MALNUTRITION
NEEDS OF THE BODY: DIET
essential components
carbohydrates
fat
protein
vitamins
water
fibre
CH2O
mono/di/poly-saccharides
glucose
sucrose
glycogen
energy source for brain (absolute requirement for glucose)
amino acids
synthesis of plasma proteins (albumin)
essential
non essential
formation of hormones
cell growth
replication
repair
MALNUTRITION
psychiatric
dementia
food deprivation
eg. developing countries
PROTEIN ENERGY MALNUTRITION
KWASHIOKOR #
malnutrition due to diet deficient in protein
CACHEXIA #
condition of abnormally low body weight associated with chronic disease
cancer
AIDS
TB
PHTHISIS
any disease resulting in wasting of tissue
MARASMUS
severe wasting in infants
examples of syndromes
collection of symptoms that define a condition
KWASHIORKOR
Ghanian term for child displaced from the breast
1933 Cicely WIlliams
Syndrome
diarrhoea
potbelly
changes in hair & nails
desquamating skin rash
decrease in linear growth
oedema
excessive accumulation of fluid in body tissues
kwashiorkor: PITTING OEDEMA
local (swelling following injury or inflammation)
general (heart or kidney failure)
within chest cavity (pleural effusions)
abdomen (ascites)
distended abdomen
within airspaces in lungs (pulmonary oedema)
decrease in protein intake
decrease in amino acid availability
decrease in production of albumin (plasma protein)
albumin function
carrier eg. fatty acids
maintains osmotic pressure in blood
in a normal blood vessel the osmotic pressure is maintained in blood vessels by albumin so only nutrients diffuse into the interstitial space
in a kwashiorkor affected blood vessel there is a decrease in albumin so water diffuses out of the vessels into the interstitial space - blood oedema
bowel movements of excessive volume & frequency & liquidity
3 different types
osmotic
eg. sorbitol
retains water in lumen of intestine
additive to sugar free sweets
secretory diarrhoea
eg. enterotoxin: increased water transport out of the cell
malabsorptive
kwashiorkor
reduced ability to digest and/or absorb nutritients
decreased digestive enzymes in pancreas and intestine
pancreas
endocrine
production of hormones
Ghrenin (ε)
glucagon (α)
somatostatin (δ)
insulin (β)
islets of langerhaan produce hormones
exocrine
Acinar
synthesis digestive enzymes
ductal
network to transport digestive enzymes
lumen come together in ducts
pancreatic duct transports enzymes to intestines from islets
intestine 
see screenshot
goblet cells (secrete mucus)
stem cells
enterocytes (absorption)
last 1-3 days and must be replaced from stem cells
villi (finger-like projections)
entero
endocrine
increases SA
panted cells
secrete lysozymes
bacteriacidal
a decrease in amino acids leads to a decrease in protein synthesis which leads to a decrease in proliferation which leads to a decrease in surface are which leads to a decrease in absorption
protective layer (underlying epithelium)
helps lubricate contents as passes along
hepatomegaly (enlarged liver)
fatty liver?
ascites? (fluid in abdomen)
hair
easily plucked out
changes colour
paler dt lack of amino acids
alternating good growth w poor growth (pigment not deposited)
nails
finger clubbing
raised nail bed (not sure why)
outer layer of epidermis of skin is removed by scaling
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale
stem cells
lost through scaling
fibroelastic tissue
CACHEXIA
kako (greek for bad)
abnormally low weight dt chronic disease
cancer
aids
tb
30% deaths
cadhesion
lung
stomach
pancreatic
oesophogeal
mechanism
hypercatabolism (breakdown of lipids and proteins
conversion into energy
cell proliferation
mediated
cytokines? hormone like
paracrine fashion
mediate immune response
cytokines
inflammatory response
TNF2
IL6
tumour factor
proteolysis inducing factor
initiate protein breakdown - proteosome
lose weight dt loss of fat and muscle