Nutrition and Disease Final

Name the correct acid/base issue

• hyperventilation

• tachycardia (fast HB)

• decreased or normal BP

• hypokalemia (low potassium)

• numbness/tingling/cramping

• seizures

• causes hyperventilation

respiratory alkalosis

Name the correct acid/base issue

• restlessness/lethargy

• dysrhythmias (tachycardia = fast HB)

• causes hypoventilation

• confusion, dizziness

• vomiting

metabolic alkalosis

Name the correct acid/base issue

• rapid/shallow respiration

• cyanotic (blue)

• hyper kalemia

• caused by COPD, pneumonia, or ARDS

respiratory acidosis

Name the correct acid/base issue

• headache

• decreased BP

• warm flushed skin

• nausea/ vomiting/ diarrhea

metabolic acidosis

This is catastrophic failure that ruptures a damaged cell and it doesn’t require any energy

necrosis

This is a controlled death of a cell that requires energy

apoptosis

What occurs after a cell ruptures from necrosis

the immune system (macrophages and neutrophils) attack the stuff that came out and clean it up

how does apoptosis occur

1. signal binds death receptor or leaking initiates response

2. Pro C-8 reacts with FADD to form C-8

3. Pro C-3 reacts with C-8 to form C-3

4. C-3 destroys organelles

5. placed into garbage bags for macrophages so it doesn’t cause immune response

who is the final electron acceptor

oxygen gas

normal concentrations for the following

glucose

sodium

potassium

glucose: 70-100mg/dL

sodium: 135-145 mEq/L

potassium: 3.5-5.5 mmol/L

concentration ranges for the following

hypertonic

isotonic

hypotonic

hyper: >350mOsmol/L

Iso: 270-300mOsmol/L

hypo: <200mOsmol/L

What elements make up the following compartments

• vascular

• interstitial

• intracellular/cellular

vascular: Na and Cl

Interstitial: Na and Cl

cellular: k and PO4

Name the type of movement for the following signaling pathways

• autocrine

• paracrine

• juxtacrine

• endocrine

• Auto: to itself

• Para: to a neighbor

• Jux: Through a channel (intestines)

• endo: to another organ

This condition causes a deficiency in saliva secretion that is caused by fear, anxiety, dehydration, fever, or drugs

xerostomia

this condition causes the secretion of too much saliva which is brought on by pregnancy, tumors, diseases

sialorhoea

This causes tiny calcium stones on salivary gland

sialolithiasis

what can inhibit saliva secretion

medicine, diabetes, blocked nose, radiotherapy

this is inflammation of the mouth/lips

stomatitis

this is inflammation from a B12 deficiency

glossitis

this causes heart burn (ulcers in esophagus) that is brought on by stomach acid leaking into lower esophagus

pyrosis

this is when the pyloric sphincter doesn’t close (bottom sphincter on stomach)

dumping syndrome

this is when the pyloric sphincter doesn’t open because there isn’t enough nitric oxide to tell muscles to relax. Causes vomiting and is usually found in premies.

pyloric stenosis

This occurs when the stomach isn’t able to squeeze which leads to a liquid diet

gastroparesis

This is caused by H. pylori and it embeds itself into the mucous barrier and eats away

gastric and duodenal ulcers

how do you treat H. Pylori

triple therapy - 2 antibiotics and 1 antacid

This occurs when muscles split and the intestines pop through

hernia

this type of hernia occurs from someone eating too much food and it pops above the diaphragm - needs surgery and is very painful

hiatel hernia

This can happen after TPN and the intestines atrophy

refeeding syndrome

what is it called when there is bacteria growth in the small intestines

C. diff

This is driven by bacteria slipping through the intestinal cells and into the blood - driver for IBD

leaky gut

What is DAMP and PAMP

DAMP: damage response

PAMP: pathogen response

how is the immune response stopped from leaky gut

T-cells release TGFB

is celiacs disease an allergy or autoimmune response

allergy (goes away if gluten is removed)

how does the liver detox blood

liver cells gobble things up as it passes by

this liver cell destroys things that leak from leaky gut

Kupffer cell

This liver cell stores vitamin A

stellate cell

how is fibrosis caused in the liver

stellate cell gets pissed off when there is damage to the cells so it makes collagen to repair the damaged cells resulting in scars

where do xenobiotics go when they make it into the liver

they can bind with bile and then get secreted out with bile

this disease causes thickening of mucous which attracts bacteria that eats through

cystic fibrosis

Explain the harm of non-alcoholic fatty liver disease

fat accumulates on the liver which confuses the cells and stresses it out

what is a hallmark sign that your body isn’t creating enough bile

you poop fat

how can gallstones cause pancreatitis

the stones can clog the pancreas from secreting enzymes - leads to the enzymes breaking down the pancreas

What parts of the pancreas secrete/produce what

Endocrine and Exocrine

endocrine - pancreatic inslet: hormones (insulin and glucagon)

exocrine - lobule: enzymes

how can you measure pancreas damage

there are markers on the liver ALT and AST

bilirubin - jaundice

distended abdomen - fluid buildup

Explain the RAA pathway

1. angiotensin is released by liver

2. angiotensin is turned into angiotensin 1 by renin (from kidneys)

3. angiotensin 1 is turned into angiotensin 2 by ACE (from the lungs)

4. angiotensin 2 causes constriction of vessels and increases Na and H2O retention

what hormone causes fluid retention

aldosterone

what is RAA supposed to be used for

dehydration

what hormone affects epinephrine and mimics aldosterone

cortisol

what increases the pre-load which results in heart failure

B vitamin deficiency - chronic alcoholics

massive vasodilation from more fluid makes heart work harder

How do we treat heart failure

myocardial infarction - antiplatelet drug (aspirin makes blood less sticky)

massive vasodilators - nitric oxide donor

Name the ABCDE for treatment of heart failure or hypertension

A: angiotensin inhibitor - decrease fxn of angiotensin 2

B: beta adenergic receptors - decreases speed of heart and force of contraction

C: calcium channel blockers - reduces force of contraction and repolarization

D: diuretics/diet/digitalis - decreases blood volume and sodium reabsorption

E: exercise - dilates blood vessels to decrease BP

what does the top and bottom number for blood pressure mean and what is the normal BP

top: systolic - reflex

bottom: diastolic - volume

120/80

How does hardening of the arteries occur?

1. increased glucose

2. glycosylation triggers cells to make adhesion molecules

3. immune cells are recruited

4. collagen synthesis increases

5. collagen causes fibrosis of the vessels

what can increase the risk for atherosclerosis

hypertension-vessels dilate so macrophages don’t get ripped off

inactivity

type 2 diabetes

smoking

sleep

why does atrial fibrillation occur

nodes are firing out of rhythm which causes an irregular heart beat

what is commonly associated with atrial fibrillation

stroke - heart can’t fill all the way so it can throw a clot

what are some treatments for atrial fibrillation

pacemaker or ablation - burning the fibers in the atrium

which steals electrons and which donates electrons

steals - oxidant

donates - antioxidant

what is the pathway for oxidation protection in the body

How do oxidants cause damage to proteins

oxidants steal electrons from the little posts on proteins therefore changing it function and structure

how do oxidants cause damage to lipids

oxidants steal electrons from the double bonds on lipids which make them free redicals and it creates a chain event

how can we prevent oxidation in the body

vitamin E - in membrane and it stops the cascade from the lipid radical

benzene ring - electron bounces around within the ring

endegenous antioxidants - antioxidants made by the body such as albumin or glutathione

how do macrophages and neutrophils use oxidation to destroy bacteria

macrophages - NADPH oxidase oxygen into superoxide which kills bacteria

neutrophils - myelo peroxidase turns superoxide into hypochlorous acid which kills bacteria

what is systolic and diastolic mean

systolic - contraction

diastolic - filling in between beats

which artery provides blood to the heart

coronary

how is artery walls different than arteriole walls

there is a layer of smooth muscle that surrounds the muscle of arteriole wall

what is the equation for pressure

pressure = flow x resistance

what is laminar flow

blood drag caused by the walls of the vessel

what is the steps of the heart pumping

1. atrial filling

2. atrial squeeze

3. ventricular filling

4. ejection

what is the formula for cardiac output

CO = HR x SV

what happens to muscles during strenuous exercise

muscles go anaerobic which overrides epi and causes a release of adenosine. Adenosine causes the blood vessels surrounding that muscle to dilate increasing blood flow.

How does atheroscleosis occur

1. LDL is oxidized and taken up by macrophage

2. macrophage then gets sleep and mad so it adheres to the wall of the artery

3. it then migrates up forming a foam cell

4. macrophage sends out chemotaxi to call more macrophages to join it

5. macrophages then pile up causing the artery to close up = plaque

what is myocardial infarction

part of the heart dies because blood flow was cut of from a portion of the heart

what is an angina

heart hurts because it is getting worn out from working so hard

what is the downfall of a stent

the mesh can get sticky which can cause macrophages to attach leading to a heart attack

what is a double bi-pass

veins from other parts of the body are inserted into the coronary artery and past the point of blockage to provide blood flow to the heart

explain congestive heart failure

pressure increases causing the lungs to get leaky. fluid leaks into lungs and causes the person to have a congested sounding cough and swelling in the ankles and feet.