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Questions and Answers
What are the two types of proteins affected in Protein-Energy Malnutrition (PEM)?
Somatic protein and Visceral protein
What is the role of biochemical tests in assessing PEM?
To provide the most objective and quantitative assessment
What is the significance of C-reactive protein in PEM assessment?
It is a positive acute-phase reactant and an indicator of immunocompetence
What are the two types of acute-phase reactants in PEM?
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What are the examples of Hepatic transport proteins used to assess PEM?
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What is nitrogen balance used to assess in PEM?
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What are the technical difficulties associated with storage tissues?
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What are the four types of storage tissues mentioned in the text?
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What are the two most commonly ordered groups of tests in clinical chemistry?
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What is the requirement for patients before taking the BMP and CMP tests?
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What are the seven components of the basic metabolic panel (BMP)?
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What additional components are included in the comprehensive metabolic panel (CMP) compared to the BMP?
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What are the components of a complete blood count (CBC)?
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What is the purpose of the differential component in a complete blood count (CBC)?
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What is the advantage of biochemical assessment in validating data obtained from dietary methods?
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What are the limitations of biochemical assessment?
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What factors can alter biochemical assessment results?
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What type of blood specimen reflects recent dietary intake?
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What is the difference between serum and plasma?
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What type of specimen is sensitive to recent dietary intake?
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What type of specimen reflects chronic nutrient status?
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What type of blood cells are more sensitive than erythrocytes?
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What is the primary purpose of biochemical assessment in nutritional assessment?
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What are the two methods used to identify subclinical deficiency states?
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What is the advantage of biochemical assessment over other assessment methods?
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What is the role of biochemical tests in detecting nutrient deficiencies?
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What is the significance of functional tests in nutritional assessment?
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How do biochemical tests help in detecting marginal subclinical deficiency?
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What is the advantage of biochemical assessment in measuring the extent of functional consequences of a specific nutrient deficiency?
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Why is biochemical assessment considered a valuable tool in nutritional assessment?
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What is the main characteristic of Kwashiorkor in Protein-Energy Malnutrition (PEM)?
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What is the difference between Kwashiorkor and Marasmus in terms of response to starvation?
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What are the common signs and symptoms of Kwashiorkor?
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What is the characteristic of Marasmus in terms of fat stores?
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What is the main difference between Kwashiorkor and Marasmus in terms of edema?
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What is the significance of half-life (t1/2) in evaluating acute-phase proteins?
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What is the characteristic of negative acute-phase respondents in PEM?
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What is an example of a negative acute-phase respondent in PEM?
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Study Notes
Protein-Energy Malnutrition (PEM)
- Somatic protein: skeletal muscle, visceral protein: hepatic protein, organs, structural protein, and protein found in blood
- Biochemical tests provide the most objective and quantitative assessment for PEM
- Assessment of PEM:
- Hormonal and cell-mediated response to stress
- Nitrogen balance
- Hepatic transport proteins (albumin, transferrin, prealbumin, retinol-binding protein, and creatinine)
- Immunocompetence (e.g., C-reactive protein)
Acute-Phase Proteins
- Change by 25% during an acute phase response
- Positive or negative acute-phase respondents
- Need to consider half-life (t1/2) of protein: amount of time which half of the protein is eliminated or broken down from the body
- Negative acute-phase respondents: albumin, transthyretin or prealbumin, transferrin, retinol-binding protein (decrease)
Clinical Chemistry Panels
- Basic Metabolic Panel (BMP) or Chem 7:
- Sodium (Na+)
- Potassium (K+)
- Chloride (Cl-)
- CO2 (Carbon dioxide)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine (Cr)
- Comprehensive Metabolic Panel (CMP) or Chem 20:
- Above plus calcium, albumin, total protein, liver function tests
- Complete Blood Count (CBC) Includes:
- Red blood cells (RBC)
- Hemoglobin (Hgb)
- Hematocrit (Hct)
- Mean corpuscular volume (MCV)
- White blood cell count (WBC)
- Differential: indicates percentages of different kinds of WBC
Biochemical Assessment
- Advantages:
- Most objective and precise method among all other assessment methods
- Detects marginal subclinical deficiency before they result in overt signs
- Only method that can by itself detect the nutrient deficiency and supplement other methods of evaluation
- Measures the extent of the functional consequences of a specific nutrient deficiency (functional vs. biochemical)
- Useful to validate data obtained from dietary methods
- Precise, accurate, and reproducible
- Disadvantages:
- Affected by technical and biological factors other than depleted body stores of the nutrient
- May be altered due to organ function, disease states, hydration status, medications, and fasting or non-fasting
Specimen Types
- Blood (whole or serum or plasma) tend to reflect recent dietary intake (acute term index)
- Erythrocytes (RBC): reflects only chronic status, unlikely to be a valid index for some nutrients
- Leukocytes (WBC): more sensitive than erythrocytes
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Description
Learn about the changes in protein levels during acute-phase response and the effects of Protein-Energy Malnutrition on the body. Topics include C-reactive protein, fibrinogen, and somatic protein.