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Medicine 3 > GIM 1 > Flashcards

GIM 1 Flashcards

(42 cards)

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1
Q

What is nutrient flux?

A

The measure of activity of a metabolic pathway

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2
Q

What are the 3 metabolic pools?

A

Functional pool - direct involvement in body function

Storage pool - provides buffer

Precursor pool - provides substrate for nutrient synthesis

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3
Q

What is glycemic index?

A

The ranking of CHOs in food and how they affect blood glucose level (pure glucose GI = 100)

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4
Q

What the the recommendations for CHO intake?

A

~50% of dietary energy

Free sugar intake < 5% of calorie intake

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5
Q

What are the anaemia preventing vitamins?

A

B12 (animal products) and folate (green veg)

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6
Q

What are the sources of vitamin D?

A

D3 = fish oil, egg yolk, butter

7-dehydrocholesterol = animal fats, plant sterols, UV light

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7
Q

What is the physiologically active form of vitamin D?

A

Calcitriol (vit. D metabolised by liver and kidney hydroxylation)

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8
Q

What are the actions of vitamin D?

A

Intestinal and renal absorption of Ca and PO4

Normal bone formation

Neuromuscular and immune functions

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9
Q

What is caused by vitamin D deficiency?

A

Rickets (children)

Osteomalacia (adults)

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10
Q

What is the toxicity of vitamin D?

A

> 250micrograms/day

Leads to hypercalcaemia and calcification of soft tissues

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11
Q

What is the use of calcium?

A

Bones, cell signalling and muscle function

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12
Q

What are the sources of calcium?

A

Milk and dairy, flour, hard water

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13
Q

What is calbindin?

A

Intestinal Ca binding protein for Ca absorption (regulated by vit. D)

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14
Q

What is the metabolic response to low plasma Ca

A

Parathyroid hormone and vitamin D synthesis.

Vitamin D activated to calcitriol

Increased Ca absorption

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15
Q

What is the metabolic response to high plasma Ca

A

Calcitronin secreted from thyroid gland

Increased Ca excretion and prevention of Ca release from bones

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16
Q

What is the purpose of iron?

A

Hb and electron transport

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17
Q

Where is iron stored?

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A

Reticulo-endothelial system and bone marrow

18
Q

What is transferrin?

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A

A plasma transport protein that transfers iron to bone marrow

19
Q

In what form is iron absorbed?

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A

Fe2+ (absorption enhanced by reducing agents)

20
Q

What are some examples of positive energy balance?

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A

Obesity, growth, pregnancy, recovery

21
Q

What are some examples of negative energy balance?

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A

Wasting disease, anorexia, starvation, voluntary weight loss

22
Q

What processes are involved in basal metabolic rate (BMR)

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A

Heart and resp.
Protein turnover
Fat and CHO turnover
Ion gradient maintenance

23
Q

What is physical activity level (PAL)

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A

Ratio of energy expenditure to BMR

24
Q

How do we assess nutritional status?

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A 
Anthropometry (height, weight, BMI)
Body composition
Biochemistry and haematology 
Function
Dietary assessment
25
What are the causes of undernutrition?
Increased nutrient demand Reduced nutrient delivery to GI system Inability for GI system to absorb nutrients
26
What are the effects of undernutrition?
``` Decreased insulin Increased amino acid release (proteolysis) Ketone bodies supply brain Gluconeogenesis Eventual protein and tissue breakdown Fatty acids as energy source ```
27
What are the different types of undernutrition?
Primary - diet related Secondary - illness related Specific - nutrient deficiency Generalised - calorie deficiency
28
What are the 2 types of protein-energy malnutrition (PEM)
Dry PEM - Marasmus (no oedema) > severe calorie and protein deficiency Wet PEM - Kwashiorkor (oedema) > severe protein deficiency > link to low [plasma albumin]
29
What is refeeding syndrome?
A syndrome of metabolic disturbances resulting from re-nutrition to patients who are starved or severely undernourished Patient re-nourished Insulin increases and glucose moves into cells Electrolytes (especially phosphate) move into cells for metabolism Hypophastaemia results
31
What is enteral nutrition support?
Small bowel feeding with pump administration. Results when patients are undernourished for 7 days
32
What is parenteral nutrition support?
Administration of nutrients through central or peripheral vein. Used when GI tract not functional or accessible.
33
What are the dietary risk factors of obesity?
Fat overconsumption Excessive sugar intake Alcohol - decreases fat oxidation and storage
34
What is the main focus for obesity treatment/management?
Lifestyle modification Limited drug therapies and bariatric surgery only used for severe obesity with co-morbidities
35
For a patient with hypertension, what diet should they be put on?
DASH diet
36
What are the benefits of a DASH diet?
High fruit and veg (lots of K+ reduces BP) Reduced Na+ reduces BP Evidence that diets high in Na+ and low in K+ result in hypertension
37
What are the dietary benefits of non-starch polysaccharides?
Decrease LDL-C Bind bile salts and prevent reuptake High fibre - lower risk of CVD
38
What are the functions of bile?
Digestion of fats and fat soluble vitamins | Secretion of waste products such as bilirubin
39
How is bile made/secreted?
Secreted into canaliculi by hepatocytes Modified by ductal epithelial cell secretions in bile ducts Further modification in gallbladder (stored there in fasting state)
40
What is the relationship between bile and cholesterol?
Cholesterol is synthesised in hepatocytes to make bile acids (cholate and chenodeoxycholate) Cholesterol in diet is converted to bile acids
41
How does bile aid lipolysis?
Bile salts emulsify lipids and break them down into little droplets - larger SA for easier digestion
42
How does enterohepatic recirculation of bile work?
Venous blood travels from ileum to the liver through portal vein Hepatocytes extract bile acids from sinusoidal blood Re-secretion into canaliculi
43
How do fish oils decease CVS risk?
Eicosapentaeonic acid (EPA) competes with arachidonic acid and reduces COX- to TXA3 instead of COX to TXA2. TXA3 has less platelet activating activity. Decreased risk of thrombosis by inhibited platelet aggregation

Medicine 3 (8 decks)

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