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Biochemistry Post Midterm > Starvation/Undernutrition > Flashcards

Starvation/Undernutrition Flashcards

1
Q

in starvation, what levels increase and what levels decrease?

A

glucose decreases

ketone bodies and fatty acids increase

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2
Q

what 3 pathways happen in the liver during starvation?

A
  • gluconeogenesis to make glucose
  • synthesis of ketone bodies
  • uptake of FA (HS lipase) and beta oxidation to make ATP
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3
Q

during starvation, the liver is frantically trying to do what

A

secrete glucose into the blood to match the amount being removed and used by the other cells - this ensures a constant BGL during fasting and prolonged starvation

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4
Q

where are free fatty acids released from?

A

adipocytes

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5
Q

where are ketone bodies released from?

A

liver

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6
Q

what is the advantage of forming 3-hydroxybutyrate in the liver?

A

its formed at high NADH levels - and acetoacetate uses it to make it.
then NAD+ is result which allwos more beta oxidation of FA

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7
Q

what do muscles perfer during fasting?

A

ketone bodies

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8
Q

no what is needed for ketone body activation?

A

No ATP is needed! Super efficient!

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9
Q

can the liver use ketone bodies?

A

no! because it lacks thiophorase (succinyl CoA acetoacetate CoA transferase)

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10
Q

during starvation, what does the brain use?

A

glucose and ketone bodies
important in “protein sparing effect” - the lvier can now use less aa from muscle protein degadation for gluconeogenesis - because it doens’t need to make it for the brain since it like ketone bodies too!

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11
Q

what happens to the urea cycle during fasting

A

it slows down

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12
Q

what are the metabolic adjustments of prolonged starvation?

A

use ketone bodies
reduce muscle degradation
reduce metabolic rate
reduce physical activity
kidney does gluconeogenesis with the liver
the amount of body fat will determint he ultimate survival time related to energy needs

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13
Q

what metabolic fuel is most abundant at the beginning of the fast?

A

FAT stores

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14
Q

what stores get depleted after one day of fasting?

A

liver glycogen stores

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15
Q

what are the deleterious effects of prolonged starvation?

A 
loss of body fat and muscle mass
vit/mineral déficiences 
reduced enzyme activites
atrophy of intestine
diarrhea, skin rashes, edema, heart failuer
hypothermia
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16
Q

what is protein energy malnutrition (PEM)?

A

leads to variable clinical conditions with extreme forms, including patients with major trauma, depressed immune system, elderly and children

marasmus
Kwashiorkor
Marasmic Kwashiorkor

17
Q

what is marasmus?

A

protein-calorie malnutrition, energy deficinecy is predominant

chronic dietary restriction of carbs, lipids, protein and others

18
Q

What is Kwashiorkor?

A

protein malnutrition is predominant, despite of adequate intake of carbs

deficiency of protein and essential aa

19
Q

what is Marasmic Kwashiorkor?

A

most severe form of PEM

20
Q

what are symptoms of marasmus?

A

tissue and muscle wasting (emaciation)
dry skin, loos skin folds over butt
drastic

21
Q

how do children look with marasmus?

A

severely starved

show less than 80% of standard weight

22
Q

what is marasmus associated with in adults?

A

anorexia nervosa
GI cancer
chronic illness
+ old age…

23
Q

what are anorexia affects on the body?

A 
brain and nerves: bad memory, fatigue
heat: low BP, palpitation
Blood: anemia
muscles: weak
joints: swollen
Kidneys: kidney stones, kidney failure
body fluids: low minerals like potassium, mg, Na
intestine: consipation
hormones: loss of menstrual cycle
24
Q

what is beri beri due to a deficiency of?

A

thiamine, B1

25
Q

what is cheilosis due to a deficiency of?

A

riboflavin, B2

26
Q

what is pellagra due to a deficiency of?

A

niacin, B3

27
Q

what is scurvy due to a deficiency of?

A

vit. C

28
Q

what is microcytic anemia due to a deficiency of?

A

vit. B6 + iron + copper

29
Q

what is macrocytic anemia due to a deficiency of?

A

vit. B12 + folic acid

30
Q

what is reduced blood clotting due to a deficiency of?

A

vitamin K

31
Q

what is reduced response to infections due to a deficiency of?

A

iron + selenium + zinc

32
Q

what is poor wound healing due to a deficiency of?

A

zinc

33
Q

what is night blindness due to a deficiency of?

A

vitamin A

34
Q

what is rickets/osteomalacia due to a deficiency of?

A

vit. D, sunlight

35
Q

what are foods with optimal protein scores?

A 
milk
eggs
soybeans
then meats...
mis of plant food can lead to optimal score too
36
Q

what are symptoms of Kwashiorkor?

A

muscle wasting due to lack of aa, stunted growth
decreased blood albumin
edema in belly and legs

37
Q

how can patients look with Kwashiorkor?

A

could look well nourished or obese becasue of edema

38
Q

what does Kwashiorkor decrease the ability of the body to do?

A

decreased ability to make digestive enzymes and new intestinal epithelial cells

39
Q

Kwashiorkor is a result of other diseases like?

A

partial obstruction of upper GI tract

children after weaning off about one year

Biochemistry Post Midterm (24 decks)

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