B5-060 Nutrition Metabolism I Flashcards by Felicia Jones

impaired absorption of nutrients

malabsorption

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impaired digestion of nutrients

maldigestion

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rome IV criteria for IBS

recurrent abdominal pain at least 1 day/week with two or more of the following:

related to defecation
change in stool frequency
change in stool form

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what symptoms should NOT be associated with IBS

weight loss
rectal bleeding
anemia
should not be nocturnal or progressive

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what carbohydrates are absorbed through NA+ dependent cotransport?

glucose
galactose

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what carbohydrate is absorbed through facillitated diffusion?

fructose

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carbohydrates, proteins, and lipids are absorbed in the

small intestine

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the surface area for absorption in the small intestine is greatly increased by the

brush border

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lactose intolerance is due to […] deficiency

lactase

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what kind of diarrhea does lactose intolerance cause?

osmotic diarrhea

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malabsorption of sugars greatly mimics

IBS

bloating, diarrhea, gas

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oligosaccharides are […] sugar units

3-10

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hydrolyze polysaccarides to monosaccarides in the brush border

a-glucosidases

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have B-glycosidic bonds and are undigestible

fiber

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FODMAP

Fermentable
Oligo
Di
Monosaccharides
And
Polyols

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family of poorly absorbed, short-chain carbohydrates

FODMAP

lactose, fructose, fructo/galacto oligosaccharides, polyols

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hallmark feature of carbohydrate maldigestion

osmotic diarrhea

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richest food sources of fructo-oliogsaccharides

wheat
rye
onion
garlic

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richest food sources of galacto-oligosaccharides

legumes

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richest food sources of fructose

honey
apples
pears
watermelon
mango

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richest food sources of sorbitol

apples
pears
peaches
sugar free items

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richest food sources of mannitol

mushrooms
cauliflower
sugar free items

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what type of fiber is more beneficial for IBS symptoms?

soluble or insoluble

soluble (psyllium husk)

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what type of fiber are cellulose, hemicellulose, and lignin?

insoluble

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what type of fiber are gum, pectin, and mucliage?

soluble

what type of fiber functions to increase fecal bulk and decrease transit time?

insoluble

food sources of insoluble fiber | 2

whole grains vegetables

which type of fiber functions to delay gastric emptying, slow glucose absorption, and decrease blood cholesterol?

soluble

food sources of soluble fibers | 4

fruits vegetables psyllium seed rice bran

the Big Nine food allergens in US

1. milk 1. eggs 1. peanuts 1. tree nuts 1. soy 1. fish 1. shellfish 1. wheat 1. sesame

resistant to or escape from gastic acid or enzymatic digestion

food allergens

symptoms of food allergens | 3; most common to least common

* GI (70%) * cutaneous (24%) * respiratory (6%)

causes: lowered bp respiratory and GI distress can be fatal

anaphylaxis

proteins are made up of [...] different amino acids, [...] of which are essential

20 9

what makes each amino acid unique?

it's side chain

almost all disorders of amino acid transport are inherited in what pattern?

autosomal recessive

* deficiency results in the inability to convert trypsinogen to trysin * leads to protein malnutrition

enterokinase deficiency

why do we need protein every day?

excess protein cannot be stored as protein | stored as muscle

* fat and lean mass loss * edema from low plasma oncotic pressure * hair pluckability * skin breakdown

Kwashiorkor | protein malnutrition

what kinds of patients are susceptible to Kwashiorkor?

trauma/sepsis patients

* body fat stores have been exhausted due to starvation, muscle wasting follows * may figdet a lot in the muscle wasting stage

marasmus

substantial loss of fat and lean body mass in the presence of chronic inflammation and disease

cachexia

in kidney failure, you'd expect to see decreased production of:

* 1,25-dihydroxycholecalciferol (active form of vitamin D) * erythropoietin

diet for persons with CKD stage 4 | general

* 23-35 kcal * low protein * low sodium * no fluid restriction

[...] restriction slows the progression of diabetic nephropathy

protein

what three things must happen to develop celiac disease?

1. inherit gene 2. consume gluten 3. have gene triggered due to stress

what HLA haplotype is associated with celiac disease?

HLA DQ2/DQ8

adverse response to gliadin that triggers immune response

celiac disease

classic celiac symptom

steatorrhea

what are the consequences of gliadin ingestion in celiac? | 5

* villous atrophy * decreased surface area * chronic inflammation down regulates transport proteins * decreased CCK and secretin -> pancreatic insufficiency * bacterial overgrowth

persons with celiac disease can get secondary [...] due to changes in enzymatic function at the brush border

lactase deficiency

what should be restricted from the diet while the gut is recovering in celiac disease?

* gluten * fat * dietary lactose

what is required to break down lipids into micelles? | 2

pancreatic lipase conjugated bile acids

what type of lipids do not require pancreatic lipolysis?

medium chain | absorbed by intestinal epithelial cells

what causes steatorrhea in the malabsorption of lipids? | 2

**lipase deficiency** maybe also depleted bile acid pool

how to correct nutrient deficiencies in pancreatic insufficiency? | 2

low fat diet PERT

# what is causing these malabsorption symptoms? bloating, gas, explosive diarrhea

sugar malabsorption

# what is causing these malabsorption symptoms? dry hair, hair loss, fluid retention

protein malabsorption

# what is causing these malabsorption symptoms? * light colored, foul smelling stools that are soft and bulky * stools may be difficult to flush

fat malabsorption

is whole wheat a low FODMAP food?

single preferred test for detection of celiac disease

IgA-TTG test

when should testing for celiac disease be performed?

while the patient is still on a gluten rich diet

what should be done for a patient experiencing extreme weight loss, rectal bleeding, anemia, progressive abdominal pain?

colonoscopy

if the patient has a positive TTGA, what kind of biopsy can be done?

duodenal

what is the best treatment advice for a newly diagnosed celiac patient?

gluten free diet refer to skilled dietician

without diet education, most celiac patients have inadequate intake of

B vitamins, iron, fiber

transported into intestinal cells by a Na+ dependent cotransport | 3

galactose glucose dipeptides

incorporated into micelles

fatty acids

transported into intestinal cells via facilitated diffusion

fructose

need to be digested to di or tri peptides to be absorbed

oligopeptides

need further lipolysis into fatty acids and incorporated into micelles

TGs

binds to recptors in brush border of the ileum for absorption

vitamin B12

if a patient reports recurrent GI symptoms after big nine allergens

suspect IgE mediated allergy and refer to allergy specialist and GI

is skin testing for food allergies productive?

B5-060 Nutrition Metabolism I Flashcards

(74 cards)