Cellular Respiration and Metabolism
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Questions and Answers

What is the primary indicator for over or under nutrition?

  • Length/height
  • Tricep skinfold
  • Head circumference
  • Weight (correct)

    • What is measured by the mid-upper arm circumference?

  • Chronic illness
  • Brain size
  • Subcutaneous fat (correct)
  • Body composition and nutritional status

    • What type of growth charts exist for specific populations or syndromes?

  • Standardized
  • Generic
  • Customized
  • Special (correct)

    • What is the unit of measurement for Body Mass Index (BMI)?

    <p>kg/m2</p> Signup and view all the answers

    What is the limitation of using Body Mass Index (BMI) in children?

    <p>It is limited in assessing 'underweight'</p> Signup and view all the answers

    What is the significance of serial measurements in assessing nutritional status?

    <p>They are important in evaluating the effectiveness of nutritional interventions</p> Signup and view all the answers

    What happens to pyruvate when it accumulates in the cell?

    <p>It is converted to Acetyl-CoA and enters the TCA cycle or gets turned into fatty acids</p> Signup and view all the answers

    What is the primary function of anaerobic glycolysis?

    <p>To regenerate NAD+ and secrete lactate when oxygen is absent</p> Signup and view all the answers

    What is the purpose of gluconeogenesis?

    <p>To synthesize glucose from pyruvate and other metabolites during fasting</p> Signup and view all the answers

    Why can't Acetyl-CoA be converted to glucose?

    <p>Because Acetyl-CoA is not a glucogenic molecule</p> Signup and view all the answers

    What is the effect of ethanol on gluconeogenesis?

    <p>It inhibits gluconeogenesis by generating NADH</p> Signup and view all the answers

    What happens to the cell when anaerobic glycolysis occurs?

    <p>The cell acidifies with lactic acid, leading to muscle cramps</p> Signup and view all the answers

    What is the difference between glucogenic and ketogenic molecules?

    <p>Glucogenic molecules can be converted to glucose, while ketogenic molecules cannot</p> Signup and view all the answers

    Why does the liver perform gluconeogenesis?

    <p>To support the body during fasting</p> Signup and view all the answers

    What is the primary mechanism of action of loperamide in treating diarrhea?

    <p>Acting directly on circular and longitudinal intestinal muscles to inhibit peristalsis</p> Signup and view all the answers

    What is a potential side effect of Lomotil?

    <p>Tachycardia</p> Signup and view all the answers

    What is the primary use of bulking agents in gastrointestinal disorders?

    <p>To treat constipation</p> Signup and view all the answers

    What is the mechanism of action of cholestyramine in treating diarrhea?

    <p>Sequestering bile salts in the gut</p> Signup and view all the answers

    What is the primary indication for cholestyramine?

    <p>Post-cholecystectomy diarrhea</p> Signup and view all the answers

    What is a common anticholinergic side effect?

    <p>Tachycardia</p> Signup and view all the answers

    What is the primary effect of loperamide on the anal sphincter?

    <p>Increased tone</p> Signup and view all the answers

    What is the primary effect of loperamide on fecal output?

    <p>Decreased fecal volume</p> Signup and view all the answers

    What is the effect of decrease in prostaglandin production on the gastric mucosal barrier?

    <p>Decreased submucosal blood flow</p> Signup and view all the answers

    What is the characteristic of H. Pylori that helps it survive in the acid environment of the stomach?

    <p>Abundant production of urease</p> Signup and view all the answers

    What is the prevalence of H. Pylori infection dependent on?

    <p>Age, SES class, and country of origin</p> Signup and view all the answers

    What is the rate of acquisition of H. Pylori infection in childhood?

    <p>0.3-0.5%/yr</p> Signup and view all the answers

    What is the consequence of H. Pylori infection on the gastric mucosa?

    <p>Focal epithelial cell damage and inflammatory infiltrate</p> Signup and view all the answers

    What is the risk of developing an ulcer with an H. Pylori infection?

    <p>4-fold increased risk</p> Signup and view all the answers

    What is the characteristic of H. Pylori that makes it a slow-growing bacterium?

    <p>Grows best in the presence of CO2</p> Signup and view all the answers

    What is the transmission mode of H. Pylori infection?

    <p>Waterborne, person-person, fecal-oral, and oral-oral transmission</p> Signup and view all the answers

    What is the mechanism of action of stimulant laxatives?

    <p>Stimulating electrolyte transport by intestinal mucosa</p> Signup and view all the answers

    Which type of laxative is indicated for refractory constipation?

    <p>Promotility drug</p> Signup and view all the answers

    What is a common side effect of promotility drugs like prucalopride?

    <p>All of the above</p> Signup and view all the answers

    What is the mechanism of action of linaclotide?

    <p>Stimulating fluid and electrolyte secretion from enterocytes</p> Signup and view all the answers

    Which type of laxative is used as an adjunct to oral laxatives when there is an incomplete response?

    <p>Enema</p> Signup and view all the answers

    What is the indication for digital disimpaction?

    <p>Fecal impaction</p> Signup and view all the answers

    What is the effect of linaclotide on pain associated with IBS?

    <p>Reduces pain</p> Signup and view all the answers

    Which type of laxative is rarely necessary but may be used in certain circumstances?

    <p>Digital disimpaction</p> Signup and view all the answers

    Study Notes

    Cell Metabolism

    • The cell cannot tolerate accumulation of pyruvate, so it shifts pyruvate into other pathways, converting it to Acetyl-CoA, which is used in the TCA cycle and fatty acid synthesis.
    • There is no feedback inhibition of triacylglycerol synthesis, making it an overflow pathway for many metabolites, occurring in many cells, even in those not supposed to store them.

    Anaerobic Glycolysis

    • Impaired TCA or lack of oxygen leads to anaerobic glycolysis, producing lactate.
    • Anaerobic glycolysis occurs to regenerate NAD+ and secrete lactate, generating ATP, but is not very efficient.
    • It occurs in strenuous or rapid exercise, or in poisoning cases, such as cyanide poisoning, and can lead to tissue acidification with lactic acid, causing muscle cramps.

    Gluconeogenesis

    • Gluconeogenesis is the process of synthesizing glucose from pyruvate and other metabolites (lactate, TCA cycle intermediates), providing glucose in times of fasting.
    • The liver performs gluconeogenesis to support the body.
    • Acetyl-CoA cannot be converted to glucose, so none of the carbons in a fatty acid can be converted into pyruvate, and therefore, glucose cannot be made from fatty acids.
    • However, ATP generated from fatty acid breakdown can be used to fuel gluconeogenesis.
    • Ethanol inhibits gluconeogenesis, leading to hypoglycemia if not eaten in a long time.

    Glucogenic vs. Ketogenic

    • Glucogenic molecules can be converted to glucose.
    • Glucogenic molecules include growth hormone, lactate, and TCA cycle intermediates.

    Assessment Tools

    • Growth charts reflect the optimal growth of a healthy population and are useful for assessing growth patterns over time.
    • Weight is a primary indicator of over/under nutrition, and is an acute indicator.
    • Length/height is a slower indicator of nutritional changes, and is a chronic indicator.
    • Body Mass Index (BMI) is calculated by dividing weight in kg by height in m2, and is useful in children over 2 years old.

    Dietary Intake

    • Dietary intake is assessed by asking who, what, where, when, how, how much, and why.
    • Pathophysiology of altered gastric mucosal barrier involves decreased prostaglandin production, decreased mucus and HCO3, and decreased submucosal blood flow.

    H. Pylori

    • H. Pylori is a slow-growing, highly motile, gram-negative, spiral-shaped bacteria that produces urease, protecting it in the acid environment of the stomach.
    • Prevalence of H. Pylori infection depends on age, SES class/hygiene, country of origin, and genetic factors.
    • Infection is usually acquired in childhood, and chronic non-atrophic gastritis is associated with a 4-fold increased risk of developing an ulcer.

    Management of Diarrhea

    • Empiric management of diarrhea includes loperamide (Imodium), Lomotil, bulking agents, and Cholestyramine.
    • Loperamide acts directly on intestinal muscles to inhibit peristalsis and prolong transit time, reducing fecal volume and electrolyte loss.
    • Lomotil is a combination of atropine and diphenoxylate, which inhibits excessive GI motility and propulsion.
    • Bulking agents include psyllium (Metamucil) and wheat dextran (Benefiber), which absorb and retain water, increasing stool bulk.
    • Cholestyramine is an oral bile acid sequestrant, indicated in patients who develop diarrhea post-cholecystectomy.

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    Description

    This quiz covers the cellular pathways involving pyruvate, Acetyl-CoA, and the citric acid cycle. It also explores the synthesis of fatty acids and triacylglycerol.

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