2.11 - Diet and Nutrition

Question 1

Where is ghrelin produced

Answer 1

Epsilon cells in pancreas

Question 2

Where is ghrelin released

Answer 2

Stomach lining

Question 3

What stimulates and inhibits ghrelin release

Answer 3

Stimulated - empty stomach via vagus nerve
Inhibited - full stomach

Question 4

What is the function of ghrelin

Answer 4

Stimulates excitatory primary neurones, stimulate appetite in the arcuate nucleus

Question 5

Where is PYY secreted, and by which cells

Answer 5

L cells in the ileum

Question 6

What stimulates the release of PYY

Answer 6

Presence of lipids, amino acids, glucose, bile in ileum

Question 7

What is the function of PYY

Answer 7

Inhibition of excitatory primary neurones in arcuate nucleus -> appetite suppression

Question 8

Name 2 hormones secreted into the ileum which are involved in appetite suppression

Answer 8

PYY
GLP-1

Question 9

Where is CCK secreted from

Answer 9

I cells in duodenum

Question 10

What stimulates CCK release

Answer 10

Lipids and proteins entering duodenum

Question 11

What are the functions of CCK (4)

Answer 11

Gallbladder contraction
Pancreatic enzyme release
Inhibits gastric emptying
Reduces appetite

Question 12

Were is GLP-1 secreted from

Answer 12

L Cells in ileum

Question 13

What stimulates GLP-1 release

Answer 13

presence of lipids, glucose, amino acids in ileum

Question 14

What are the functions of GLP-1 (4)

Answer 14

Reduces gastric emptying
Increases upper intestinal mobility
Decreases gastric acid secretion
Reduces appetite

Question 15

Where is leptin released from

Answer 15

white adipocytes in bloodstream

Question 16

What stimulates leptin release

Answer 16

high fat stores

Question 17

What are the functions of leptin (3)

Answer 17

stimulates inhibitory neurones and inhibits excitatory neurones in arcuate nucleus
Suppresses appetite
Increases basal metabolic rate

Question 18

Where is insulin released from

Answer 18

beta cells in pancreas

Question 19

What stimulates insulin release

Answer 19

Hyperglycaemia

Question 20

What is the function of insulin (in terms of appetite)

Answer 20

Appetite suppressor

Question 21

What is the fancy word for a hormone that suppresses appetite

Answer 21

Anorexigenic

Question 22

What factors influence satiety (2)

Answer 22

Rate of gastric emptying
Volume and type of food

Question 23

What factors can increase rate of gastric emptying (6)

Answer 23

High volume food
Low pH
Cholinergic drugs
Gastrin
Motilin
Distension

Question 24

What factors can decrease the rate of gastric emptying (6)

Answer 24

High osmolarity foods
Anti-cholinergics
Secretin
CCK
Glucagon
Stress, fear, depression

Question 25

What is the main function of Vitamin A, and what can deficiency cause

Answer 25

Synthesis of photoreceptors in the eye Deficiency -> Night blindness

Question 26

What is the main function of vitamin B1 (thiamine), and what can deficiency cause

Answer 26

Carbohydrate and amino acid metabolism Deficiency -> neuropathy, wernicke-korsakoff syndrome, heart failure

Question 27

What is the main function of vitamin B3 (Niacin) and what can deficiency cause

Answer 27

Energy metabolism and cholesterol regulation Deficiency -> 4 Ds (Dermatitis, Diarrhoea, Dementia, Death)

Question 28

What can vitamin B6 (Pyridoxine) deficiency cause

Answer 28

Anaemia, irritability, seizures

Question 29

What can vitamin B7 (Biotin) deficiency cause

Answer 29

Dermatitis

Question 30

What is the main function of vitamin B9 (folic acid) and what can deficiency cause

Answer 30

DNA synthesis Deficiency -> Megaloblastic anaemia, neural tube defects (during pregnancy)

Question 31

What is the main function of vitamin B12 (cyanocobalamin) and what can deficiency cause

Answer 31

Myelination Deficiency -> Megaloblastic anaemia, peripheral neuropathy

Question 32

What is the main function of vitamin C (asorbic acid) and what can deficiency cause

Answer 32

Immune system function Deficiency -> Scurvy (arr)

Question 33

What is the main function of vitamin D and what can deficiency cause

Answer 33

Synthesis of Calbindin D -> Calcium absorption Deficiency -> rickets, osteomalacia

Question 34

What is the main function of vitamin E and what can deficiency cause

Answer 34

antioxidant - prevents free radical damage to RBCs Deficiency -> haemolytic anaemia in newborns, ataxia, peripheral neuropathy

Question 35

What is the main function of vitamin K and what can deficiency cause

Answer 35

Synthesis of vitK dependent clotting factors (X, IX, VII, II) Deficiency -> haemorrhagic disease of the newborn, bleeding diathesis

Question 36

What are the main functions of sodium

Answer 36

Maintain fluid balance Nerve function Muscle function

Question 37

What are the symptoms of sodium deficiency

Answer 37

Dizziness Muscle weakness Seizures

Question 38

What are the main functions of potassium

Answer 38

Maintain fluid balance Nerve and muscle functions

Question 39

What are the symptoms of potassium deficiency

Answer 39

Cramping Muscle weakness Mood changes Arrhythmias

Question 40

What are the main functions of calcium

Answer 40

Bone protection Muscle function

Question 41

What are the symptoms of calcium deficiency

Answer 41

Osteoporosis Muscle cramps

Question 42

What is the function of phosphate

Answer 42

Required for ATP production

Question 43

What are the symptoms of phosphate deficiency

Answer 43

Sore bones Anxiety Changes in body weight

Question 44

What are the main functions of magnesium

Answer 44

Energy metabolism Release of neurotransmitters

Question 45

What are the symptoms of magnesium deficiency

Answer 45

Irritability Muscle weakness Arrhythmias

Question 46

What is the main function of iron

Answer 46

Haemoglobin synthesis

Question 47

What are the symptoms of iron deficiency

Answer 47

Anaemia fatigue shortness of breath

Question 48

Having one or more of these factors puts you at a high risk of refeeding syndrome (4)

Answer 48

BMI <16 Unintentional loss of >15% of body weight over last 3-6 months Little or no nutritional intake for >10 days Low potassium, phosphate, or magnesium

Question 49

Having 2 or more of these factors puts you at a high risk of refeeding syndrome (5)

Answer 49

BMI <18.5 Unintentional loss of >10% body weight over last 3-6 months Little or no nutritional intake for >5 days History of alcohol abuse Certain medications

Question 50

What are the clinical features of refeeding syndrome (4)

Answer 50

Hypophosphataemia (Pi deficiency) Hypomagnesaemia (Mg deficiency) Hypokalaemia (K deficiency) Increased sodium and water retention

Question 51

What are the complications of refeeding syndrome (3)

Answer 51

Cardiac arrhythmias Cardiac failure Respiratory failure