Clinical Nutrition Set 2

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Clinical Nutrition Set 2
2012-12-10 13:32:05

Midterm -> Final
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  1. This vitamin is for:
    -Energy metabolism
    -Synthesis of nucleic acids and ATP
    -Membranes on nerve cells
    B1 (Thiamin)
  2. What patients are high risk for B1 deficiency?
    • Malnourished
    • Homeless
    • Alcholics
  3. What are the symptoms of B1 deficiency?
    • Enlarged heart
    • possible cardiac failure
    • Muscular weakness
    • Apathy, poor short term memory, confusion, irritability
    • Anorexia and weight loss
  4. What diseases are associated with B1 deficiency?
    • Beriberi - damage to nervous system as well as heart and other muscles
    • Dry Beriberi - peripheral neuropathy
    • Wet Beriberi - tachycardia, cardiomegaly, severe edema, difficulty breathing, CHF
    • Wernicke-Korsakoff syndrome (esp in alcoholics) - disorientation, loss of short-tem memory, jerky eye movements, staggering gait
  5. What types of patients should be taking B1?
    • Strenous physcial exertion
    • Fever
    • Pregnancy
    • Breast-feeding
    • Adolescent growth
  6. This vitamin is associated with FAD, Kreb cycle and Electron Transport Chain.
    B2 (Riboflavin)
  7. What are symptoms of B2 deficiency?
    • Inflamed eyelids, Photophobia, Reddening of cornea
    • Sore throat, cracks and redness at the corners of mouth (cheilosis)
    • Painful smooth purplish / magenta tongue (glossitis)
    • Skin lesions convered with greasy scales
  8. Who is at risk for B2 deficiency?
    • Alcoholics
    • Anorexics
    • Lactose Intolerance
  9. This vitamin is:
    -central in energy-transfer reactions
    -metabolism of glucose, fat and alcohol
    -helps many functions of cells
    • B3 (Niacin)
    • *Tryptophan can be converted to niacin
  10. What are symptoms of B3 deficiency?
    • Skin: pellagra - thick, scaly, darkly pigmented rash esp with sun exposure
    • Digestive: vomiting, diarrhea
    • Nervous: headache, apathy, fatigue, depression, disorientation, memory loss
    • Dermatitis, dementia, death
  11. What are the symptoms of B3 toxicity?
    • Painful flush, tingling, hives, rash
    • Excessive sweating
    • Nausea, vomiting
    • Blurred vision
    • Liver damage
    • Impared glucose tolerance
    • Elevated serum levels of uric acid leading to gout
  12. This term refers to the dilation of capillaries that may be painful, tingling sensation
    • Niacin Flush - due to intake of 3-4 times the RDA (recommended dietary allowance)
    • *high does can also lower cholesterol levels but liver enzymes must be monitored closely (as with statins)
  13. What are negative effects of homocysteine?
    • High levels of it increase risk of heart disease
    • B6, 9, & 12, deficiencies may raise serum homocysteine levels
  14. This vitamin:
    -is involved in amino acid metabolism (gluconeogenesis)
    -is involved in fatty acid metabolism
    -converts tryptophan to niacin / serotonin
    -synthesizes neurotransmitters (dopamin, norepinephrine, GABA)
    -helps make RBCs
    -releases glucose from glycogen
    -has hormone functions
    B6 (Pyroxidine)
  15. What are symptoms of B6 deficiency?
    • Scaly dermatitis
    • Anemia
    • Depression, confusion, abnormal brain wave pattern, convulsions
    • Carpal Tunnel Syndrome
    • *certain medications interfere with the metabolism of b6, such as drugs for tuberculosis
    • *Alcohol contributes to the destruction of B6
    • *Oral contraceptives (estrogen) may create a B6 shortage
  16. What are the symptoms of B6 toxicity?
    • Depression, fatigue, irritability, headaches
    • Nerve damage causing numbness, muscles weakness
    • Convulsions
    • Skin lesions
  17. Microcytic Anemia is exacerbated by deficiencies of which vitamins?
    B2 & B6
  18. This vitamin:
    -is involved in DNA synthesis and new cell formation
    -reduces risk of neural tube defect (women of child-bearing age)
    B9 (folate)
  19. What are sympotoms of B9 deficiency?
    • increased blood levels of homocysteine (increased risk of heart disease)
    • Megaloblastic / Macrocytic anemia (decreased O2 carrying capacity, Intrinsic Factor deficiency)
  20. This vitamin:
    -is involved in new cell synthesis
    -maintains nerve cells, myelin
    -reforms folate coenzyme
    -is involved in DNA synthesis
    B12 (cobalamin)
  21. What are sympotoms of B12 deficiency?
    • Anemia (Pernicious)
    • Degeneration of peripheral nerves / myelin progressing to paralysis
    • GI Symptoms (intrinsic factor deficiency)
    • Atrophic gastritis
  22. What are food sources of B12?
    • Only found in animals
    • *strict vegetarians / vegans and long-term use of acid-reducing drugs can lead to B12 deficiency
  23. This vitamin:
    -is an antioxidant
    -is a cofactor of collagen synthesis
    -is a cofactor in neurotransmitter synthesis
    -increases need during stress
    -decreases histamine (help for common cold)
    -decreases clotting
    -deficiency can cause scurvy
    C (ascorbic acid)
  24. What are symptoms of vitamin C deficiency?
    • Scurvy:
    • Inadequate collagen synthesis leading to hemorrhage
    • Degenerating muscles (including heart)
    • Skin becomes rough, brown, scaly, dry
    • Hair loss
    • Wounds fail to heal
    • Bone rebuilding falters
    • Joint pain and swelling
    • Loose teeth
    • Anemia (microcytic)
    • Infections
    • Hysteria, depression
    • Sudden Death caused by internal bleeding
    • "Pithed frog position" in infants
    • Weakened blood vessels, connective tissue, bone (collagen related)
  25. This vitamin:
    -promotes vision
    -part of rhodopsin
    -involved in protein synthesis and cell differentiation
    A (retinol)
  26. What are the symptoms of vitamin A deficiency?
    • Measles / Impaired Immunity
    • Night blindness
    • Blindness
    • Keratinization
  27. This vitamin:
    -is invovled in bone growth
    -facilitates intestinal absorption of calcium and phosphate
    -support protein synthesis and cell differentiation
    -increases blood concentration of calcium
    -facilitates in bone mineralization
    -is invovled in a series of steps involving the skin, liver, and kidneys
    D (calciferol)
  28. What are the symptoms of vitamin D deficiency?
    • Rickets
    • Osteomalacia
    • Osteoporosis
    • Cancer
    • Autoimmune Diseases
  29. This vitamin:
    -protects PUFA and vitamin A from oxidizing (antioxidant)
    -Megadoses can cause hemorrhage / bleeding
    -slows down clotting factors
    E (α / β / χ / δ-tocopherol)
  30. This vitamin:
    -is involved in the synthesis of bone-clotting proteins
    -is involved in the synthesis of bone proteins that bind calcium
    -prevent osteoporosis
    • K
    • *deficiency of K can cause uncontrolled bleeding
    • *hemophilia cannot be cured with K intake
  31. This mineral:
    -helps bone and teeth formation
    -enzyme activation (muscle contraction, nerve impulse transmission, cell membrane potential)
    Calcium (Ca2+)
  32. What are the symptoms of Calcium deficiency?
    • impair muscle contraction / cause muscle crapms
    • osteoporosis (typical persons at risk are white, female, who smoke and drink)
  33. What is "The Triad" for athletic patients?
    • Disordered eating
    • Amenorrhea
    • Osteoporosis
  34. The mineral:
    -is involved with ATP
    Phosphorus (P)
  35. What are symptoms of Phosphorus deficiency?
    • bone loss
    • *High intake can result in osteoporosis (inhibits mautre vit D formation)
  36. The mineral:
    -is stored in the skeletal system
    -is a component of over 300 enzymes
    -part of ATP
    -involved in cardiovascular and neuromuscular function
    -involved in protein synthesis
    -can lower high blood pressure
    Magnesium (Mg)
  37. What are possible symptoms of Magnesium deficiency?
    • Apathy
    • Muscle weakness / cramps
    • High Blood Pressure
    • Heart rate arrhythmias
    • Increased cardiovascular risk
    • *toxicity can cause diarrhea
  38. This mineral:
    -involved in the formation of hemoglobin, myoglobin, oxidative enzymes
    -is stored in the body as ferritins
    Iron (Fe)
  39. What are symptoms of Iron deficiency?
    • depletion of bone marrow stores
    • decreased serum ferritin (storage form of iron)
    • Iron-deficient erythorpoiesis
    • Iron-deficiency anemia
    • pica
  40. What occurs when there is an overabunance of Iron intake?
    • associated with hemosderosis, cancer, heart attack
    • excessive ingestion decreases absorption of calcium
  41. This mineral:
    -is involved in oxygen metabolism
    -necessary for the absorption and use of iron in the formation of hemoglobin
    • Copper (Cu)
    • *excessive ingestion decreases absorption of zinc and vice versa
  42. What are symptoms of Copper deficiency?
  43. This mineral:
    -is involved in over 300 enzymes, protein synthesis, LDH, taste perception
    -helps with wound healing, immune function, bone formation
    -transports A
    Zinc (Zn)
  44. What are symptoms of Zinc deficiency?
    • Impaired immune systems
    • Failure to grow properly
  45. This mineral:
    -is a component of glucose-tolerance factor associated with insulin
    -may enhance insulin effect
    • Chromium (Cr)
    • *large does might damage chromosomes thereby increasing the risk for developing cancer
  46. This mineral:
    -works with vitamin E as an antioxidant
    -involved in immune functions
    -theorized to help prevent cancer
    -involved in liver detoxification
    Selenium (Se)
  47. What are symptom of Selenium deficiency?
    • Cardiomyopathy
    • Impaired immune function
    • Links to cancer (esp. prostate)
  48. This mineral:
    -may affect cell membrane to influence mineral metabolism
    -may influence steroid hormones (estrogen, testosterone) to affect bone metabolism
    Boron (B)
  49. What are symptoms of Boron deficiency?
    May be involved in bone metabolism (estrogen related)
  50. This mineral:
    -are not know; possible insulin-like effect
    Vanadium (V)
  51. What are symptoms of Vanadium deficiency?
    Theorized to impair glucose metabolism
  52. This mineral:
    -helps in the prevention of dental caries
    Fluoride (F)
  53. This mineral:
    -helps prevent goiters
    Iodine (I)
  54. Some with hypertension respond favorably when what mineral is restricted in diet?
    Cl (Chloride)
  55. High intake of this mineral can cause hypertension, esp to those sensitive.
    High intake may result in calcium oxalate kidney stones.
  56. The mineral is toxic.
    Interferes with hemoglobin synthesis, interferes with the incorporation of iron into hemoglobin, and causes neuropathy and cognitive changes.
    Lead (Pb)
  57. This term refers to difficulty swallowing.
    Foods with multiple textures that are not soft and cohesive can be difficult to swallow.  There is a risk of aspiration.
  58. This term refers to the reflux of acidic stomach contents in to the esophagus?
    GERD (gastroesophageal reflux)
  59. What are potential causes of PUD (peptic ulcer disease)?
    • Helicobacter pylori
    • NSAIDs
    • Alcohol abuse
  60. This term refers to black and tarry stools that are a sign of Upper GI Bleeding?
  61. What is the condition called when one has a problem with producing B12?
    Atrophic gastritis (which leads to Intrinsic Factor deficiency and then leads Pernicious Anemia)
  62. What do you advise patients with constipation?
    • gradually increase fiber intake
    • adequate fluid intake
    • exercise daily
  63. Severe upper abdominal pain, radiating through to back, sometimes with nausea and vomiting.
    Elevated levels of serum amylase and lipase.
    What condition is this?
  64. The causes of this condition:
    Excessive alcohol
    High triglycerides
    Acute Pancreatitis
  65. This condition is 70% alcohol induced.
    Chronic Pancreatitis
  66. This is the most common life-threatening genetic disorder amoung Caucasians.
    Unusually viscous exocrine secretions.
    Complications involve lungs, pancreas, sweat glands.
    Thick mucus blocks digestive enzymes from the pancreas to the intestines and the absorption of protein, fats and fat-soluble vitamins is impaired.
    Cystic Fibrosis
  67. -Abnormal immune response to gluten, a protein in wheat, barley, and rye
    What condition is this?
    Celiac Disease
  68. Often right lower quadrant pain, bloody diarrhea; may occur in any region of GI tract and most often invovle ileum and / or colon; lesions in different areas in the intestine with normal tissue separating affected regions called "skip lesions".
    What condition is this?
    Crohn's Disease
  69. Affects the rectum & colon; Often left lower quadrant pain.
    Frequent urgent bowel movements that are small in volume.
    Stools often streaked with blood and contains mucus.
    Nutrient losses dues to tissue damage, bleeding, & diarrhea.
    What condition is this?
    Ulcerative Colitis
  70. Chronic and recurring intestinal symptoms including diarrhea, constipation, flatulence, bloating, and distension and that cannot be explained by specific physical abnormalities; this disease is characterized by the tendency for excessive colonic responses to meals, GI hormones, and stress.
    What condition is this?
    IBS (irritable bowel syndrome)
  71. Presence of peeble-sized outpockets in intestinal wall
    Prevalence increases with age
    Persistent abdominal pain, fever, alternating constipation and diarrhea
    High-fiber diet can be preventative
    May need to avoid nuts, popcorn, & food with seeds
    Drink plenty of fluids
    What condition is this?
    Diverticular Disease
  72. Pain in the upper right abdomen that can sometimes move around to the back or right shoulder blade.  Other symptoms include nausea and vomiting.  Symptoms may be made worse by fatty or greasy foods, may occur after a meal, and may cause jaundice and / or fever.
    What condition is this?
    Cholelithiasis (Gallstones)