Download D6dr7x7rx7rcr c tc55ff and more Lecture notes History of Yugoslavia in PDF only on Docsity!
9 NUTRITIONAL FACTORS IN DISEASE
The daily essential nutrient requirements in man include a 1-2 mg vitamins D, K, and B b 1-2 mg vitamins A, 131 and 136 c 50 g protein d 50 mg vitamin C e 100 mg calcium and phosphate 2. The following statements about adult dietary energy resources are true a Carbohydrates have a calorific value of 4kcal/g b Fats have a calorific value of 5 kcal/g c Sucrose, lactose and maltose are monosaccharicles d Linoleic and linolenic acids are essential fatty acids e Proteins provide 4 kcal/g and all nine essential amino acids 3. A healthy daily diet for a slim, active man should include a 1700 kcal (8.4 MJ) b 50 g of carbohydrate c 15 mg of both iron and zinc d 60 g of protein of good biological value e 50 mg of folic acid 68
The following statements about the basal metabolic rate (13MR) and energy balance are true a The 13MR is the largest single component of energy expenditure b The BMR increases with lean body mass and age c The BMR is greater in females than males d Children require 2500 kcal per day
e The normal 13M I range = 20-25 and is calculated from the formula Weight (kg)/Height (M) 5. Clinical features of protein-energy malnutrition in adults include a a body mass index = 20- 25 b oedema in the absence of hypoalburninaemia c nocturia, cold intolerance and diarrhoea d skin depigmentation, hair loss and covert infection e cerebral atrophy and sinus tachycardia
Expected laboratory findings in protein energy malnutrition in adults include a decreased plasma free fatty acid concentrations b increased plasma cortisol and reverse T concentrations c impaired delayed skin sensitivity to tuberculin d decreased plasma insulin, glucose and T3 concentrations e decreased urinary osmolality and creatinine excretion
The following statements about iron balance in a healthy young adult female are true a The healthy daily diet should provide 15 mg of iron b 60% of dietary inorganic iron is absorbed c Organic iron is better absorbed than inorganic iron d Daily iron losses of 1 mg result from clesquamated cells e 500 ml of blood contains 25 mg of iron
The following statements about deficiency states are true a Iodine deficiency produces goitre and thyrotoxicosis b Soft drinking water contains more fluoride than hard water c Zinc deficiency produces dermatitis, hair loss and diarrhoea d Copper deficiency in children produces anaernia and poor growth e Phosphate deficiency occurs in neonates fed on cow's milk 69
Vitamin A is a a fat-soluble vitamin b present as retinol in carrots and certain green vegetables c the treatment of choice in xerophthalmia and keratornalacia d recommended in minimum dietary requirements of 50 mg daily for adults e present in high concentrations in fish liver oils
Vitamin D a is present in high concentrations in dairy products b is non-essential in the diet given adequate sunlight exposure c like vitamin A is stored mainly in the liver d is converted from cholecalciferol to 1,25 dihydroxycholecalciferol e enhances calcium absorption by the induction of specific enterocyte transport proteins
Rickets a results from vitamin D deficiency before epiphyseal fusion b in the UK occurs principally in children of Asiatic origin c is suggested by delayed motor milestones and dental eruption d produces cranio-tabes and epiphyseal swelling of the ribs e produces chest wall deformities and kyphosis if untreated 70
Characteristic findings in severe rickets include a epiphyseal expansion of the lower radius on X-ray b hypophosphataemia due to secondary hyperparathyroidism c hyperphosphaturia and an increased serum alkaline phosphatase
Vitamin K is a a fat-soluble vitamin found in leafy vegetables b synthesised in the liver by the conversion of vitamin K c vital for the synthesis of clotting factors 2, 7,9, d often deficient in neonates due to the absence of normal gut flora e absorbed by an active process which is inhibited by warfarin therapy
Vitamin C deficiency a impairs wound healing due to defective collagen synthesis b would develop within 4 months given a daily intake of 5 mg c produces bleeding gums in edentulous individuals d produces perifollicular haemorrhages and 'corkscrew' hairs e in childhood produces anaemia and bone and joint pains
In thiamin deficiency a anaerobic glycolysis is impaired resulting in lactic acidosis b the diet is deficient in green vegetables and dairy products c sudden death results from low output cardiac failure d peripheral neuropathy results in marked muscle wasting e Wernicke's encephalopathy is usually suggested by ataxia, nystagmus and gaze palsies
Deficiency of the following B vitamins is associated with the clinical syndromes listed below a niacin - pellagra b pyridoxine - isoniazid-induced peripheral neuropathy c pyridoxine - haemolytic anaemia d riboflavin - angular stomatitis and nasolabial seborrhoea e riboflavin - cheilosis 9 C,
The following statements about vitamin B12 and folic acid are true
a The serum vitamin B12 level is lower in vegetarians than omnivores b Both vitamin B12 and folate are essential for DNA synthesis c A daily intake of 1-2 Vg of vitamin B12'S recommended d A daily intake of 1-2 mg of folic acid is recommended e Deficiency of either vitamin produces a peripheral blood macrocytosis and pancytopenia
In the nutritional support of hospital patients a vitamin K deficiency is associated with antibiotic use b polymeric feeds are indicated in inflammatory bowel disease c 2.5 L of 10% dextrose provides 1000 kcal d solutions of up to 20% dextrose can safely be given by peripheral vein e the use of dextrose alone as a calorie source produces muscle wasting
The following statements about dietary fibre are true a Cereals increase stool bulk due to waterholding effects b Pulses increase stool bulk due to colonic bacterial growth c Pectins and gums retard gastric emptying d Monosaccharides produced by bacterial digestion are absorbed e Average daily intakes of 15 g are inadequate
Patients with the following characteristics are at increased risk of malnutrition a alcoholism b major burns c leukaemia receiving chemotherapy d weight loss of 10% or more in the past 6 months e steroid therapy 71
In the assessment of nutritional deficiency in hospital patients a nutritional supplementation is not required until clinical signs are apparent b 1 kg of weight loss approximates to 6000 kcal of energy c plasma albumin is a reliable index of visceral protein depletion d elevated serum methyl malonate suggests vitamin B deficiency e lymphocytosis suggests protein depletion
Characteristic findings in simple obesity in adults include a a body mass index > 30 b increased plasma cortisol and insulin concentrations c a family history of obesity of similar degree and distribution d onset in females at the menarche, in pregnancy or menopause e basal metabolic rates and thermic responses to food are similar to lean subjects
Recognised associations of obesity include a hyperuricaernia b depression c gallstones d type 11 diabetes mellitus e hyperlipoproteinaernia
Ideal weight reducing diets in the treatment of moderate obesity should a provide no more than 500 kcal (2.1 MJ) b theoretically achieve a weight loss of at least 2 kg per week c be accompanied by anorectic drug therapy in most d maintain nitrogen balance given a daily intake of 25 g protein e reduce carbohydrate intake much more than total fat intake
The following statements about the management of obesity are correct a The long-term results of therapeutic starvation are no better than conventional dieting b Jogging for 20 minutes five times per week will expend an additional 900 kcal per week c Effective calorie restriction usually produces symptomatic ketosis d The calorie content of 200 ml of wine or 500 ml of beer = 150 kcal e D-fenfluramine and fluoxetine increase satiety rather than suppress the appetite
The mechanical disabilities associated with obesity include a pes planus b osteoarthrosis of the hips and knees c increased proneness to accidents d temporo-mandibular arthritis e atlanto-axial subluxation
Drug therapies known to increase appetite and body weight include a oral contraceptives b chlorpromazine c amitriptyline d fluoxetine e glipizide
