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59 Cards in this Set
- Front
- Back
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Define malnutrition and the side effects (generally)
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when a person doesn't absorb and use nutrietns adequately
loss of weight lethargic weakness |
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what are the two categories of malnutrition
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primary
secondary |
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describe the cause of primary malnutrition
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due to poor diet
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describe the cause of secondary malnutrition
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the diet is sufficient but some of other problem creates deficient nutrition
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name same causes of secondary malnutrition
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digestive problems
malabsorption of nutrients in the stomach or intestine catabolic destruction of macromolecules or tissues increased demand for nutrients due to high metablic rates, fever or malignancy |
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name two examples of primary malnutrition
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marasmus
kwashiorkor |
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what is the primary problem in marasmus
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problem with energy and with loss of SOMATIC proteins (mostly skeletal muscles)
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what is the primary problem with kwashiorkor
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a problem with VISCERAL proteins notably the liver
occurs when protein deprivation is relatively greater than the reduction in total calories |
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what are some symptoms of marasmus
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growth retardation and loss of muscle (due to catabolism and depletion of somatic protein compartment)
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if the albumin levels of a child diagnosed with marasmus were taken, what would the result be?
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serum albumin is normal (visceral protein compartment is only minimally depleted - liver still produces sufficient albumin)
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in a child with marasmus, in addition to lack of proper nutrtition why do they look emaciated?
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subcutaenous fat is also catabolized for fuel
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What are the physiological effects of lack of protein in an individual diagnosed with kwashiorkor
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lack of protein and reduced liver albumin synthesis leads to decreased serum albumin
cases a decrease in plasma oncotic pressure causing fluid transudation into tissues (edema) |
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why might a child with kwashiorkor look heavy yet they actually have weight loss?
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weight loss is masked by their fluid retention
gaining fluid weight but losing the weight of healthy organs and tissues |
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describe the appearance of the liver of an individual diagnosed with kwashiorkor and the cause of this appearance
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enlarged fatty liver
reason: reduced lipid carrier proteins synthesis causing lipid accumulation in hepatocytes |
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what is cachexia?
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catabolic disorder in which proteins are degraded often by soluble factors produced by tumors as well as host factors such as TNF
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what type of patients are susceptible to cachexia?
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present in patients with serious diseases especially cancer
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name the fat soluble vitamins
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A
D E K |
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what compounds are part of the vitamin A group
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retinol
retinal retinoic acid |
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name the food that would contain vitamin A
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yellow and leafy green vegetables
ex: carrots, squash and spinach |
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what are the 2 main fucntions of vitamin A
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normal vision
cell growth and differentiatoin` |
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what is the most light sensitive pigment
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rhodopsin in the rods
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what is a necessary molecule for the synthesis of rhodopsin
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retinal
a major step in this process is the isomerization of all trans to 11-cis retinal |
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what is necessary for the isomerization reaction to occur during proper vision
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a photon of light causes the isomerization of al
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during what part of the day is the isomerization reaction of retinal more important and what is the effect if it doesn't occur properly?
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during night
signs of defect in vitamin A: night blindnes or poor night vision |
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What is the effect of a lack of vitamin A during cell differentiation?
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the corneal or urothelial epithelium undergoes squamous metaplasia
it differentiates into a keratinizing epithelium |
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define metaplasia
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pathologic response in which one type of epithelium substitutes for another type
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what are some symptoms of metaplasia of corneal epithelium
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dryness of the eye (xeropthalmia)
focal necrosis |
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define keratomalacia and what is the cause of this problem
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accumulation of keratin in a place which would normally not be keratinized
leads to corneal plaques and corneal destruction (keratomalacia) can cause blindness due to a lack of vitamin A and improper cell differentiation |
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What are some possibilities for a lack of vitamin A
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primary due to dietary deficiency
secondary due to malabsoprtion in conditions of fat malabsorption (steatorrhea) |
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besides the affect of the lack of vitamin A in the eye, what other organ in the body be affected by this deficiency
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presence of keratinizing squamous metaplasia in the renal urothelium can lead to accumulation of kartin forming renal stones
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in genreal why is vitamin D important
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important for caclium metabolism
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what are two ways humans can get vitamin D3?
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they can synthesize vittamin D3 from a vitamin D precurosr (7-dehydrocholesterol) in the presence of sufficient sun exposure
dietary sources - fish, plants, grain |
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what organ metabolizes vitamin D precursors and into what
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kidney
vitamin D precursors to 1,25 dihydroxyvitamin D |
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what is the importance of 1,25 dihydroxyvitamin D
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steroid hormone that binds to vit D receptors which increases calcium reabsorption in the intestine and the kidney
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what genes are necessary to encode calcium transport channels and in which organs are they found
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TRPV6 in the intestine
TRPV5 in the kidney |
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a vitamin D deficiency in children causes what
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rickets
- leads to severe bowing of leg bones and overgrowth of cartilage |
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a vitamin D deficiency in adults leads to what?
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can present with hip fractures
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what are the histologic observations of a vitamin D deficiency
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poorly mineralized bone matrix with uncalcified osteoid
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in what process is vitamin k important?
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serves as a co-factor for carboxylation of glutamic acid residues on clotting factors (II, VII, IX and X)
carboxylation is important for these factors to actively coagulate blood |
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what would individuals with a vitamin K deficiency present with?
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poor blood clotting or bleeding
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what are some causes for vitamin K deficiency
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dietary deficiency (found in green leafy vegetables)
secondary vitamin deficiency (esp with patients with liiver disease) |
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where is vitamin K absorbed
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because it's fat soluble it's absorbed in the intestine after solubilization by bile acids
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describe how severe liver disease can cause improper blood clotting
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with severe liver disease...
-reduced bile acid production -leads to decreased vitamin K absoprtion -leads to poor blood clotting |
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What is another name for vitamin c and why is it "special"
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ascorbic acid
it's an essential vitamin and NOT synthesized by humans must be obtained from the diet |
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in what type of foods can one find vitamin C
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milk
animal products (liver, fish) fruits vegetables |
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what is the function of vitamin C
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serves as a cofactor for prolyl and lysyl hydroxylases
modification of the amino acids leads to the presence of a hydroxyl group (allows hydrogen binding) - which then allows for the formation of a triple helix - essential for strong collagen |
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a deficiency in vitamin C can lead to what condition and what are some symptoms/signs
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scurvy
gum bleeding, loosening of teeth (due to weak collagen) |
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what is another name for thiamine?
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vitamin B1
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what is the importance of vitamin b1 (thiamine)
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cofactor in reations such as dehydrogenases for alpha-ketoglutarate and pyruvate, pentose phosphate pathway
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a deficiency in vitamin B1 (thiamine) can lead to what disorders
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beriberi - dilated heart disorder - initally reversible - marked by confusion, ataxia
Wernicke's encephalopathy- (reversed by infusion of thiamine) korsakoff's syndrome (irreversible) - irreversible psychosis above conditions most commonly found in alcoholics |
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what is another name for vitamin B2
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riboflavin
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what is another name for vitamin B3
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niacin
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why are Vitamin B2 (riboflavin) and vitamin B3 (niacin) important?
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building blocks for the essential cofactors flavoproteins (vitamin B2) and NAD (vitamin B3)
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what is a deficiency in Niacin (vit B3) called and what are the classic findings
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pelllagra
dermatitis diarrhea dementia death |
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a deficiency in Vit B2 (riboflavin) presents with what?
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presents with oral findings along with dermititis
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what is another name for vitamin B9
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folic acid
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why are vitamin B9 and 12 imp?
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cofactors important in generation of sulfhydryl proteins such as cysteine and methione
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what type of food has folic acid?
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(vitamin B9)
leafy green vegetables |
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what types of foods contains vit b12
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animal products - meat, egg, dairy
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