GI & Metabolism Flashcards

1
Q

What are the four major functions of the GI tract?

A
  • Motility - propulsion of food bolus from motuth to anus
  • Disgestion - Breakdown of food bolus to form chyme (occurs in stomach)
  • Secretion- secretion of enzymes to faciliatate digestion
  • Absorption - into small bowel and colon (faciliated by digestion & secretion)
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2
Q

Why is Disease Affecting the GI Tract Important?

A
  • Gastrointestinal disease is the third most common cause of death
  • Gastrointestinal cancer has highest moratlity rate of cancers
  • Most common cause of hospital admissions
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3
Q

How many GP referrals are related to GI problems?

A

1 in 6

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4
Q

What is the prevalence of contipation, dyspepsia and IBS?

A

Constipation - 1 in 10
Dyspepsia - 1 in 10
IBS - 1 in 20

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5
Q
What do the following nutritional requirements acronyms stand for?
EAR
LRNI
RNI
Safe intake
A

EAR - estimated average requirement (half the population needs more and half the population needs less than the EAR)

Lower Reference Nutrient Intake- does not meet the needs of 97.5% population)

Reference Nutrient Intake -suffiencient for 97.5% poplation. If RNI of ppulation is met the risk of disease is small

Safe intake- Not enough information to assess the above. However an amount that seems sufficient and not disease causing.

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6
Q

How much protein does an average adult require?

A

0.75g/kg/day

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7
Q

Name the 9 (10) esstential amino acids

A
P = Phenylalinine
V = Valine
T= Threonine
T= Tryptophan
I= Isoleucine
M= Methionine

H= Histodine
A = Arginine (During preganancy or growth the body cannot self synthesise enough)
L= Lysine
L=Leucine

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8
Q

Why do we needs lipids?

A

Energy release -TRYGLERCEROLS (1g = 9kcal)
Carbs and protein only 4kcal per g

Cholesterol & fatty acids - precursors for hormones and prostaglandins, vitamin D production

Protect vital organs

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9
Q

What is Lipodystrophy?

A

Genetic illness resulting in an inability to store fat

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10
Q

What is the recommended dietry intake for fat (%)?

A

30-35% total

11% saturated

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11
Q

What are the 4 dietry carbohydrate groups?

A

Polysaccharides – mainly starch

Disaccharides – mainly sucrose

Monosaccharides – mainly glucose and fructose

Non-starch polysaccharide (dietary fibre)

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12
Q

What are micronutrients?

A

Vitamins

Organic compounds required for normal metabolic function, which cannot be synthesised in the body – deficiency results in disease which can be treated by restoring appropriate levels of the compound

Required in small amounts (µg – mg)

Minerals

Inorganic elements which have a physiological function

Required in varying amounts from µg (‘trace elements’), mg (Fe, Mg) 
to g (Na, Ca)
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13
Q

Why is Niacin different from most vitamins?

A

It can be synthesised by the body using the amino acid tryptophan

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14
Q

Which vitamins are fat/ water soluable?

A

fat soluable- A,D,E & K

water soluable - B vitamins & vit C

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15
Q

What is the recommended dietry salt intake?

A

< 6g/day

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16
Q

What are common nutritional deficiences in the UK?

A
Protein/energy
Iron
Vitamin D
Vitamin B12
Folate
Vitamin C
17
Q

What are the causes of nutritional deficiency?

A

Inadequate intake

Food availability (poverty, disability)
Food choices (cost, convenience, limited range, vegans)
Problems with eating (sore mouth, dysphagia, eating disorders) 

Inadequate absorption

  • Problems with fat absorption affects fat soluble vitamins (cystic fibrosis, coeliac disease, Crohn’s disease)
  • Pernicious anaemia (B12 absorption)

Excess loss/increased requirements

Iron deficiency anaemia often arises as a result of persistent blood loss – gastric ulceration, colon cancer, excessive menstrual loss

Folic acid deficiency in pregnancy – additional requirement may not be met

18
Q

What is malnutrition?

A

Inadequate or excess intake of protein, energy, and micronutrients such as vitamins & minerals

19
Q

What are the consequences of vitamin B12 deficiency?

A

Can cause anaemia and/or irreversible neurological damage. Common symptoms include numbness and tingling of toes and fingertips

If untreated, more serious symptoms include limb weakness, poor coordination, altered gait, incontinence …. death

20
Q

Which eating disorders are new to the DSM-V?

A

OSFED (other specified feeding & disorders)

ARFID (avoidant and restricitve intake feeding disorder)

21
Q

Diagnostic features of Anorexia nervosa

A

Active mainatinance of low weight (<85% expected weight or BMI <17)

Concern about weight & shape
Types: restricting, binge/purging

22
Q

Diagnostic features of Bulimia

A
recurrent binge eating
- large amounts quickly, loss of control
compensatory behaviour
- vomiting, laxatives, fasting, exercise 
extreme shape &amp; weight concern
binge frequency (1/wk for 3 months)
not anorexia nervosa
23
Q

Prevalence of Anorexia & Bulimia

A

95% of cases of both BN and AN are female

AN- 0.5% girls aged 15-18
BN- 1-3% girls aged 18-25

24
Q

Binge eating disorder characteristics

A

similar to BN BUT does not inclde compensatory behaviour eg. vomiting, laxative etc

25
Q

What did Fairburn (2003) develop?

A

Transdiagnostic Cognitive Behavioural Model of eating disorders

26
Q

What core pathology did the does the transdiagnostic model suggest?

A

Over evaluation of eating, shape, weight and control.

Over evaluation of PERFECTIONISM

27
Q

Patton et al: What are the risk factors for developig an eating disorder (ED)

A
3 year cohort study, ~2000 15 year olds
30 girls, 3 boys with partial syndrome ED
risk:
- moderate dieting 5x
- severe dieting 18x
- poor mental health 6x
28
Q

What are the stages of treatment for an eating disorder?

A
  1. Weight management/ restoration
  2. Psychological therapies
  3. Relapse prevention
29
Q

What is the recommended treatment for children/adolescents with ED?

A

Family based treatment (FBT)

30
Q

What is the key time period for successful recovery from ED?

A

People more likely to recover if help is received within THREE YEARS

31
Q

What is MUST?

A

Malnutrition Universal Screening Tool

32
Q

What are the 3 measurements of MUST?

A
  • Body Mass Index (BMI) (Weight/Height2)
  • Recent weight loss (%)
  • Acute illness with, or likely to be, no nutritional intake for 5 days
33
Q

How are the MUST measurements scored?

A

BMI 0, 1 or 2
Recent weight loss 0, 1 or 2
No intake for previous 5 days 0 or 2

Score 0 – 6
0: Low 1: Medium ≥2: High