Download - Nut Disorders
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By:
DR. ANTOINETTE T. LEUTERIO
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FORMS
> UNDERNUTRITION
> OVERNUTRITION
> NUTRITIONAL DEFICIENCY
> NUTRITIONAL EXCESS
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PATHOGENESIS
> TISSUE DEPLETION
> BIOCHEMICAL CHANGES
FUNCTIONAL CHANGES
SUBJECTIVE SYMPTOMS
CLASSICAL SYMPTOMS
ANATOMIC LESIONS
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UNDERNUTRITION
> PROTEIN CALORIE MALNUTRITION
MARASMUS
KWASHIORKOR
> EATING DISORDERSANOREXIA NERVOSA
BULIMIA
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TABLE 1
PRINCIPAL FEATURES OF CHON-CAL DEF
MARASMUS/ KWASHIORKOR
Usual age : M- 0 -2 K- 1- 3 yo
Edema: M- none K- lower legs (dec albumin)
Muscle wasting: M- loss of fat all skin & bone K- sometimes
Growth retardation: M- obvious K- sometimes hidden
Mental changes: M- apathetic K - irritableAppetite: M- good K - bad
Diarrhea: M & K often
Skin changes: M- seldom K- flaky paint dermatsis
Hair changes: M- seldom K- sparse w/ dyspigmentation
Moonface: M-seldom K- oftenHepatic enlargement: M- seldom K- always
Serum albumin: M- normal K- low
Urinary urea per g creatinine: M- normal K- always
Serum essential amino acid index: M-normal K- low
Anemia: M- uncommon K- common( iron def)Liver biopsy: M- normal K- fatty change ( abnormal lipid)
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TABLE 2
EATING DISORDERSANOREXIA NERVOSA/ BULIMIA
Predominant sex: Both- FEMALE (yong women)
Method of weight control: A- restriction B- vomiting
Binge eating: A- uncommon B- common ( Mallory- Weiss Syn )
Weight at diagnosis: A- decreased B- near normalRitualized exercise: A- A- usual B- rare
Amenorrhea: A- 100% B- 50%
Antisocial behavior: A- rare B- frequent
Cardovascular changes(bradycardia):A-commonB-uncommon
Skin changes (hirsutism,dryness): A- usual B- rareHypothermia: A- usual B- rare
Edema- : both A & B - + /-
Medical complication: both HYPOKALEMIA
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DEFINITION
BMI > 30 kg/m2 ( obese)
normal BMI 25 kg/m2overwt BMI bet 25 to 29.9kg/m2
ETIOLOGY
heredity, environmental, psychosocial
ASSOCIATED DISODERS
HYPOVENTILATION SYNDROME / PICKWIKIAN SYN
OVERNUTRITION- OBESITY
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Adult- onset diabetes mellitusM- due to increased resistance to insulin action
C- atherosclerosis
HypertensionM due increased adrenal glucocorticoids
C- stroke
Hyperlipidemia
M- increased lipoprotein synthesisC- hypercholesterolemia
Atherosclerotic arterial diseaseCholelithiasis: M- inc cholesterol in bile C- cholecystitisOsteoarthrosis: M- cartilage degeneration in wt bearing joints
C- hips
TABLE 3
DISEASES ASSOCIATED WITH
OBESITY
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FAT-SOLUBLE VITS
A, D, E, K
WATER-SOLUBLE VITS
VIT C & B
VITAMINS AND MINERALS
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FAT SOLUBLE VITSVIT A (retinol): D- nyctalopia E- carotenemia S- leafy vege
VIT D (steroid alcohols): D- rickets E- hypercalcemia S- liver oil
VIT E (tocopherol): D- sterility E- unknown S- eggyolkVIT K ( naphthoquinones):D- bleeding E-hemolytic A. S-tomato
WATER SOLUBLE VITSVIT C ( ascorbic acid):D-scurvy E- oxaluria S- citrus fruit
VIT B COMPLEX
Thiamine( B1): D-beri-beri (Korsakoffs / Wernikes ) E- noneS- whole grain
Riboflavin ( B2):D- glossitis E- none S- milk products
Niacin ( Nicotinic acid):D-pellagra E- flushing S- peanut
Pyridoxine (B6): D-convulsions E- unknown S- legumes
Cobalamine (B12): D-pernicious A E- unknown S-meatFolate folic acid :D-me aloblastic A E- unknownS- reen v
TABLE 4
VITAMINS FX / DEF/ EXCESS/ SOURCES
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MINERALSMINERALS
a FunctionsFunctions Sodium, potassium, chloride, magnesiumSodium, potassium, chloride, magnesium
Neuromuscular excitationNeuromuscular excitation
Calcium & phosphorousCalcium & phosphorous Bone metabolismBone metabolism
ZincZinc Cofactor for certain enzymesCofactor for certain enzymes
ManganeseManganese Involved in protein metablismInvolved in protein metablism
CopperCopper Involved in electron transportInvolved in electron transport
IronIron Production of normal red cellsProduction of normal red cells
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Def iciencySODIUM- muscle cramps
POTASSSIUM- muscle weakness
CHLORIDE- with sodiumMAGNESIUM- with CA
CALCIUM- with Vit D
PHOSPHOROUS- w/ CA & VIT D
ZINC- delayed wound healing
MANGANESECOPPER- Wilsons dses
IRON- hypochromic macrocytic anemia
IODINE- goiter, cretinism
FLOURINE- dental caries
SELENIUM
TABLE 5
MINERALS FX / DEF/ EXCESS/ SOURCES
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MINERALSMINERALS
a EXCESS C a lc i um - mi l k a l k al i sy bdro me Iro n h emoc hrom ato si s Coppe r Wi lso ns di sea se