Chapter 8 - Nutritional disorders

Question 1

Which is the only dietary fuel for RBCs?

Answer 1

Glucose.

And because RBCs lack mitochondria, they use only anaerobic glycolysis to generate ATP

Question 2

Tell me one virus infection that causes temporary destruction of brush border, with a consequent diarrhea and disaccharidases’ insufficiency

Answer 2

Rotavirus

Question 3

Transaminases remove amine groups from AAs to form …

Answer 3

α-ketoacids

Question 4

Long-chain free FAs are the major source of energy for all cells except … and …

Answer 4

RBCs and Brain tissue

Question 5

Where is glycogen stored?

Answer 5

Muscle and liver

Question 6

What do micelles contain?

Answer 6

1. MGs
2. FAs
3. fat soluble vits
4. CH esters

Question 7

Which apolipoprotein is required for fomation and secretion in blood of chylomicrons?

Answer 7

apoB48

Question 8

In marasmus, pathogenesis of loss of subcutaneous fat

Answer 8

Decrease in leptin stores in adipose-> stimulates hypothalamic-pituitary axis -> release of CORT-> lipolysis

Question 9

Which disorder carries the highest death rate of all psychiatric disorders?

Answer 9

Anorexia nervosa

Question 10

Hypoestrinism has what effect on bones?

Answer 10

Osteoporosis.
Esteogen normally: (+) osteoblastic activity
(-) osteoclastic activity

Question 11

What is the most probable cause of death in a girl with anorexia nervosa?

Answer 11

Ventricular arrhythmia usually related to hypokalemia from laxative abuse

Question 12

Diarrhea can cause hypomagnesemia, which can cause decreased synthesis and release of which hormone?

Answer 12

Parathyroid hormone

Question 13

How can one distinguish hypercarotenemia with jaundice?

Answer 13

In hypercarotenemia the scleras are white

Question 14

In which disease macrophages in granulomas synthasize 1-α-hydroxylase, synthesizing vitD and producing hypervitaminosis D?

Answer 14

Sarcoidosis

Question 15

Which CYP enzyme of P450 system is a 25-hydroxylase?

production of 25-OH vitD

Answer 15

CYP27A1

Question 16

VitE also called…

Answer 16

tocopherol or tocotrienol

Question 17

Breast milk is deficient in vitamins … and …

Answer 17

D and K

Question 18

Other name of vitK

Answer 18

Phytomenadione
Phylloquinone
Phytonadione

Question 19

Warfarin or heparin provides immediate anticoagulation?

Answer 19

Heparin. Prothrombin has the longest half-life. Warfarin requires at least 3-4 days before all functional prothrombin has disappeared. (previously γ-carboxylated factors are still present)
So patients are initially placed on both heparin and warfarin.

Question 20

Which is the MC vit deficiency ni the USA?

Answer 20

Folate deficiency.

Question 21

Which deugs can cause folate deficiency?

Answer 21

Phenytoin
Sulfonamides
Methotrexate

Question 22

Cigarette smoking can cause vitamin … deficiency

Answer 22

vit C

Question 23

Deficiency in which vitamin can cause combined iron and folate deficiency?

Answer 23

VitC

Question 24

For which 3 enzymes is copper a cofactor?

Answer 24

1. ferroxidase (binds iron to transferrin)
2. lysyl oxidase (cross-linking of collagen and elastic tissue)
3. tyrosinase (melanin synthesis)

Question 25

Clinical findings in copper deficiency

Answer 25

1. Microcytic anemia 2. Aortic dissection 3. Poor wound healing

Question 26

Total serum copper in Wilson disease is increased or decreased?

Answer 26

Decreased because of decreased ceruloplasmin. | Increased serum free copper, increased urine copper.

Question 27

Chromium is a component of ... and a cofactor for ...

Answer 27

Glucose tolerance factor -> maintains normal serum glucose | Insulin-> fascilitates the binding of glucose to adipose and muscle GLUTs

Question 28

Clinical findings in chromium deficiency

Answer 28

1. Impaired glucose tolerance | 2. Peripheral neuropathy

Question 29

Clinical findings in selenium deficiency

Answer 29

1. Muscle pain and weakness | 2. Dilated cardiomyopathy

Question 30

Which is the only bile acid that is not reabsorbed in the terminal ileum?

Answer 30

Lithocholic acid. It may have a causative role in producing colorectal cancer. Insoluble fiber would eliminate the lithocholic acid that would have contact with the bowel mucosa.

Question 31

Symptoms of calcium deficiency

Answer 31

1. Tetany | 2. Osteoporosis

Question 32

Symptoms of phosphorus deficiency

Answer 32

Decreased ATP causes : a. Muscle weakness: rhabdomyolysis with myoglobinuria b. Hemolytic anemia

Question 33

Symptoms of sodium deficiency

Answer 33

1. Mental status abnormalities (cerebral edema-> water shifts into cells by osmosis) 2. Convulsions

Question 34

Symptoms of potassium deficiency

Answer 34

1. Muscle weakness (cannot repolarize muscle) | 2. Polyuria (renders collenting ducts resistant to ADH)

Question 35

Symptoms of magnesium deficiency

Answer 35

1. Hypocalcemia with tetany (acquired hypoparathyroidism due to impaired PTH secretion and resistance it target tissue) 1. Tachycardia

Question 36

Symptoms of calcium excess

Answer 36

1. Kidney stones (calcium oxalate and phosphate) 2. Metastatic calcification (eg nephrocalcinosis) 3. Polyuria (due to calcification of renal tubule BMs)

Question 37

Symptoms of phosphorus excess

Answer 37

1. Hypocalcemia (increased P drives Ca2+ into bone and soft tissue) 2. Hypovitaminosis D (inhibits activity of 1-α-hydroxylase)

Question 38

Symptoms of sodium excess

Answer 38

1. Mental status abnormalities (intracellular shrinkage of neuroglial cells and neurons) 2. Convulsions

Question 39

Symptoms of potassium excess

Answer 39

Heart stops in diastole (treat with calcium gluconate)

Question 40

Symptoms of magnesium excess

Answer 40

1. Neuromuscular depression (decreased DTRs, muscle weakness) 2. Bradycardia