Nutritional

Question 1

What are the 2 categories of nutritional disorders? Outline & give examples.

Answer 1

Dietary; over/under nutrition, deficiency, etc… (e.g. obesity, anorexia, iron deficiency)
Physiological dysfunction; abnormal digestion, absorption(e.g. IBS, gastric ulcers), abnormal metabolism/excretion(e.g. metabolic syndrome)

Question 2

Describe some nutritional disorders that occur from a young age.

Answer 2

Oral abnormalities preventing suckling(e.g. cleft palate), metabolic disorders(e.g. galactosemia), etc…

Question 3

How are nutritional disorders that begin from a young age assessed?

Answer 3

Poor growth(i.e. feeding frequency, food intolerance), crying, stool(i.e. abnormal stool is green & watery with blood present sometimes)

Question 4

What roles does nutrition have on growth and development?

Answer 4

Nutrition is vital in growing children; affecting skeletal development (if there is a lack of calcium & Vit.D the child can have weak bones and stunted growth), sexual development (which can be delayed, late puberty), and mental development.

Question 5

What are the types of malnutrition and their respective consequences?

Answer 5

Under; individuals are suspect idle to infection and disease often occurring with poor health(immunosuppresed).
Over; individuals with high BP, CVD, etc…
Abnormal consumption; where the body is incapable of utilizing the nutrients, resulting in vomiting, malabsorption, etc…

Question 6

How is nutritional status assessed?

Answer 6

Clinical exam, radiography, diet history, blood testing, etc…

Question 7

Name 3 vitamin deficiencies and their consequences.

Answer 7

Vit A; night blindness.
Vit C survey; connective tissue breakdown, bleeding, poor healing.
Vit D rickets; soft bones, deformity of long bones.

Question 8

Describe 2 examples of malnutrition (Marasmus & Kwashiokor).

Answer 8

Marasmus; categorized as undernourishment and is very similar to starvation.
Kwashiokor; results from a poor balance diet -> there is enough energy in the diet t prevent starvation, however a lack of proteins and surplus of carbs causes muscle wasting. This results in abnormal liver size, oedema(distended abdomen).

Question 9

What are some nutritional disorders related to mental health?

Answer 9

Anorexia; self-starvation

Bulimia; episodes of binge-eating causes compensatory behavior (i.e. vomiting)

Question 10

Describe and outline the 2 most common mineral deficiencies.

Answer 10

Iron Deficiency; is commonly found in females due to its association with the menstrual cycle. Otherwise, Iron is found in high amount in meat products which are expensive and therefore unconsumed.
Iodine; less common but causes severe consequence(e.g. goiter, cretinism). Otherwise, iodine is found in high amounts in seafood.

Question 11

What are the consequences of iodine deficiency?

Answer 11

Goiter; The thyroid gland is hypertrophied due to iodine deficiency, causing a visible lump in the neck. Due to the lack of iodine, the pituitary gland in the brain is signaling the thyroid gland to produce thyroid hormone, however the thyroid has no building blocks to produce any hence the hypertrophy.
Cretinism; A condition of severely stunned physical and mental growth due to iodine deficiency. Iodine is vital in the product of thyroid hormone(T3, T4). Thyroid hormone is important for regulating the basal metabolic rate. If there is too much thyroid hormone the individual may become irritable, the lack of the hormone will cause the individual to become fatigued.

Question 12

What are the consequences of iron deficiency?

Answer 12

Anemia; lack of healthy RBCs to carry oxygen. Can cause a number of symptoms, in extreme cases: fainting, angina, etc…

Question 13

What results in B9 vitamin deficiency?

Answer 13

B9/folic acid causes neural tubes defects(e.g. spina bifida). (This is why pregnant women are instructed to take folic acid).

Question 14

Define obesity and its causes.

Answer 14

Obesity is the excess of adipose tissue. Obesity is causes by: excess caloric intake and limited activity, genetics, psychological disorders, etc…

Question 15

Outline the types of obesity. How are they distinguished or diagnosed?

Answer 15

Upper body; an apple physique
Lower body; pear physique
These are distinguished through a waist/hip circumference diagnosis.

Question 16

What are the risks of fat distribution with respect to the types of obesity?

Answer 16

Upper; (more risk associated with this form of obesity!) ischemia heart disease, stroke, hypertension, etc…
Lower; similar to upper body with the addition of varicose veins.

Question 17

How is obesity treated?

Answer 17

Long term management of diet and lifestyle changes, morbid obesity is also treated with surgery(e.g. gastric bypass) and pharmacological intervention.

Question 18

Define Hypolactasia.

Answer 18

Lactose malabsorption.

Question 19

What are the forms of lactose deficiency?

Answer 19

Congenital lactose deficiency; happens at birth, infants have diarrhea and fail to thrive.
Primary lactose deficiency; occurs in adults (most common one)
Secondary lactose deficiency; occurs in lactose tolerant persons due to stress or disease (e.g. coeliac disease). This is normally reversible.

Question 20

Symptoms of lactose malabsorption? Diagnosis?

Answer 20

A hydrogen gas breath test is commonly used, where >20ppm after lactose ingestion is positive. Additionally, Abdominal pain, boating, diarrhoea etc…

Question 21

How is lactose malabsorption typically managed?

Answer 21

Avoid milk and diary products, lactose tablets can help.

Question 22

Does lactose malabsorption cause IBS?

Answer 22

No but they both have similar symptoms and can be present in individuals at the same time.

Question 23

Define Menkes disease.

Answer 23

A rare genetic disorder(ATP7A) disabling the proper absorption of copper.

Question 24

Outline how Menkes disease works in context of copper.

Question 25

Any symptoms of Menkes?

Answer 25

Mental retardation, seizures, fraying hair, hypothermia, etc…

Question 26

Any treatments for Menkes?

Answer 26

Additional dietary supplements of copper are ineffective. Parenteral administration of Cu can raise blood levels but brain is slow to response to treatment. Usually cerebral degeneration occurs despite treatments.

Question 27

Outline peptic ulcer disease. Any treatments?

Answer 27

PUD is when ulcers develop in the lining of the stomach and is more common than Menkes. Usually relieved by antiacids.

Question 28

How is H. Pylori related to PUD?

Answer 28

Most patients with ulcers have been infected with H. Pylori.

Question 29

How is nutritional status assessed physically?

Answer 29

Height, weight, BMI, waist-hip ratio, etc…

Question 30

How is nutrition managed in poor health?

Answer 30

During ill health, nutrition must be managed to promote recover and meet metabolic demands. As intervention modified diets may be introduced, as well as, NG tubes, parenteral feeding, etc…