(Mnemonic: Both Mara and Kwashi can't Waa-gi)

1) Growth failure

2) Decreased body weight (60% in M; 60- 80% in K)

3) Protuberant abdomen

4) Anemia

5) impaired immune responses - infections

Low

TEST QUESTION -

"Severe edema occurs in Kwashiorkor and not in Marasmus. This is consistent with which of the following features of Kwashiorkor? Low serum albumin."

Mnemonic (Etiology of Sia-La is GA-BA)

General Malnutrion

Alcoholism

Anorexia

Bulimia

Mnemonics: the 3 E's: eyes, epithelial cells, enhancement

1) maintaining normal vision in reduced light

2) potentiating the differentiation of specialized epithelial cells - mainly mucous secreting cells

3) enhancing immunity to infections

Dryness of the conjuctivae

build up of keratin debris

erosion of the corneal surface

destruction of the cornea

blindness

(Mnemonic: HPVs)

Headache

Papilledema (change in eye exam)

Vomiting

Stupor

Weight loss

Nausea

Vomiting

Dry mouth

Bone and joint pain

Hepatomegaly

Alcoholics

Persons with poor overall nutrition

Special diets (like lack of Vit B12)

People w/ intestinal absorption problems

Vitamin B deficiencies -- deficiency of B1 -- aka?

- causes what disease?

Polyneuropathy

Edema

Cardiac failure

Weight loss/ muscle

wasting

uncontrolled vascular dilatation

Alcoholics

Special diets

Debilitating diseases

Malabsorption diseases

NONE

(B2, B3, B6, B12 => all result in oral mucosa atrophy)

Angular cheilitis (Cheilosis)

Dermatitis

Smooth, magenta tongue

Corneal damage/ photophobia

The FOUR D's for PELLAGRA!

Dermatitis w/ pig + depigment.

Diarrhea

Dementia

Death

and, Mucosal atrophy (oral+ genital)

CNS disorders (seizures) Similar to other B vit def.

Pyridoxine-responsive anemia (hypochromic and microcytic) 

iron def. anemia

1) Autoimmune destruction of parietal cells of the stomach - lack of secretion of intrinsic factor in the stomach prevents absorption of vitamin B12 in the ileum

2) Gastro-intestinal bipass surgery

3) Chronic gastritis

4) Vegetarian diets

Megaloblastic anemia

(weakness, malaise, shortness of breath, glossitis and angular cheilitis, spoon shaped fingernails)

Pernicious Anemia (degeneration of the spinal cord)

Test question: In pern anemia, NO RESPONSE to dietry inc in the deficient nutrient.

Subperiosteal hemorrhages

Purpura (petechiae, echymoses)

Swollen + bleeding gums

Alveolar bone resorption

Poor wound healing

Anemia due to impaired iron absorption

Insufficient dietary intake

Insufficient production in the skin due to limited sun exposure

Malabsorption diseases, abnormal conversion to active metabolites (liver disease and chronic renal failure)

Deformation of the skeleton

Frontal bossing

Squared appearance of the head

Anterior protrusion of the sternum

Bowing of the legs

Disturbance in new bone formation: fractures

Osteopenia - loss of skeletal mass

Hypercalcemia - weakness and headaches

Nephrolithiasis (kidney stones)

Ectopic calcification

Vitamin K deficiency-

Vit K is necessary for the activity of:

Necessary for activity of prothombin

factor VII

factor IX

Factor X

Test question: Which of the following is the most likely vit def that would hemorrhagic disease in a newborn infant? VITAMIN K

=Dietary intake dificiency

=Excessive loss

(hemorrhage, menstruation, pregnancy, lactation)

Weakness

Malaise

Shortness of breath

Glossitis and angular cheilitis

Spoon- shaped fingernails

Plummer-Vinson syndrome

1) iron def anemia

2) atrophy of the upper alimentary tract

3) dysphagia

4) increased risk of Oral Cancer

Skinfold thickness

Waist circumference

Waist to hip circumeference rations

Ultrasound, CT, MRI

(Skin, waist waist)

Sedentary lifestyle

Improved socioeconomic conditions

Avaiability of processed, high calorie foods and soft drinks

Intake/expenditure are finely regulated by neural and hormonal mechanisms

LIPOSTAT

Hereditary vs environmental factors

Pathogenesis of Obesity:

Hereditary factors vs. env factors

2 examples

Asians and indians in the US - (inc obesity compared w/ counterparts in ASIA and INDIA)

Twins reared apart show striking concordance in adiposity

Test quest: which of the following support the genetic component of multifactorial inheritance of obesity?

1- twins raised apart show striking similarity related to obesity

2- genes associated with obesity have been identified in animal models

Leptin

Insulin

Ghrelin

adipose tissue

(L for lipid... adipose!)

Obesity: Humoral signals generated

INSULIN comes from?

stomach

(the stromach GRowls)

Transmits signals that:

DEC appetite

INC energy use

directly INC glucose metabolism

disturbance in the

ability to regulate caloric intake and metabolism

Beta 3 adrenergic receptor

gastrointestinal

Being fat def have: hypertension, dyslipidemia, diabetes (type 2), coronary heart disease, stroke, some cancers

Others need to know: ( mnemonic: GO get some action!) Gallbladder disease, osteoarthritis, gout, sleep apnea

Retinoid = a class of chemical compounds that are related chemically to vitamin A

(mnemonic: Aunt Cheili says: Be 12 and Be 2 Funny And Ironic)

Vit B2

Vit B12

Folic acid

Iron

Intestinal malabsorption syndromes interefere with the absorption of some vitamins. Which of the following would NOT be expected to be a def. related to an intestinal malabsorption syndrome?

Vit C

Thiamin

Riboflavin

Vit D

 Vit K

VITAMIN C

- only DIET deficiency

Note: all vitamin B have intestinal absorption

Abnormal gait (walking) and impaired reflexes

Would see megaloblastic anemia

Generalized weakness and malaise

Angular cheilitis, and depap erth tongue

spoon shaped fingers

IN BOTH DEFICIENCIES