Lecture 24: Nutritional Metabolic Disorders Flashcards Preview

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Flashcards in Lecture 24: Nutritional Metabolic Disorders Deck (37):
1

Lead poisoning

Presents differently in children (behavioral/IQ problems) vs adults (ab pain, constipation, wrist drop, encephalopathy, unusual taste in mouth, hypochromic, microcytic anemia)

2

Burton's line

Discoloration of upper gum margin due to lead poisoning

3

Mercury poisoning

Encephalopathy, sensorimotor neuropathy, seizures, tremor

4

Arsenic and where it's found

Encephalopathy, painful neuropathy, nausea, vomiting, diarrhea, renal failure, arrhythmias; warfare, murder, ground water

5

Thallium and where it was and is found

Vomiting, diarrhea, paresthesias (small fiber neuropathy), cognitive impairment; rat poison (since banned), shellfish near coal burning plants

6

Manganese and associated job

Psychiatric: confusion, irritability, compulsive behavior, then Parkinson’s disease symptoms BUT with increased reflexes (NOT like PD); associated with welders

7

Forms of malnutrition (4)

1. Undernutrition; 2. Overnutrition; 3. Specific Deficiencies; 4. Imbalance

8

Malnutrition can be due to...what's one specific one in the US?

GI causes; bariatric surgery

9

Marasmus

Balanced starvation often due to insufficient breast milk with wasting, mental changes, growth retardation

10

Kwashiorkor

Low protein w/ enough carbohydrates; encephalopathy, muscle wasting

11

Obesity specific definition

>20% than desirable weight

12

Pickwickian Syndrome. What are lab tests?

Complication of obesity w/ severe cardiorespiratory distress & alveolar hypoventilation; polycythemia, hypoxemia, cyanosis, CHF & somnolence

13

Hypersomnia sleep apnea presents with...other effects?

Excessive daytime sleepiness; oxygen desaturation, arrhythmias

14

Neurological complications of DM (6). All due to...

Dementia, ischemic cranial nerves, peripheral neuropatihies, plexopathies (plexes become involved), bilndness, increased risk of stroke; strokes of blood vessels to nerves

15

Dietary excess: Vitamin A

Increased intracranial pressure

16

Dietary excess: Water

Encephalopathy (water intoxication)

17

Dietary excess: Protein

Hepatic encephalopathy

18

Dietary excess: Pyridoxine

Peripheral neuropathy

19

Dietary excess: Tryptophan (contaminated)

Neuropathy/myopathy

20

Dietary excess: Emetine, ipecac

Myopathy (related to anorexia)

21

What is the first step of alcohol withdrawal, followed by...

"Rum fits" (12-48 hours) --> DTs

22

What optic nerve effect is related to alcoholism?

Amblyopia (degenerative)

23

Serum alcohol levels and CNS toxicity

0.15 - 0.25 = slurred speech/ataxic gait, 0.3 = stupor, 0.4 = coma, 0.5 = death

24

Cental pontine myelinolysis and cause

Demyelinated pons --> severe paralysis, dysphagia, dysarthria (death); alcoholism, over correction of hyponatremia

25

Marchiafava-Bignami disease and cause

Demyelinated CC --> rapid psychosis, stupor, coma, death; alcoholism

26

Alcoholic cerebellar degeneration

Truncal ataxia w/ midline problems

27

Hepatic encephalopathy symptoms test

Dementia and ataxia; "Flapping tremor"

28

Why might alcoholics get subdural hematoma

Shrinking brain (stretching of bridging veins)

29

Thiamine deficiency: alcoholic vs pure

When due to alcohol, length dependent sensory or sensorimotor neuropathy;
pure thiamine deficiency polyneuropathy starts with weakness or numbness, rapid progression

30

Wernicke's encephalopathy triad and associated conditions

Ataxia, ophthalmoplegia, confusion; impaired absorption (various gastric disorders or bariatric surgery) or poor intake of thiamine (as in alcoholism), HIV, hyperemesis gravidarum

31

Wernicke's encephalopathy pathology

Lesions of medial thalamic nuclei, mammillary bodies, PAG, cerebellar vermis

32

Korsakoff's pathology

Neuronal loss/gliosis, hemorrhage into mammillary bodies, thalamus (DM, anterior group)

33

How does Korsakoff's develop? Presentation

Untreated Wernicke's; memory loss (anterograde and retrograde) w/ confabulation, dementia, etc.

34

Pyridoxine deficiency

Various types, often presents in infancy as seizures, necessitates Pyridoxine supplementation

35

Cobalamine deficiency and other name

Can be related to diet (rare), congenital pernicious anemia, or NO abuse; combination of UMN and LMN problems due to demyelination, symptoms are symmetric and diffuse; subacute combined degernation of spinal cord

36

Cobalamine deficiency can cause...(disease name) and test

Posterolateral column disease (UMN disease); Romberg test

37

Vitamine E deficiency symptoms and causes

Progressive spinocerebellar syndrome and peripheral neuropathy w/ dry hair, baldness, muscle weakness, leg cramps; GI, pancreatic, hepatic disease

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