Term
|
Definition
poverty
ignorance: switching baby to rice milk
chronic alcoholism: not buying groceries, malabsorption
self imposed: anorexia, dieting
malabsorption: GI disease, acquired, inherited
drugs
total parentral nutrition |
|
|
Term
| define primary malnutrition |
|
Definition
|
|
Term
| define secondary malnutrition |
|
Definition
| cannot be absorbed, utilized, stored, or used faster than consumed |
|
|
Term
| what are the three most common causes of secondary malnutrition |
|
Definition
GI disease
chronic wasting disease
acute critical illness |
|
|
Term
| what causes protein energy malnutrition, what is the main sign to start looking at protein |
|
Definition
inadequate protein or calorie intake
weight <80% normal |
|
|
Term
|
Definition
| calorie deficiency > protein deficiency |
|
|
Term
| what organ system is affected by marasmus, why does it cause symptoms |
|
Definition
somatic organs
they are degraded for AA and fat |
|
|
Term
|
Definition
reduced midarm circumference
loss of muscle and SC fat
growth retardation except in head because body spares brain
weight 60% normal
anemia
vitamin deficiency
immune deficiency mostly T cell
normal serum albumin |
|
|
Term
|
Definition
| protein deficiency > calorie deficiency |
|
|
Term
|
Definition
classic; baby weaked too early and fed carb based diet (rice milk)
GI malbsorption
burns
nephrotic syndrome |
|
|
Term
|
Definition
reduced serum albumin causes generalized dependant edema
hepatomeagly and fatty liver
weight 60-80% normal
skin lesions: altered pigment and peeling (flaky paint)
hair color and texture changes
apathy, appetite loss
immune deficiency less prominent than marasmus
small bowel villous atrophy causes diccaridase deficnecy (lactose intolerance) and malabsorption |
|
|
Term
| why is secondary PEM seen in |
|
Definition
chronically ill or hospitalized (cancer pt)
if seen in healthy suspect anorexia/bulemia |
|
|
Term
|
Definition
|
|
Term
| what is the cause of cachexia |
|
Definition
TNF acts as cachexin and stimulates acute phase response and uses up SC fat and reduces appetite
proteolysis inducing factor acts as cachexin and reduces appetite |
|
|
Term
| 2 eating disorders, define each |
|
Definition
anorexia: self induced starvation
bulemia: binge eating followed by vomiting/laxatives |
|
|
Term
| what is the main difference physiologically between anorexia and bulemia |
|
Definition
bulemia has a better prognosis
weight and gonadotropin levels remain near normal |
|
|
Term
|
Definition
amenorrhea
decreased T3/4: cold intolerance, bradycardia, constipation
laungo hair
yellow skin due to excess carotene
loss of bone density due to low estrogen |
|
|
Term
| why is amenorrhea important sign of anorexia |
|
Definition
it happens in most pt
anorexia should always be in amenorrhea ddx |
|
|
Term
|
Definition
50% get amenorrhea
electrolyte imbalance
pulmonary aspiration
esophageal and stomach rupture |
|
|
Term
| complications of eating disorders |
|
Definition
anemia
lymphopenia
hypoalbumina
hypokalemia: cardiac arrhythmia and sudden death |
|
|
Term
| what are the fat and water soluble vitamins |
|
Definition
|
|
Term
| what is the most common cause of fat soluble vitamin deficiency |
|
Definition
| malabsorption in intestinal disease |
|
|
Term
|
Definition
animal derived: liver, egg, milk
polyvitamins/B-carotene: yellow or leafy green veggies |
|
|
Term
| what are forms of vitamin A |
|
Definition
| retinol, retinal, retinoic A, retinoids |
|
|
Term
| which form of vitamin A isnt really one, why |
|
Definition
| retinoids: structurally related, no vitamin A activity |
|
|
Term
| where is vitamin A stored, how long is the reserve |
|
Definition
|
|
Term
| explain absorption and distribution of vitamin A |
|
Definition
absorbed in villi and into chylomicron which goes to APO E recepto on liver
binds retinol binding protein in retinyl ester form for transport
oxidized at tissue to retinoic acid |
|
|
Term
|
Definition
part of rhodopsin in rods and idopsins in cones
epithelial differentiation
enhance immunity esp in measles and diarrhea diseases |
|
|
Term
| risk factors for vitamin A deficiency |
|
Definition
infants: poor absorption
kids: stores depeleted in infection
malabsorption syndromes: celiac disease example
bariatric surgery
use of mineral oil laxatives |
|
|
Term
| signs of vitamin A deficiency |
|
Definition
night blindnes
squamous metaplasia esp mucosa (and its complications like blindness)
immune deficiency |
|
|
Term
| what are the complications of squamous metaplasia |
|
Definition
xeropthalmia: dry eye due to replacement of lacrimal epithelium with kertinized
biot spots: keritanized plaqye due to epithelial replacement
keritomalacia: softening and destruction of cornea due to keratin
blindness
increased respiratory infection and UTI and renal stones |
|
|
Term
| signs of acute vitamin A toxicity |
|
Definition
headache
dizzy
vomiting
stupor
blurred vision
teratogen |
|
|
Term
| signs of chronic vitamin A toxicity |
|
Definition
weight loss due to anorexia, vomiting, nausea
bone and joint pain due to retinoic acid stimulating osteoclasts
teratogen |
|
|
Term
| signs of vitamin D deficiency |
|
Definition
rickets in kids
osteomalacia in adults |
|
|
Term
| signs of vitamin E deficiency |
|
Definition
| spinocerebellar degeneration |
|
|
Term
| signs of vitamin K deficiency |
|
Definition
|
|
Term
| signs of B1 deficiency, aka |
|
Definition
thiamine
dey and wet beriberi, werinke and korsakoff |
|
|
Term
| signs of B2 deficiency, aka |
|
Definition
riboflavin
cheilosis, stomatitis, glossitis, dermatitis, corneal vascularization |
|
|
Term
| signs of niacin deficiency |
|
Definition
| pellatra- dermatitis, dementia, diarrhea |
|
|
Term
| signs of B6 deficiency, aka |
|
Definition
pyridoxine
cheilosis, glossitis, dermatitis, peripherial neropathy |
|
|
Term
|
Definition
| combined system disease - anemia, posterolateral spinal cord degeneration |
|
|
Term
|
Definition
|
|
Term
|
Definition
milk and animal products
fruit and veggies |
|
|
Term
|
Definition
hydroxylation of procollagen: stabilizes helix and cross links in collage (esp in vessels)
antioxidant: direct and assist in vitamin E production |
|
|
Term
| risk factors for vitamin C deficiency |
|
Definition
food fads
dialysis patients
anorexia
elderly
alcoholic |
|
|
Term
|
Definition
bleeding and petechiae due to poor vessel support
impaired wound healing
decreased periosteum in joints |
|
|
Term
| signs of vitamin C toxicity |
|
Definition
water soluble and mostly excreted in urine so uncommon
uricosuria: high uric acid
increased Fe absorption |
|
|
Term
| signs of folate deficiency |
|
Definition
anemia
neural tube defects |
|
|
Term
| signs of pantotenic acid deficiency |
|
Definition
|
|
Term
| signs of biotin deficiency |
|
Definition
|
|
Term
| 4 ways we define or qualify obesity |
|
Definition
adipose levels high enough to cause adverse health effects
BMI (weight/height) >30 kg/m2
skin fold measurements
body circumferences / hip to waist ratio |
|
|
Term
| 7 peripherial or afferent regulators of energy |
|
Definition
leptin
adiponectin
cytokines
chemokines
stored hormones
gherlin
peptide Yy |
|
|
Term
| 5 energy regulators adipose releases |
|
Definition
leptin
adiponectin
cytokines
chemokines
stored hormones |
|
|
Term
| what type of molecule is leptin |
|
Definition
|
|
Term
|
Definition
| reduced food intake and increased energy expendurature |
|
|
Term
| function of adiponectin, cytokines, chemokines, and stored hormone in adipose |
|
Definition
| regulate metabolism, nutrition, and inflammation |
|
|
Term
|
Definition
|
|
Term
| explain the changes in gherlin levels |
|
Definition
rises before meals
falls 1-2 hours later |
|
|
Term
|
Definition
|
|
Term
| where is peptide YY made, what sitmulates |
|
Definition
| endocrine cells of ileum and colon in response to food |
|
|
Term
|
Definition
|
|
Term
| what is the efferent regulator of energy blanace |
|
Definition
| hypothalamus arcuate nucleus |
|
|
Term
| what are the 4 neuron regulator of energy paths of the arcuate nucleus, what do they do |
|
Definition
POMC and CART neurons cause energy expendature and weight loss
NPT and AhRP neurons cause food intake and weight gain |
|
|
Term
| define: POMC, CART, NPY, AhRP |
|
Definition
pro-opiomelanocortin neuron
cocaine and aphmetamine regulated transport neuron
neuropeptide Y neuron
aqouti-released peptide neuron |
|
|
Term
| what are the three causes of obesity |
|
Definition
leptin pathway mutation
total adipocyte number is determine as kid so more build up means more obesity
decreased gherlin degration |
|
|
Term
| what are 4 leptin mutations causing obesity |
|
Definition
melanocortin receptor 4 (MCR4) mutation
leptin recptor resistance / high leptin blood levels |
|
|
Term
| what is an exam finding that can determine that someone is more at risk for obesity complications |
|
Definition
| central / visceral obesity |
|
|
Term
| 11 complications of obesity |
|
Definition
hypertriglyceridemia
cancer
insulin resistance
hyperinsulinemia (diabetes II)
metabolic syndrome
non-alcoholic steatohepatitis
cholelithiasis
hypoventilation syndrome w/ hypersomnolence
osteoarthritis
elevated markers of inflammation (CRP) |
|
|
Term
| when someone has obesity and gets hyperTG what can this cause |
|
Definition
| low HDL and coronary artery disease |
|
|
Term
| what are the common obesity associated cancers in men |
|
Definition
esophageal
thyroid
colon
kidney |
|
|
Term
| what are the common obesity associated cancers in women |
|
Definition
esophageal
endometrial
gallbladder
idney |
|
|
Term
| signs of metaoblic syndrome |
|
Definition
visceral obesity
abnormal glucose and lipid metabolism
HTN
pro-inflammatory state |
|
|
Term
| what is non-alcoholic steatohepatitis, what are complications |
|
Definition
fatty liver disease
fibrosis and chirrosis |
|
|
Term
| why do people with obesity get cholelithiasis |
|
Definition
| increased cholesterol causes changes in biliary excretion |
|
|
Term
| signs of hypoventilation syndrome w/ hypersomnolence |
|
Definition
apenic pause
polycythemia
right sided heart failure |
|
|
