Environmental and Nutritional Diseases V Flashcards Preview

PBD II Exam 1 > Environmental and Nutritional Diseases V > Flashcards

Flashcards in Environmental and Nutritional Diseases V Deck (89):
1

appropriate diet

sufficient energy
amino acids and FA building blocks
Vits and Minerals - coenzymes

2

primary malnutrition

missing component of diet

3

secondary malnutrition

adequate supply of nutrients
-but malabsorption, impaired storage, excess loss, etc.

4

causes of dietary insufficiency

poverty
infection
acute/chronic illness
chronic alcoholism
ignorance
self-imposed diet restriction

5

PEM

protein energy malnutrition
-BMI < 16 kg/m2

6

chronic alcoholism

deficiency in vitamins
-thiamin, pyridoxine, folate, vit A

7

thiamine deficiency

in chronic alcoholics
-brain damage

8

malabsorption

non-tropical and tropical sprue

9

marasmus

depleted somatic compartment
decreased T cells - susceptible to viral infection

serum albumin normal

10

kwashiorkor

depleted visceral compartment

edema, skin, hair changes
-serum albumin decreased

fatty liver

11

cachexia

in aids and cancer patients

weight loss, fatigue, muscle atrophy, anorexia, edema, anemia

12

causes of cachexia

agents secreted by tumors

PIF

LMF > TNF and IL-6 > acute phase response > C reactive protein

13

PIF and pro-inflammatory cytokines

in cachexia patients
-skeletal m breakdown
-via NF-kappaB activation of ubiquitin pathway
-degrade myosin heavy chain

MuRF1 and MAFBx - two muscle specific ubiquitin ligases

14

bulimia

more common than anorexia

amenorrhea less than 50%

sign - scars on hands - from gagging self

15

highest death rate of psych disorder

anorexia

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concerns with bulimia and anorexia

hypokalemia***
muscle cramping, paralytic ileus, cardiac arrhythmia and arrest

17

anorexia

amenorrhea very common
also cold intolerance, bradycardia, constipation, skin and hair changes

18

fat soluble vitamins

ADEK

more readily stored in body

19

vitamin A

retinoids - family name
-retinol is chemical name

20

sources of pre-formed Vit A

liver, fish, eggs, milk, butter

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provitamins for Vit A

carotenoids
-metabolized to Vit A

yellow and leafy green vegetables, carrots, squash, spinach

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beta-carotene

efficiently converted to Vit A

23

Vit A metabolism

fat-soluble - to liver
-stored in Ito cells
-binds RBP (retinol binding protein) before release

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function of Vit A

maintain vision
-rhodopsin in rods and iodopsins in cones

cell growth and differentiation
-mucus epithelium - to squamous metaplasia and then to keratinizing epithelium

25

photon causes

11-cis retinal to 11-trans retinal

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RAR/RXR

receptor for retinoic acid - increase growth receptors

27

Tx of skin disorders - acne and psoriasis

retinoids

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vitamin A deficiency

night blindness
epithelial squamous metaplasia and keratinzation
-susceptible to pulmonary infection and bladder stones

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eye changes in vit A deficiency

bitot spots
corneal ulcers
keratomalacia

30

Vit A toxicity

too much - long time ago - people ate livers

acute - HA, dizzy, vomit, bulrry vision
chronic - weight loss, anorexia, nausea, vomit, bone and joint pain

31

Vitamin D

maintenance of the calcium and phosphorus levels

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Vit D deficiency in children

rickets

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Vit D deficiency in adults

osteomalacia

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source of Vit D

synthesis in skin
-sun conversion of 7-dehydrochoesterol > cholecalciferol (Vit D3)

35

Vitamin D metabolism

Vit D synthesized in skin
-transport to liver (bound to DBP)
-liver conversion to 25-hydroxycholecalciferol
-kidney conversion to 1,25 hydroxycholecalciferol

36

regulation of 1,25 Vit D formation

PTH - increases
hypophosphatemia -increases

both activate alpha-1 hydroxylase**

also negative feedback mechanism

37

effects of 1,25 Vit D

skeletal homeostasis

stimulate intestinal Ca absorption
stimulate Ca reabsorption in kidney
increase RANKL - bone breakdown
also effect on bone mineralization

38

Vit D deficiency

normal range - 20-100 ng/mL
-deficiency > 20

children - rickets
adult - osteomalacia

elderly - increased bone loss and hip Fxs

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nonambulatory rickets

head and chest stress
-craniotabes - bones snap back
-pigeon breast deformity
-frontal bossing and squared head
-rachitic rosary

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ambulatory rickets

lumbar lordosis and bowed legs

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vit D toxicity

metastastic calcification of soft tissues
-children

bone pain and hypercalcemia
-adults

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ascorbic acid

Vit C

43

Vit C deficiency

scurvy

hemorrhage and healing defects in children and adults

44

Vit C sources

need all from diet (no endogenous production)

milk, liver, fish, fruits, veggies

45

antimicrobial effect of Vit D

TLRs stimiulated increase vit D receptor expression and increase mitochondria CYP27B

synthesis of catyhelicidin occurs (anti-microbial)

46

function of Vit C

activation of prolyl and lysyl hydroxylases from inactive precursors - providing for hydroxylation of procollagen

also antioxidant - scavenge free radicals

47

Vit C deficiency

impaired collagen formation
-impaired wound healing
-bleeding tendency
inadequate osteoid synthesis

48

beri beri

vit B1 deficiency (thiamine)
alcoholics and africans

can lead to wernicke/korsakoff syndrome

49

wernicke

vit B1 deficiency
-CNS - ataxia, ocular problems, dementia

50

korsakoff

vit B1 deficiency
-psych - amnesia

51

pellagra

vit B3 deficiency (niacin)

-or of tryptophan

3 D's - dementia, dermatitis, diarrhea

52

riboflavin

Vit B2

53

zinc deficiency

rash around eyes, mouth, nose, anus

anorexia/diarrhea

growth retardation

depressed mental function

infertility

54

iron deficiency

hypochromic microcytic anemia

55

iodine deficiency

goiter
hypothyroidism

56

copper deficiency

muscle weakness
neuro defects

57

normal BMI range

18.5 - 25 kg/m2

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obese BMI

> 30

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overweight BMI

25-30

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central and visceral adiposity

fat in abdomen and mesentery and organs
-higher risk for diseases

61

hypothalamic control of hunger

arcuate nucleus
-POMC/CART - stop eating
-NPY/AgRP - eat more

62

leptin

synthesized by fat cells

stimulate POMC/CART
-to stop eating

63

mutation in MC4R

massive obesity

64

thermogenesis

mediated by leptin

65

adiponectin

stimulates FA oxidation and decrease in fat mass

produced by adipocytes

66

AdipoR1

adiponectin receptor in skeletal muscle

67

AdipoR2

adiponectin receptor in liver

68

adipose and inflammation

pro-inflammatory
-levels of C-reactive protein high

69

orexigenic

increased food intake

70

anorexigenic

decreased food intake

71

ghrelin

only gut hormone that increases food intake

72

PYY

from endocrine cell in ileum and colon
-low during fasting, increase after eating

decreased in individuals with prader willi syndrome (ch 15)

reduce food intake and weight gain

73

amylin

secreted with insulin from pancreatic beta-cells
-reduces food intake and weight gain

74

activity of PYY and amylin

activate POMC/CART
-dont eat

75

metabolic syndrome

visceral or intra-abdominal adiposity, insulin resistance, hyperinsulinemia, glucose intolerance, HTN, low HDL

76

non-alcoholic fatty liver disease

in obese

77

cholelithiathis

gallstones
-6x more likely in obese patients

78

pickwickian syndrome

hypoventilation in obese individuals

obesity with hypersomnolence as well

79

results of obesity

insulin resistance
-DM II
-hyperinsulinemia

increased IGF-1

80

obese males and cancer

BMI > 25
-associatd with increased adenocarcinoma of esophagus, thyroid, colon, kidney

81

obese females and cancer

BMI > 25
-increased adenocarcinomas of esophagus, endometrium, gallbladder, kidney

82

mechanism of obesity and cancer

hyperinsulinemia and insulin resistance

-increased IGF-1

mitogenic and anti-apoptotic

also increased steroid hormones

83

adiponectin in obese

role in insulin sensitization

low levels - lead to hyperinsulinemia and insulin resistance

84

aflatoxin

development in hepatocellular carcinomas and asia and africa

-causes p53 mutations

85

nitrosamines and nitrosamides

formation of gastric carcinomas

-formed in body from ingested nitrites and nitrates

86

colon cancer and diet

high animal fat intake with low fiber

87

fiber

increased intake related to decreased risk of colon cancer

88

poly-unsaturated fatty acids

in fish oils

decrease in atherosclerosis

89

recommended diet

veggies, fruits, whole grains, olive and peanut oils, complex carbs, low in salt