus carinatum (pigeon-breast) • Harrison’s groove • Kyphoscoliosis and lumbar lordosis • Genu valgus, Genu varus • Widened wrists and ankles • Greenstick fractures |
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Vit. E
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• Antioxidant, free radical scavenger
• Deficiency and toxicity are rare |
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Vit.K...
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Cofactor for liver microsomal carboxylase that
carboxylates glutamate residues in some proteins (Gla-proteins) that facilitates calcium binding |
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Vit K is derived from
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napthoquinone
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What are the players invoved in vit k fxns
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Carboxylase
vit K epoxide VitK hydroxquinone Vit K epoxide reductase |
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Pro coagualtn prteins that need vit
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2, 7, 9, 10
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anti coaglatn proteins.. that need vit k
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Protein C, S and Z
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Vit k proteins invoved in bone metabolsim
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Bone metabolism
o Osteocalcin o Calcification inhibiting Matrix Gla-protein (MGP) |
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Vit K def. can lead to..
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bleeding diathesis and hemorrhic dx of the new born.
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Vit. C. what are the fxns
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Ascorbic acid
activation of prolyl and lysyl hydroxylases from inactive precurors... and these hydroylases are reqiured for hydroxylation of proyl and lysly residues of procollagen... an important cause for cross linking and stability and strgenth. it is aslo an antioxidant ... regernartethe anioxidant from of vit. e also impotrnat in the synthesis of Da, Noradrenaline andrenalin in the NS and adrenal glands. Syntheis of Carnitine |
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What are the antioxidants
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A
C E Salenium and Zinc |
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What happens if you get Vit C def.
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Scurvy...
Hemorraghes.. .....purpura and echymosis on the kin and mucosa .....subperiosteal hemorrhages and hemarthroses .....retrobulbr sucharch. and intracerebral hemorrhages. Skeletal changes ....poor formation of osteoid matrix resulting in cartilagionsus overgrowith. thus wideing of epiphysis .... bowing of the long bones of the lower legs ....sternal depression perifollicualr, hyperkeratotic papular rash, ringed by hemorrhages impaired wound healing and localization of infections. |
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Vit. B1 is also called
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thiamine
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Vit b2 is also called
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riboflavin
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Vit B3
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niacin
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Bint b5
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pantothenic acid
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Vit b 6 also called
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pyridoxine
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vit b7 is also called
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biotin
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vit b9
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folic acid
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vit b12 is also called
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cobalamin
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whats the active form of vit b1 and what does it do
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thiamine pyroPO4 and is a cofactor for...
a. pyruvate dehy. and alpha keto glut dehy b. transketolase (PPP) c. maintenco of nerual membr. and nerve conduction. |
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in thiamine def... a subclinical sate may be converted to overt disease by..
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extended IV glucose therpay or refeeding of chronically malnourshed persons (particuarly alcholics)
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What are some of the dx assoicated with thiamine def.
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Chronic alchol
Dry beriberi (polneuro) Wet beriberi (cardo sydn) Wernike-koraskoff synd. |
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IN dry beriberi what do you see
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its a def. in thiamine vit. b1
it has symmetric peripheral neruopathy... it has a mixed motor, and sensory symptoms... you see toe drop foot drop and wrist drop |
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what are the clinical manfiestations of wet beriberi
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see this in thiamne def. its a cardo synd.
Peripheral VD which leads to high output cardiac failure Dialted cardiomyopthy Heart enlarged.. and globular with four chamber dialation and thin vetn. walls.. |
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What are the clinical manfestino in Werkcky encephaloapthy in the Wernki-koraskoff pysocoiss
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its ass. with Thiamne def.
DISORETNATION... ATAXIA, APATHY GLOBAL CONFUSION NYSTAGMUS IT RESPONDS TO THIAMINE ADMINSTRATION..... |
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WHAT ARE THE CLINICAL MANFESTATOINS THAT YOU SEE IN KORSAKOFF PYSCHOSIS
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ASSOCIATIED WITH THIAMINE DEF.. THINK MEMORY...
RETROGRADE AMNEIS WITH CONFABULATION. INABILITY TO ACQUIRE NEW INFO (ANTEGRADE AMNEISA) dONT NOT RESPOND TO THERAPY... |
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LESIONS IN WHAT PART OF THE THALMUS APPEAR TO CORRELATE BEST WITH MEMORY PROBLEMS
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MEDIAL DORSAL AND OR ANTERIOR NUCL... MIGHT BE ABNORMAL IN PTHS WITH THIAMNE DEF THAT HAVE KORSAKOFF PSYCHOSIS
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In regards to wernike enceph.. what parts of the areas of the brain are particualy vulnerable...
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thalmus
HT periquedeuctal area the colliculi and the nuclei of the pontomeduallry tegmentum. Basically the areas aournd the 3rd and 4th ventricles.. |
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Riboflain is a component of what..
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remember riboflavin is vit b2 and it is a component of
FMN FAD (flavin adenine dinucleotie) |
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what are the fxns of riboflavin (vit b2)
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remember they are components of FMN and FAD and thus partipacte in oxidation and redction rxns involved in energy production from fats, carbs and proteins.
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The defiency of Vit B2 (riboflavin) is called
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Ariboflavinosis
angular stomatitis and cheilosis Glossitis Interstial Kerantitis Dermatitis of cheeks scrotum and vulva |
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Vit b3 (niacin) its fxn is
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rember that Vit B3 or niacin is a component of the following coenymes NAD, and NADP.... thusit participates in dehydrogenation rxns in ergy met. of fats, carbs and proteins..
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The defiency of Vit b3 or niacin leads to ..
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Pellagra... 3 Dsss
Diarhea Dementia Dermatitis |
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Vit B6 aslo called pyridoxine.. its fxn is..
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well the coenxyme from pyridoxal 5-phosphate particapates in transamination, carboxlation, and deamination rxns in teh metabolsim of LIPIDS AND AMINO ACIDS.
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Vit B6 def. can casue what clinical manfestiaons..
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Dermatitis
Cheiolosis Glossitis Peripheral neruoapthy convusions Pydroxine dependent epilepsy |
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what 2 vit b def. cause poly neuropathy
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1 and 6
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Pyridoxine dependent epilpsy is what can a disorder
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it is a genetic disordr that is caused by mutations in
ALDH7A1.. THAT ENCODES ALPHA AMINOADIPIC SEMIALDEHYDE |
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VIT B9 (FOLIC ACID)IT IS FXN IS
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folate deraviatives are coexnymes in a nmber of single cargon transfer
alo involved in the syntesis of nucleic acids.. |
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What are the secondary casues of folate def.
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OCP, anitconvul
Cigarte smoking Malabsor. Cancer chem (methotrexase, a folate analog that ingibits DHFR Vit B12 def.. more on diff. note card... |
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why does vit b12 def cause folate def.
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well vit b12 is needed b/c it helps regenerate THF from methylTHF, which is important for purine and pyrmindine syntheis, and helps regerate methionie from Homocystein which s important for adenosine synthists.. thus not cobalumin... then folate is trapped as methylTHF, which is a nonusable from
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SAM is importatn from
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methylation rxns
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Folate Def. can lead to
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Megoblastic anemia
GI s/s ... sore tounge with taste bud atrophy ...small bowel and vilous atrophy ...diarrhea Fetal neural tube defect. |
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what do you see in cobalumin def. but not in folate def.
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well in additoin to help regenerating THF.. Cobalmumin also helps in the conversoin of methylmalonyl CoA to Succyinal Coa.. thus in if there is a def. in Cobalmuin, then you get an accumlation of methylamalonyl coa and tis can get in neural membrands and thus give you neurological symptoms.... such as. SUBACUTE COMBINED DEGENERATION. mORE ON THIS ON A DIFF. NC
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What is Subacute Neuronal Degeneration
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it s a dx associated with vit b12 def.
it is degeration of the spinal cord involving demyelination of dorsal col (ascend) and corticospinal Prom(dece) tracts. thus gives you sensory and motor symptoms.. ataxia, numbnes, tingling to spastic weakiness and paraplegia. |
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in treating for megoblastic anemia which is found vit b12 and vit b9 def. what do you use and does this improve neurological symptoms
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folate.... no.
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