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ClinChem Test3
Chpt 10- Assessment of Nutrition and Digestive Function
| Question | Answer |
|---|---|
| Macronutrient assessment consists of: | Proteins, Lipids, Carbohydrates and their derivatives |
| Micronutrient status focuses on | vitamins and minerals |
| Twenty amino acids are important to human body function, how many of these can NOT be made by the adult human and are considered essential nutrients | eight |
| Humans are also unable to produce two important what? | fatty acids and these must be included in the diet |
| Biochemical measurements of such compounds as creatinine, albumin, transferrin, and a few others provide a | quantitative measure of nutritional status |
| Creatinine is a waste product of muscle metabolism, and provides an assessment of | the total muscle mass in patients with normal renal function |
| Hypoalbuminemia is an indicator of | protein deficiency |
| Retinol binding protein correlates well with protein-energy status of the patient. However, retinol-binding protein concentration is affected by | glomerular filtration rate, so assessment of this protein must also be carefully evaluated like with creatinine |
| Transferrin is the protein that acts as a carrier for iron. It has a half life of 8 days, which makes it a | sensitive marker for protein-energy nutritional status |
| Iron concentration must be taken into account along with | transferrin concentration |
| Transthyretin or TBPA (PreAlbumin) is the protein that acts as a carrier for | thyroid hormones |
| Thyroid hormone levels must be taken into account when considering | Transthyretin concentration |
| Nitrogen Balance is the measurement of the difference between nitrogen intake and | excretion |
| A positive nitrogen balance is recommended for certain disorders such as | wound healing, anabolism and growth |
| Since most nitrogen is excreted in urine, nitrogen balance may be estimated by | measurement of urinary urea nitrogen |
| Vitamins are classified by | the solubility: fat soluble vitamins must have carrier molecules while water soluble vitamins do not |
| Trace Elements are vital to normal function and are necessary for restoring health during | the recovery phase from a disease |
| Zinc, Copper, Selenium and Chromium are considered | trace minerals |
| Copper is found mostly in ceruloplasmin, a deficiency in copper results in | decreased hemoglobin and collagen production. |
| Vitamin A has three active forms : | Retinol, Retinal, and Retinoic acid |
| What happena when the body needs vitamin A | free Retinol is released from the liver bound to retinol binding protein and travels through the blood to the target cell |
| In Rods of the eye, Retinol is oxidized to | Retinal. This aldehyde combines with opsin to form rhodopsin, a photopigment of vision |
| Night blindness is the result of a combined deficiency of | Zinc and carrier proteins for Retinol |
| Macrocytic anemia may be caused by | vitamin deficiencies of folic acid or vitamin B 12 |
| Folate is a coenzyme that is necessary for | carbon transfers in metabolism. Folate deficiencies also result in hematologic affects |
| In the small intestine Vitamin B12 becomes bound to | intrinsic factor (Glycoprotein which is secreted by parietal cells of the gastric mucosa) This allows it to be absorbed by the small intestine |
| Failure to produce intrinsic factor causes | pernicious anemia due to the bodies inability to absorb Vit B12 |
| you can become Vitamin B 12 deficient by not taking in enough meat and eggs which contain Vitamin B 12, or you can have problems with | your Intrinsic factor they will both cause a Vitamin B 12 deficiency which will result in a macrocytic anemia |
| Diseases that can interfere with the secretion or activation of intrinsic factor are: | Destruction of Gastro Intestinal mucosa, malabsorption, intestinal parasites, gastric resection, celiac sprue( gluten intolerance), Crohn’s Disease and autoimmunity that results in destruction of the gastric parietal cells. |
| Folic acid is present in | green vegetables, liver, and yeast |
| The functions of folate and Vit B 12 are | linked |
| In the conversion of Homocysteine to methionine, Vit B12 is a coenzyme in the reaction in which | a methyl group is transferred by folic acid |
| Folic acid is a B vitamin that is required for | the production of normal red blood cells |
| Prediabetes is defined by | results that fall into the impaired range but not the diabetic range. These results include fasting glucose 101 – 125 and 2 hour plasma glucose 140 – 199 |
| Prediabetes and metabolic syndrome are associated with | high triglycerides, low HDL, hypertension, and the development of cardio vascular disease. |
| The digestive enzymes or exocrine secretions, hydrolyze large molecules in food into small, soluble molecules that can be | transported across the lining of the gastrointestinal tract into the blood where they can travel to cells |
| Nutrients are ground into small pieces by the teeth, partially digested by | salivary amylase |
| Chief cells synthesize and secrete | pepsin and pepsinogen, the precursor to pepsin |
| Pepsin is a proteolytic enzyme that | degrades polypeptide chains |
| Parietal cells produce hydrochloric acid and intrinsic factor. Hydrogen Ion secretion is stimulated by | the hormone gastrin, which is produced by the cells of the pyloric region of the stomach and the duodenum |
| First section of the small intestine is the | duodenum |
| Both the gallbladder and the pancreas drain into the duodenum. The gallbladder drains bile, which is comprised of | bile acids, and bile pigments produced by the liver. |
| The release of bile from the gall bladder is stimulated by the hormone cholecystokinin. Bile acids contain | lipids that have been conjugated to hydrophilic groups to make them more soluble in the water-based fluids of the intestinal system |
| Bile pigments consist of the breakdown products of | hemoglobin, which contribute to the color of the feces |
| The pancreas secretes | sodium bicarbonate which brings the pH back up to around 8. it also releases proteolytic enzymes which attack proteins in the gastric fluid. |
| Pancreatic fluid secretion is controlled by | hormones |
| Secretin controls the release of | sodium bicarbonate, and cholecystokinin controls the release of catabolic enzymes |
| Amylase breaks down starch polymers into monosacharides, and lipase hydrolyzes | triglycerides into fatty acids and monoglycerides |
| Final digestion of nutrients occurs in the | villi, which line the lumen of the small intestine |
| The large intestine’s main function is | to reabsorb water, if too much is reabsorbed then constipation can occur |
| Symptoms of Malabsorption are caused both by the effects of water absorption from nondigested substances and | by nutritional deficiencies in tissue cells. Symptoms include weight loss, bruising, flatulence, bloating and diarrhea |
| A common consequence of malabsorption is | steatorrhea, is the presence of excess fat in feces |
| Severe vomiting and diarrhea can result in | acid base imbalance as well as dehydration or renal failure |
| Lab tests for malabsorption include: | Fecal fat, Iron, Folate, Vit B12, D-Xylose absorption, and Lactose breath test |
| Gastric fluid analysis may be useful in | assessing gastrin-secreting tumors such as in Zollinger-Ellison syndrome, evaluating gastric hyperacidity, and diagnosing achlorhydria |
| Zollinger –Ellison is a syndrome that is cause by | a gastrin producing tumor or gastrinoma |
| High levels of gastrin cause the overproduction of stomach acid, and | the high acid levels lead to multiple ulcers in the stomach and small bowel |
| Cystic Fibrosis is | an inherited, autosomal recessive disease that affects nearly all exocrine glands in the body |
| Cystic Fibrosis is characterized by: | COPD, pancreatic insufficiency, and abnormally high sweat electrolytes. The disease causes the exocrine glands to become clogged with viscous material |
| Excessive sweating leads | to episodes of hypotonic dehydration, and circulatory failure. (The formation of salt crystals on skin is an indicator of CF) |
| The diagnosis of CF is made by | clinical symptoms and positive sweat chloride test |
| Newborns with CF have an increased amount of | immunoreactive trypsin in their blood.. (Used for newborn screening of CF) |
Created by:
Mgoodall
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