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NUTRITION FINAL EXAM MASTER QUIZLET- MACROMINERALS

Terms in this set (170)

list the macrominerals
SNaCK PMg
SNa - Sodium (Na)
C - Chloride and Calcium
K- Potassium

P- Phosphorus
Mg- Magnesium
list the microminerals
1. Iron (Fe)
2. Copper (Cu)
3. Zinc (Zn)
4. Selenium (Se)
5. Chromium (Cr)
6. Iodine (I)
7. Manganese (Mn)
8. Molybdenum (Mo)
9. Fluoride (F)
10. Boron (B)
11. Silicon (Si)
12. Vanadium (V)
which minerals are present in higher amounts, with usually +1 or +2 valency?
macrominerals
which minerals are transition metals; have 2-3 e- in their outer shell, and can be displaced by aluminum (3e- in outer shell)?
microminerals
which condition is characterized by deterioration of bone, low bone density, and increased fractures?
osteoporosis
who is at increased risk of developing osteoporosis?
elderly
ppl on certain meds
low estrogen
sedentary lifestyle
high sodium intake
caffeine intake
chronic alcohol abuse
smoking
how would an ND approach treating osteoporosis?
· Ca: part of hydroxyapatite crystals
· Vit D: stimulates Ca absorption ; Vit C and K: for bone proteins; folic acid, Vit B12 and B6: important in homocystenemia
· Protein: important for bone formation
· Mg and Zn: for bone mineralization and alkaline phosphatase
· Cu and Si: osteoblasts and crosslinking of collagen
· B: promotes absorption/retention of minerals in bone
· Mn: bone mineralization and synthesis of connective tissue
· Strontium: component of hydroxyapatite crystal
· Weight bearing exercise
· Decrease: sodium, alcohol, caffeine, no smoking
· Hormonal balance (thyroid hormones, PTH, estrogen , androgens, cortisol)
which molecule is used to transport microminerals such as iron, chromium, manganese, and vanadium in the blood?
TRANSFERRIN
which molecule helps transport calcium, magnesium, copper, zinc, chromium, and vanadium in the blood?
albumin
which molecule transports/ changes valency of +2 to +3 in iron, manganese, and copper?
CERULOPLASMIN
which molecule is used in the storage of copper and zinc?
METALLOTHIONE
which molecule stimulates absorption of calcium, magnesium, and phosphorus?
CALCITRIOL
what is calcitriol?
the active form of Vit D (1,25 (OH)2 D3)
Calcitriol is a synthetic (man-made) active form of vitamin D3 (cholecalciferol). It is used to treat and prevent low levels of calcium in the blood of patients who have kidney disease or problems with their parathyroid gland, the gland that controls the amount of calcium in blood through its secretion of parathyroid hormone.
which molecule decreases absorption of calcium, phosphorus, iron, copper, zinc, selenium, chromium, and manganese?
phytates
one should avoid taking the following minerals together because they compete:
Calcium, non-heme iron, zinc, magnesiu, and mangesium (all of the +2 molecules)
phosphorus should not be taken with which mineral because it lowers it?
calcium
molybdenum should not be taken with which minerals?
silicon or copper
the following minerals should not be taken together
iron, calcium, and iodine
the following minerals should not be taken together
calcium, magnesium and flouride
copper is needed for the transport of which mineral?
iron
T/F
copper and zinc can be taken together, BUT, high amounts of zinc can cause copper deficiency?
zinc
magnesium should be taken with
vitamin K
non-heme iron should be taken with
vitamin C
if a patient were deficient in calcium, what foods would you recommend?
nuts/ seeds especially sesame
spinach
broccoli
tofu
soybeans
salmon
molasses
fortified fruit juices or nut milks
dairy (but not absorbable)
why is present in dairy which depletes the body of calcium?
phosphorous
what is the most abundant mineral in the body
Calcium
what are the two things in the brassica family that inhibit calcium absorption?
oxalate (strongest one)
phytate
what veggies are in the brassica family?
Broccoli
Bok choy
Brussels sprouts
Cabbage
Calabrese
Cauliflower
Collards
Kale
Kohlrabi
Rutabaga or Swede
Turnips
what percentage of calcium is found in the blood/tissues?
1%
what percent of calcium is found in bones?
99%
what is required in the digestion of calcium to solubilize calcium from salts?
HCl (hydrochloric acid)
which mineral is absorbed mostly in the small intestine but 4-10% in the large intestine?
calcium
absorption of which mineral occurs through two routes, one being active, one being passive
calcium
which calcium pathway is active (requires ATP), saturable, involves calbindin (CBP) and is stimulated by calcitriol and a low calcium diet?
TRANSCELLULAR
which calcium pathway is passive, unsaturable, stimulated by calcium in lumen, FOS, inulin
PARACELLULAR- P, THINK PASSIVE
Ca is increased by:
growth
pregnancy
vitamin D
protein
simple sugars
food
Ca is decreased by:
oxalate
phytate
fiber
divalent cations
undigested fats
which molecules transport calcium?
calbindin and Ca-ATPase (exchanged for sodium)
in the blood, 50% of the calcium is
free
in the blood, 40% of the calcium is
bound to albumin
in the blood, 10% of calcium is
complexed with sulfate, phosphate, or citrate
extracellular Ca levels are regulated by
PTH
calcitriol (active form of vitamin D)
calcitonin (a hormone that the C-cells in the thyroid gland produce and release).
Low calcium increases PTH release, then calcitriol (Vit D) release, and then what?
decreased calcitonin
increased renal reabsorption of Ca
stimulation of osteoclasts (release of calcium from bone)
calcitriol stimulates Ca absorption in the intestines
High calcium causes PTH decrease then increased Calcitonin release and then what?
stimulates osteoBLASTS (which put Ca in the bone)
lowers Ca absorption, increases Ca excretion
intracellular levels of calcium are kept low in the
cytoplasm of most cells
excitable cells have voltage-gated Ca channels (AP causes Ca influx) in extra or intracellular calcium regulation?
intracellular
how is Ca excreted?
urine
feces
sweat
Functions of Calcium
· Bone mineralization: hydroxyapatite crystals (Ca + phosphate)
· Nerve conduction: needed to close nerve Na channels (low Ca = repeated impulse transmission)
· Muscle contraction: influx allows actin-myosin binding = contraction
· Coagulation: required for activation of 7 clotting factors in coagulation cascade
What causes kidney stones?
Increased Ca intake inhibits absorption of oxalate (biggest risk of Ca oxalate stones)
is Ca def more common in men or women?
women
what causes hypocalcemia
o Usually from abnormal parathyroid
o Can be from kidney failure, Vit D deficiency, low Mg; common in alcoholics
o Symptoms: tetany, muscle spasms, muscle pain, paresthesias
o Tests: Chvostek's sign (tap on cheek); Trousseau's sign (wrist flexion with BP cuff on)
Milk-alkali syndrome
hypercalcemia caused by consuming too much milk and high calcium antacids
mild symptoms hypercalcemia
low appetite
nausea
vomiting
constipation
abdominal pain
dry mouth
thirst
frequent urination
severe symptoms hypercalcemia
confusion
delirium
coma
death
Ca toxicity causes an increased risk of MI in men by
increasing blood coagulation
high levels of what mineral increases calcium EXCRETION?
sodium
high levels of Ca decrease absorption of which minerals?
iron and zinc
also decrease tissue levels of Mg
best form of Ca
Microcrystalline hydroxyapatite concentrate
often in combo w Mg
serum levels of Ca can be
both free and protein-bound
60% of magnesium is found in:
bones
25% of magnesium is found in
muscle tissue
less than 1% of magnesium is found in
extracellular fluids
pt presents w magnesium def, what foods do you recommend?
nuts
seeds
green leafy veg
chocolate
tea
coffee
seafood
dairy
magnesium is absorbed in the
small intestine
T/F
magnesium is absorbed through active diffusion only
FALSE
magnesium is absorbed through both active and passive diffusion
which pathway of magnesium absorption is saturable, carrier-mediated, and stimulated by calcitriol?
ACTIVE
which pathway of magnesium absorption is stimulated by magnesium in the lumen?
PASSIVE
absorption of magnesium is increased by
calcitriol and simple sugars
absorption of magnesium is decreased by
phtates
fiber
undigested fat
other minerals (Calcium, phosphorous)
about 50% of magnesium is transported in
free ionized form
30% of mg is bound to
ALBUMIN
10% of mg is
complexed with ions
PTH increases Mg concentration via:
increased intestinal absorption
decreased renal excretion
taking Mg from the bone
how is Mg excreted
urine
stool
sweat
· Energy production: required cofactor in Krebs
· Structural: part of bone crystal matrix
· Ion transport across cell membrane: including K and Ca
· Cell signalling: required for cAMP (second messenger)
are functions of which mineral?
magnesium
migraines and hypertension call for supplementation of which mineral?
magnesium
T/F
severe magnesium deficiency is common
FALSE
severe def is rare, mild def is common
people with renal disorders, diabetes, alcohol abuse, and the elderly are at increased risk of developing a deficiency of what mineral?
magnesium
hypocalcemia
Na retention
low potassium
muscle tremors/ weakness
chest tightness
shortness of breath
palpitations
anxiety
depression
fatigue
insomnia
loss of appetite
nausea and vomiting
are all symptoms of what?
magnesium deficiency
why can hypocalcemia be caused by a magnesium deficiency?
Without sufficient levels of magnesium, parathyroid hormone (PTH) cannot function properly.
a common sign of magnesium toxicity is
diarrhea
magnesium lowers or raises BP?
LOWERS, it dilates blood vessels (hence why it helps high blood pressure and migraines)
low BP
lethargy
confusion
arrythmias
kidney dysfunction
ARE ALL SYMPTOMS OF
hypermagnesemia
if a patient presents with end stage renal disease, myasthenia gravis, UTI with elevated phosphates, is an infant, or has hyperparathyroidism, we want to avoid giving them which mineral?
magnesium
magnesium is needed for the uptake of what mineral
potassium!
high amounts of what mineral lower tissue levels of Mg?
ca
high levels of what mineral lower absorption of Mg?
zinc
which mineral increases the need for more Mg?
thiamine (B1)
which mineral increases cellular uptake of Mg (and vice versa)?
B6 (pyridoxine)
which form of Mg is neurotoxic in high doses?
aspartate
which form of Mg crosses BBB and helps w anxiety, insomnia, depression?
threonate
which form of magnesium is for muscle pain/ injury/ MVAs?
malate
which form of Mg is used as a laxative and is also known as epsom salts?
SULFATE
(think S- SALT)
which form of Mg should be avoided due to low absorption?
enteric-coated Mg chloride
which form of assessment is best for long-term Mg?
RBC magnesium levels
which method is most reliable for testing Mg levels?
24 hr renal excretion in IV magnesium
phosphorous is mainly seen as
phosphates
85% of phosphorus is found in
the bone
14% of phosphorus is found in
the tissues
1% of phosphorus is found in the
blood/fluids
a pt presents with phosphorus deficiency. what foods do you recommend?
nuts esp ALMONDS
dairy
coffee
tea
eggs
meat
which mineral is present in plant seeds as phytates where we lack the enzymes to break it down?
phosphorus
organically bound phosphorus needs to be hydrolyzed from ________ in order to be digested
proteins
phosphorus is absorbed in the SMALL OR LARGE INTESTINE
SMALL INTESTINE
T/F
phosphorous is absorbed in its organic form
FALSE
it is absorbed in inorganic form
the primary route of absorption of phosphorus is
facilitated diffusion
carrier-mediated, Na-dependent, stimulated by calcitriol describes absorption of what mineral?
phosphorus
absorption of phosphorus is increased by which mineral?
vitamin D
absorption of phosphorus is decreased by what?
phytates
calcium
magnesium
aluminum
which mineral is transported mostly as organic phosphate in phospholipids and lipoproteins?
phosphorus
phosphorus is stored mostly in the
bone and muscle, but is also stored in all cells
· Structural: hydroxyapatite; cell membranes, nucleic acids
· Energy production/storage: ATP
· Cell signalling: phosphorylation
· pH buffering: acts as buffer
· oxygen availability: P-containing molecule liberates oxygen for tissue uptake
describes the functions of which mineral?
phosphorus
T/F
def of phosphorus is common
FALSE
it is very rare
symptoms of which mineral deficiency are described below:
anemia
muscle weakness
bone issues (Rickets in children, osteomalacia in adults)
peripheral neuropathy
death if severe
phosphorus
pts with alchohol abuse, diabetics w ketoacidosis, people taking high amounts of antacids are at higher risk of deficiency in what mineral?
phosphorus
the disorder which entails people with end stage renal disease where calcification of non-skeletal tissue (ie kidney) occurs is known as what and is caused by toxicity of what mineral?
hyperphosphatemia
toxicity of phosphorus
what role does P play in osteoporosis?
high phosphorus can lower calcium absorption, causing the body to take calcium from the bones
high levels of what mineral lowers blood calcium?
phosphorus
which mineral is not normally supplemented but in hydroxyapatite?
phosphorus
which mineral is a primary intracellular cation?
POTASSIUM (K)
absorption of potassium occurs in
the small and large intestine
absorption of potassium occurs in both small and large intestines through
active transport (K+/H+-ATPase pump) as well as passive diffusion
how is potassium transported?
Into the cells via active transport: Na+/K+-ATPase (3 Na for 2 K)
there is a high concentration of what mineral inside the cells?
potassium
(Potassium is the principal positively charged ion (cation) in the fluid inside of cells, while sodium is the principal cation in the fluid outside of cells)
if there is increased serum potassium, the adrenal cortex produces _____________ and causes increased potassium excretion in the kidneys
aldosterone
potassium is excreted mainly in the
urine
(some in feces and sweat)
· Maintains membrane potential: important for muscle contraction, heart function, nerve impulses
· Intracellular fluid balance: can easily cross cell membranes
describe functions of what mineral?
potassium (K)
what type of diet is recommended for high blood pressure and which diet does Dr Val prefer?
DASH diet recommended but not enough, Dr Val likes meditteranean diet
when would we use potassium clinically?
hypertension!
high K= lower BP
fatigue
muscle weakness and cramps
muscular paralysis and
cardiac arrhythmias
are symptoms of what mineral deficiency?
hypokalemia
(low potassium)
what factors increase risk of hypokalemia (potassium def)?
high fluid loss
medications such as diuretics
herbs (licorice)
low magnesium
which herb can cause hypokalemia (K def)
licorice!
is it possible to OD on K through diet?
no
what factors increase risk for K toxicity?
renal insuffiency
hypoaldosteronism
meds causing K retention
hemolysis
tissue damage releasing K into ECF
which mineral lowers excretion of calcium?
potassium
what mineral is needed for potassium uptake into cells?
magnesium
high potassium increases excretion of what mineral?
sodium
best way to test for K levels
RBC potassium levels best
electrolyte and chemistry panels can be usd but may be elevated in dehydration
70% of this mineral is in the ECF
sodium
30% of this mineral is on surface of bone crystals
sodium
sources of sodium
salt (NaCl) either added, in processed foods, or from water/ veg/ eggs
which mineral has a 95-100% absorption rate?
sodium
which mineral is absorbed in three pathways across the intestinal mucosa?
sodium
3 pathways of sodium absorption:
· Na/glucose co-transport: active, small intestine, SGLT1
· Na/Cl : active, small intestine and proximal colon; exchanges Na/Cl for H/HCO3
· Electrogenic Na: concentration dependent, colon
the sodium potassium pump pumps sodium in or out of the cells?
OUT of cells
refresher on sodium potassium pump
The sodium-potassium pump moves sodium ions out of and potassium ions into the cell. This pump is powered by ATP. For each ATP that is broken down, 3 sodium ions move out and 2 potassium ions move in.
T/F
sodium moves freely in the blood
TRUE
Renin-angiotensin-aldosterone role in sodium regulation:
Renin-angiotensin-aldosterone: decrease in BP/vol causes kidney to release renin > angiotensin I becomes angiotensin II by ACE that causes (1) vasoconstriction and increases BP and (2) aldosterone secretion that increases reabsorption of Na (water follows Na)
(sodium regulation)
Vasopressin/ADH role in sodium regulation:
decrease in BP/vol causes ADH secretion that causes kidneys to increase water reabsorption
Atrial natriuretic hormone (ANP) function in sodium regulation:
high blood volume causes ANP secretion from heart cells that increases GFR (therefore excretion of Na and water) and vasodilator
sodium is excreted
mostly in urine
some by sweat
functions of sodium
· Maintain membrane potential: important for muscle contraction, heart function, nerve impulses
· Maintain blood volume and pressure: part of ECF; baroreceptors sense changes in blood Na
· headache, nausea, vomiting, muscle cramps, fatigue, weakness, fainting
· Complications: cerebral edema, seizures, coma, brain damage
· Possible insulin resistance
these symptoms describe deficiency of what mineral?
hyponatremia
sodium deficiency
what would cause a sodium def?
increased fluid retention or increased Na loss (excessive water loss, use of diuretics, kidney disease)
cerebral edema, seizures, coma and brain damage can be complications of severe def of what mineral?
sodium
insulin resistance may result from def of what mineral?
sodium
toxicity of sodium is known as
hypernatremia (Increased extracellular Na leads to water being pulled out of cells into ECF (kidneys can usually balance this))
is sodium toxicity usually a result of excess consumption or excessive fluid loss?
fluid loss
nausea, vomiting, diarrhea and abdominal cramps can be a sign of mild toxicity of what mineral?
sodium
edema
hypertension
tachycardia
SOB
convulsions
coma and death can be result of severe toxicity of what mineral?
sodium
high levels of what mineral increase sodium excretion?
potassium
high sodium increases excretion of what mineral?
calcium
ways to assess sodium
· Electrolyte panel (can be elevated in dehydration)
· 24hr urinary excretion can assess Na intake
what is the most abundant anion in the ECF?
chloride (Cl)
sources of chloride
salt (NaCl)
eggs
meat
seafood
chloride is absorbed in the
small intestine through:
· Na/glucose cotransport: Cl follows actively absorbed Na; SGLT1
· Na/Cl: active; creates electrical gradient
· Electrogenic Na: Cl follows Na
chloride is excreted in
urine and perspiration
· Gastric hydrochloric acid production: secreted from parietal cells of stomach as HCL
· Exchange anion for HCO3- in RBC: the chloride shift; CO2 waste from cells converted to HCO3- in RBC to go back to lungs
describe functions of which mineral?
chloride!
T/F
deficiency of chloride is common
FALSE
rare, may occur in severe fluid loss
how would we assess chloride?
electrolyte panel
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