# migrations

dir: embeddings_queue
filename: 00001-embeddings.sqlite.sql
hash: d3755dfd232be8e8301f4d7fcfb3a486
sql:
CREATE TABLE embeddings_queue (
    seq_id INTEGER PRIMARY KEY,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    operation INTEGER NOT NULL,
    topic TEXT NOT NULL,
    id TEXT NOT NULL,
    vector BLOB,
    encoding TEXT,
    metadata TEXT
);


dir: sysdb
filename: 00001-collections.sqlite.sql
hash: 38352d725ad1c16074fac420b22b4633
sql:
CREATE TABLE collections (
    id TEXT PRIMARY KEY,
    name TEXT NOT NULL,
    topic TEXT NOT NULL,
    UNIQUE (name)
);

CREATE TABLE collection_metadata (
    collection_id TEXT REFERENCES collections(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (collection_id, key)
);


dir: sysdb
filename: 00002-segments.sqlite.sql
hash: 2913cb6a503055a95f625448037e8912
sql:
CREATE TABLE segments (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    topic TEXT,
    collection TEXT REFERENCES collection(id)
);

CREATE TABLE segment_metadata (
    segment_id TEXT  REFERENCES segments(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (segment_id, key)
);


dir: sysdb
filename: 00004-tenants-databases.sqlite.sql
hash: 048867ce8fcdefe4023c7110e4433591
sql:
CREATE TABLE IF NOT EXISTS tenants (
    id TEXT PRIMARY KEY,
    UNIQUE (id)
);

CREATE TABLE IF NOT EXISTS databases (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per tenant
    tenant_id TEXT NOT NULL REFERENCES tenants(id) ON DELETE CASCADE,
    UNIQUE (tenant_id, name) -- Ensure that a tenant has only one database with a given name
);

CREATE TABLE IF NOT EXISTS collections_tmp (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per database
    topic TEXT NOT NULL,
    dimension INTEGER,
    database_id TEXT NOT NULL REFERENCES databases(id) ON DELETE CASCADE,
    UNIQUE (name, database_id)
);

-- Create default tenant and database
INSERT OR REPLACE INTO tenants (id) VALUES ('default_tenant'); -- The default tenant id is 'default_tenant' others are UUIDs
INSERT OR REPLACE INTO databases (id, name, tenant_id) VALUES ('00000000-0000-0000-0000-000000000000', 'default_database', 'default_tenant');

INSERT OR REPLACE INTO collections_tmp (id, name, topic, dimension, database_id)
    SELECT id, name, topic, dimension, '00000000-0000-0000-0000-000000000000' FROM collections;
DROP TABLE collections;
ALTER TABLE collections_tmp RENAME TO collections;


dir: sysdb
filename: 00005-remove-topic.sqlite.sql
hash: b1367c826b8fba5f96f27befdc1d42d2
sql:
-- Remove the topic column from the Collections and Segments tables

ALTER TABLE collections DROP COLUMN topic;
ALTER TABLE segments DROP COLUMN topic;


dir: sysdb
filename: 00006-collection-segment-metadata.sqlite.sql
hash: 4eea7468935bf25d4604a0fed2366116
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE collection_metadata ADD COLUMN bool_value INTEGER;
ALTER TABLE segment_metadata ADD COLUMN bool_value INTEGER;


dir: metadb
filename: 00001-embedding-metadata.sqlite.sql
hash: 2b4cf52c4bb2676e21d6860a4409f856
sql:
CREATE TABLE embeddings (
    id INTEGER PRIMARY KEY,
    segment_id TEXT NOT NULL,
    embedding_id TEXT NOT NULL,
    seq_id BLOB NOT NULL,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    UNIQUE (segment_id, embedding_id)
);

CREATE TABLE embedding_metadata (
    id INTEGER REFERENCES embeddings(id),
    key TEXT NOT NULL,
    string_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (id, key)
);

CREATE TABLE max_seq_id (
    segment_id TEXT PRIMARY KEY,
    seq_id BLOB NOT NULL
);

CREATE VIRTUAL TABLE embedding_fulltext USING fts5(id, string_value);


dir: metadb
filename: 00002-embedding-metadata.sqlite.sql
hash: 12a570f7121b3a8ce750a2a7c36da20f
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE embedding_metadata ADD COLUMN bool_value INTEGER


dir: metadb
filename: 00003-full-text-tokenize.sqlite.sql
hash: f97ad6334aeaa8f419f01110b648b97a
sql:
CREATE VIRTUAL TABLE embedding_fulltext_search USING fts5(string_value, tokenize='trigram');
INSERT INTO embedding_fulltext_search (rowid, string_value) SELECT rowid, string_value FROM embedding_metadata;
DROP TABLE embedding_fulltext;


# embeddings_queue

created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9896169d-2556-4b60-b9d4-1ab3427027de
encoding: FLOAT32
metadata:
{"original_content": "1 - Nutritional Disorders\nChapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral deficiencies in the human body?  \n2. How do dietary imbalances contribute to the development of metabolic disorders?  \n3. What are the health risks associated with obesity and how can they be managed through nutrition?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d394becf-b0b8-4795-9919-0d40a390f571
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\nIntroduction\nNutrition is the science of food and its relationship to health.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that can lead to specific nutritional disorders?  \n2. How do vitamin and mineral imbalances contribute to metabolic disorders?  \n3. What is the relationship between poor nutrition and the development of obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 23c8fd99-2a71-4404-babb-b74bd0d80811
encoding: FLOAT32
metadata:
{"original_content": "Nutrients are chemicals in foods that are\nused by the body for growth, maintenance, and energy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do nutrient deficiencies contribute to the development of metabolic disorders?  \n2. What role do vitamins and minerals play in preventing dietary-related health conditions?  \n3. How can imbalances in nutrient intake lead to obesity or other nutritional disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 830eb7f7-935d-4245-88ed-3b96d35a05d4
encoding: FLOAT32
metadata:
{"original_content": "Nutrients that cannot be synthesized by the body\nand thus must be derived from the diet are considered essential.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the health consequences of a deficiency in essential nutrients that the body cannot synthesize?  \n2. How do dietary deficiencies in essential nutrients contribute to the development of metabolic disorders?  \n3. What role do essential nutrients play in preventing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2020782d-9219-4f1d-9f56-adeecb06b85e
encoding: FLOAT32
metadata:
{"original_content": "They include vitamins, minerals, some\namino acids, and some fatty acids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What role do specific vitamins and minerals play in preventing nutritional disorders?  \n2. How can deficiencies in certain amino acids contribute to metabolic disorders?  \n3. What are the health consequences of imbalances in essential fatty acids?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 13f0b89f-2834-4444-97d5-b9a8fb1b5ae9
encoding: FLOAT32
metadata:
{"original_content": "Nutrients that the body can synthesize from other compounds,\nalthough they may also be derived from the diet, are considered nonessential.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do nonessential nutrients impact metabolic disorders when synthesized inadequately by the body?  \n2. Can a deficiency in dietary sources of nonessential nutrients contribute to vitamin and mineral imbalances?  \n3. What role do nonessential nutrients play in the development or prevention of obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a790593-696f-4da8-9dd7-a084a5fb9616
encoding: FLOAT32
metadata:
{"original_content": "Macronutrients are\nrequired by the body in relatively large amounts; micronutrients are needed in minute amounts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can a deficiency in macronutrients lead to metabolic disorders?  \n2. What are the potential health consequences of an imbalance between macronutrient and micronutrient intake?  \n3. How do micronutrient deficiencies contribute to specific dietary-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 63568357-6e73-4bfd-a318-7478e617a201
encoding: FLOAT32
metadata:
{"original_content": "Lack of nutrients can result in deficiency syndromes (eg, kwashiorkor, pellagra) or other disorders (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the potential health consequences of nutrient deficiencies such as kwashiorkor and pellagra?  \n2. How do specific dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 32e1215e-4c64-470c-9b67-09b294a2994e
encoding: FLOAT32
metadata:
{"original_content": "9\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and how can they be managed nutritionally?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 92d1e92c-07c3-4869-bec9-c53d008b431b
encoding: FLOAT32
metadata:
{"original_content": "Excess intake of macronutrients can lead to obesity (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does excessive consumption of macronutrients contribute to the development of obesity?  \n2. What are the potential health risks associated with obesity caused by overconsumption of macronutrients?  \n3. Are there specific macronutrients that are more likely to lead to obesity when consumed in excess?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d9d219d2-6420-4ce1-aaff-030e47f379cc
encoding: FLOAT32
metadata:
{"original_content": "56\n) and related disorders; excess intake of\nmicro-nutrients can be toxic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the potential health risks associated with excessive intake of micronutrients?  \n2. How can excess micronutrient consumption lead to nutritional or metabolic disorders?  \n3. What are the symptoms of toxicity caused by overconsumption of specific vitamins or minerals?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4a0a315c-18d1-487c-a5e0-a0d6418cf4e9
encoding: FLOAT32
metadata:
{"original_content": "Also, the balance of various types of nutrients, such as how much\nusaturated vs saturated fat is consumed, can influence the development of disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the balance between unsaturated and saturated fat consumption impact the risk of developing nutritional disorders?  \n2. What role does saturated fat play in the development of metabolic disorders?  \n3. Can an imbalance in unsaturated and saturated fat intake contribute to obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1b1acfdc-0aa9-44d9-a240-4c5965b1e67e
encoding: FLOAT32
metadata:
{"original_content": "Macronutrients\nMacronutrients constitute the bulk of the diet and supply energy and many essential nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can an imbalance in macronutrient intake contribute to obesity?  \n2. What role do macronutrients play in preventing dietary deficiencies and related health conditions?  \n3. How might insufficient macronutrient consumption lead to metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab5b2662-c7ca-4c34-8d2c-fac9d785a9e7
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates, proteins (including essential amino acids), fats (including essential fatty acids),\nmacrominerals, and water are macronutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What role do essential amino acids play in preventing protein deficiency disorders?  \n2. How can a lack of essential fatty acids contribute to metabolic disorders?  \n3. What are the potential health consequences of macromineral imbalances in the diet?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b10b38dd-9295-454b-b3e6-7e27c76f8175
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates, fats, and proteins are interchangeable as\nsources of energy; fats yield 9 kcal/g (37.8 kJ/g); proteins and carbohydrates yield 4 kcal/g (16.8 kJ/g).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the body's reliance on carbohydrates, fats, or proteins for energy impact metabolic disorders like diabetes?  \n2. What role does the caloric yield of macronutrients play in the development of obesity?  \n3. How might a deficiency in one macronutrient affect the body's ability to compensate with others in cases of malnutrition?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5860b518-6621-4807-9339-0be3a36fd43b
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates:\n Dietary carbohydrates are broken down into glucose and other monosaccharides.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the breakdown of dietary carbohydrates into glucose impact metabolic disorders like diabetes?  \n2. Can deficiencies in carbohydrate metabolism lead to specific nutritional disorders?  \n3. What role do monosaccharides play in the development of obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: eea8b197-8bd4-477a-88a6-ebe824f300f5
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates increase blood glucose levels, supplying energy. Simple carbohydrates are composed of\nsmall molecules, generally monosaccharides or disaccharides, which increase blood glucose levels\nrapidly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do simple carbohydrates affect blood glucose levels in individuals with diabetes?  \n2. What role do monosaccharides and disaccharides play in energy supply for individuals with hypoglycemia?  \n3. Can the rapid increase in blood glucose levels from simple carbohydrates contribute to obesity or metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9705a7c2-29fe-43c1-b300-cc8b7ac68b92
encoding: FLOAT32
metadata:
{"original_content": "Complex carbohydrates are composed of larger molecules, which are broken down into\nmonosaccharides.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the breakdown of complex carbohydrates into monosaccharides impact individuals with metabolic disorders like diabetes?  \n2. Can a deficiency in enzymes required to break down complex carbohydrates lead to specific nutritional disorders?  \n3. What role do complex carbohydrates play in managing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a51b67de-5092-41f9-a7d1-82cedded927e
encoding: FLOAT32
metadata:
{"original_content": "Complex carbohydrates increase blood glucose levels more slowly but for a longer\ntime.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can the consumption of complex carbohydrates impact blood glucose management in individuals with diabetes?  \n2. What role do complex carbohydrates play in preventing hypoglycemia in metabolic disorders?  \n3. Can a diet rich in complex carbohydrates help manage obesity-related insulin resistance?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c630547-044f-4037-8e39-223887ecac0b
encoding: FLOAT32
metadata:
{"original_content": "Glucose and sucrose are simple carbohydrates; starches and fiber are complex carbohydrates.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do simple carbohydrates like glucose and sucrose impact metabolic disorders such as diabetes?  \n2. Can a diet high in complex carbohydrates like starches and fiber help prevent obesity or related health conditions?  \n3. What role do simple versus complex carbohydrates play in managing dietary deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e5030dc1-743e-4234-9d85-c13e6840e0ab
encoding: FLOAT32
metadata:
{"original_content": "The glycemic index measures how rapidly consumption of a carbohydrate increases plasma glucose\nlevels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the glycemic index of carbohydrates impact the management of metabolic disorders like diabetes?  \n2. Can a diet focused on low glycemic index foods help prevent obesity and related health conditions?  \n3. What role does the glycemic index play in addressing dietary deficiencies and maintaining balanced plasma glucose levels?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: acfba41d-7fc8-496f-b8ff-a0e0540a2e55
encoding: FLOAT32
metadata:
{"original_content": "Values range from 1 (the slowest increase) to 100 (the fastest increase, equivalent to pure glucose\n\u2014see\nTable 1-1\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the glycemic index of a food impact blood sugar levels in individuals with metabolic disorders?  \n2. What role does the glycemic index play in managing obesity through dietary planning?  \n3. Can foods with a high glycemic index exacerbate symptoms of certain nutritional deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a28d4877-0ce3-41bd-a7a5-24747d3435be
encoding: FLOAT32
metadata:
{"original_content": "However, the actual rate of increase also depends on what foods are consumed with the\ncarbohydrate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do different food combinations impact the rate of carbohydrate absorption in individuals with metabolic disorders?  \n2. What role does the consumption of specific foods alongside carbohydrates play in managing blood sugar levels for people with obesity?  \n3. Can pairing carbohydrates with certain nutrients help mitigate the effects of dietary deficiencies or vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 14da6a6a-026a-4853-80ff-954f9afdbd01
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates with a high glycemic index may increase plasma glucose to high levels rapidly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How do high-glycemic-index carbohydrates contribute to the development or worsening of metabolic disorders like diabetes?  \n2. What role do high-glycemic-index carbohydrates play in the onset of obesity and related health conditions?  \n3. Can consuming high-glycemic-index carbohydrates exacerbate symptoms of insulin resistance or other glucose regulation disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f3fa5fee-979d-4113-8c4c-d3efcfc26a85
encoding: FLOAT32
metadata:
{"original_content": "It is\nhypothesized that, as a result, insulin levels increase, inducing hypoglycemia and hunger, which tends to\nlead to consumption of excess calories and weight gain.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does an increase in insulin levels contribute to hypoglycemia and subsequent hunger in metabolic disorders?  \n2. What is the relationship between hypoglycemia-induced hunger and the risk of obesity?  \n3. Can insulin dysregulation lead to excessive calorie consumption and weight gain in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0f8c72a5-2e26-4cfe-af52-2206bf6ade51
encoding: FLOAT32
metadata:
{"original_content": "Carbohydrates with a low glycemic index\nincrease plasma glucose levels slowly, resulting in lower postprandial insulin levels and less hunger,\nwhich probably makes consumption of excess calories less likely.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can consuming low glycemic index carbohydrates help manage obesity?  \n2. What role do low glycemic index carbohydrates play in controlling postprandial insulin levels in individuals with metabolic disorders?  \n3. Can a diet focused on low glycemic index carbohydrates reduce the risk of overeating in patients with nutritional imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cbceff76-5b62-4c76-b14d-15bc59cd711e
encoding: FLOAT32
metadata:
{"original_content": "These effects are predicted to result in\na more favorable lipid profile and a decreased risk of obesity, diabetes mellitus, and complications of\ndiabetes if present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can dietary changes improve lipid profiles and reduce the risk of obesity?  \n2. What are the potential benefits of managing lipid levels for individuals with diabetes mellitus?  \n3. How might improved lipid profiles decrease the complications associated with diabetes?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 97ecfa4c-d178-43e6-94b8-5bbc7ab979d0
encoding: FLOAT32
metadata:
{"original_content": "Proteins:\n Dietary proteins are broken down into peptides and amino acids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does a deficiency in dietary protein affect the body's ability to produce essential amino acids?  \n2. What role do peptides and amino acids play in addressing metabolic disorders related to protein malabsorption?  \n3. Can inadequate protein intake contribute to obesity or other nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 90ac4a13-613e-471a-b628-883841ca439b
encoding: FLOAT32
metadata:
{"original_content": "Proteins are required for\ntissue maintenance, replacement, function, and growth.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does protein deficiency impact tissue maintenance and growth in individuals with dietary deficiencies?  \n2. What role do proteins play in the recovery and replacement of tissues in metabolic disorders?  \n3. Can inadequate protein intake contribute to health conditions related to impaired tissue function?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c2f50e4-b4d1-4db0-a11e-b63a8ef65f7a
encoding: FLOAT32
metadata:
{"original_content": "However, if the body is not getting enough\ncalories from dietary sources or tissue stores (particularly of fat), protein may be used for energy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the body compensate for a lack of caloric intake from dietary sources in cases of malnutrition?  \n2. What are the potential consequences of protein being used as an energy source instead of its primary functions in the body?  \n3. How does insufficient fat storage impact the body's ability to maintain proper metabolic balance during periods of caloric deficiency?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fcb32b25-3ebf-46c6-ba38-aeeb5b99afd9
encoding: FLOAT32
metadata:
{"original_content": "As the body uses dietary protein for tissue production, there is a net gain of protein (positive nitrogen\nbalance).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does a positive nitrogen balance relate to the body's ability to recover from protein-energy malnutrition?  \n2. What role does dietary protein play in addressing muscle wasting associated with metabolic disorders?  \n3. Can a positive nitrogen balance indicate recovery from a nutritional deficiency or imbalance?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 79ea324b-1301-45e8-a4ef-6d7ce08b720e
encoding: FLOAT32
metadata:
{"original_content": "During catabolic\n[\nTable 1-1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the metabolic changes that occur during catabolic states in individuals with nutritional disorders?  \n2. How do vitamin and mineral imbalances contribute to the progression of catabolic conditions?  \n3. What dietary interventions can mitigate the effects of catabolic states in patients with obesity or other metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b637369f-3267-41d9-8aba-20a7a00c381d
encoding: FLOAT32
metadata:
{"original_content": "Glycemic Index of Some Foods]\nstates (eg, starvation, infections, burns), more protein may be used (because body tissues are broken\ndown) than is absorbed, resulting in a net loss of protein (negative nitrogen balance).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How does the glycemic index of foods impact protein metabolism during states of negative nitrogen balance?  \n2. What role does dietary protein play in mitigating the effects of starvation or severe infections on the body's nitrogen balance?  \n3. Can high-glycemic foods exacerbate protein loss in individuals with metabolic disorders such as burns or severe trauma?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ec7f34b-0386-4dd9-828a-1034e1964a82
encoding: FLOAT32
metadata:
{"original_content": "Nitrogen balance is\nbest determined by subtracting the amount of nitrogen excreted in urine and feces from the amount of\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. How can nitrogen balance be used to assess protein metabolism in individuals with dietary deficiencies?  \n2. What role does nitrogen excretion play in diagnosing metabolic disorders related to protein intake?  \n3. How is nitrogen balance measurement relevant in managing malnutrition or obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff659672-ac62-471f-a39c-5a7e711922a2
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\n53", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 0, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that contribute to the development of nutritional disorders?  \n2. How do vitamin and mineral imbalances affect metabolic processes in the body?  \n3. What are the nutritional factors that can lead to obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 51b871a2-17f8-4460-bbd7-7820247daddc
encoding: FLOAT32
metadata:
{"original_content": "nitrogen consumed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does nitrogen consumption impact the development of protein deficiency disorders?  \n2. Can excessive nitrogen intake contribute to metabolic imbalances or toxicity in the body?  \n3. What role does nitrogen play in addressing dietary deficiencies related to amino acids?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 965b3e1a-bc1c-4003-a0e8-60cc8680103e
encoding: FLOAT32
metadata:
{"original_content": "Of the 20 amino acids, 9 are essential amino acids (EAAs); they cannot be synthesized and must be\nobtained from the diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the potential health consequences of a dietary deficiency in essential amino acids (EAAs)?  \n2. How does the inability to synthesize essential amino acids contribute to metabolic disorders?  \n3. Can a lack of essential amino acids in the diet lead to specific nutritional deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 922b7c9c-2735-4d7b-83cc-fca5d96bbcd1
encoding: FLOAT32
metadata:
{"original_content": "All people require 8 EAAs; infants also require histidine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the potential health consequences of a dietary deficiency in essential amino acids (EAAs) for adults and infants?  \n2. How does the requirement for histidine in infants relate to their metabolic and nutritional needs?  \n3. Could a lack of histidine in an infant's diet lead to specific nutritional or metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7b17824b-0714-4cbf-bc33-bd05917fd035
encoding: FLOAT32
metadata:
{"original_content": "The weight-adjusted requirement for dietary protein correlates with growth rate, which decreases from\ninfancy until adulthood.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the weight-adjusted dietary protein requirement impact growth rates in individuals with metabolic disorders?  \n2. Can inadequate protein intake during infancy contribute to nutritional deficiencies or growth-related health conditions?  \n3. What role does dietary protein play in preventing obesity or related health issues during different growth stages?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a10a8b17-8b61-4b19-bccd-607a1171891b
encoding: FLOAT32
metadata:
{"original_content": "The daily dietary protein requirement decreases from 2.2 g/kg in 3-mo-old infants\nto 1.2 g/kg in 5-yr-old children and to 0.8 g/kg in adults.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does insufficient protein intake during early childhood affect growth and development?  \n2. What are the potential health consequences of exceeding the recommended protein intake in adults?  \n3. How do protein requirements vary in individuals with metabolic disorders compared to healthy individuals?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a41a6ce6-83eb-45d9-9c8b-ec90e4e3e00f
encoding: FLOAT32
metadata:
{"original_content": "Protein requirements correspond to EAA\nrequirements (see\nTable 1-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do essential amino acid (EAA) requirements influence protein intake recommendations for individuals with metabolic disorders?  \n2. What role do protein and EAA requirements play in addressing dietary deficiencies in patients with malnutrition?  \n3. Can imbalances in EAA intake contribute to the development or exacerbation of nutrition-related health conditions like obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d59a3d05-f9c1-457f-90e8-079fec878c1a
encoding: FLOAT32
metadata:
{"original_content": "Adults trying to increase muscle mass need very little extra protein beyond the requirements in\nthe table.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does excessive protein intake affect individuals with metabolic disorders?  \n2. Can inadequate protein consumption contribute to muscle wasting in adults with dietary deficiencies?  \n3. What are the potential health risks of overconsuming protein for individuals with obesity-related conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2aec04b8-14a2-4632-9cc9-669b288f74ca
encoding: FLOAT32
metadata:
{"original_content": "The amino acid composition of protein varies widely.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the variation in amino acid composition of dietary proteins impact the management of protein-energy malnutrition?  \n2. Can differences in amino acid profiles of proteins influence the development or treatment of metabolic disorders like phenylketonuria?  \n3. What role does amino acid composition play in addressing deficiencies in essential amino acids in vegetarian or vegan diets?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 70cda2cf-f46d-47bc-948e-63fe89816786
encoding: FLOAT32
metadata:
{"original_content": "Biological value (BV) reflects the similarity in amino\nacid composition of protein to that of animal tissues; thus, BV indicates what percentage of a dietary\nprotein provides EAAs for the body.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the biological value of dietary protein impact the management of protein-energy malnutrition?  \n2. Can low biological value proteins contribute to the development of essential amino acid deficiencies in individuals with metabolic disorders?  \n3. What role does the biological value of protein play in addressing muscle wasting in obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5823e027-e88a-457c-869a-7064926a61cc
encoding: FLOAT32
metadata:
{"original_content": "A perfect match is egg protein, with a value of 100.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the protein quality of eggs compare to other dietary protein sources in addressing protein-energy malnutrition?  \n2. Can egg protein be considered an optimal dietary choice for individuals recovering from muscle-wasting conditions due to metabolic disorders?  \n3. What role does high-quality protein, such as egg protein, play in managing obesity-related nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7630b9f0-100d-4d01-ba15-2de1d5dc260a
encoding: FLOAT32
metadata:
{"original_content": "Animal proteins in\nmilk and meat have a high BV (~90); proteins in cereal and vegetables have a lower BV (~40), and some\nderived proteins (eg, gelatin) have a BV of 0.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the biological value (BV) of dietary proteins impact the management of protein-energy malnutrition?  \n2. Can a diet primarily based on cereal and vegetable proteins contribute to protein deficiency disorders?  \n3. What role does the BV of animal proteins play in addressing muscle wasting in metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d571a6fe-baf0-4891-aeb8-b20c4510e9dc
encoding: FLOAT32
metadata:
{"original_content": "The extent to which dietary proteins supply each other's\nmissing amino acids (complementarity) determines the overall BV of the diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the concept of protein complementarity impact the management of dietary protein deficiencies in individuals with metabolic disorders?  \n2. Can the biological value (BV) of a diet influence the severity of amino acid-related nutritional deficiencies?  \n3. What role does protein complementarity play in addressing malnutrition caused by imbalanced amino acid intake?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d1ebf5ec-a8fb-4143-9934-0bb1d811590f
encoding: FLOAT32
metadata:
{"original_content": "The recommended daily\nallowances (RDA) for protein assumes that the average mixed diet has a BV of 70.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does a diet with a biological value (BV) lower than 70 impact protein deficiency and related nutritional disorders?  \n2. What are the potential health consequences of failing to meet the RDA for protein in individuals with metabolic disorders?  \n3. How does the BV of dietary protein influence the management of obesity and associated health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e25ced5e-e6ed-4424-a566-1e7d1c16077e
encoding: FLOAT32
metadata:
{"original_content": "Fats:\n Fats are broken down into fatty acids and glycerol.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the breakdown of fats into fatty acids and glycerol impact metabolic disorders?  \n2. Can impaired fat metabolism contribute to obesity or other nutrition-related health conditions?  \n3. What role do fatty acids and glycerol play in addressing dietary deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 89b5245b-9c2e-4f17-a54d-dd1e4bf0e8be
encoding: FLOAT32
metadata:
{"original_content": "Fats are required for tissue growth and hormone\nproduction.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How can a deficiency in dietary fats impact hormone production and contribute to metabolic disorders?  \n2. What role do fats play in tissue growth, and how might their absence lead to nutritional deficiencies?  \n3. Could an imbalance in fat intake contribute to obesity or other related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9a3cb258-76bd-4ef1-a6b0-75455aac5068
encoding: FLOAT32
metadata:
{"original_content": "Saturated fatty acids, common in animal fats, tend to be solid at room temperature.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do saturated fatty acids contribute to the development of obesity and related metabolic disorders?  \n2. What role do saturated fatty acids play in the progression of cardiovascular diseases linked to poor dietary habits?  \n3. Can excessive consumption of saturated fatty acids lead to nutritional imbalances or deficiencies in essential fatty acids?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fc62ce4c-fe19-4be3-b998-9e5917de024a
encoding: FLOAT32
metadata:
{"original_content": "Except for\npalm and coconut oils, fats derived from plants tend to be liquid at room temperature; these fats contain\nhigh levels of monounsaturated fatty acids or polyunsaturated fatty acids (PUFAs).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do the types of fatty acids in plant-derived fats influence the risk of developing cardiovascular diseases?  \n2. Can the consumption of plant-based fats high in polyunsaturated fatty acids help prevent obesity-related metabolic disorders?  \n3. What role do monounsaturated and polyunsaturated fatty acids play in addressing dietary deficiencies linked to essential fatty acids?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5ded51f2-2ba2-464b-a572-2f0968469dd6
encoding: FLOAT32
metadata:
{"original_content": "Partial hydrogenation of unsaturated fatty acids (as occurs during food manufacturing) produces trans\nfatty acids, which are solid or semisolid at room temperature.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the consumption of trans fatty acids produced through partial hydrogenation contribute to obesity or metabolic disorders?  \n2. What are the potential health risks associated with dietary deficiencies caused by replacing unsaturated fats with trans fatty acids?  \n3. Can the intake of trans fatty acids influence the development of cardiovascular-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 57385477-0437-442a-98ef-87037f099244
encoding: FLOAT32
metadata:
{"original_content": "In the US, the main dietary source of trans\nfatty acids is partially hydrogenated vegetable oils, used in manufacturing certain foods (eg, cookies,\ncrackers, chips) to prolong shelf-life.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do trans fatty acids from partially hydrogenated vegetable oils contribute to the development of obesity or other metabolic disorders?  \n2. What role do trans fatty acids play in exacerbating nutritional imbalances or deficiencies?  \n3. Can the consumption of trans fatty acids increase the risk of specific health conditions related to poor dietary habits, such as cardiovascular disease?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 93994e77-5e77-4f1b-9c61-4ebdaff5c06f
encoding: FLOAT32
metadata:
{"original_content": "Trans fatty acids may elevate LDL cholesterol and lower HDL; they\nmay also independently increase the risk of coronary artery disease.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do trans fatty acids impact LDL and HDL cholesterol levels in the body?  \n2. What role do trans fatty acids play in increasing the risk of coronary artery disease?  \n3. How might dietary intake of trans fatty acids contribute to metabolic disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f9d4f302-74d2-497d-bed2-883fb8304c4d
encoding: FLOAT32
metadata:
{"original_content": "Essential fatty acids (EFAs) are linoleic acid, an \n\u03c9\n-6 (n-6) fatty acid, and linolenic acid, an \n\u03c9\n-3 (n-3) fatty\nacid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in essential fatty acids like linoleic acid and linolenic acid?  \n2. How do imbalances in \u03c9-6 and \u03c9-3 fatty acid intake contribute to metabolic disorders?  \n3. Can a lack of essential fatty acids in the diet lead to specific symptoms or conditions related to nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e8636228-495f-4161-9134-eb64336ea11b
encoding: FLOAT32
metadata:
{"original_content": "Other \n\u03c9\n-6 acids (eg, arachidonic acid) and other \n\u03c9\n-3 fatty acids (eg, eicosapentaenoic acid,\ndocosahexaenoic acid) are required by the body but can be synthesized from EFAs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the body synthesize arachidonic acid and eicosapentaenoic acid from essential fatty acids, and what are the implications of deficiencies in these processes?  \n2. What role do \u03c9-6 and \u03c9-3 fatty acids play in preventing or managing metabolic disorders?  \n3. Can a deficiency in essential fatty acids contribute to the development of specific nutritional or dietary deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 229e3024-5306-4143-8059-9f0ba63ed0a6
encoding: FLOAT32
metadata:
{"original_content": "EFAs (see also p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do essential fatty acid (EFA) deficiencies contribute to the development of specific nutritional disorders?  \n2. What are the metabolic consequences of inadequate intake of EFAs in the diet?  \n3. Can EFA imbalances exacerbate symptoms of obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 53b5ccc7-88af-4f79-a860-9f564e223913
encoding: FLOAT32
metadata:
{"original_content": "19\n) are needed for the formation of various eicosanoids (biologically active lipids),\nincluding prostaglandins, thromboxanes, prostacyclins, and leukotrienes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do deficiencies in essential fatty acids impact the production of eicosanoids like prostaglandins and thromboxanes?  \n2. What role do eicosanoids play in the development or management of metabolic disorders?  \n3. Can dietary imbalances affecting eicosanoid formation contribute to inflammation-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a9620008-ab28-4282-960e-860bf8929487
encoding: FLOAT32
metadata:
{"original_content": "Consumption of \n\u03c9\n-3 fatty acids\nmay decrease the risk of coronary artery disease.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does the consumption of \u03c9-3 fatty acids influence the risk of developing coronary artery disease?  \n2. Can a deficiency in \u03c9-3 fatty acids contribute to the progression of coronary artery disease?  \n3. What role do dietary sources of \u03c9-3 fatty acids play in managing or preventing metabolic disorders related to heart health?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f863921a-ed48-4863-b838-575c66438af3
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 1-2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors associated with the onset and progression of obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9de0a1c1-ac8b-40ee-bab5-d386dfc598ea
encoding: FLOAT32
metadata:
{"original_content": "Essential Amino Acid Requirements in mg/kg Body Weight]\nRequirements for EFAs vary by age.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do essential amino acid deficiencies impact metabolic disorders in different age groups?  \n2. What are the specific essential amino acid requirements for preventing dietary deficiencies in children versus adults?  \n3. Can inadequate intake of essential amino acids contribute to obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 89e46662-b577-47b5-9e4b-6b75462de42c
encoding: FLOAT32
metadata:
{"original_content": "Adults require amounts of linoleic acid equal to at least 2% of total\ncaloric needs and linolenic acid equal to at least 0.5%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the minimum dietary requirements of linoleic and linolenic acids to prevent deficiency-related disorders in adults?  \n2. How can insufficient intake of linoleic and linolenic acids contribute to metabolic or nutritional disorders?  \n3. What health conditions might arise from failing to meet the essential fatty acid requirements in an adult diet?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c68c49d1-e7fe-41a8-8eb9-5a804efacc43
encoding: FLOAT32
metadata:
{"original_content": "Vegetable oils provide linoleic acid and linolenic\nacid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does a deficiency in linoleic acid and linolenic acid affect metabolic disorders?  \n2. Can the absence of vegetable oils in the diet contribute to dietary deficiencies related to essential fatty acids?  \n3. What role do linoleic acid and linolenic acid play in preventing or managing obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 69db9519-2aad-4d01-9b69-37a9fd8e3cf3
encoding: FLOAT32
metadata:
{"original_content": "Oils made from safflower, sunflower, corn, soya, primrose, pumpkin, and wheat germ provide large\namounts of linoleic acid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How can a deficiency in linoleic acid contribute to metabolic disorders or skin conditions?  \n2. What role do oils rich in linoleic acid play in managing dietary deficiencies related to essential fatty acids?  \n3. Can the consumption of linoleic acid-rich oils help prevent or alleviate symptoms of certain nutritional disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e70a474d-c2c7-4a98-ae20-3283765e1dc4
encoding: FLOAT32
metadata:
{"original_content": "Marine fish oils and oils made from flax-seeds, pumpkin, soy, and canola provide\nlarge amounts of linolenic acid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How can linolenic acid from marine fish oils and plant-based oils help address dietary deficiencies in essential fatty acids?  \n2. What role does linolenic acid play in managing metabolic disorders or reducing inflammation associated with obesity?  \n3. Can a deficiency in linolenic acid contribute to specific nutritional or health disorders, and how can these oils help prevent them?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6afa4e92-49a3-48f0-9805-f54628f6236f
encoding: FLOAT32
metadata:
{"original_content": "Marine fish oils also provide some other \n\u03c9\n-3 fatty acids in large amounts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How can marine fish oils contribute to addressing dietary deficiencies in \u03c9-3 fatty acids?  \n2. What role do \u03c9-3 fatty acids from marine fish oils play in managing metabolic disorders?  \n3. Can a deficiency in \u03c9-3 fatty acids lead to specific nutritional disorders, and how might marine fish oils help prevent them?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 435d69ab-53e3-4b10-af7c-180006224f9d
encoding: FLOAT32
metadata:
{"original_content": "Macrominerals:\n Na, Cl, K, Ca, P, and Mg are required in relatively large amounts per day (see\nTables 1-3\n,\n1-4\n, and\n5-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the potential health consequences of a dietary deficiency in macrominerals like calcium (Ca) or magnesium (Mg)?  \n2. How do imbalances in sodium (Na) and potassium (K) levels contribute to metabolic disorders?  \n3. What role do phosphorus (P) and chloride (Cl) play in preventing nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e9c9fc9b-0b60-4bbf-948b-de1331a9b5ee
encoding: FLOAT32
metadata:
{"original_content": "Water:\n Water is considered a macronutrient because it is required in amounts of 1 mL/kcal (0.24 mL/kJ)\nof energy expended, or about 2500 mL/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How does inadequate water intake contribute to metabolic disorders?  \n2. What role does water consumption play in managing obesity?  \n3. Can insufficient hydration exacerbate symptoms of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 59026a65-5c8a-48e9-b364-ccbc4cabd113
encoding: FLOAT32
metadata:
{"original_content": "Needs vary with fever, physical activity, and changes in\nclimate and humidity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. How do changes in climate and humidity impact the nutritional needs of individuals with metabolic disorders?  \n2. What dietary adjustments are necessary for individuals with vitamin deficiencies during periods of fever?  \n3. How does increased physical activity affect the nutritional requirements of someone managing obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b10144db-be69-41d1-8d5d-449b6d5c8999
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 1-3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors associated with the onset and progression of obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8633834c-377e-4ae7-a071-d2865b4cf6c8
encoding: FLOAT32
metadata:
{"original_content": "Macrominerals]\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1. Nutrition: General Considerations\n54", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 1, "type": "text ", "chroma:document": "1. What are the clinical symptoms and health consequences of macromineral deficiencies in the human body?  \n2. How do dietary imbalances of macrominerals contribute to the development of metabolic disorders?  \n3. What are the recommended dietary sources and intake levels for maintaining proper macromineral balance?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a5339ef-c659-4520-8769-3c3bd12b3151
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 1-4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors associated with the onset and progression of obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 68314b18-da6d-4428-8217-0b1b87cd55a9
encoding: FLOAT32
metadata:
{"original_content": "Recommended Dietary Reference Intakes* for Some Macronutrients, Food and Nutrition\nBoard, Institute of Medicine of the National Academies]\nMicronutrients\nVitamins and minerals required in minute amounts (trace minerals) are micronutrients (see \nChs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the recommended dietary reference intakes for specific vitamins and minerals to prevent deficiencies and related health disorders?  \n2. How can imbalances in trace minerals contribute to the development of metabolic disorders?  \n3. What role do micronutrient deficiencies play in the onset of obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bf220fb1-9626-4038-9ba2-ec44e0626ae0
encoding: FLOAT32
metadata:
{"original_content": "4\n and \n5\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the potential health consequences of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What role does obesity play in the onset of nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c3c5bcd2-7a01-43c6-ba87-df9691ec0645
encoding: FLOAT32
metadata:
{"original_content": "Water-soluble vitamins\n are vitamin C (ascorbic acid) and 8 members of the vitamin B complex: biotin,\nfolate, niacin, pantothenic acid, riboflavin (vitamin B\n2\n), thiamin (vitamin B\n1\n), vitamin B\n6\n (pyridoxine), and\nvitamin B\n12\n (cobalamin).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in water-soluble vitamins like vitamin C or the B-complex vitamins?  \n2. How does a lack of vitamin B12 (cobalamin) contribute to metabolic disorders or anemia?  \n3. What role does niacin deficiency play in the development of pellagra?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0652e904-5674-4eba-9a24-b75ad6402caa
encoding: FLOAT32
metadata:
{"original_content": "Fat-soluble vitamins\n are vitamins A (retinol), D (cholecalciferol and ergocalciferol), E (\n\u03b1\n-tocopherol), and\nK (phylloquinone and menaquinone).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in fat-soluble vitamins like vitamin A or D?  \n2. How do imbalances in fat-soluble vitamins contribute to metabolic disorders?  \n3. What role do fat-soluble vitamins play in preventing dietary deficiencies and related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 87774cd5-7bba-4502-9b1c-a233d0b9b849
encoding: FLOAT32
metadata:
{"original_content": "Only vitamins A, E, and B\n12\n are stored to any significant extent in the body; the other vitamins must be\nconsumed regularly to maintain tissue health.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. Why is it important to regularly consume vitamins other than A, E, and B12 to prevent dietary deficiencies?  \n2. How can the body's ability to store vitamins A, E, and B12 impact the development of vitamin-related metabolic disorders?  \n3. What are the potential health consequences of failing to consume non-stored vitamins regularly in relation to tissue health?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8eef80a3-ddce-4fc6-9983-d6afc440dacd
encoding: FLOAT32
metadata:
{"original_content": "Essential trace minerals\n include chromium, copper, iodine, iron, manganese, molybdenum, selenium,\nand zinc.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in essential trace minerals like iodine or zinc?  \n2. How does a lack of selenium contribute to metabolic disorders or oxidative stress?  \n3. What role does iron play in preventing nutritional anemia and related health conditions?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 127f2d67-9501-4885-ba2a-9c824e0da521
encoding: FLOAT32
metadata:
{"original_content": "Except for chromium, each of these is incorporated into enzymes or hormones required in\nmetabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How do deficiencies in enzymes or hormones related to metabolism contribute to nutritional disorders?  \n2. What role does chromium play in metabolism compared to other minerals incorporated into enzymes or hormones?  \n3. How can imbalances in metabolic hormones or enzymes lead to dietary deficiencies or obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f0771f27-ec8a-469f-a70d-b4ff00ea818c
encoding: FLOAT32
metadata:
{"original_content": "Except for deficiencies of iron and zinc, micromineral deficiencies are uncommon in\ndeveloped countries (see \nCh.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the reasons for the rarity of micromineral deficiencies, other than iron and zinc, in developed countries?  \n2. How do dietary patterns in developed countries contribute to adequate levels of most microminerals?  \n3. What are the health implications of iron and zinc deficiencies compared to other micromineral deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 514988d3-76d3-439f-9f26-1be412af7f28
encoding: FLOAT32
metadata:
{"original_content": "5\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific vitamins or minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e5289ad3-3223-4542-950f-d201be9ca78c
encoding: FLOAT32
metadata:
{"original_content": "Other minerals (eg, aluminum, arsenic, boron, cobalt, fluoride, nickel, silicon, vanadium) have not been\nproved essential for people. Fluoride, although not essential, helps prevent tooth decay by forming a\ncompound with Ca (CaF\n2\n), which stabilizes the mineral matrix in teeth.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does fluoride contribute to the prevention of tooth decay in relation to mineral stabilization?  \n2. Are there any known health consequences of deficiencies or excesses of non-essential minerals like fluoride?  \n3. What role does calcium fluoride (CaF2) play in maintaining the structural integrity of teeth?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c23eb271-c4c0-4f21-a31a-176459c1227a
encoding: FLOAT32
metadata:
{"original_content": "All trace minerals are toxic at high levels, and some (arsenic, nickel, and chromium) may cause cancer.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How can excessive intake of trace minerals like arsenic, nickel, and chromium contribute to the development of cancer?  \n2. What are the potential health risks associated with high levels of trace minerals in the diet?  \n3. How do trace mineral imbalances impact the risk of developing nutrition-related disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e7251eca-9d24-44f4-ab88-a3834b7a8ce1
encoding: FLOAT32
metadata:
{"original_content": "Other Dietary Substances\nThe daily human diet typically contains as many as 100,000 chemicals (eg, coffee contains 1000).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How might the presence of numerous chemicals in the daily diet contribute to metabolic disorders?  \n2. Could the variety of chemicals in foods like coffee influence vitamin and mineral imbalances in the body?  \n3. What role do dietary chemicals play in the development or exacerbation of obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e52393d5-269b-4209-bf9a-142fbc15725c
encoding: FLOAT32
metadata:
{"original_content": "Of\nthese, only 300 are nutrients, only some of which are essential.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the essential nutrients required to prevent dietary deficiencies?  \n2. How do imbalances in essential nutrients contribute to metabolic disorders?  \n3. Which essential nutrients are most commonly linked to vitamin and mineral deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c4262de2-54bf-4b25-960a-5cd39b3ef53c
encoding: FLOAT32
metadata:
{"original_content": "However, many nonnutrients in foods are\nuseful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How can nonnutrients in foods contribute to managing dietary deficiencies?  \n2. What role do nonnutrients play in preventing or mitigating metabolic disorders?  \n3. Can nonnutrients in foods help address vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 509224ce-2dde-428f-88df-4702c095825f
encoding: FLOAT32
metadata:
{"original_content": "For example, food additives (eg, preservatives, emulsifiers, antioxidants, stabilizers) improve the\nproduction and stability of foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How do food additives like preservatives and stabilizers impact the risk of developing metabolic disorders?  \n2. Can the use of emulsifiers in processed foods contribute to obesity or related health conditions?  \n3. What role do antioxidants in food additives play in preventing or exacerbating vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9c969e99-4a37-40fb-8e67-fc912207e9ee
encoding: FLOAT32
metadata:
{"original_content": "Trace components (eg, spices, flavors, odors, colors, phytochemicals,\nmany other natural products) improve appearance and taste.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How do trace components like phytochemicals influence dietary deficiencies or metabolic disorders?  \n2. Can the appearance and taste improvements from trace components impact eating behaviors in individuals with obesity?  \n3. What role do natural product-derived flavors and colors play in addressing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e2d6f41b-1f99-4e0e-9eb5-85a4ccbb4139
encoding: FLOAT32
metadata:
{"original_content": "Fiber:\n Fiber occurs in various forms (eg, cellulose, hemicellulose, pectin, gums).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does a deficiency in dietary fiber contribute to the development of metabolic disorders such as type 2 diabetes?  \n2. What role do different forms of fiber (e.g., cellulose, pectin) play in preventing or managing obesity?  \n3. Can inadequate fiber intake lead to specific gastrointestinal disorders or exacerbate existing conditions like irritable bowel syndrome (IBS)?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ed5491ce-f523-4f7e-9861-d806f6b98266
encoding: FLOAT32
metadata:
{"original_content": "It \nincreases GI motility,\nprevents constipation, and helps control diverticular disease.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does increased gastrointestinal motility benefit individuals with diverticular disease?  \n2. What dietary interventions can help prevent constipation in individuals with metabolic disorders?  \n3. How can managing fiber intake aid in controlling symptoms of diverticular disease?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b569abc5-7e90-45f7-975e-d20a14da9ed5
encoding: FLOAT32
metadata:
{"original_content": "Fiber is thought to accelerate the elimination\nof cancer-causing substances produced by bacteria in the large intestine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does dietary fiber influence the risk of developing colon cancer in individuals with metabolic disorders?  \n2. Can a deficiency in dietary fiber contribute to the accumulation of harmful substances in the large intestine?  \n3. What role does fiber play in mitigating the effects of bacterial byproducts linked to nutritional disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b6419ded-a3cc-4add-b965-398ec683f891
encoding: FLOAT32
metadata:
{"original_content": "Epidemiologic evidence\nsuggests an association between colon cancer and low fiber intake and a beneficial effect of fiber in\npatients with functional bowel disorders, Crohn's disease, obesity, and hemorrhoids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does low fiber intake contribute to the risk of developing colon cancer?  \n2. What role does dietary fiber play in managing functional bowel disorders and Crohn's disease?  \n3. Can increasing fiber intake help alleviate symptoms of obesity and hemorrhoids?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b27b0ebf-0497-42db-82ff-b0eaca7273a6
encoding: FLOAT32
metadata:
{"original_content": "Soluble fiber\n(present in fruits, vegetables, oats, barley, and legumes) reduces the postprandial increase in blood\nglucose and insulin and can reduce cholesterol levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How can soluble fiber help manage postprandial blood glucose levels in individuals with diabetes?  \n2. What role does soluble fiber play in reducing cholesterol levels to prevent cardiovascular diseases?  \n3. Can a diet rich in soluble fiber aid in managing metabolic disorders related to insulin resistance?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a50049c8-c580-4f22-b607-3187a6519c2a
encoding: FLOAT32
metadata:
{"original_content": "The typical Western diet is low in fiber (about 12 g/day) because of a high intake of highly refined wheat\nflour and a low intake of fruits and vegetables.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does a low-fiber diet contribute to the development of gastrointestinal disorders such as constipation or diverticulosis?  \n2. What are the potential long-term health risks associated with a diet high in refined wheat flour and low in fruits and vegetables?  \n3. Can a low-fiber diet increase the likelihood of developing metabolic disorders like type 2 diabetes or obesity?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9747a8c0-e037-43dd-9993-afcc2543fd5f
encoding: FLOAT32
metadata:
{"original_content": "Increasing fiber intake to about 30 g/day by consuming\nmore vegetables, fruits, and high-fiber cereals and grains is generally recommended.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How can increasing fiber intake help manage or prevent obesity?  \n2. What role does dietary fiber play in addressing metabolic disorders?  \n3. Can a high-fiber diet alleviate symptoms of certain nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f70f5180-6ee2-475f-8d01-8842925a05e6
encoding: FLOAT32
metadata:
{"original_content": "However, very high\nfiber intake may reduce absorption of certain minerals.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does excessive fiber intake contribute to mineral deficiencies in the body?  \n2. Which specific minerals are most affected by very high fiber consumption?  \n3. Can reduced mineral absorption due to high fiber intake lead to long-term nutritional disorders?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: eed8ce2d-5859-4689-9f0e-8e5b903b4166
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Requirements\nGood nutrition aims to achieve and maintain a desirable body composition and high potential for physical\nand mental work.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How can maintaining a desirable body composition help prevent obesity-related health conditions?  \n2. What role does good nutrition play in addressing vitamin and mineral imbalances?  \n3. How does proper nutrition support mental work in individuals with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b7727ef6-6ca2-4a6e-89ec-1d292c84f879
encoding: FLOAT32
metadata:
{"original_content": "Balancing energy intake with energy expenditure is necessary for a desirable body\nweight.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does an imbalance between energy intake and expenditure contribute to obesity?  \n2. What role does energy balance play in preventing metabolic disorders?  \n3. Can maintaining energy balance help address vitamin and mineral imbalances related to dietary deficiencies?  "}


created_at: 2025-03-03 11:15:11
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 354f29cf-7bf7-4305-9ea9-1efd8c3a5022
encoding: FLOAT32
metadata:
{"original_content": "Energy expenditure depends on age, sex, weight (see \nTable 1-4\n), and metabolic and physical\nactivity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does age influence energy expenditure in individuals with metabolic disorders?  \n2. What role does sex play in determining energy needs for managing obesity?  \n3. How can weight variations impact energy expenditure in cases of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 45bcab9a-088e-4e71-81bc-6c9309286747
encoding: FLOAT32
metadata:
{"original_content": "If energy intake exceeds expenditure, weight is gained.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does excessive energy intake contribute to the development of obesity?  \n2. What are the potential metabolic disorders associated with prolonged weight gain due to energy imbalance?  \n3. Can an imbalance between energy intake and expenditure lead to vitamin and mineral deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: aa036c23-4951-4a87-9761-4a200075fb12
encoding: FLOAT32
metadata:
{"original_content": "Taking in about 100 calories/day more\nthan needed results in a weight gain of about 4 to 5 kg in a year.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does consuming an excess of 100 calories per day contribute to obesity over time?  \n2. What is the relationship between small daily caloric surpluses and long-term weight gain in individuals with metabolic disorders?  \n3. Can consistent overconsumption of calories lead to nutritional imbalances or exacerbate existing dietary deficiencies?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2f1f4315-2b80-43bc-8cf6-ecddb4cccf80
encoding: FLOAT32
metadata:
{"original_content": "If energy intake is less than expenditure,\nweight is lost.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. How does a prolonged energy deficit contribute to the development of malnutrition or underweight conditions?  \n2. What role does energy imbalance play in the progression of metabolic disorders such as anorexia nervosa?  \n3. Can sustained energy expenditure exceeding intake lead to deficiencies in essential vitamins and minerals?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 54b39e93-c77b-4bfe-b3b4-25734d30e795
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health complications associated with prolonged obesity and how can they be mitigated?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4b8cf295-74c5-4959-9911-cbd10050be8a
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\n55", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 2, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that contribute to the development of nutritional disorders?  \n2. How do vitamin and mineral imbalances affect metabolic processes in the body?  \n3. What are the potential health risks associated with obesity as a nutritional disorder?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ca4cd2a4-01fc-475d-819b-47e4d7bce7e6
encoding: FLOAT32
metadata:
{"original_content": "Daily dietary requirements for essential nutrients also depend on age, sex, weight, and metabolic and\nphysical activity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How do daily dietary requirements for essential nutrients vary for individuals with metabolic disorders?  \n2. What role does age and sex play in the risk of developing vitamin and mineral imbalances?  \n3. How can physical activity levels influence dietary deficiencies in individuals with obesity?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2ec627d3-6a1e-47d2-afd8-f605d5853eed
encoding: FLOAT32
metadata:
{"original_content": "Every 5 yr, the Food and Nutrition Board of the National Academy of Sciences/National\nResearch Council and the US Department of Agriculture (USDA) issues the dietary reference intakes\n(DRIs) for protein, energy, and some vitamins and minerals (see \nTables 1-4\n,\n4-1\n, and \n5-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the recommended dietary reference intakes (DRIs) for vitamins and minerals to prevent nutritional deficiencies?  \n2. How do the DRIs for protein and energy intake relate to managing obesity or metabolic disorders?  \n3. What guidelines are provided for addressing vitamin and mineral imbalances in individuals with specific nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e75fd046-8622-46ec-bd35-309a6770687c
encoding: FLOAT32
metadata:
{"original_content": "For vitamins and minerals about which less is known, safe and adequate daily dietary\nintakes are estimated.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How are safe and adequate daily dietary intakes determined for vitamins and minerals with limited research?  \n2. What are the potential health risks of consuming inadequate amounts of lesser-known vitamins and minerals?  \n3. How can estimated dietary intakes help prevent nutritional deficiencies and related metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 820632cb-977e-4694-b647-3f49e9f932f6
encoding: FLOAT32
metadata:
{"original_content": "Pregnant women (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies that pregnant women are at risk of developing?  \n2. How can vitamin and mineral imbalances during pregnancy affect maternal and fetal health?  \n3. What dietary recommendations can help prevent metabolic disorders in pregnant women?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 85d4d979-6b52-41db-8a61-ea5aa04cc530
encoding: FLOAT32
metadata:
{"original_content": "2608\n) and infants (see p. 2703\n) have special nutritional needs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the specific nutritional needs of infants to prevent dietary deficiencies?  \n2. How do nutritional requirements differ for individuals with metabolic disorders?  \n3. What role do vitamin and mineral imbalances play in the development of obesity?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 446eb07a-8737-440d-9311-7a6d14db4b78
encoding: FLOAT32
metadata:
{"original_content": "The USDA publishes the Food Guide Pyramid, which specifies the number of recommended daily\nservings of various food groups.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How can the Food Guide Pyramid help prevent dietary deficiencies and ensure balanced nutrition?  \n2. What role does the Food Guide Pyramid play in managing obesity through portion control and food group recommendations?  \n3. How can following the Food Guide Pyramid reduce the risk of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a15f798f-f92b-4f63-bb63-8c8ddb67c1de
encoding: FLOAT32
metadata:
{"original_content": "The recommendations are individualized based on age, sex, and\nphysical activity (see\nTable 1-5\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How do age, sex, and physical activity levels influence dietary recommendations for managing vitamin and mineral imbalances?  \n2. What individualized dietary guidelines are suggested for addressing obesity in different age groups?  \n3. How can physical activity levels be factored into nutritional plans for preventing metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c5acc06-0f76-4bff-aaa9-d81972aae3b5
encoding: FLOAT32
metadata:
{"original_content": "Generally, the recommended intake decreases with aging because physical activity tends to\ndecrease, resulting in less energy expended.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How does decreased physical activity with aging contribute to the risk of obesity or metabolic disorders?  \n2. What are the potential nutritional deficiencies that may arise from reduced energy intake in older adults?  \n3. How can dietary recommendations be adjusted to prevent vitamin and mineral imbalances in aging populations with lower energy expenditure?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5de1771e-fc6e-4a0a-862d-63b8279b25e5
encoding: FLOAT32
metadata:
{"original_content": "The new Food Guide Pyramid emphasizes the following:\n\u2022 Increasing consumption of whole grains\n\u2022 Increasing consumption of vegetables and fruits\n\u2022 Substituting fat-free or low-fat milk products (or equivalents) for whole-fat milk products\n\u2022 Reducing consumption of saturated fats and trans fatty acids\n\u2022 Exercising regularly\nAdequate fluid intake is also important.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How can increasing the consumption of whole grains help manage or prevent metabolic disorders such as type 2 diabetes?  \n2. What role does reducing saturated fats and trans fatty acids play in preventing obesity and cardiovascular diseases?  \n3. How does substituting low-fat or fat-free milk products impact calcium intake and the prevention of osteoporosis?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5d0d179-9643-41e3-9957-6c528281c269
encoding: FLOAT32
metadata:
{"original_content": "Fats should constitute \u2264 30% of total calories, and saturated and trans fatty acids should constitute <\n10%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How can excessive intake of saturated and trans fats contribute to obesity and related metabolic disorders?  \n2. What role does limiting dietary fat intake to \u2264 30% of total calories play in preventing cardiovascular diseases?  \n3. How does the consumption of saturated and trans fatty acids below 10% impact the risk of developing nutritional disorders like hyperlipidemia?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 83979b7b-d4ee-48ad-b662-3e40dbf9485b
encoding: FLOAT32
metadata:
{"original_content": "Excess intake of saturated fats contributes to atherosclerosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How does excessive consumption of saturated fats contribute to the development of atherosclerosis?  \n2. What role do dietary fats play in the progression of cardiovascular-related nutritional disorders?  \n3. Can reducing saturated fat intake help mitigate the risk of atherosclerosis and related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ffbb5d12-9447-46a9-b800-535a1d8b794c
encoding: FLOAT32
metadata:
{"original_content": "Substituting polyunsaturated fatty\nacids for saturated fats can decrease the risk of atherosclerosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How does substituting polyunsaturated fatty acids for saturated fats impact the progression of atherosclerosis?  \n2. Can dietary changes involving polyunsaturated fatty acids reduce the risk of cardiovascular-related metabolic disorders?  \n3. What role do saturated fats play in the development of atherosclerosis compared to polyunsaturated fatty acids?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0f22b786-6ea4-4627-a676-1b4021e5803a
encoding: FLOAT32
metadata:
{"original_content": "Routine use of nutritional supplements is\nnot necessary or beneficial; some supplements can be harmful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. Can the routine use of nutritional supplements lead to vitamin or mineral imbalances?  \n2. Are there specific health risks associated with taking unnecessary nutritional supplements for individuals with metabolic disorders?  \n3. How might the overuse of supplements contribute to obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 07aa1501-b4b0-4e75-94d5-31cd25df257f
encoding: FLOAT32
metadata:
{"original_content": "For example, excess vitamin A can lead to\nhypervitaminosis A, with headaches, osteoporosis, and rash.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the symptoms of hypervitaminosis A caused by excess vitamin A intake?  \n2. How can excessive consumption of vitamin A impact bone health?  \n3. What are the dermatological effects of vitamin A toxicity?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dad9137f-5443-4192-8c7b-982d1c27a8e5
encoding: FLOAT32
metadata:
{"original_content": "Nutrition in Clinical Medicine\nNutritional deficiencies can often worsen health outcomes (whether a disorder is present or not), and\nsome disorders (eg, malabsorption) can cause nutritional deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How do malabsorption disorders contribute to nutritional deficiencies?  \n2. What are the potential health outcomes of untreated vitamin and mineral imbalances?  \n3. Can nutritional deficiencies exacerbate pre-existing metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 98e7f8bc-f4cd-418a-ba42-9f334b12d857
encoding: FLOAT32
metadata:
{"original_content": "Also, many patients (eg, elderly\npatients during acute hospitalization) have unsuspected nutritional deficiencies that require treatment.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the common nutritional deficiencies observed in elderly patients during acute hospitalization?  \n2. How can unsuspected nutritional deficiencies in hospitalized patients be identified and treated?  \n3. What are the potential health risks associated with untreated dietary deficiencies in elderly individuals?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4ed5cd49-f37d-4463-8914-d6b716af3648
encoding: FLOAT32
metadata:
{"original_content": "Many medical centers have multi-disciplinary nutrition support teams of physicians, nurses, dietitians, and\npharmacists to help the clinician prevent, diagnose, and treat occult nutritional deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How can a multi-disciplinary nutrition support team assist in diagnosing occult nutritional deficiencies?  \n2. What role do dietitians play in preventing vitamin and mineral imbalances in patients?  \n3. How can pharmacists contribute to the treatment of metabolic disorders through nutrition support?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a2988297-5b07-4e69-bcb6-f8309b367bee
encoding: FLOAT32
metadata:
{"original_content": "Overnutrition may contribute to chronic disorders, such as cancer, hypertension, obesity, diabetes\nmellitus, and coronary artery disease.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How does overnutrition contribute to the development of obesity and related health conditions?  \n2. What is the relationship between overnutrition and the risk of developing coronary artery disease?  \n3. Can overnutrition increase the likelihood of chronic disorders such as diabetes mellitus and hypertension?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 26422314-360a-406a-971f-69803f46c4cf
encoding: FLOAT32
metadata:
{"original_content": "Dietary restrictions are necessary in many hereditary metabolic\ndisorders (eg, galactosemia, phenylketonuria).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What dietary restrictions are required for managing hereditary metabolic disorders like galactosemia and phenylketonuria?  \n2. How do specific metabolic disorders influence the need to avoid certain nutrients in the diet?  \n3. What are the potential health consequences of not adhering to dietary restrictions in conditions like phenylketonuria?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 50c15660-d339-4afb-bdac-e8c675274d6d
encoding: FLOAT32
metadata:
{"original_content": "Evaluation of Nutritional Status\nIndications for nutritional evaluation include undesirable body weight or body composition, suspicion of\nspecific deficiencies or toxicities\n[\nTable 1-5.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the key indicators used to evaluate undesirable body weight or body composition in nutritional disorders?  \n2. How can specific dietary deficiencies or toxicities be identified through a nutritional evaluation?  \n3. What role does nutritional status assessment play in diagnosing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 539017e2-7643-4d9a-96c1-0a83ac104214
encoding: FLOAT32
metadata:
{"original_content": "Recommended Dietary Intake for 40-yr-Olds with Moderate Physical Activity*]\nof essential nutrients, and, in infants and children, insufficient growth or development.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the recommended dietary intakes of essential nutrients for 40-year-olds with moderate physical activity to prevent vitamin and mineral deficiencies?  \n2. How can insufficient intake of essential nutrients in 40-year-olds lead to metabolic disorders or related health conditions?  \n3. What dietary adjustments are recommended for 40-year-olds with moderate physical activity to address potential risks of obesity or nutrient imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0dc15f08-940e-413d-9a0f-8912c9023941
encoding: FLOAT32
metadata:
{"original_content": "Nutritional status\nshould be evaluated routinely as part of the clinical examination for infants and children, the elderly,\npeople taking several drugs, people with psychiatric disorders, and people with systemic disorders that\nlast longer than several days.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. How can routine nutritional evaluations help identify vitamin and mineral imbalances in elderly individuals?  \n2. What role does nutritional assessment play in managing systemic disorders lasting longer than several days?  \n3. Why is it important to monitor the nutritional status of individuals taking multiple medications?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6a653e85-7213-4b9d-be51-e7b5c9ba9cbb
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin and mineral deficiencies in adults?  \n2. How can metabolic disorders like phenylketonuria be diagnosed and managed nutritionally?  \n3. What are the recommended treatment strategies for obesity-related health complications?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ced49436-d36c-46f5-9588-e5455d79aa6e
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\n56", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 3, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that contribute to the development of nutritional disorders?  \n2. How do vitamin and mineral imbalances affect metabolic processes in the body?  \n3. What are the nutritional factors that can lead to obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3af89900-45d4-4531-b401-533498481b27
encoding: FLOAT32
metadata:
{"original_content": "Evaluating general nutritional status includes history, physical examination, and sometimes tests.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can a physical examination help identify signs of vitamin and mineral deficiencies?  \n2. What role does a patient's medical history play in diagnosing metabolic disorders?  \n3. When are diagnostic tests necessary to confirm a suspected nutritional imbalance?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 31426e62-2cbe-40fd-bb8c-e2e22928e0b0
encoding: FLOAT32
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{"original_content": "If\nundernutrition is suspected, laboratory tests (eg, albumin levels) and skin tests for delayed\nhypersensitivity may be done (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can albumin levels be used to assess undernutrition in patients?  \n2. What role do skin tests for delayed hypersensitivity play in diagnosing nutritional deficiencies?  \n3. What laboratory tests are commonly recommended for identifying dietary deficiencies or metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9bb1068-f643-4a98-8fca-ed1be9dde626
encoding: FLOAT32
metadata:
{"original_content": "13\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in essential vitamins and minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cd929ead-4308-4e04-8e4a-178b27d09011
encoding: FLOAT32
metadata:
{"original_content": "Body composition analysis (eg, skinfold measurements, bioelectrical impedance analysis) is used to\nestimate percentage of body fat and to evaluate obesity (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can body composition analysis help in diagnosing obesity?  \n2. What methods are used to estimate body fat percentage in individuals with suspected nutritional disorders?  \n3. How does bioelectrical impedance analysis contribute to evaluating metabolic health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 93ca25cd-7f96-441e-a711-2f574a3fc38a
encoding: FLOAT32
metadata:
{"original_content": "58\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the common symptoms and health risks associated with vitamin and mineral imbalances?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What role does obesity play in the progression of nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9f71db48-c3c7-466a-8d3b-8494793948af
encoding: FLOAT32
metadata:
{"original_content": "History includes questions about dietary intake, weight change, and risk factors for nutritional deficiencies\nand a focused review of systems (see\nTable 2-1\n on p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What dietary factors or habits might contribute to the development of specific nutritional deficiencies?  \n2. How can recent weight changes indicate the presence of a metabolic or nutritional disorder?  \n3. What symptoms in a focused review of systems could help identify vitamin or mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0975dbcb-c36e-4505-b7c7-7ad8e2c8af37
encoding: FLOAT32
metadata:
{"original_content": "11\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific vitamins or minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with long-term obesity and its relation to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1e74f8cb-d076-41ac-b6ca-18e14f99fb36
encoding: FLOAT32
metadata:
{"original_content": "A dietitian can obtain a more detailed dietary history.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What specific dietary deficiencies could contribute to the development of a particular nutritional disorder?  \n2. How might a detailed dietary history help identify the root causes of vitamin and mineral imbalances in a patient?  \n3. What patterns in a dietary history could indicate a risk for obesity or related metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8be7a57a-40d9-458b-8136-02beac580dac
encoding: FLOAT32
metadata:
{"original_content": "It usually includes a list of foods\neaten within the previous 24 h and a food questionnaire.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What specific dietary patterns or food choices within the past 24 hours could contribute to a vitamin or mineral deficiency?  \n2. How might the consumption of certain foods in the last 24 hours be linked to the development or management of obesity?  \n3. Are there any indications of potential metabolic disorders based on the types and quantities of foods consumed in the previous day?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48e1826f-1f26-47f4-b6c2-ac73dd3ac1ed
encoding: FLOAT32
metadata:
{"original_content": "A food diary may be used to record all foods\neaten.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can a food diary help identify potential dietary deficiencies contributing to a nutritional disorder?  \n2. What role does tracking food intake play in managing obesity or other metabolic disorders?  \n3. How can a food diary assist in detecting patterns of vitamin and mineral imbalances in a person's diet?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c10c483c-9046-431f-be9d-de271122d749
encoding: FLOAT32
metadata:
{"original_content": "The weighed ad libitum diet, in which the patient weighs and writes down all foods consumed, is\nthe most accurate record.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can the weighed ad libitum diet help in identifying specific dietary deficiencies in patients with nutrition disorders?  \n2. What role does the weighed ad libitum diet play in managing obesity and tracking caloric intake?  \n3. How can the weighed ad libitum diet assist in monitoring vitamin and mineral imbalances in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5f317d47-5e7d-45a5-8834-d0c1a316f417
encoding: FLOAT32
metadata:
{"original_content": "A complete physical examination, including measurement of height and weight and distribution of body\nfat, should be done.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can body fat distribution measurements help in diagnosing obesity-related health conditions?  \n2. What role does height and weight assessment play in identifying potential nutritional deficiencies or imbalances?  \n3. How does a physical examination contribute to detecting metabolic disorders linked to improper nutrition?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b04fc89e-3449-4263-998f-187411c4a3f3
encoding: FLOAT32
metadata:
{"original_content": "Body mass index (BMI)\u2014weight(kg)/height(m)\n2\n, which adjusts weight for height (see\nTable 6-2\n on p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How is Body Mass Index (BMI) calculated and used to assess obesity or undernutrition?  \n2. What role does BMI play in identifying risks associated with metabolic disorders?  \n3. How can BMI be utilized to evaluate the impact of dietary deficiencies on body weight?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5b56167c-4a5d-400f-ab76-bc32cb4e9e29
encoding: FLOAT32
metadata:
{"original_content": "59\n), is more accurate than height and weight tables.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can height and weight tables be less accurate in diagnosing obesity compared to other methods?  \n2. What are the limitations of using traditional metrics for assessing nutritional disorders?  \n3. Why might alternative measurements be preferred for evaluating vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a30ea8df-90bb-47c0-838c-49ffc81a99d8
encoding: FLOAT32
metadata:
{"original_content": "There are standards for growth and\nweight gain in infants, children, and adolescents (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the nutritional benchmarks for identifying growth delays or weight gain issues in infants and children?  \n2. How can deviations from standard growth patterns indicate potential dietary deficiencies or metabolic disorders?  \n3. What role do vitamin and mineral imbalances play in abnormal weight gain during adolescence?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9b0ecb24-ca5b-4357-9c17-625d947dd265
encoding: FLOAT32
metadata:
{"original_content": "2756\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 050a4134-2b4b-4d00-95cc-1b9c8b885547
encoding: FLOAT32
metadata:
{"original_content": "Distribution of body fat is important. Disproportionate truncal obesity (ie, waist/hip ratio > 0.8) is\nassociated with cardiovascular and cerebrovascular disorders, hypertension, and diabetes mellitus more\noften than fat located elsewhere.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does a high waist/hip ratio contribute to the risk of cardiovascular disorders?  \n2. What is the relationship between truncal obesity and the development of diabetes mellitus?  \n3. Why is fat distribution a significant factor in the risk of hypertension?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f7768b0d-c698-4501-a0ae-0de071a0bf44
encoding: FLOAT32
metadata:
{"original_content": "Measuring waist circumference in patients with a BMI of < 35 helps\ndetermine whether they have truncal obesity and helps predict risk of diabetes, hypertension,\nhypercholesterolemia, and cardiovascular disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can waist circumference measurements in patients with a BMI of < 35 help predict the risk of developing diabetes?  \n2. What role does truncal obesity play in the likelihood of hypertension and cardiovascular disorders?  \n3. Can waist circumference be used as an indicator for assessing the risk of hypercholesterolemia in individuals with a BMI of < 35?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9a0bc524-e8b4-4a61-823b-20d683e083dc
encoding: FLOAT32
metadata:
{"original_content": "Risk is increased if waist circumference is > 102 cm\n(> 40 in) in men or > 88 cm (> 35 in) in women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does waist circumference correlate with the risk of developing obesity-related health conditions?  \n2. What are the gender-specific thresholds for waist circumference that indicate an increased risk of metabolic disorders?  \n3. How can waist circumference measurements be used to assess the likelihood of nutrition-related health issues?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9556c788-cc5f-4fb1-8bde-c282fde78747
encoding: FLOAT32
metadata:
{"original_content": "Nutrient-Drug Interactions\nNutrition can affect the body's response to drugs; conversely, drugs can affect the body's nutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can a vitamin D deficiency impact the effectiveness of certain medications?  \n2. What are the potential nutritional side effects of long-term use of antacid medications?  \n3. Can specific nutrient imbalances exacerbate the side effects of drugs used to treat metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7b659731-073b-4d85-93b0-f421c663a7bf
encoding: FLOAT32
metadata:
{"original_content": "Foods can enhance, delay, or decrease drug absorption.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can specific dietary deficiencies impact the absorption of medications used to treat metabolic disorders?  \n2. What role do vitamin and mineral imbalances play in altering the effectiveness of drugs prescribed for obesity management?  \n3. Can certain foods delay the absorption of medications used to address nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a3c86129-e48d-4e04-accf-093c891f8fa7
encoding: FLOAT32
metadata:
{"original_content": "Foods impair absorption of many antibiotics.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do certain foods impact the effectiveness of antibiotics in treating bacterial infections related to nutritional deficiencies?  \n2. Can vitamin or mineral imbalances caused by specific diets worsen the absorption of antibiotics?  \n3. Are there metabolic disorders that increase the likelihood of food-antibiotic interactions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e419752a-fcd0-4336-9e58-4c5b88fe1cdf
encoding: FLOAT32
metadata:
{"original_content": "They can alter metabolism of drugs; eg, high-protein diets can accelerate metabolism of certain drugs by\nstimulating \ncytochrome P-450.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do high-protein diets influence the metabolism of drugs in individuals with metabolic disorders?  \n2. What role does cytochrome P-450 play in drug metabolism for patients with dietary deficiencies or imbalances?  \n3. Can altering dietary protein intake impact the effectiveness of medications in individuals with obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9f5359d1-35f9-4f53-a7d2-fa5360396388
encoding: FLOAT32
metadata:
{"original_content": "Eating grapefruit can inhibit cytochrome P-450 34A, slowing metabolism of\nsome drugs (eg, amiodarone, carbamazepine, cyclosporine, certain Ca channel blockers).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does grapefruit consumption affect the metabolism of medications in individuals with metabolic disorders?  \n2. Can the inhibition of cytochrome P-450 34A by grapefruit lead to drug toxicity in patients with nutritional deficiencies?  \n3. What dietary considerations should be made for individuals on calcium channel blockers to avoid adverse interactions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 62448db2-a09b-4b6e-9d65-027fe8619467
encoding: FLOAT32
metadata:
{"original_content": "Diets that alter\nthe bacterial flora may markedly affect the overall metabolism of certain drugs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do dietary changes that affect gut bacterial flora influence drug metabolism in individuals with metabolic disorders?  \n2. Can altering gut microbiota through diet impact the effectiveness of medications in treating obesity?  \n3. What role does gut bacterial flora play in the metabolism of drugs for patients with vitamin or mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0c24aeb8-c620-42b3-b505-15e6e2b43b23
encoding: FLOAT32
metadata:
{"original_content": "Some foods affect the\nbody's response to drugs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do specific foods influence the effectiveness of medications in individuals with metabolic disorders?  \n2. Can vitamin or mineral imbalances alter the body's response to certain drugs?  \n3. What dietary considerations should be made for obese individuals taking prescription medications?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6db19d3d-0af9-46f9-a094-28b8a75c5406
encoding: FLOAT32
metadata:
{"original_content": "For example, tyramine, a component of cheese and a potent vasoconstrictor,\ncan cause hypertensive crisis in some patients who take monoamine oxidase inhibitors and eat cheese.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does the consumption of tyramine-rich foods like cheese affect patients taking monoamine oxidase inhibitors?  \n2. What are the potential health risks associated with dietary components that act as vasoconstrictors?  \n3. Which dietary restrictions are necessary for individuals on monoamine oxidase inhibitors to prevent hypertensive crises?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c5bb4fc7-aef9-4ace-83be-23aae6b43cc6
encoding: FLOAT32
metadata:
{"original_content": "Nutritional deficiencies can affect drug absorption and metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do vitamin deficiencies impact the absorption and effectiveness of certain medications?  \n2. Can mineral imbalances alter the metabolism of prescription drugs in the body?  \n3. What role does obesity play in the metabolism of medications influenced by nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 42476692-007d-47c4-b047-63502b5e40ee
encoding: FLOAT32
metadata:
{"original_content": "Severe energy and protein\ndeficiencies reduce enzyme tissue concentrations and may impair the response to drugs by reducing\nabsorption or protein binding and causing liver dysfunction.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do severe energy and protein deficiencies impact the body's ability to metabolize drugs?  \n2. What role does liver dysfunction play in the response to dietary deficiencies?  \n3. How can protein binding be affected by nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c51784c3-91f0-49ca-99e7-6abeae4db22b
encoding: FLOAT32
metadata:
{"original_content": "Changes in the GI tract can impair absorption\nand affect the response to a drug.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do changes in the gastrointestinal tract impact the absorption of essential vitamins and minerals in individuals with metabolic disorders?  \n2. Can impaired GI absorption exacerbate dietary deficiencies in patients with obesity-related health conditions?  \n3. What role does altered drug response play in managing vitamin and mineral imbalances caused by GI tract changes?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ce79470c-65fc-413e-82a0-4cc83f714361
encoding: FLOAT32
metadata:
{"original_content": "Deficiency of Ca, Mg, or zinc may impair drug metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does a deficiency in calcium, magnesium, or zinc affect the body's ability to metabolize medications?  \n2. What are the potential health risks associated with impaired drug metabolism due to mineral deficiencies?  \n3. Can dietary supplementation of calcium, magnesium, or zinc improve drug metabolism in individuals with deficiencies?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fdaac054-3b95-4d5f-947d-9ffccba3616a
encoding: FLOAT32
metadata:
{"original_content": "Vitamin C\ndeficiency decreases activity of drug-metabolizing enzymes, especially in the elderly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does vitamin C deficiency impact the activity of drug-metabolizing enzymes in elderly individuals?  \n2. What are the potential health consequences of reduced drug metabolism due to vitamin C deficiency?  \n3. Why might elderly individuals be more susceptible to the effects of vitamin C deficiency on enzyme activity?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dcbcad65-9df0-4dcd-8a30-e7d2e9715821
encoding: FLOAT32
metadata:
{"original_content": "Many drugs affect appetite, food absorption, and tissue metabolism (see\nTable 1-6\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do specific drugs influence appetite and contribute to nutritional disorders?  \n2. What role do medications play in altering food absorption and leading to dietary deficiencies?  \n3. Can certain drugs impact tissue metabolism in a way that exacerbates metabolic disorders or obesity?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3213bd35-4c6d-41f1-9a55-9351942f4f95
encoding: FLOAT32
metadata:
{"original_content": "Some drugs (eg, metoclopramide) increase GI motility, decreasing food absorption.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does increased gastrointestinal motility caused by certain drugs contribute to nutritional deficiencies?  \n2. Can the use of drugs like metoclopramide lead to vitamin and mineral imbalances due to reduced food absorption?  \n3. What are the potential metabolic consequences of decreased nutrient absorption in patients taking medications that enhance GI motility?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2eebdb77-9498-4881-828b-d4d35458dace
encoding: FLOAT32
metadata:
{"original_content": "Other\ndrugs (eg, opioids, anticholinergics) decrease GI motility.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do opioids and anticholinergics impact gastrointestinal motility in patients with nutritional disorders?  \n2. Can decreased gastrointestinal motility caused by certain drugs lead to malabsorption of essential nutrients?  \n3. What dietary adjustments can help mitigate the effects of drug-induced decreased GI motility on nutrient absorption?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 30d1e037-63f6-4a37-9f7f-83a03eb72b66
encoding: FLOAT32
metadata:
{"original_content": "Some drugs are better tolerated if taken with\nfood.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How can taking medication with food help manage symptoms of metabolic disorders?  \n2. Are there specific dietary deficiencies that make certain drugs harder to tolerate on an empty stomach?  \n3. Can vitamin or mineral imbalances affect the absorption or side effects of medications when taken without food?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2cf29e6c-a354-4b1d-8c63-07ac58415165
encoding: FLOAT32
metadata:
{"original_content": "Certain drugs affect mineral metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do certain drugs interfere with the absorption of essential minerals, potentially leading to nutritional deficiencies?  \n2. What are the potential metabolic disorders caused by drug-induced alterations in mineral metabolism?  \n3. Can drug interactions with mineral metabolism exacerbate existing vitamin and mineral imbalances in patients?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dedd3f32-8cf5-4b96-a9c1-b786e509c1f1
encoding: FLOAT32
metadata:
{"original_content": "For example, diuretics, especially thiazides, and corticosteroids\ncan deplete body K, increasing susceptibility to digoxin-induced cardiac arrhythmias.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do thiazide diuretics contribute to potassium depletion and its impact on cardiac health?  \n2. What role does potassium play in preventing digoxin-induced cardiac arrhythmias?  \n3. How can corticosteroid use lead to nutritional imbalances, specifically potassium deficiency?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 50d9dd6f-d533-40b9-b6e6-9e48cda7a0ca
encoding: FLOAT32
metadata:
{"original_content": "Repeated use of\nlaxatives may deplete K.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does repeated laxative use contribute to potassium deficiency?  \n2. What are the potential health risks associated with potassium depletion caused by laxative abuse?  \n3. Can potassium depletion from laxative overuse lead to metabolic imbalances or other nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 506641fd-6687-492b-a7b0-413535ac87f7
encoding: FLOAT32
metadata:
{"original_content": "Cortisol, desoxycorticosterone, and aldosterone cause marked Na and water\nretention, at least temporarily; retention is much less with prednisone, prednisolone, and some other\ncorticosteroid analogs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do cortisol and aldosterone contribute to sodium and water retention in the context of metabolic disorders?  \n2. What is the difference in sodium retention effects between natural corticosteroids and their analogs like prednisone in nutritional or metabolic conditions?  \n3. Can corticosteroid-induced water retention exacerbate symptoms of obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0ae56faa-4551-456a-8836-16f720fcc224
encoding: FLOAT32
metadata:
{"original_content": "Sulfonylureas and lithium can impair the uptake or release of iodine by the thyroid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do sulfonylureas and lithium contribute to iodine-related thyroid dysfunction?  \n2. Can impaired iodine uptake or release due to medication lead to specific nutritional or metabolic disorders?  \n3. What dietary adjustments can mitigate the effects of sulfonylureas and lithium on thyroid iodine metabolism?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b576e9cc-387a-4f80-81db-5d8a500d9ea8
encoding: FLOAT32
metadata:
{"original_content": "Oral contraceptives can lower blood zinc levels and increase copper levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do oral contraceptives contribute to zinc deficiency and what are the potential health implications?  \n2. What dietary adjustments can help mitigate the increased copper levels caused by oral contraceptives?  \n3. Could the imbalance of zinc and copper levels from oral contraceptive use lead to specific metabolic or nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cae9d698-2c2b-467f-9380-0e3aff9f4f1a
encoding: FLOAT32
metadata:
{"original_content": "Certain antibiotics (eg,\ntetracyclines) reduce iron absorption, as can certain foods (eg, vegetables, tea, bran).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do tetracycline antibiotics impact iron absorption and contribute to potential iron deficiency?  \n2. What dietary components, such as vegetables, tea, and bran, can interfere with iron absorption and lead to nutritional imbalances?  \n3. What strategies can be used to manage iron deficiency in individuals taking antibiotics that reduce iron absorption?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3ac8f8ab-945f-43c5-a342-4437034bf65c
encoding: FLOAT32
metadata:
{"original_content": "Certain drugs affect vitamin absorption or metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do specific medications interfere with the absorption of essential vitamins, potentially leading to dietary deficiencies?  \n2. What metabolic disorders can arise from drug-induced disruptions in vitamin metabolism?  \n3. Can certain drugs contribute to vitamin and mineral imbalances that exacerbate obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5f1f9c6e-f63e-46d9-8dae-90fe53d98497
encoding: FLOAT32
metadata:
{"original_content": "Ethanol impairs thiamin utilization, and isoniazid\ninterferes with niacin and pyridoxine metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How does ethanol consumption contribute to thiamin deficiency and related metabolic disorders?  \n2. What are the effects of isoniazid on niacin and pyridoxine metabolism in the context of nutritional deficiencies?  \n3. What nutritional strategies can mitigate the impact of ethanol and isoniazid on vitamin metabolism?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c4404f91-b6c6-49b4-a9f5-e4eea53dfb74
encoding: FLOAT32
metadata:
{"original_content": "Ethanol and oral contraceptives inhibit folate (folic acid)\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. How do ethanol and oral contraceptives contribute to folate deficiency in the body?  \n2. What are the potential health consequences of folate deficiency caused by ethanol consumption or oral contraceptive use?  \n3. What dietary or supplemental interventions can mitigate folate deficiency in individuals using oral contraceptives or consuming ethanol?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 79ca21b9-9f21-4e5c-9cf0-f94797c31394
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\n57", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 4, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that contribute to the development of nutritional disorders?  \n2. How do vitamin and mineral imbalances affect metabolic processes in the body?  \n3. What are the potential health risks associated with obesity as a nutritional disorder?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5f9fd0c4-3eef-4d2b-a92e-3ec6f642c8d9
encoding: FLOAT32
metadata:
{"original_content": "absorption.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does impaired nutrient absorption contribute to vitamin and mineral deficiencies in the body?  \n2. What are the potential health consequences of malabsorption disorders on metabolic processes?  \n3. Which dietary interventions can help manage absorption-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 45c47033-7df2-42f0-a729-2d12b31d7e53
encoding: FLOAT32
metadata:
{"original_content": "Most patients receiving phenytoin, phenobarbital, primidone, or phenothiazines develop folate\ndeficiency, probably because hepatic microsomal drug-metabolizing enzymes are affected.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How do hepatic microsomal drug-metabolizing enzymes contribute to folate deficiency in patients taking certain medications?  \n2. What is the relationship between folate deficiency and the use of phenytoin, phenobarbital, primidone, or phenothiazines?  \n3. What dietary interventions can help mitigate folate deficiency in patients on long-term anticonvulsant therapy?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e6e4bf5c-8843-4962-93be-1b8e7160fd8b
encoding: FLOAT32
metadata:
{"original_content": "Folate\nsupplements may\n[\nTable 1-6.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How can folate supplements help address dietary deficiencies related to folate?  \n2. What role do folate supplements play in preventing metabolic disorders caused by folate deficiency?  \n3. Can folate supplementation mitigate health conditions associated with vitamin imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3719426b-fd3f-4ab8-a375-88e9b44b4f47
encoding: FLOAT32
metadata:
{"original_content": "Effects of Some Drugs on Nutrition]\nmake phenytoin less effective.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does phenytoin interact with nutritional factors to affect its efficacy?  \n2. What dietary considerations should be taken into account when using phenytoin to avoid nutritional imbalances?  \n3. Can certain drugs exacerbate vitamin or mineral deficiencies in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f837cfea-49f7-4ec0-97d5-5e1caa2c11e0
encoding: FLOAT32
metadata:
{"original_content": "Anticonvulsants can cause vitamin D deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How do anticonvulsant medications contribute to vitamin D deficiency?  \n2. What are the potential health consequences of vitamin D deficiency caused by anticonvulsants?  \n3. What dietary or supplemental strategies can help mitigate vitamin D deficiency in individuals taking anticonvulsants?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0cf7ef9e-0aef-4944-9727-06a7a0a08468
encoding: FLOAT32
metadata:
{"original_content": "Malabsorption of vitamin\nB\n12\n can occur with use of aminosalicylic acid, slow-release K iodide, colchicine, trifluoperazine, ethanol,\nand oral contraceptives.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does the use of oral contraceptives contribute to vitamin B12 malabsorption?  \n2. What role does ethanol consumption play in the development of vitamin B12 deficiency?  \n3. Can the use of aminosalicylic acid lead to nutritional disorders related to vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9d72162c-4ca8-4a4e-bd00-dae91c7b7a20
encoding: FLOAT32
metadata:
{"original_content": "Oral contraceptives with a high progestin dose can cause depression, probably\nbecause of metabolically induced tryptophan deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does a high progestin dose in oral contraceptives contribute to tryptophan deficiency?  \n2. What are the metabolic pathways affected by oral contraceptives that could lead to nutritional deficiencies?  \n3. Can tryptophan deficiency caused by oral contraceptives increase the risk of depression?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d30d0670-3994-4c5b-bc36-ad05d7aceb69
encoding: FLOAT32
metadata:
{"original_content": "Food Additives and Contaminants\nAdditives:\n Chemicals are often combined with foods to facilitate their processing and preservation or to\nenhance their desirability.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How can certain food additives contribute to metabolic disorders or obesity?  \n2. Are there specific additives linked to vitamin or mineral imbalances in the body?  \n3. Can the use of food additives exacerbate dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 944f6b60-a070-493f-9aa6-64ecb99f0d3a
encoding: FLOAT32
metadata:
{"original_content": "Only amounts of additives shown to be safe by laboratory tests are permitted in\ncommercially prepared foods. Weighing the benefits of additives (eg, reduced waste, increased variety of available foods, protection\nagainst food-borne illness) against the risks is often complex.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How do food additives impact the risk of developing metabolic disorders?  \n2. Can the use of food additives contribute to vitamin or mineral imbalances in the diet?  \n3. Are there any links between food additives and the prevalence of obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 81743dc8-d8ee-4def-9226-4dd186cd80ef
encoding: FLOAT32
metadata:
{"original_content": "For example, nitrite, which is used in cured\nmeats, inhibits the growth of \nClostridium botulinum\n and improves flavor.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does the use of nitrites in cured meats impact the risk of foodborne illnesses like botulism?  \n2. Can the consumption of nitrite-containing foods contribute to any nutritional or metabolic disorders?  \n3. Are there any health risks or benefits associated with nitrites in the context of dietary deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 464eefc9-246d-420b-be4b-cc9106359bc5
encoding: FLOAT32
metadata:
{"original_content": "However, nitrite converts to\nnitrosamines, which are carcinogens in animals.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How do nitrosamines formed from nitrites contribute to the development of cancer in animals?  \n2. What dietary sources are most likely to lead to nitrite exposure and potential nitrosamine formation?  \n3. Are there specific nutritional strategies to minimize the risk of nitrosamine-related health disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 77ce6c32-30dc-4ec6-99bd-56146d19023b
encoding: FLOAT32
metadata:
{"original_content": "On the other hand, the amount of nitrite added to cured\nmeat is small compared with the amount from naturally occurring food nitrates converted to nitrite by the\nsalivary glands.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does the conversion of naturally occurring food nitrates to nitrites by salivary glands impact metabolic disorders?  \n2. Can the small amount of nitrite added to cured meat contribute to dietary imbalances or health risks?  \n3. What role do nitrites from dietary sources play in the development or prevention of nutrition-related disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a0f41a0a-f5c0-4db0-8078-34ebdf43dd46
encoding: FLOAT32
metadata:
{"original_content": "Dietary vitamin C can reduce nitrite formation in the GI tract.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How does dietary vitamin C intake influence the risk of nitrite-related metabolic disorders in the gastrointestinal tract?  \n2. Can a deficiency in vitamin C exacerbate conditions related to nitrite formation in the GI tract?  \n3. What role does vitamin C play in preventing nutritional disorders associated with excessive nitrite levels?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3851cfa1-0aa0-49fb-95de-70b0835c0e6e
encoding: FLOAT32
metadata:
{"original_content": "Rarely, some additives (eg,\nsulfites) cause food hypersensitivity (allergy) reactions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How do sulfite additives contribute to food hypersensitivity reactions in individuals with metabolic disorders?  \n2. Can sulfite-induced food allergies exacerbate existing vitamin or mineral imbalances?  \n3. What dietary adjustments can help manage sulfite sensitivity in individuals with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d23c7595-f097-4a7c-ac16-75caab180766
encoding: FLOAT32
metadata:
{"original_content": "Most of these reactions are caused by ordinary\nfoods (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the common foods that trigger adverse reactions related to nutritional disorders?  \n2. How do ordinary foods contribute to metabolic disorders or dietary deficiencies?  \n3. What role do specific foods play in causing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c420a1c7-b618-4cf9-bb0e-a3c7df4531d8
encoding: FLOAT32
metadata:
{"original_content": "1118\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific populations?  \n2. How do vitamin and mineral imbalances contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its relation to nutritional disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c3fdd7e6-f73c-40bb-a49c-fa67b6217553
encoding: FLOAT32
metadata:
{"original_content": "Contaminants:\n Sometimes limited amounts of contaminants are allowed in foods because the\ncontaminants cannot be completely eliminated without damaging the foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How can the presence of contaminants in food contribute to vitamin and mineral imbalances in the body?  \n2. Could trace contaminants in food exacerbate existing metabolic disorders or dietary deficiencies?  \n3. What role do food contaminants play in the development or progression of obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6bd8d828-65e5-4853-8b24-2c348f0d4130
encoding: FLOAT32
metadata:
{"original_content": "Common contaminants are\npesticides, heavy metals (lead, cadmium, mercury), nitrates (in green leafy vegetables), aflatoxins (in nuts\nand milk), growth-promoting hormones (in dairy products and meat), animal hairs and feces, and insect\nparts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How can exposure to heavy metals like lead and cadmium through contaminated food contribute to metabolic disorders?  \n2. What role do aflatoxins in nuts and milk play in the development of nutritional deficiencies or related health conditions?  \n3. Can the presence of growth-promoting hormones in dairy and meat products lead to obesity or hormonal imbalances?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f033548c-f3f2-4936-a3d7-4f9941f9b269
encoding: FLOAT32
metadata:
{"original_content": "FDA-estimated safe levels are levels that have not caused illness or adverse effects in people.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the potential health risks of consuming nutrients or substances above FDA-estimated safe levels?  \n2. How do FDA-estimated safe levels relate to preventing vitamin and mineral imbalances?  \n3. Can exceeding FDA-estimated safe levels contribute to the development of metabolic disorders?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 741fa9d3-b911-414d-b57d-ec6d370777d8
encoding: FLOAT32
metadata:
{"original_content": "However,\ndemonstrating a causal relationship between extremely low level exposures and adverse effects is\ndifficult; long-term adverse effects, although unlikely, are still possible.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the potential long-term adverse effects of extremely low-level exposures to certain nutrients or dietary components?  \n2. How can causal relationships between low-level nutrient exposures and metabolic disorders be studied?  \n3. Are there any documented cases of vitamin or mineral imbalances resulting from prolonged low-level exposures?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3e992214-8b31-437f-b7eb-e2be8e29a60a
encoding: FLOAT32
metadata:
{"original_content": "Safe levels are often determined\nby consensus rather than by hard evidence.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. How are safe levels of vitamins and minerals determined in the context of preventing nutritional deficiencies or imbalances?  \n2. What role does consensus play in establishing dietary guidelines for managing metabolic disorders?  \n3. Can the lack of hard evidence in determining safe nutrient levels contribute to the development of obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 81502a68-4b93-440f-b778-d94c4ca09681
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin and mineral deficiencies in adults?  \n2. How are metabolic disorders like phenylketonuria diagnosed and managed?  \n3. What are the recommended treatment strategies for obesity-related health complications?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 69d4b880-92eb-4400-99b6-96a905095f7a
encoding: FLOAT32
metadata:
{"original_content": "Nutrition: General Considerations\n58", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 5, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies that contribute to the development of nutritional disorders?  \n2. How do vitamin and mineral imbalances affect metabolic processes in the body?  \n3. What are the potential health risks associated with obesity as a nutritional disorder?  "}


created_at: 2025-03-03 11:15:14
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c2dd129d-c0d1-4c14-93b9-208852fc728b
encoding: FLOAT32
metadata:
{"original_content": "Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the primary dietary deficiencies that contribute to the development of metabolic disorders?  \n2. How do vitamin and mineral imbalances affect the progression of obesity-related health conditions?  \n3. What are the common symptoms and treatments for nutrition-related disorders caused by malabsorption?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f688e7aa-522c-4090-9455-e425be4fcc62
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\nIntroduction\nUndernutrition is a form of malnutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What is undernutrition and how is it classified as a form of malnutrition?  \n2. What are the potential health consequences of dietary deficiencies associated with undernutrition?  \n3. How does undernutrition relate to vitamin and mineral imbalances in the body?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7713421d-89f9-4f4d-9ea7-0b40e5b02f8c
encoding: FLOAT32
metadata:
{"original_content": "(Malnutrition also includes overnutrition\u2014see \nCh.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the potential health consequences of overnutrition and how does it relate to malnutrition?  \n2. How do vitamin and mineral imbalances contribute to the development of metabolic disorders?  \n3. What dietary deficiencies are commonly associated with specific nutritional disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fd175c40-1870-4cf0-b9b8-230ad1740b3a
encoding: FLOAT32
metadata:
{"original_content": "6\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in individuals?  \n2. How do vitamin and mineral imbalances contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its relation to nutritional disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 47f3dd20-8e24-4a4e-9372-09b0c61edfcf
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition can result from inadequate ingestion of nutrients, malabsorption, impaired\nmetabolism, loss of nutrients due to diarrhea, or increased nutritional requirements (as occurs\nin cancer or infection).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the potential causes of undernutrition in individuals with chronic infections?  \n2. How does malabsorption contribute to nutrient deficiencies in the body?  \n3. Why might cancer patients have increased nutritional requirements leading to undernutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ef71dd3d-2b21-45fd-b32a-9c1708ba7e19
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition progresses in stages; each stage usually takes\nconsiderable time to develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the progressive stages of undernutrition, and how long does each stage typically take to develop?  \n2. How does the gradual progression of undernutrition impact the body's ability to absorb essential vitamins and minerals?  \n3. What are the early warning signs of undernutrition before it reaches advanced stages?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6eb389c5-6ccd-4d7b-b860-1c02d88c49ec
encoding: FLOAT32
metadata:
{"original_content": "First, nutrient levels in blood and tissues change, followed by\nintracellular changes in biochemical functions and structure.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How do changes in nutrient levels in blood and tissues contribute to the progression of nutritional disorders?  \n2. What intracellular biochemical and structural changes occur as a result of vitamin or mineral imbalances?  \n3. How can early detection of nutrient level changes in blood help prevent metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2dddfc37-ce8a-4a75-8c89-7d33adbf40d8
encoding: FLOAT32
metadata:
{"original_content": "Ultimately, symptoms and signs\nappear.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the common symptoms and signs associated with dietary deficiencies?  \n2. How do vitamin and mineral imbalances manifest in the body?  \n3. What are the early indicators of metabolic disorders linked to nutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5af2cc1e-9c5b-476b-80c6-e3f01a99d8a7
encoding: FLOAT32
metadata:
{"original_content": "Risk Factors\nUndernutrition is associated with many disorders and circumstances, including poverty and social\ndeprivation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does poverty contribute to the risk of undernutrition-related disorders?  \n2. What role does social deprivation play in the development of dietary deficiencies?  \n3. Are there specific nutritional disorders more prevalent in populations experiencing poverty?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 35281256-729d-478a-afa7-56b936bbd032
encoding: FLOAT32
metadata:
{"original_content": "Risk is also greater at certain times (ie, during infancy, early childhood, adolescence,\npregnancy, breastfeeding, and old age).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. Why are certain life stages, such as infancy and adolescence, associated with a higher risk of nutritional disorders?  \n2. How do pregnancy and breastfeeding increase the likelihood of vitamin and mineral imbalances?  \n3. What nutritional challenges are commonly faced by older adults due to age-related metabolic changes?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b6e27c91-5a2d-46b4-959c-416cd663c9ca
encoding: FLOAT32
metadata:
{"original_content": "Infancy and childhood:\n Infants and children are particularly susceptible to undernutrition because of\ntheir high demand for energy and essential nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. Why are infants and children at a higher risk of undernutrition compared to adults?  \n2. What are the specific energy and nutrient requirements for infants and children to prevent undernutrition?  \n3. How does undernutrition during infancy and childhood impact long-term health and development?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 37540360-f47f-46e2-8d6c-f6c1c39f4cf3
encoding: FLOAT32
metadata:
{"original_content": "Because vitamin K does not readily cross the\nplacenta, neonates may be deficient, so all are given a single injection of vitamin K within 1 h of birth to\nprevent hemorrhagic disease of the newborn, a life-threatening disorder (see pp.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. Why are neonates at risk of vitamin K deficiency at birth?  \n2. What is the purpose of administering a vitamin K injection to newborns?  \n3. How does vitamin K deficiency contribute to hemorrhagic disease of the newborn?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 813e03ac-4822-47f6-aa69-fca15a5e8da0
encoding: FLOAT32
metadata:
{"original_content": "46\n and\n2783\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the potential health consequences of prolonged vitamin and mineral imbalances?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What role does obesity play in the progression of nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 82c14d11-2d61-4936-8a22-48a896a10adf
encoding: FLOAT32
metadata:
{"original_content": "Infants fed only breast milk, which is typically low in vitamin D, are given supplemental vitamin D;\nthey can develop vitamin B\n12\n deficiency if the mother is a vegan.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. Why are breastfed infants at risk of vitamin D deficiency, and how can it be prevented?  \n2. How can a vegan mother's diet lead to vitamin B12 deficiency in her breastfed infant?  \n3. What are the potential health consequences of vitamin B12 deficiency in infants?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bbc74345-7da0-4cbe-80fd-51a278756b56
encoding: FLOAT32
metadata:
{"original_content": "Inadequately fed infants and children\nare at risk of protein-energy undernutrition (PEU\u2014previously called protein-energy malnutrition) and\ndeficiencies of iron, folate (folic acid), vitamins A and C, copper, and zinc.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies that inadequately fed infants and children are at risk of developing?  \n2. How does protein-energy undernutrition (PEU) affect the health of infants and children?  \n3. Which vitamins and minerals are commonly deficient in children with inadequate diets?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 71bc9f90-bdc3-42d1-8b8c-30d87e415678
encoding: FLOAT32
metadata:
{"original_content": "During adolescence, nutritional\nrequirements increase because the growth rate accelerates.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does accelerated growth during adolescence contribute to the risk of developing dietary deficiencies?  \n2. What specific vitamin and mineral imbalances are adolescents more prone to due to increased nutritional requirements?  \n3. Can inadequate nutrition during adolescence lead to long-term metabolic disorders or obesity?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 123c0651-f9ed-4d32-a06f-a9d636619f4f
encoding: FLOAT32
metadata:
{"original_content": "Anorexia nervosa (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the nutritional deficiencies commonly associated with anorexia nervosa?  \n2. How does anorexia nervosa impact the body's metabolism and energy balance?  \n3. What are the potential long-term health consequences of vitamin and mineral imbalances caused by anorexia nervosa?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: baa6f697-3ccc-4d14-ad85-f078f04c1df5
encoding: FLOAT32
metadata:
{"original_content": "1535\n) may affect\nadolescent girls in particular.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What nutritional disorders are adolescent girls particularly susceptible to?  \n2. How do dietary deficiencies impact the health of adolescent girls?  \n3. What role do vitamin and mineral imbalances play in the development of health conditions in adolescent girls?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9b4f247b-1f9d-467e-bdc8-5658aef70332
encoding: FLOAT32
metadata:
{"original_content": "Pregnancy and breastfeeding:\n Requirements for nutrients increase during pregnancy and\nbreastfeeding.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How can inadequate nutrient intake during pregnancy lead to vitamin and mineral deficiencies in both the mother and the baby?  \n2. What are the potential metabolic disorders that can arise from insufficient nutrient consumption during breastfeeding?  \n3. How does obesity in pregnant or breastfeeding women impact nutrient requirements and the risk of related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9be5406a-121b-42df-8a13-975c543fb7b3
encoding: FLOAT32
metadata:
{"original_content": "Aberrations of diet, including pica (consumption of nonnutritive substances, such as clay\nand charcoal), may occur during \npregnancy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies or imbalances associated with pica during pregnancy?  \n2. How might the consumption of nonnutritive substances like clay and charcoal impact maternal and fetal health?  \n3. What are the possible metabolic or dietary factors that contribute to the development of pica in pregnant individuals?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 02eff676-7a8d-454e-a312-748a68db236a
encoding: FLOAT32
metadata:
{"original_content": "Anemia due to iron deficiency is common, as is anemia due\nto folate deficiency, especially among women who have taken oral contraceptives.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does the use of oral contraceptives contribute to folate deficiency anemia in women?  \n2. What are the nutritional differences between anemia caused by iron deficiency and anemia caused by folate deficiency?  \n3. What dietary interventions can help prevent anemia due to iron or folate deficiency?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6cf99080-b87a-48a4-a9fe-1521971c3155
encoding: FLOAT32
metadata:
{"original_content": "Vitamin D deficiency is\ncommon during late pregnancy, predisposing the child to decreased bone mass.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does vitamin D deficiency during late pregnancy affect the bone mass of the child?  \n2. What are the potential long-term health consequences of decreased bone mass in children caused by maternal vitamin D deficiency?  \n3. What nutritional interventions can help prevent vitamin D deficiency in pregnant women?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b07b18ce-f740-4e02-b510-ca4598876baf
encoding: FLOAT32
metadata:
{"original_content": "Old age:\n Aging\u2014even when disease or dietary deficiency is absent\u2014leads to sarcopenia (progressive\nloss of lean body mass), starting after age 40 and eventually amounting to a muscle loss of about 10 kg\n(22 lb) in men and 5 kg (11 lb) in women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does aging contribute to sarcopenia and its impact on lean body mass?  \n2. What role do dietary deficiencies play in exacerbating muscle loss in older adults?  \n3. Are there specific nutritional interventions that can help mitigate sarcopenia in aging individuals?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9489b4e2-5bfb-4149-9d24-c535cf7612f7
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition contributes to sarcopenia, and sarcopenia\naccounts for many of the complications of undernutrition (eg, decreased nitrogen balance, increased\nsusceptibility to infections).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does undernutrition contribute to the development of sarcopenia?  \n2. What are the complications associated with sarcopenia caused by undernutrition?  \n3. Why does undernutrition increase susceptibility to infections?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b804869f-21bc-4f65-9547-eee0c5ff1c89
encoding: FLOAT32
metadata:
{"original_content": "Causes of sarcopenia include the following:\n\u2022 Decreased physical activity\n\u2022 Decreased food intake\n\u2022 Increased levels of cytokines (particularly interleukin-6)\n\u2022 Decreased levels of growth hormone and mechano growth factor (insulin-like growth factor-3)\n\u2022 In men, decreasing androgen levels\nAging decreases basal metabolic rate (due mainly to decreased fat-free mass), total body weight, height,\nand skeletal mass; aging increases mean body fat (as a percentage of body weight) to about 30% (from\n20%) in men and to 40% (from 27%) in women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does decreased food intake contribute to the development of sarcopenia?  \n2. What role do cytokines, such as interleukin-6, play in the progression of sarcopenia?  \n3. How does aging-related metabolic rate reduction impact body composition and the risk of sarcopenia?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6496c092-1a03-4443-b638-ba753c605898
encoding: FLOAT32
metadata:
{"original_content": "From age 20 to 80, food intake decreases, especially in men.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. How does the decrease in food intake from age 20 to 80 contribute to the risk of developing nutritional deficiencies in men?  \n2. What specific metabolic disorders might arise due to reduced food intake in aging men?  \n3. Could the decline in food intake with age lead to vitamin and mineral imbalances, and how might these imbalances affect overall health?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8f1c3e11-119d-4995-9fc0-b15875eb77b8
encoding: FLOAT32
metadata:
{"original_content": "Anorexia due to aging itself has many\ncauses, including reduced adaptive relaxation of the stomach's fundus, increased release and activity of\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2. Undernutrition\n59", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 6, "type": "text ", "chroma:document": "1. What are the physiological changes in the stomach associated with anorexia in aging individuals?  \n2. How does reduced adaptive relaxation of the stomach's fundus contribute to undernutrition in elderly populations?  \n3. What role does increased release and activity of certain factors play in the development of anorexia due to aging?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18364401-822b-4fd0-8f76-848bfa202cd4
encoding: FLOAT32
metadata:
{"original_content": "cholecystokinin (which produces satiation), and increased leptin (an anorectic hormone produced by fat\ncells).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do increased leptin levels influence appetite regulation in individuals with obesity?  \n2. What role does cholecystokinin play in the development of metabolic disorders related to overeating?  \n3. How might disruptions in leptin signaling contribute to dietary deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff9044be-79fd-4a01-b5ac-447b30ebd300
encoding: FLOAT32
metadata:
{"original_content": "Diminished taste and smell can decrease eating pleasure but usually decrease food intake only\nslightly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does diminished taste and smell impact food intake in individuals with nutritional disorders?  \n2. Can diminished taste and smell contribute to dietary deficiencies or imbalances in specific nutrients?  \n3. What role do sensory changes play in the development or management of obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8c08083e-fec8-413d-80dd-bde7c491c041
encoding: FLOAT32
metadata:
{"original_content": "Anorexia may have other causes (eg, loneliness, inability to shop or prepare meals, dementia,\nsome chronic disorders, use of certain drugs).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What chronic disorders could contribute to the development of anorexia as a nutritional disorder?  \n2. How might dementia impact an individual's ability to maintain proper nutrition and lead to anorexia?  \n3. What role do certain medications play in causing anorexia and subsequent nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a6480a3f-a369-41ff-b798-146635179397
encoding: FLOAT32
metadata:
{"original_content": "Depression is a common cause.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to the development of depression?  \n2. What role do vitamin and mineral imbalances play in mood disorders like depression?  \n3. Can metabolic disorders linked to obesity increase the risk of depression?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d2ea864c-4221-49a9-b199-55d39a711461
encoding: FLOAT32
metadata:
{"original_content": "Occasionally, anorexia\nnervosa (sometimes called anorexia tardive in the elderly), paranoia, or mania interferes with eating.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does anorexia nervosa in the elderly (anorexia tardive) impact nutritional intake and dietary deficiencies?  \n2. What are the potential nutritional consequences of paranoia or mania interfering with eating habits?  \n3. Can mental health conditions like anorexia nervosa lead to vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7d76c254-ad2e-45ff-853c-b3496056271a
encoding: FLOAT32
metadata:
{"original_content": "Dental problems limit the ability to chew and subsequently to digest foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do dental problems impact the digestion and absorption of nutrients?  \n2. What nutritional deficiencies can arise from an inability to properly chew food?  \n3. How can dietary modifications help individuals with dental problems maintain adequate nutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: be2ff2b3-c053-49c4-8b03-ba66786f2b39
encoding: FLOAT32
metadata:
{"original_content": "Swallowing difficulties (eg, due\nto strokes, other neurologic disorders, esophageal candidiasis, or xerostomia) are common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How can swallowing difficulties caused by neurologic disorders impact nutritional intake and lead to dietary deficiencies?  \n2. What are the potential risks of vitamin and mineral imbalances in individuals with xerostomia affecting their ability to consume a balanced diet?  \n3. How might esophageal candidiasis contribute to malnutrition or metabolic disorders in patients with swallowing difficulties?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: de9d0214-e8c7-4854-a656-595882fbb9fb
encoding: FLOAT32
metadata:
{"original_content": "Poverty or\nfunctional impairment limits access to nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does poverty contribute to dietary deficiencies and related health conditions?  \n2. What are the potential impacts of functional impairments on nutrient absorption and metabolism?  \n3. How can limited access to nutrients due to socioeconomic factors lead to vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e5da9f7d-7cc6-4ebe-b7ac-bab20c90bc2c
encoding: FLOAT32
metadata:
{"original_content": "The institutionalized elderly are at particular risk of PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What factors contribute to Protein-Energy Undernutrition (PEU) in institutionalized elderly populations?  \n2. How does PEU impact the overall health and metabolic functions of the elderly in care facilities?  \n3. What dietary interventions can help prevent or manage PEU in institutionalized elderly individuals?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b5a132bc-a2f0-4319-a167-ec3ad92429e5
encoding: FLOAT32
metadata:
{"original_content": "They are often confused and may be unable to\nexpress hunger or preferences for foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How can confusion and difficulty expressing hunger be linked to specific nutritional deficiencies or metabolic disorders?  \n2. What dietary strategies can help individuals who struggle to communicate their food preferences due to a nutritional disorder?  \n3. Are there specific vitamin or mineral imbalances that contribute to cognitive symptoms like confusion in individuals with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9f1ea68e-4259-40ca-956c-d3705ad65eb5
encoding: FLOAT32
metadata:
{"original_content": "They may be physically unable to feed themselves.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What nutritional disorders could lead to physical inability to feed oneself?  \n2. How might severe vitamin or mineral deficiencies impact motor skills required for self-feeding?  \n3. Are there metabolic disorders that impair physical coordination or strength, making self-feeding difficult?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e1342633-faf1-4a8b-9902-80cd5b0b0843
encoding: FLOAT32
metadata:
{"original_content": "Chewing or\nswallowing may be very slow, making it tedious for another person to feed them enough food.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How can slow chewing or swallowing impact the nutritional intake of individuals with dietary deficiencies?  \n2. What strategies can caregivers use to ensure adequate nutrition for individuals with metabolic disorders who experience slow swallowing?  \n3. Could slow chewing or swallowing contribute to vitamin and mineral imbalances in individuals with related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2d84f6c4-085d-4ab3-a5db-88809925c6b1
encoding: FLOAT32
metadata:
{"original_content": "In the elderly, particularly the institutionalized elderly, inadequate intake and often decreased absorption\nor synthesis of vitamin D, increased demand for vitamin D, and inadequate exposure to sunshine\ncontribute to osteomalacia (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What factors contribute to vitamin D deficiency in institutionalized elderly individuals?  \n2. How does inadequate vitamin D intake and absorption lead to osteomalacia in the elderly?  \n3. Why is sunshine exposure important for preventing vitamin D-related nutritional disorders in older adults?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18b7ddd7-4205-4c20-b286-7bc6abec3370
encoding: FLOAT32
metadata:
{"original_content": "41\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific vitamins and minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f7a40cc5-6db4-4298-a95b-d5111a0de5c9
encoding: FLOAT32
metadata:
{"original_content": "Disorders and medical procedures:\n Diabetes, some chronic disorders that affect the GI tract, intestinal\nresection, and certain other GI surgical procedures tend to impair absorption of fat-soluble vitamins,\nvitamin B\n12\n, Ca, and iron.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does intestinal resection impact the absorption of fat-soluble vitamins and minerals like calcium and iron?  \n2. What nutritional deficiencies are commonly associated with chronic gastrointestinal disorders?  \n3. Why might vitamin B12 absorption be impaired after certain GI surgical procedures?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 81688b94-d891-409f-a3e3-359adf4c4ce2
encoding: FLOAT32
metadata:
{"original_content": "Gluten enteropathy, pancreatic insufficiency, or other disorders can result in\nmalabsorption.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does gluten enteropathy contribute to malabsorption of nutrients?  \n2. What role does pancreatic insufficiency play in the development of dietary deficiencies?  \n3. Which metabolic disorders are commonly associated with malabsorption issues?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48773bd2-e766-42d3-bc1b-e849d360a298
encoding: FLOAT32
metadata:
{"original_content": "Decreased absorption possibly contributes to iron deficiency and osteoporosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does decreased absorption of nutrients contribute to the development of iron deficiency?  \n2. What is the relationship between impaired nutrient absorption and the risk of osteoporosis?  \n3. Which dietary or metabolic factors might exacerbate decreased absorption leading to mineral imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 551d02ad-f572-4d94-9216-d30e96fdbb47
encoding: FLOAT32
metadata:
{"original_content": "Liver\ndisorders impair storage of vitamins A and B\n12\n and interfere with metabolism of protein and energy\nsources.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do liver disorders affect the storage of vitamins A and B12 in the body?  \n2. What impact do liver disorders have on protein metabolism and energy utilization?  \n3. Can impaired vitamin storage due to liver disorders lead to specific nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6c21752b-dd4a-4ade-9957-351482d15e66
encoding: FLOAT32
metadata:
{"original_content": "Renal insufficiency predisposes to protein, iron, and vitamin D deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does renal insufficiency contribute to protein deficiency in the body?  \n2. What is the relationship between renal insufficiency and iron deficiency?  \n3. Why are individuals with renal insufficiency at risk for vitamin D deficiency?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 565c666d-bff2-4ccb-8b4c-189cda6c8e5a
encoding: FLOAT32
metadata:
{"original_content": "Anorexia causes\nsome patients with cancer or depression and many with AIDS to consume inadequate amounts of food.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does anorexia contribute to inadequate food consumption in patients with cancer or depression?  \n2. What is the relationship between AIDS and anorexia in terms of nutritional deficiencies?  \n3. Why might anorexia lead to dietary imbalances in individuals with chronic illnesses?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2694581f-0ac5-4146-9f48-51a84fc5014a
encoding: FLOAT32
metadata:
{"original_content": "Infections, trauma, hyperthyroidism, extensive burns, and prolonged fever increase metabolic demands.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do prolonged fevers impact the nutritional needs of individuals with metabolic disorders?  \n2. What dietary adjustments are necessary for patients with hyperthyroidism to meet increased metabolic demands?  \n3. How can extensive burns lead to nutritional deficiencies or imbalances in the body?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: eb86aeb5-eb5b-4e2d-bdfb-11d14fc8a00d
encoding: FLOAT32
metadata:
{"original_content": "Any condition that increases cytokines may be accompanied by muscle loss, lipolysis, low albumin levels,\nand anorexia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do elevated cytokine levels contribute to muscle loss in individuals with nutritional disorders?  \n2. What is the relationship between cytokine activity and low albumin levels in metabolic disorders?  \n3. Can cytokine-induced anorexia exacerbate vitamin and mineral deficiencies in patients with chronic illnesses?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5cf6cbe-c7a6-441f-9721-e363b7a231da
encoding: FLOAT32
metadata:
{"original_content": "Vegetarian diets:\n Iron deficiency can occur in ovo-lacto vegetarians (although such a diet can be\ncompatible with good health).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does an ovo-lacto vegetarian diet contribute to the risk of iron deficiency?  \n2. What nutritional strategies can ovo-lacto vegetarians use to prevent iron deficiency?  \n3. Are there specific health conditions associated with iron deficiency in ovo-lacto vegetarians?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 75c78d9e-1fb9-422d-a7ef-f72b383e8888
encoding: FLOAT32
metadata:
{"original_content": "Vegans may develop vitamin B\n12\n deficiency unless they consume yeast\nextracts or Asian-style fermented foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What dietary sources can vegans rely on to prevent vitamin B12 deficiency?  \n2. How does the lack of vitamin B12 in a vegan diet contribute to nutritional disorders?  \n3. Are yeast extracts and Asian-style fermented foods effective in addressing vitamin B12 deficiency in vegans?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9409b17c-c2ad-4087-8ca1-8961dcb07f26
encoding: FLOAT32
metadata:
{"original_content": "Their intake of Ca, iron, and zinc also tends to be low.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does a low intake of calcium, iron, and zinc contribute to the development of nutritional deficiencies?  \n2. What are the potential health consequences of prolonged deficiencies in calcium, iron, and zinc?  \n3. Which dietary strategies can help address low levels of calcium, iron, and zinc in individuals with nutritional disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 16e0c594-8702-4683-a24a-97535145caef
encoding: FLOAT32
metadata:
{"original_content": "A fruit-only\ndiet is not recommended because it is deficient in protein, Na, and many micronutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What nutritional deficiencies can arise from following a fruit-only diet?  \n2. How does a lack of sodium (Na) in the diet affect metabolic health?  \n3. What are the potential health risks associated with a diet deficient in protein and micronutrients?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8579bc84-ce68-4d9e-be8e-eb31ad34b920
encoding: FLOAT32
metadata:
{"original_content": "Fad diets:\n Some fad diets result in vitamin, mineral, and protein deficiencies; cardiac, renal, and\nmetabolic disorders; and sometimes death.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies caused by fad diets?  \n2. How can fad diets contribute to the development of metabolic disorders?  \n3. What are the possible health risks, including cardiac and renal issues, associated with fad diets?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b1509598-1f7e-4802-b413-a722459fa797
encoding: FLOAT32
metadata:
{"original_content": "Very low calorie diets (< 400 kcal/day) cannot sustain health\nfor long.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the potential health risks associated with following a very low-calorie diet of less than 400 kcal/day?  \n2. How might a diet providing fewer than 400 kcal/day contribute to nutritional deficiencies or metabolic disorders?  \n3. Can prolonged adherence to a very low-calorie diet lead to vitamin and mineral imbalances, and if so, how?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 743d604c-6104-4033-883b-e6e7355c17c1
encoding: FLOAT32
metadata:
{"original_content": "Drugs and nutritional supplements:\n Many drugs (eg, appetite suppressants, digoxin) decrease\nappetite; others impair nutrient absorption or metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do appetite suppressants contribute to nutritional deficiencies?  \n2. What impact does digoxin have on nutrient absorption and metabolism?  \n3. Can certain medications exacerbate vitamin and mineral imbalances in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e11af219-ed48-4d0b-bcd4-47ea1d683f7f
encoding: FLOAT32
metadata:
{"original_content": "Some drugs (eg, stimulants) have catabolic\neffects.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do stimulant drugs with catabolic effects influence metabolic disorders?  \n2. Can the catabolic effects of certain drugs contribute to vitamin and mineral imbalances?  \n3. What role do stimulant drugs play in the development or exacerbation of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a0c1a9f5-4ed5-4448-a55f-0bbe6eb7d318
encoding: FLOAT32
metadata:
{"original_content": "Certain drugs can impair absorption of many nutrients; eg, anticonvulsants can impair absorption\nof vitamins.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do anticonvulsant medications affect the absorption of specific vitamins and contribute to nutritional deficiencies?  \n2. What are the potential health consequences of impaired nutrient absorption caused by certain drugs?  \n3. Which vitamins are most commonly affected by the use of anticonvulsant medications, and how can these deficiencies be managed?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c781e3c-2d8d-4d43-9d22-a964be57a03b
encoding: FLOAT32
metadata:
{"original_content": "Alcohol or drug dependency:\n Patients with alcohol or drug dependency may neglect their nutritional\nneeds.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does alcohol or drug dependency contribute to nutritional deficiencies in patients?  \n2. What specific dietary deficiencies are commonly observed in individuals with alcohol or drug dependency?  \n3. Can alcohol or drug dependency lead to vitamin and mineral imbalances, and if so, which ones are most affected?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2ed373a3-001b-4d3d-aad9-7dbd0f3a43d8
encoding: FLOAT32
metadata:
{"original_content": "Absorption and metabolism of nutrients may also be impaired.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How do nutrient absorption impairments contribute to vitamin and mineral deficiencies in the body?  \n2. What metabolic disorders are commonly associated with impaired nutrient metabolism?  \n3. How can impaired nutrient absorption affect the management of obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0e98ded0-ba84-426f-b9d2-3f2cf73a3f6f
encoding: FLOAT32
metadata:
{"original_content": "IV drug addicts typically become\nundernourished, as do\n[\nTable 2-1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does intravenous drug use contribute to undernutrition and related metabolic disorders?  \n2. What specific vitamin and mineral deficiencies are commonly observed in IV drug addicts?  \n3. What are the potential long-term health consequences of dietary deficiencies in individuals with substance abuse disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a53339a1-a75b-4b45-81a1-5eefaff55bc7
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs of Nutritional Deficiency]\nalcoholics who consume \u2265 1 quart of hard liquor/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the specific nutritional deficiencies commonly observed in individuals who consume \u2265 1 quart of hard liquor per day?  \n2. How does excessive alcohol consumption contribute to vitamin and mineral imbalances in the body?  \n3. What are the metabolic disorders associated with chronic alcohol abuse and poor dietary intake?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8afaf051-3111-4db5-b854-d8c6dd2e2005
encoding: FLOAT32
metadata:
{"original_content": "Alcoholism can cause deficiencies of Mg, zinc, and\ncertain vitamins, including thiamin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. How does alcoholism contribute to magnesium and zinc deficiencies?  \n2. What role does thiamin deficiency play in the health complications associated with alcoholism?  \n3. Which nutritional disorders are commonly linked to chronic alcohol consumption?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a05dc194-7c59-4072-8010-7fe0fd5713fd
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nSymptoms vary depending on the cause and type of undernutrition (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the specific symptoms associated with different types of undernutrition?  \n2. How do the signs of undernutrition vary based on its underlying cause?  \n3. What are the common indicators of vitamin and mineral imbalances in the body?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8b4d5862-d9e8-4768-ae46-793ac0e900c6
encoding: FLOAT32
metadata:
{"original_content": "15\n and \nChs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f77a716c-1bef-4ca1-ab4f-84e8bc6e436c
encoding: FLOAT32
metadata:
{"original_content": "4\n and \n5\n). Evaluation\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the diagnostic criteria for identifying vitamin and mineral imbalances in patients?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the recommended therapeutic approaches for managing obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6521280e-6be2-4a2e-bb48-eefab57bafd5
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n60", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 7, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1f4a6c6e-2a83-4b6a-8d62-ded2abec39c8
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is based on results of medical and diet histories, physical examination, body composition\nanalysis (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can body composition analysis aid in diagnosing obesity or related metabolic disorders?  \n2. What role does a patient's diet history play in identifying potential vitamin or mineral deficiencies?  \n3. How can physical examination findings contribute to the diagnosis of nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 26c28470-ffcd-4984-bb58-211faa584301
encoding: FLOAT32
metadata:
{"original_content": "58\n), and selected laboratory tests.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What laboratory tests are commonly used to diagnose vitamin and mineral imbalances?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors associated with the onset of obesity?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 28e93fb0-d908-428e-99a5-384c13abd194
encoding: FLOAT32
metadata:
{"original_content": "History:\n History should include questions about dietary intake (see\nFig.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What specific dietary deficiencies could contribute to the development of a nutritional disorder in a patient?  \n2. How can a history of dietary intake help identify potential vitamin or mineral imbalances?  \n3. What role does dietary history play in diagnosing obesity or related metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 798e7807-c234-4e1b-ae01-a28847ca67b2
encoding: FLOAT32
metadata:
{"original_content": "2-1\n), recent changes in weight, and risk factors for undernutrition, including drug and alcohol use.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How do recent changes in weight contribute to the risk of undernutrition?  \n2. What role do drug and alcohol use play in the development of nutritional disorders?  \n3. What are the risk factors associated with undernutrition in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a98600c0-df82-4625-ac7f-4edcf6c17157
encoding: FLOAT32
metadata:
{"original_content": "Unintentional loss of \u2265 10% of usual body weight during a 3-mo period indicates a high probability of\nundernutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What percentage of body weight loss over a 3-month period is considered a strong indicator of undernutrition?  \n2. How is unintentional weight loss linked to the diagnosis of nutritional disorders?  \n3. What are the clinical thresholds for identifying undernutrition based on body weight changes?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9a841c48-c5b1-4246-87d2-e84abeeba01b
encoding: FLOAT32
metadata:
{"original_content": "Social history should include questions about whether money is available for food and\nwhether the patient can shop and cook.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How might financial constraints impact a patient's ability to maintain a nutritionally balanced diet and prevent dietary deficiencies?  \n2. Could a patient's inability to shop or cook contribute to the development of obesity or other metabolic disorders?  \n3. What role does access to food and cooking resources play in preventing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b5c2320b-c40d-443c-86b5-a0da10844a42
encoding: FLOAT32
metadata:
{"original_content": "Review of systems should focus on symptoms of nutritional deficiencies (see \nTable 2-1\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What symptoms might indicate a deficiency in specific vitamins or minerals?  \n2. How can a review of systems help identify potential nutritional deficiencies?  \n3. What are the common clinical signs associated with metabolic disorders linked to poor nutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 04d1c71c-a1ac-40e5-9339-9d95d638cd5f
encoding: FLOAT32
metadata:
{"original_content": "For example,\nimpaired night vision may indicate vitamin A deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What dietary deficiencies could lead to impaired night vision?  \n2. How does a lack of specific vitamins or minerals contribute to metabolic disorders?  \n3. What are the nutritional causes and health risks associated with obesity?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 739a5c1d-177c-4916-ab9b-04a9f8d651cd
encoding: FLOAT32
metadata:
{"original_content": "Physical examination:\n Physical examination should include measurement of height and weight,\ninspection of body fat distribution, and anthropometric measurements of lean body mass.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can body fat distribution patterns help identify potential nutritional or metabolic disorders?  \n2. What role do anthropometric measurements play in diagnosing vitamin or mineral deficiencies?  \n3. How can changes in lean body mass indicate the presence of dietary imbalances or obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3086a577-871f-4e1f-9aa6-fac0e46e5e2a
encoding: FLOAT32
metadata:
{"original_content": "Body mass\nindex (BMI = weight(kg)/height(m)\n2\n) adjusts weight for height (see\nTable 6-2\n on p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can BMI be used to assess the risk of obesity-related health conditions?  \n2. What role does BMI play in identifying potential nutritional or metabolic disorders?  \n3. How does BMI help in evaluating the impact of dietary deficiencies on body weight and height?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ef5bf7a-52da-4982-b1bf-30fb9dc92f8c
encoding: FLOAT32
metadata:
{"original_content": "59\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5ccd8958-893f-4e11-b74d-96146bf49c08
encoding: FLOAT32
metadata:
{"original_content": "If weight is < 80% of what is predicted for the patient's height or if BMI is \u2264 18,\nundernutrition should be suspected.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can undernutrition be identified based on a patient's weight and height?  \n2. What BMI threshold indicates a suspicion of undernutrition?  \n3. What are the clinical criteria for diagnosing undernutrition in patients?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b1d08cb0-5601-48de-88d5-30f58acf9140
encoding: FLOAT32
metadata:
{"original_content": "Although these findings are useful in diagnosing undernutrition and\nare acceptably sensitive, they lack specificity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the sensitivity of diagnostic methods for undernutrition be balanced with their specificity?  \n2. What are the limitations of current diagnostic tools in distinguishing undernutrition from other nutritional disorders?  \n3. Why is specificity important in diagnosing dietary deficiencies and metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f246c0c7-90fa-435f-aad2-3dc7daf7b75f
encoding: FLOAT32
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{"original_content": "[\nFig.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and how can they be managed nutritionally?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6e52fc65-19ae-4cbd-b50c-b93c220d57d0
encoding: FLOAT32
metadata:
{"original_content": "2-1. Mini nutritional assessment.]\nThe mid upper arm muscle area estimates lean body mass.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the mid-upper arm muscle area measurement help assess lean body mass in individuals with malnutrition?  \n2. What role does the Mini Nutritional Assessment play in identifying dietary deficiencies in older adults?  \n3. How can lean body mass estimation aid in diagnosing metabolic disorders related to muscle wasting?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 178cc20e-769d-49ed-9019-552b97c4a9bf
encoding: FLOAT32
metadata:
{"original_content": "This area is derived from the triceps skinfold\nthickness (TSF) and mid upper arm circumference.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can triceps skinfold thickness and mid-upper arm circumference measurements help assess malnutrition in individuals?  \n2. What role do anthropometric measurements play in diagnosing obesity or undernutrition?  \n3. How can mid-upper arm circumference be used to evaluate muscle wasting in cases of protein-energy malnutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0b4cfb6f-99fc-45af-bf1b-d1761cd54b47
encoding: FLOAT32
metadata:
{"original_content": "Both are measured at the same site, with the patient's\nright arm in a relaxed position.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can arm measurements be used to assess nutritional deficiencies or imbalances?  \n2. What role does body composition analysis play in diagnosing obesity-related health conditions?  \n3. How might relaxed arm measurements help identify metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 66dfafe5-0357-4a4c-b00e-7ad0f8d7c6f3
encoding: FLOAT32
metadata:
{"original_content": "The average mid upper arm circumference is about 32 \u00b1 5 cm for men and\n28 \u00b1 6 cm for women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can mid-upper arm circumference measurements help identify malnutrition in men and women?  \n2. What role does mid-upper arm circumference play in assessing muscle wasting due to dietary deficiencies?  \n3. Can deviations from the average mid-upper arm circumference indicate risks of obesity or undernutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b68c42c7-a958-425e-a30a-a2de80191d4b
encoding: FLOAT32
metadata:
{"original_content": "The formula for calculating the mid upper arm muscle area in cm\n2\n is as follows:\nThis formula corrects the upper arm area for fat and bone.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the mid upper arm muscle area be used to assess muscle wasting in individuals with malnutrition?  \n2. What role does the mid upper arm muscle area play in diagnosing protein-energy malnutrition?  \n3. How can the mid upper arm muscle area help differentiate between fat loss and muscle loss in cases of severe dietary deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cd3df330-ef64-4a80-b097-2bdd74290f27
encoding: FLOAT32
metadata:
{"original_content": "Average values for the mid upper arm muscle\narea are 54 \u00b1 11 cm\n2\n for men and 30 \u00b1 7 cm\n2\n for women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can deviations from the average mid-upper arm muscle area indicate potential malnutrition or muscle wasting in men and women?  \n2. What role does mid-upper arm muscle area play in diagnosing protein-energy malnutrition in individuals?  \n3. Can differences in mid-upper arm muscle area between men and women be linked to specific dietary deficiencies or metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 527e4cbf-52d1-40b6-8a6d-af3b2d6dfc6e
encoding: FLOAT32
metadata:
{"original_content": "A value < 75% of this standard (depending on\nage) indicates depletion of lean body mass (see\nTable 2-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How is lean body mass depletion quantified in relation to age-specific standards?  \n2. What are the implications of having a lean body mass value below 75% of the standard?  \n3. How does lean body mass depletion relate to specific nutritional or metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c6152ca7-841a-4be1-a33b-e12a84dad413
encoding: FLOAT32
metadata:
{"original_content": "This measurement may be affected by physical activity, genetic factors, and age-related\nmuscle loss.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How does age-related muscle loss influence the measurement of metabolic rates in individuals with obesity?  \n2. What role do genetic factors play in the development of dietary deficiencies related to muscle mass?  \n3. Can physical activity mitigate the effects of muscle loss on nutritional and metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8457565e-5167-4ae9-a320-8ccf1397df2c
encoding: FLOAT32
metadata:
{"original_content": "Physical examination should focus on signs of specific nutritional deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What physical signs can indicate a deficiency in specific vitamins or minerals?  \n2. How can a physical examination help identify potential dietary deficiencies?  \n3. What observable symptoms might suggest a metabolic disorder related to nutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 025acdff-57a6-47bc-9bb4-dffceaeebac1
encoding: FLOAT32
metadata:
{"original_content": "Signs of PEU (eg, edema,\nmuscle wasting, skin changes) should be sought.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the physical signs that indicate protein-energy undernutrition (PEU)?  \n2. How can edema be linked to nutritional deficiencies or metabolic disorders?  \n3. What skin changes might suggest the presence of a dietary deficiency or malnutrition?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6ba978b6-1cff-4645-b6cd-cf96a4f3d5b4
encoding: FLOAT32
metadata:
{"original_content": "Examination should also focus on signs of conditions\nthat could predispose to nutritional deficiencies, such as dental problems.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can dental problems contribute to the risk of developing nutritional deficiencies?  \n2. What are the signs of conditions that predispose individuals to dietary deficiencies?  \n3. What role do oral health issues play in the diagnosis of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5f34367f-466a-42ca-89d8-99624a815b89
encoding: FLOAT32
metadata:
{"original_content": "Mental status should be\nassessed, because depression and cognitive impairment can lead to weight loss.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can depression contribute to unintentional weight loss in individuals with nutritional disorders?  \n2. What role does cognitive impairment play in the development of dietary deficiencies or malnutrition?  \n3. Why is assessing mental status important in diagnosing and managing weight loss related to metabolic disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a1fe39d7-0c71-48a1-a0ca-ff8b8b8f67ef
encoding: FLOAT32
metadata:
{"original_content": "The widely used Subjective Global Assessment (SGA) uses information from the patient history (eg,\nweight loss, change in intake, GI symptoms), physical examination findings (eg, loss of muscle and\nsubcutaneous fat, edema, ascites), and the clinician's judgment of the patient's nutritional status.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the Subjective Global Assessment (SGA) be used to identify malnutrition in patients with significant weight loss and dietary changes?  \n2. What physical examination findings are indicative of muscle and fat loss in patients with suspected nutritional deficiencies?  \n3. How does the presence of edema or ascites contribute to the assessment of a patient's overall nutritional status?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1a3d8356-e176-4839-a402-08ec2f0c2c27
encoding: FLOAT32
metadata:
{"original_content": "The\nMini Nutritional Assessment (MNA) has been validated and is widely used, especially for elderly patients\n(see \nFig.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the Mini Nutritional Assessment (MNA) be utilized to identify malnutrition in elderly patients?  \n2. What role does the MNA play in detecting vitamin and mineral deficiencies in older adults?  \n3. How effective is the MNA in assessing the risk of obesity-related health conditions in elderly populations?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 790b5726-8dea-4c69-a1af-c85fe8caec5f
encoding: FLOAT32
metadata:
{"original_content": "2-1\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 77457362-37fa-46a3-8cf6-74e4abce6318
encoding: FLOAT32
metadata:
{"original_content": "The Simplified Nutrition Assessment Questionnaire (SNAQ), a simple, validated method of\npredicting future weight loss, may be used (see\nFig.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can the Simplified Nutrition Assessment Questionnaire (SNAQ) be used to predict future weight loss in individuals with nutritional disorders?  \n2. What role does the SNAQ play in identifying risks associated with dietary deficiencies or malnutrition?  \n3. Can the SNAQ help in early detection of obesity-related health conditions through weight loss prediction?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7c52709b-28b4-43dc-966e-5c2a8b721f5d
encoding: FLOAT32
metadata:
{"original_content": "2-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5e8f2053-8a7b-4521-813c-e40077de846d
encoding: FLOAT32
metadata:
{"original_content": "Testing:\n The extent of laboratory testing needed is unclear and may depend on the patient's\ncircumstances.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can a patient's specific circumstances influence the extent of laboratory testing required for diagnosing a nutritional disorder?  \n2. What factors determine the necessity of laboratory tests for identifying vitamin and mineral imbalances?  \n3. In what situations might extensive testing be warranted for metabolic disorders related to dietary deficiencies?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f12bf1b3-681d-4f14-b5de-98b186c4cf58
encoding: FLOAT32
metadata:
{"original_content": "If the cause is obvious and correctable (eg, a wilderness survival situation), testing is\nprobably of little benefit.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies that could arise in a wilderness survival situation?  \n2. How can obvious and correctable causes of dietary deficiencies be identified and addressed?  \n3. When is it unnecessary to conduct extensive testing for nutritional disorders?  "}


created_at: 2025-03-03 11:15:17
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 57fe4b6f-5170-465c-abdb-d93763b4eb2e
encoding: FLOAT32
metadata:
{"original_content": "Other patients may require more detailed evaluation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What additional evaluations are necessary for diagnosing specific vitamin and mineral imbalances?  \n2. How can detailed assessments help in identifying underlying causes of metabolic disorders?  \n3. What role does comprehensive evaluation play in managing severe cases of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 149b7684-20a5-4cd2-b6d3-1044579df6e8
encoding: FLOAT32
metadata:
{"original_content": "Serum albumin measurement is the laboratory test most often used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How is serum albumin measurement used to assess protein-energy malnutrition?  \n2. What role does serum albumin play in diagnosing nutritional deficiencies or imbalances?  \n3. Can serum albumin levels indicate the severity of a metabolic disorder related to nutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dc85c8d2-fc39-4206-bab2-d4b722252404
encoding: FLOAT32
metadata:
{"original_content": "Decreases in albumin and other\nproteins (eg, prealbumin [transthyretin], transferrin, retinol-binding protein) may indicate protein deficiency\nor PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can decreases in albumin levels be used to identify protein-energy undernutrition (PEU)?  \n2. What role do prealbumin and transferrin play in diagnosing protein deficiency?  \n3. Can retinol-binding protein levels indicate dietary protein insufficiency?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d202fcdf-90e8-4257-b281-324c7a624e90
encoding: FLOAT32
metadata:
{"original_content": "As undernutrition progresses, albumin decreases slowly; prealbumin, transferrin, and retinol-\nbinding protein decrease rapidly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How do levels of prealbumin, transferrin, and retinol-binding protein change in the early stages of undernutrition?  \n2. Why does albumin decrease more slowly compared to other proteins during undernutrition?  \n3. What biomarkers can be used to assess the progression of undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 33f6f166-9602-4eb0-8d26-4df34aa6b377
encoding: FLOAT32
metadata:
{"original_content": "Albumin measurement is inexpensive and predicts morbidity and\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. How can albumin levels be used to predict morbidity in patients with nutritional disorders?  \n2. What is the role of albumin measurement in diagnosing protein-energy malnutrition?  \n3. How does hypoalbuminemia relate to dietary deficiencies and metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff4948ef-d2f2-4062-9c3a-cd003a13c092
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n61", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 8, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ee9c1af3-8405-41df-875b-f20059ab28fb
encoding: FLOAT32
metadata:
{"original_content": "mortality better than measurement of the other proteins.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does the measurement of specific proteins correlate with mortality rates in individuals with nutritional disorders?  \n2. What role do protein levels play in assessing the severity of dietary deficiencies or metabolic disorders?  \n3. Can protein biomarkers be used to predict outcomes in patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 320cdb02-68d0-4029-935b-97e34f01c306
encoding: FLOAT32
metadata:
{"original_content": "However, the correlation of albumin with\nmorbidity and mortality may be related to nonnutritional as well as nutritional factors.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does albumin level correlate with nutritional deficiencies in patients with chronic illnesses?  \n2. Can low albumin levels be used as an indicator of dietary protein insufficiency in malnourished individuals?  \n3. What role do nonnutritional factors play in the relationship between albumin levels and mortality in metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0c172a9e-696e-431d-ad63-c1eadf69003a
encoding: FLOAT32
metadata:
{"original_content": "Inflammation\nproduces cytokines that cause albumin and other nutritional protein markers to extravasate, decreasing\nserum levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does inflammation affect serum levels of albumin and other nutritional protein markers?  \n2. What role do cytokines play in the extravasation of nutritional protein markers during inflammation?  \n3. How might decreased serum levels of albumin impact the diagnosis of nutritional disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fd80bbb4-c519-4e11-b08d-9b3b4d5ab740
encoding: FLOAT32
metadata:
{"original_content": "Because prealbumin, transferrin, and retinol-binding protein decrease more rapidly during\nstarvation than does albumin, their measurements are sometimes used to diagnose or assess the severity\nof acute starvation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can prealbumin levels be used to assess the severity of acute starvation?  \n2. What is the role of retinol-binding protein in diagnosing nutritional deficiencies?  \n3. Why do transferrin levels decrease more rapidly than albumin during starvation?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3b7e223a-15d9-414a-b68a-6d526043dd6e
encoding: FLOAT32
metadata:
{"original_content": "However, whether they are more sensitive or specific than albumin is unclear.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does the sensitivity and specificity of alternative biomarkers compare to albumin in diagnosing nutritional disorders?  \n2. What role does albumin play in identifying dietary deficiencies or metabolic imbalances?  \n3. Are there specific nutritional conditions where albumin is less effective as a diagnostic marker compared to other indicators?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b33486fd-a392-4048-b468-3724c20677ab
encoding: FLOAT32
metadata:
{"original_content": "Total lymphocyte count, which often decreases as undernutrition progresses, may be determined.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does undernutrition affect total lymphocyte count in the body?  \n2. Can total lymphocyte count be used as an indicator to assess the severity of undernutrition?  \n3. What role does total lymphocyte count play in diagnosing nutritional deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 414525a0-4c32-417d-95a9-fa1055771698
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition causes a marked decline in CD4+ T lymphocytes, so this count may not be useful in\npatients who have AIDS.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does undernutrition impact CD4+ T lymphocyte levels in individuals with AIDS?  \n2. Why might CD4+ T lymphocyte counts be unreliable as a diagnostic tool in undernourished AIDS patients?  \n3. What is the relationship between nutritional deficiencies and immune system function in the context of AIDS?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 613b0c2e-5ddf-44e4-b303-6fcd493a657c
encoding: FLOAT32
metadata:
{"original_content": "Skin tests using antigens can detect impaired cell-mediated immunity in PEU and in some other disorders\nof undernutrition (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can skin tests using antigens help identify impaired cell-mediated immunity in protein-energy undernutrition (PEU)?  \n2. What role does cell-mediated immunity play in the diagnosis of undernutrition-related disorders?  \n3. Are there other nutritional or metabolic disorders, besides PEU, where antigen-based skin tests are effective diagnostic tools?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c61271e0-006b-4f38-88fa-3477deb6466b
encoding: FLOAT32
metadata:
{"original_content": "1098\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How can dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d84adec8-51c7-43f9-9ed2-aec368493da9
encoding: FLOAT32
metadata:
{"original_content": "Other laboratory tests, such as measuring vitamin and mineral levels, are used selectively to diagnose\nspecific deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can laboratory tests help identify specific vitamin deficiencies in individuals with suspected nutritional disorders?  \n2. What role do mineral level measurements play in diagnosing dietary deficiencies?  \n3. Which laboratory tests are most commonly used to detect imbalances in vitamins and minerals related to metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5e676ba7-25d4-4645-a8b0-a103eda96d56
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 2-2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors associated with the onset and progression of obesity?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e0994ff0-782d-4e1f-b38d-9011d1d70493
encoding: FLOAT32
metadata:
{"original_content": "Mid Upper Arm Muscle Area in Adults]\n[\nFigure 2-2. Simplified Nutrition Assessment Questionnaire (SNAQ).]\nProtein-Energy Undernutrition\nProtein-energy undernutrition (PEU), previously called protein-energy malnutrition, is an energy\ndeficit due to chronic deficiency of all macronutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can the Mid Upper Arm Muscle Area measurement be used to assess protein-energy undernutrition in adults?  \n2. What role does the Simplified Nutrition Assessment Questionnaire (SNAQ) play in identifying chronic macronutrient deficiencies?  \n3. What are the clinical indicators of protein-energy undernutrition in adults?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ead6e8af-7c91-4518-a498-ad895efb35f5
encoding: FLOAT32
metadata:
{"original_content": "It commonly includes deficiencies of\nmany micronutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the common micronutrient deficiencies associated with specific nutritional disorders?  \n2. How do deficiencies in multiple micronutrients contribute to the development of metabolic disorders?  \n3. What health conditions can arise from prolonged dietary deficiencies of essential vitamins and minerals?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2bd767dd-c712-43d0-9491-ab4018ede11c
encoding: FLOAT32
metadata:
{"original_content": "PEU can be sudden and total (starvation) or gradual.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the differences between sudden and gradual forms of Protein-Energy Undernutrition (PEU)?  \n2. How does starvation as a form of PEU impact the body compared to gradual nutritional deficiencies?  \n3. What are the potential health consequences of total starvation as a nutritional disorder?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8c80c48e-02f2-40e5-b8ae-bf0d9df629c6
encoding: FLOAT32
metadata:
{"original_content": "Severity ranges from\nsubclinical deficiencies to obvious wasting (with edema, hair loss, and skin atrophy) to\nstarvation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the physical manifestations of severe nutritional deficiencies, such as wasting and edema?  \n2. How does hair loss and skin atrophy relate to dietary deficiencies or malnutrition?  \n3. What are the progressive stages of severity in nutritional disorders, from subclinical deficiencies to starvation?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c8264268-025b-420f-b5d5-f3abca064e4e
encoding: FLOAT32
metadata:
{"original_content": "Multiple organ systems are often impaired.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can a severe vitamin or mineral deficiency lead to the impairment of multiple organ systems?  \n2. What metabolic disorders are most likely to cause widespread organ dysfunction?  \n3. How does obesity contribute to the simultaneous failure of multiple organ systems?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9d9c1ec-8cce-4996-90dc-671aaf6429a2
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis usually involves laboratory\ntesting, including serum albumin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How is serum albumin used to diagnose nutritional deficiencies?  \n2. What role does serum albumin play in identifying protein-energy malnutrition?  \n3. Can low serum albumin levels indicate a specific type of metabolic disorder?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c309ea8-dca5-4b2a-ab71-0837ad669d2e
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of correcting fluid and electrolyte deficits\nwith IV solutions, then gradually replenishing nutrients, orally if possible.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can fluid and electrolyte imbalances be corrected in patients with severe nutritional disorders?  \n2. What is the recommended approach for reintroducing nutrients in individuals recovering from malnutrition?  \n3. Why is oral nutrient replenishment preferred after initial IV treatment in cases of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6f877452-f2c4-472b-8e91-c65931294f96
encoding: FLOAT32
metadata:
{"original_content": "In developed countries, PEU is common among the institutionalized elderly (although often not suspected)\nand among patients with disorders that decrease appetite or impair nutrient digestion, absorption, or\nmetabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What factors contribute to Protein-Energy Undernutrition (PEU) in institutionalized elderly populations in developed countries?  \n2. How do disorders that impair nutrient digestion, absorption, or metabolism lead to nutritional deficiencies?  \n3. Why might PEU often go undetected in elderly individuals with decreased appetite?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f4fe1f62-edfa-440b-8966-208eda0588b6
encoding: FLOAT32
metadata:
{"original_content": "In developing countries, PEU affects children who do not consume enough calories or\nprotein.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the primary causes of Protein-Energy Undernutrition (PEU) in children in developing countries?  \n2. How does insufficient calorie and protein intake contribute to nutritional disorders in children?  \n3. What are the health impacts of PEU on children in regions with limited access to adequate nutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 16349cfa-f9a0-4f9e-8fa4-ac240b14ec18
encoding: FLOAT32
metadata:
{"original_content": "Classification and Etiology\nPEU is graded as mild, moderate, or severe.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How is Protein-Energy Undernutrition (PEU) classified based on severity?  \n2. What criteria are used to determine mild, moderate, or severe PEU?  \n3. What are the underlying causes (etiology) of Protein-Energy Undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d3f1634a-7a71-4d03-8032-28fb4d72da13
encoding: FLOAT32
metadata:
{"original_content": "Grade is determined by calculating weight as a percentage\nof expected weight for length or height using international standards (normal, 90 to 110%; mild PEU, 85 to\n90%; moderate, 75 to 85%; severe, <75%).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How is the severity of protein-energy undernutrition (PEU) classified based on weight as a percentage of expected weight for height or length?  \n2. What percentage range of expected weight for height indicates moderate protein-energy undernutrition?  \n3. At what percentage of expected weight for height is protein-energy undernutrition considered severe?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 647a8646-cdac-46b2-94b0-dedf391ff93e
encoding: FLOAT32
metadata:
{"original_content": "PEU may be primary or secondary.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the differences between primary and secondary Protein-Energy Undernutrition (PEU)?  \n2. How can secondary PEU develop as a result of underlying health conditions?  \n3. What dietary interventions are effective in managing primary PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a1f4ae1-cc27-4ba6-a655-7696395182fe
encoding: FLOAT32
metadata:
{"original_content": "Primary PEU is caused by inadequate nutrient intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the primary causes of Protein-Energy Undernutrition (PEU)?  \n2. How does inadequate nutrient intake contribute to the development of nutritional disorders?  \n3. What dietary deficiencies are directly linked to the onset of primary PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5b4582f0-7cf0-4ca4-9053-3f26b381b819
encoding: FLOAT32
metadata:
{"original_content": "Secondary PEU\nresults from disorders or drugs that interfere with nutrient use.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How do certain drugs interfere with the body's ability to utilize nutrients, leading to secondary protein-energy undernutrition (PEU)?  \n2. What types of disorders are commonly associated with secondary PEU due to impaired nutrient use?  \n3. What are the potential health consequences of secondary PEU caused by metabolic disruptions?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 27ad3feb-9e4b-4891-a944-c667fe6b9d85
encoding: FLOAT32
metadata:
{"original_content": "Primary PEU:\n Worldwide, primary PEU occurs mostly in children and the elderly who lack access to\nnutrients, although a common cause in the elderly is depression.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the primary age groups affected by primary protein-energy undernutrition (PEU) worldwide?  \n2. How does depression contribute to primary PEU in the elderly?  \n3. What are the common causes of nutrient access issues leading to primary PEU in children?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0f7bbb81-e6a2-4f0c-8e4f-cf95cf86eb7e
encoding: FLOAT32
metadata:
{"original_content": "PEU can also result from fasting or\nanorexia nervosa.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does fasting contribute to the development of Protein-Energy Undernutrition (PEU)?  \n2. What is the relationship between anorexia nervosa and Protein-Energy Undernutrition (PEU)?  \n3. What are the nutritional consequences of prolonged fasting on the body?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 39c07dfb-1933-413d-a242-57fe66adc6b6
encoding: FLOAT32
metadata:
{"original_content": "Child or elder abuse may be a cause.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How can signs of malnutrition in children or elders indicate potential abuse?  \n2. What specific nutritional deficiencies might arise as a result of neglect or abuse in vulnerable populations?  \n3. How can healthcare professionals differentiate between a metabolic disorder and malnutrition caused by abuse?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c45b1499-dec4-4d3e-937a-e7aacfa38c12
encoding: FLOAT32
metadata:
{"original_content": "In children, chronic primary PEU has 2 common forms: marasmus and kwashiorkor.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the distinguishing characteristics of marasmus and kwashiorkor in children with chronic primary Protein-Energy Undernutrition (PEU)?  \n2. How does chronic primary PEU contribute to the development of marasmus and kwashiorkor?  \n3. What dietary deficiencies are associated with the onset of marasmus and kwashiorkor in children?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cf0cd3a6-ca3f-4d3e-8a02-e71acf809465
encoding: FLOAT32
metadata:
{"original_content": "The form depends on\nthe balance of nonprotein and protein sources of energy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. How does the balance of protein and nonprotein energy sources impact the development of metabolic disorders?  \n2. Can an imbalance in protein and nonprotein energy sources contribute to dietary deficiencies or obesity?  \n3. What role does the ratio of protein to nonprotein energy sources play in preventing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 09b3fee5-4258-47c8-9172-d971d0afd01f
encoding: FLOAT32
metadata:
{"original_content": "Starvation is an acute severe form of primary\nPEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What is the relationship between starvation and primary Protein-Energy Undernutrition (PEU)?  \n2. How does acute severe starvation manifest as a nutritional disorder?  \n3. What are the key characteristics that differentiate starvation from other forms of PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4835934b-72fd-4d2a-8b4b-6c948954b2a4
encoding: FLOAT32
metadata:
{"original_content": "Marasmus (also called the dry form of PEU) causes weight loss and depletion of fat and muscle.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the physical manifestations of marasmus in terms of fat and muscle depletion?  \n2. How does marasmus differ from other forms of protein-energy undernutrition (PEU)?  \n3. What are the primary causes of weight loss in individuals with marasmus?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9c219e09-21ec-447f-a22d-011b70b14098
encoding: FLOAT32
metadata:
{"original_content": "In\ndeveloping countries, marasmus is the most common form of PEU in children.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What is the most common form of protein-energy undernutrition (PEU) in children in developing countries?  \n2. How does marasmus manifest as a nutritional disorder in children?  \n3. What are the primary dietary deficiencies associated with marasmus in developing countries?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 45ca8f70-07ab-4907-a418-838f8897827a
encoding: FLOAT32
metadata:
{"original_content": "Kwashiorkor (also called the wet, swollen, or edematous form) is associated with premature abandonment\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the nutritional deficiencies associated with the development of kwashiorkor?  \n2. How does premature abandonment contribute to the onset of kwashiorkor in children?  \n3. What are the distinguishing symptoms of the edematous form of malnutrition, such as kwashiorkor?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ec5b96c-5834-4b02-8c77-fe38d0d05937
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n62", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 9, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 517d888e-f6b7-44dd-bb4f-db7fa5fe7fdd
encoding: FLOAT32
metadata:
{"original_content": "of breastfeeding, which typically occurs when a younger sibling is born, displacing the older child from the\nbreast.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does the displacement of an older child from breastfeeding impact their risk of developing nutritional deficiencies?  \n2. What are the potential metabolic consequences of weaning an older child prematurely due to the birth of a younger sibling?  \n3. Could the cessation of breastfeeding in an older child lead to vitamin or mineral imbalances, and how might these be addressed?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0c2765f5-54d9-4229-aa0c-0fc2e107184b
encoding: FLOAT32
metadata:
{"original_content": "So children with kwashiorkor tend to be older than those with marasmus.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. Why are children with kwashiorkor typically older than those with marasmus?  \n2. How do the dietary deficiencies leading to kwashiorkor differ from those causing marasmus?  \n3. What are the metabolic or physiological factors that contribute to the age difference in children affected by kwashiorkor and marasmus?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c685d767-0ff2-4003-b866-ae5f6c2c6d42
encoding: FLOAT32
metadata:
{"original_content": "Kwashiorkor may also\nresult from an acute illness, often gastroenteritis or another infection (probably secondary to cytokine\nrelease), in a child who already has PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does an acute illness like gastroenteritis contribute to the development of kwashiorkor in children with pre-existing protein-energy undernutrition (PEU)?  \n2. What role does cytokine release play in the progression of kwashiorkor during infections?  \n3. Why are children with protein-energy undernutrition (PEU) more susceptible to developing kwashiorkor during acute illnesses?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 85242910-d3b3-4939-803d-f2c2900c149d
encoding: FLOAT32
metadata:
{"original_content": "A diet that is more deficient in protein than energy may be more\nlikely to cause kwashiorkor than marasmus.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does a diet deficient in protein but sufficient in energy contribute to the development of kwashiorkor?  \n2. What are the key differences in dietary causes between kwashiorkor and marasmus?  \n3. Why might energy intake alone be insufficient to prevent protein-deficiency-related disorders like kwashiorkor?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8d07b73a-9784-409e-9b53-5329730a7bcf
encoding: FLOAT32
metadata:
{"original_content": "Less common than marasmus, kwashiorkor tends to be\nconfined to specific parts of the world, such as rural Africa, the Caribbean, and the Pacific islands.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What regions of the world are most commonly associated with the occurrence of kwashiorkor?  \n2. How does the prevalence of kwashiorkor compare to that of marasmus?  \n3. What geographic factors might contribute to the higher incidence of kwashiorkor in rural Africa, the Caribbean, and the Pacific islands?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7b4868af-3113-44e8-9e60-60e81fdc5a33
encoding: FLOAT32
metadata:
{"original_content": "In\nthese areas, staple foods (eg, yams, cassavas, sweet potatoes, green bananas) are low in protein and\nhigh in carbohydrates.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How can a diet primarily consisting of low-protein, high-carbohydrate staple foods contribute to protein-energy malnutrition?  \n2. What are the potential health consequences of relying on yams, cassavas, and sweet potatoes as primary dietary staples in terms of nutrient deficiencies?  \n3. How might a diet dominated by green bananas and other similar staples impact the risk of developing metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0dd855cc-7fed-4397-bc09-8d4056ff26d8
encoding: FLOAT32
metadata:
{"original_content": "In kwashiorkor, cell membranes leak, causing extravasation of intravascular fluid\nand protein, resulting in peripheral edema.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does protein deficiency contribute to the development of peripheral edema in kwashiorkor?  \n2. What role do cell membrane integrity and intravascular fluid balance play in the pathology of kwashiorkor?  \n3. Why does kwashiorkor specifically cause leakage of proteins and fluids from blood vessels?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ad3011b0-44dc-4f80-9f9a-8a3743e08e30
encoding: FLOAT32
metadata:
{"original_content": "Starvation is a complete lack of nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the physiological effects of a complete lack of nutrients on the human body?  \n2. How does starvation differ from other forms of dietary deficiencies or malnutrition?  \n3. What are the potential long-term health consequences of prolonged starvation?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ac7895be-de8e-4f7c-884a-b477c534d7ab
encoding: FLOAT32
metadata:
{"original_content": "It occasionally occurs when food is available (as in fasting or\nanorexia nervosa) but usually occurs because food is unavailable (eg, during famine or wilderness\nexposure).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the nutritional consequences of prolonged fasting or anorexia nervosa?  \n2. How does food unavailability during famine or wilderness exposure contribute to nutritional disorders?  \n3. What are the metabolic effects of starvation caused by dietary deficiencies?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9d5dc891-7202-4c36-bbe0-deeb1f93278d
encoding: FLOAT32
metadata:
{"original_content": "Secondary PEU:\n This type most commonly results from the following:\n\u2022 Disorders that affect GI function: These disorders can interfere with digestion (eg, pancreatic\ninsufficiency), absorption (eg, enteritis, enteropathy), or lymphatic transport of nutrients (eg,\nretroperitoneal fibrosis, Milroy's disease).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How do gastrointestinal disorders like pancreatic insufficiency contribute to secondary protein-energy undernutrition (PEU)?  \n2. What role does lymphatic transport dysfunction, such as in Milroy's disease, play in the development of secondary PEU?  \n3. How can enteritis or enteropathy lead to nutrient malabsorption and secondary PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b7879838-38d9-40f6-bcbd-7ad76ccf8d57
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Wasting disorders: In wasting disorders (eg, AIDS, cancer) and renal failure, catabolism causes cytokine\nexcess, resulting in undernutrition via anorexia and cachexia (wasting of muscle and fat).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does cytokine excess contribute to undernutrition in individuals with wasting disorders like AIDS and cancer?  \n2. What role does anorexia play in the development of cachexia in patients with renal failure?  \n3. How does catabolism affect muscle and fat stores in wasting disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3196c9b1-2f16-480b-ac63-c535e43783ab
encoding: FLOAT32
metadata:
{"original_content": "End-stage\nheart failure can cause cardiac cachexia, a severe form of undernutrition; mortality rate is particularly\nhigh.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does cardiac cachexia manifest as a severe form of undernutrition in patients with end-stage heart failure?  \n2. What are the nutritional implications and challenges associated with managing cardiac cachexia?  \n3. Why is the mortality rate particularly high in individuals suffering from cardiac cachexia?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dcf039c8-c9fd-4dd6-a7cc-9b5b3ece913d
encoding: FLOAT32
metadata:
{"original_content": "Factors contributing to cardiac cachexia may include passive hepatic congestion (causing\nanorexia), edema of the intestinal tract (impairing absorption), and, in advanced disease, increased O\n2\nrequirement due to anaerobic metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does passive hepatic congestion contribute to anorexia in cardiac cachexia?  \n2. In what ways does intestinal edema impair nutrient absorption in individuals with cardiac cachexia?  \n3. Why does advanced cardiac cachexia lead to increased oxygen requirements due to anaerobic metabolism?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f9c7d0e0-4498-4217-9935-bc9fefb36f81
encoding: FLOAT32
metadata:
{"original_content": "Wasting disorders can decrease appetite or impair\nmetabolism of nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How do wasting disorders affect the metabolism of essential nutrients in the body?  \n2. What impact do wasting disorders have on appetite regulation and nutrient intake?  \n3. Can wasting disorders lead to specific vitamin or mineral deficiencies due to impaired nutrient absorption?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b68898fd-3785-41f2-bd07-9f8b2e4e75d2
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Conditions that increase metabolic demands: These conditions include infections, hyperthyroidism,\npheochromocytoma, other endocrine disorders, burns, trauma, surgery, and other critical illnesses.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How do conditions like hyperthyroidism and pheochromocytoma contribute to nutritional deficiencies or imbalances?  \n2. What dietary adjustments are necessary to meet increased metabolic demands caused by burns or trauma?  \n3. How can critical illnesses that elevate metabolic rates lead to vitamin and mineral deficiencies?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 89a3ce54-c9ae-4f58-a403-d1d4c9236fb7
encoding: FLOAT32
metadata:
{"original_content": "Pathophysiology\nThe initial metabolic response is decreased metabolic rate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does a decreased metabolic rate impact the progression of certain nutritional disorders?  \n2. What dietary interventions can help counteract the effects of a decreased metabolic rate in metabolic disorders?  \n3. Are there specific vitamin or mineral imbalances associated with a decreased metabolic rate in nutritional disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1fa8153d-b660-44da-9f0b-8fa9cf7a9ad2
encoding: FLOAT32
metadata:
{"original_content": "To supply energy, the body first breaks down\nadipose tissue.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does the breakdown of adipose tissue contribute to energy supply in individuals with metabolic disorders?  \n2. What role does adipose tissue play in energy metabolism during periods of dietary deficiencies?  \n3. How might the process of adipose tissue breakdown be affected in individuals with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e3fa3067-2e3f-4e95-b563-2b91b380b3f4
encoding: FLOAT32
metadata:
{"original_content": "However, later when these tissues are depleted, the body may use protein for energy,\nresulting in a negative nitrogen balance.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does the body\u2019s use of protein for energy contribute to a negative nitrogen balance in cases of malnutrition?  \n2. What are the potential health consequences of prolonged negative nitrogen balance in individuals with dietary deficiencies?  \n3. How does the depletion of energy reserves in tissues affect protein metabolism in metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 194913a8-e52d-4c38-b3b0-53dbc9747365
encoding: FLOAT32
metadata:
{"original_content": "Visceral organs and muscle are broken down and decrease in\nweight.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What nutritional deficiencies or metabolic disorders could lead to the breakdown and weight loss of visceral organs and muscle?  \n2. How does prolonged malnutrition or starvation affect the weight and function of visceral organs and muscle tissue?  \n3. What dietary interventions can prevent or mitigate the loss of muscle and visceral organ mass in individuals with severe nutritional disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bd23e65a-39ec-4245-8d16-9986aadb09b3
encoding: FLOAT32
metadata:
{"original_content": "Loss of organ weight is greatest in the liver and intestine, intermediate in the heart and kidneys,\nand least in the nervous system.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does malnutrition or dietary deficiency affect the weight of different organs in the body?  \n2. Why is the liver and intestine more susceptible to weight loss compared to the nervous system during nutritional disorders?  \n3. What role do metabolic disorders play in the differential weight loss of organs like the heart, kidneys, and liver?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5e9b2d87-6715-4836-81a1-6ccb043611e3
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nSymptoms of moderate PEU can be constitutional or involve specific organ systems.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the constitutional symptoms associated with moderate Protein-Energy Undernutrition (PEU)?  \n2. How does moderate PEU affect specific organ systems in the body?  \n3. What are the distinguishing signs of moderate PEU compared to other nutritional disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6c6d0af3-28e1-4625-a9d9-1e1e1894edeb
encoding: FLOAT32
metadata:
{"original_content": "Apathy and irritability\nare common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to symptoms like apathy and irritability?  \n2. What specific vitamin or mineral imbalances are associated with mood changes such as irritability?  \n3. Are there dietary interventions that can help alleviate apathy caused by metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f2a675a4-d33d-4bc1-89a6-d7d67476bd00
encoding: FLOAT32
metadata:
{"original_content": "The patient is weak, and work capacity decreases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to decreased work capacity and physical weakness?  \n2. How might vitamin or mineral imbalances contribute to a patient's reduced energy levels?  \n3. Could a metabolic disorder be responsible for the patient's symptoms of weakness and decreased work capacity?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d8b1dcec-4997-405a-a80c-478271a3b76f
encoding: FLOAT32
metadata:
{"original_content": "Cognition and sometimes\nconsciousness are impaired.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How can dietary deficiencies lead to impaired cognition and consciousness?  \n2. What specific vitamin or mineral imbalances are associated with cognitive impairment?  \n3. Can metabolic disorders resulting from poor nutrition affect consciousness levels?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18b3b48c-45ef-4408-bc8a-b4c733286718
encoding: FLOAT32
metadata:
{"original_content": "Temporary lactose deficiency and achlorhydria develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does temporary lactose deficiency affect nutrient absorption and digestion?  \n2. What dietary adjustments are recommended for individuals with achlorhydria to prevent nutritional deficiencies?  \n3. Can achlorhydria and lactose deficiency occur simultaneously, and how might this impact overall metabolic health?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7c5bcfc5-6b83-4144-9dbd-14648fc961be
encoding: FLOAT32
metadata:
{"original_content": "Diarrhea is common\nand can be aggravated by deficiency of intestinal disaccharidases, especially lactase (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does a deficiency of intestinal disaccharidases, such as lactase, contribute to the development of diarrhea?  \n2. What role does lactase deficiency play in the aggravation of nutritional disorders?  \n3. Can dietary management alleviate diarrhea caused by lactase deficiency?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dfb02b48-2fd7-4271-856e-e54aaefe0369
encoding: FLOAT32
metadata:
{"original_content": "157\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f95c7bef-d134-4737-855a-9adce46eb450
encoding: FLOAT32
metadata:
{"original_content": "Gonadal tissues atrophy. PEU can cause amenorrhea in women and loss of libido in men and women.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does Protein-Energy Undernutrition (PEU) contribute to amenorrhea in women?  \n2. What is the relationship between PEU and loss of libido in both men and women?  \n3. Can gonadal tissue atrophy be linked to dietary deficiencies or metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 60f4047d-44ea-4eb2-b4a5-ca3fcfed3876
encoding: FLOAT32
metadata:
{"original_content": "Wasting of fat and muscle is common in all forms of PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the common physical manifestations of Protein-Energy Undernutrition (PEU)?  \n2. How does PEU contribute to the wasting of fat and muscle in affected individuals?  \n3. What are the underlying mechanisms linking dietary deficiencies to muscle and fat wasting in PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 824ec8ab-dbb0-4ead-ae15-6f7de7d1f75b
encoding: FLOAT32
metadata:
{"original_content": "In adult volunteers who fasted for 30 to 40\ndays, weight loss was marked (25% of initial weight).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the potential metabolic effects of prolonged fasting on body weight in adults?  \n2. How does extended fasting contribute to weight loss as a percentage of initial body weight?  \n3. What are the nutritional risks associated with fasting for 30 to 40 days?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8fd6e165-d1ff-485f-922c-4ae6f5680998
encoding: FLOAT32
metadata:
{"original_content": "If starvation is more prolonged, weight loss may\nreach 50% in adults and possibly more in children.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What is the potential percentage of weight loss in adults and children during prolonged starvation?  \n2. How does prolonged starvation impact weight loss differently in adults compared to children?  \n3. What are the physiological consequences of losing 50% or more of body weight due to starvation?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5d8bc3ff-f865-422e-901a-e418bf06f783
encoding: FLOAT32
metadata:
{"original_content": "In adults, cachexia is most obvious in areas where prominent fat depots normally exist.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does cachexia affect fat depots in adults compared to other nutritional disorders?  \n2. What are the visible signs of fat loss in cachexia-affected individuals?  \n3. Which nutritional or metabolic factors contribute to the development of cachexia in adults?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c1ac630f-d204-4f48-924b-2e1f444ada8a
encoding: FLOAT32
metadata:
{"original_content": "Muscles shrink\nand bones protrude.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to muscle wasting and bone protrusion?  \n2. How does severe malnutrition affect muscle mass and skeletal structure?  \n3. What are the metabolic disorders associated with muscle shrinkage and visible bone protrusion?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e625f3a4-c736-4d08-9c2b-2a135506d52f
encoding: FLOAT32
metadata:
{"original_content": "The skin becomes thin, dry, inelastic, pale, and cold.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to thin, dry, and inelastic skin?  \n2. How does a lack of essential vitamins or minerals affect skin elasticity and temperature regulation?  \n3. What metabolic disorders are associated with pale and cold skin symptoms?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 908a5692-b493-45b5-90f6-5c8a29ec4c60
encoding: FLOAT32
metadata:
{"original_content": "The hair is dry and falls out\neasily, becoming sparse.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause hair to become dry and fall out easily?  \n2. How do vitamin and mineral imbalances contribute to sparse hair growth?  \n3. Could a metabolic disorder be responsible for changes in hair texture and density?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0a9f6e92-f3d5-4ab7-ba32-4fde8801db32
encoding: FLOAT32
metadata:
{"original_content": "Wound healing is impaired.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How do vitamin C deficiencies impact the body's ability to heal wounds?  \n2. Can protein-energy malnutrition delay the wound healing process?  \n3. What role does zinc play in wound healing, and how does a deficiency affect recovery?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7fdab9e4-767c-421a-a540-3b04f91737d4
encoding: FLOAT32
metadata:
{"original_content": "In elderly patients, risk of hip fractures and pressure\n(decubitus) ulcers increases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does a deficiency in calcium and vitamin D contribute to an increased risk of hip fractures in elderly patients?  \n2. What role does protein malnutrition play in the development of pressure (decubitus) ulcers in elderly individuals?  \n3. Can metabolic disorders or imbalances in essential nutrients exacerbate the risk of fractures and ulcers in aging populations?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 88b961dc-b30a-4d71-b337-64b079c545db
encoding: FLOAT32
metadata:
{"original_content": "With acute or chronic severe PEU, heart size and cardiac output decrease; pulse slows\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. How does severe protein-energy undernutrition (PEU) affect heart size and cardiac output?  \n2. What are the cardiac symptoms associated with acute or chronic severe PEU?  \n3. How does severe PEU influence pulse rate in affected individuals?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8b8c274f-341b-43b9-8480-126b82c77a58
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n63", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 10, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ae47b479-1d8b-423c-8b1c-88ab32f306c8
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 2-3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies associated with specific nutritional disorders?  \n2. How do vitamin and mineral imbalances contribute to the development of metabolic disorders?  \n3. What are the potential health risks linked to obesity and its relationship with nutritional imbalances?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b668bac1-759b-44a9-a99c-70b261466846
encoding: FLOAT32
metadata:
{"original_content": "Values Commonly Used to Grade the Severity of Protein-Energy Undernutrition]\nand BP falls.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the clinical indicators used to assess the severity of protein-energy undernutrition?  \n2. How does protein-energy undernutrition affect blood pressure regulation?  \n3. What grading criteria are commonly applied to evaluate the progression of dietary deficiencies in protein-energy undernutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8da48fa3-4902-4904-989c-a21d52bde856
encoding: FLOAT32
metadata:
{"original_content": "Respiratory rate and vital capacity decrease.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to a decrease in respiratory rate and vital capacity?  \n2. What role do vitamin and mineral imbalances play in affecting lung function and respiratory health?  \n3. Can obesity-related metabolic disorders lead to reduced respiratory capacity and vital signs?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8d3c1861-ac0c-469b-a1bf-fb16af02003a
encoding: FLOAT32
metadata:
{"original_content": "Body temperature falls, sometimes contributing\nto death.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to a drop in body temperature?  \n2. What metabolic disorders are associated with a decrease in body temperature and potential fatal outcomes?  \n3. Which vitamin or mineral imbalances might lead to hypothermia-like symptoms?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 02a6f619-bc34-4257-9356-eaa4ed4eea8d
encoding: FLOAT32
metadata:
{"original_content": "Edema, anemia, jaundice, and petechiae can develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies can lead to the development of anemia and edema?  \n2. How might vitamin or mineral imbalances contribute to the appearance of petechiae?  \n3. What dietary factors are associated with the onset of jaundice in metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: de52975a-3314-47a0-985d-9469a408473e
encoding: FLOAT32
metadata:
{"original_content": "Liver, kidney, or heart failure may occur.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to the risk of liver, kidney, or heart failure?  \n2. What role do vitamin and mineral imbalances play in the development of organ failure?  \n3. Can metabolic disorders linked to obesity increase the likelihood of liver, kidney, or heart failure?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48334252-d4c8-4416-bc7d-f29bdcd70a4d
encoding: FLOAT32
metadata:
{"original_content": "Cell-mediated immunity is impaired, increasing susceptibility to infections.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does a deficiency in specific nutrients impair cell-mediated immunity and increase susceptibility to infections?  \n2. What role do vitamins and minerals play in supporting cell-mediated immunity in individuals with nutritional disorders?  \n3. Can dietary interventions or supplementation improve cell-mediated immunity in cases of malnutrition or metabolic disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 44bce145-fbb1-47d4-9b5a-28bc50ad96d3
encoding: FLOAT32
metadata:
{"original_content": "Bacterial infections (eg,\npneumonia, gastroenteritis, otitis media, UTIs, sepsis) are common in both forms of PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does protein-energy undernutrition (PEU) increase susceptibility to bacterial infections like pneumonia and gastroenteritis?  \n2. What role does nutritional status play in the development of sepsis in individuals with PEU?  \n3. Are there specific dietary interventions that can reduce the risk of recurrent bacterial infections in patients with PEU?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 904b2723-2aa7-42fa-8aa8-c5a6c1f8b2f3
encoding: FLOAT32
metadata:
{"original_content": "Infections result\nin release of cytokines, which cause anorexia, worsen muscle wasting, and cause a marked decrease in\nserum albumin levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How do cytokines released during infections contribute to muscle wasting in individuals with nutritional disorders?  \n2. What is the relationship between cytokine-induced anorexia and serum albumin levels in the context of dietary deficiencies?  \n3. How might infections exacerbate metabolic disorders through changes in appetite and protein metabolism?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7baee645-f822-4479-b9e9-19dd983c2f09
encoding: FLOAT32
metadata:
{"original_content": "Marasmus in infants causes hunger, weight loss, growth retardation, and wasting of subcutaneous fat\nand muscle.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the physical symptoms associated with marasmus in infants?  \n2. How does marasmus affect the growth and development of infants?  \n3. What are the specific tissues and body components impacted by marasmus?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 328f4169-81e0-4056-8e6c-0cb6aab4fd58
encoding: FLOAT32
metadata:
{"original_content": "Ribs and facial bones appear prominent.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause prominent ribs and facial bones?  \n2. How does severe malnutrition affect bone visibility and body composition?  \n3. What dietary interventions can address the symptoms of extreme thinness and bone prominence?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 31a9fc63-c814-43bf-82c2-81232d5b859f
encoding: FLOAT32
metadata:
{"original_content": "Loose, thin skin hangs in folds.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies or metabolic disorders could cause loose, thin skin to hang in folds?  \n2. How might rapid weight loss or malnutrition contribute to the development of loose, thin skin?  \n3. Could a lack of specific vitamins or minerals, such as collagen-supporting nutrients, lead to skin changes like thinness and sagging?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e296b6bd-6fd1-4a14-b454-8605ac57fdd7
encoding: FLOAT32
metadata:
{"original_content": "Kwashiorkor is characterized by peripheral and periorbital edema.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What dietary deficiencies contribute to the development of kwashiorkor?  \n2. How does protein deficiency lead to peripheral and periorbital edema in kwashiorkor?  \n3. What are the distinguishing nutritional and metabolic features of kwashiorkor compared to other malnutrition disorders?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a1a27cb2-76d6-485f-ba74-1be433afc47b
encoding: FLOAT32
metadata:
{"original_content": "The abdomen protrudes because\nabdominal muscles are weakened, the intestine is distended, the liver enlarges, and ascites is present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances can lead to weakened abdominal muscles and a distended intestine?  \n2. How does liver enlargement relate to dietary or metabolic disorders?  \n3. What role does ascites play in diagnosing nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2975b02c-9d84-4647-97a3-8961c9c4b1a3
encoding: FLOAT32
metadata:
{"original_content": "The skin is dry, thin, and wrinkled; it can become hyperpigmented and fissured and later hypopigmented,\nfriable, and atrophic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to dry, thin, and wrinkled skin that becomes hyperpigmented and later hypopigmented?  \n2. How do vitamin or mineral imbalances contribute to the development of friable and atrophic skin?  \n3. What metabolic disorders are associated with fissured and hyperpigmented skin changes?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 793964cb-3dd4-47f0-8058-b5e37f1642d3
encoding: FLOAT32
metadata:
{"original_content": "Skin in different areas of the body may be affected at different times.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can vitamin deficiencies lead to skin issues that manifest in different areas of the body at different times?  \n2. What role do dietary imbalances play in the development of skin conditions that vary by location and timing?  \n3. Can metabolic disorders cause skin symptoms to appear inconsistently across different body regions?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d2d65d71-912a-4069-addf-015ff376d8ed
encoding: FLOAT32
metadata:
{"original_content": "The hair can\nbecome thin, reddish brown, or gray.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies can cause hair to become thin, reddish brown, or gray?  \n2. How does a lack of specific vitamins or minerals affect hair pigmentation and texture?  \n3. Can metabolic disorders lead to changes in hair color or thickness?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ec9f9be9-562d-45ff-b4c9-46dd981671f1
encoding: FLOAT32
metadata:
{"original_content": "Scalp hair falls out easily, eventually becoming sparse, but eyelash\nhair may grow excessively.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could cause scalp hair loss and excessive eyelash growth?  \n2. How might metabolic disorders contribute to uneven hair growth patterns on the scalp and eyelashes?  \n3. Are there specific vitamin or mineral deficiencies linked to sparse scalp hair and excessive eyelash growth?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3bcffe61-0489-4f5c-8b57-9900d29c3186
encoding: FLOAT32
metadata:
{"original_content": "Alternating episodes of undernutrition and adequate nutrition may cause the\nhair to have a dramatic \"striped flag\" appearance.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does alternating periods of undernutrition and adequate nutrition affect hair appearance in individuals with nutritional disorders?  \n2. What specific nutritional deficiencies contribute to the \"striped flag\" appearance of hair?  \n3. Can the \"striped flag\" appearance of hair be reversed with consistent adequate nutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: daaab0b2-0b2e-484b-a1c5-4b8a8e09a697
encoding: FLOAT32
metadata:
{"original_content": "Affected children may be apathetic but become irritable\nwhen held.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to irritability in children when they are physically handled?  \n2. What specific dietary imbalances might cause apathy and irritability in affected children?  \n3. Are there particular metabolic disorders linked to behavioral changes, such as irritability, in children with poor nutrition?  "}


created_at: 2025-03-03 11:15:20
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d061391f-3435-49e2-a377-bab112054534
encoding: FLOAT32
metadata:
{"original_content": "Total starvation is fatal in 8 to 12 wk.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How long can the human body survive without any nutritional intake before total starvation becomes fatal?  \n2. What are the physiological effects of prolonged total starvation on the body?  \n3. How does the timeline for fatality in total starvation compare to other forms of severe nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c5a4bc81-687a-40cd-b7ca-7039f46b21ae
encoding: FLOAT32
metadata:
{"original_content": "Thus, certain symptoms of PEU do not have time to develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the symptoms of Protein-Energy Undernutrition (PEU) that may not develop due to time constraints?  \n2. How does the progression of PEU differ when symptoms are unable to fully manifest?  \n3. What factors influence the delayed or absent development of symptoms in nutritional disorders like PEU?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8d23e127-8f72-4a8f-914c-13fadca3c038
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Diagnosis usually based on history\n\u2022 To determine severity: BMI, serum albumin, total lymphocyte count, CD4+ count, serum transferrin\n\u2022 To diagnose complications and consequences: CBC, electrolytes, BUN, glucose, Ca, Mg, phosphate\nDiagnosis can be based on history when dietary intake is markedly inadequate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can serum albumin levels help determine the severity of a nutritional disorder?  \n2. What diagnostic tests are used to identify complications arising from dietary deficiencies?  \n3. How is BMI utilized in assessing the severity of a metabolic or nutritional imbalance?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e6fdcc28-fbe3-47f8-941f-4ffde954eb4f
encoding: FLOAT32
metadata:
{"original_content": "The cause of inadequate\nintake, particularly in children, needs to be identified.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the primary factors contributing to inadequate nutrient intake in children?  \n2. How can dietary deficiencies in children be identified and addressed effectively?  \n3. What role do socioeconomic and environmental factors play in causing inadequate nutrition in children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b53e8753-103d-4532-9d84-b22383d2b4e1
encoding: FLOAT32
metadata:
{"original_content": "In children and adolescents, child abuse and\nanorexia nervosa should be considered.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How might child abuse contribute to the development of anorexia nervosa in children and adolescents?  \n2. What are the nutritional and metabolic consequences of anorexia nervosa in young individuals?  \n3. Are there specific dietary interventions that can address the effects of anorexia nervosa in adolescents who have experienced abuse?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5c41426e-3b8e-41e5-8187-6d790f13c95f
encoding: FLOAT32
metadata:
{"original_content": "Physical examination findings can usually confirm the diagnosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can physical examination findings help confirm a diagnosis of a vitamin or mineral deficiency?  \n2. What specific physical signs are indicative of a metabolic disorder during a clinical examination?  \n3. Can obesity-related health conditions be diagnosed through physical examination findings alone?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2edc83c3-625a-46a3-a708-0d64f6a40a97
encoding: FLOAT32
metadata:
{"original_content": "Laboratory tests are required if dietary\nhistory does not clearly indicate inadequate caloric intake. Measurement of serum albumin, total\nlymphocyte count, CD4+ T lymphocytes, transferrin, and response to skin antigens may help determine\nthe severity of PEU (see \nTable 2-3\n) or confirm the diagnosis in borderline cases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can laboratory tests help confirm a diagnosis of Protein-Energy Undernutrition (PEU) in borderline cases?  \n2. What biomarkers are used to assess the severity of Protein-Energy Undernutrition (PEU)?  \n3. When is it necessary to measure serum albumin and lymphocyte counts in evaluating nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 66e44855-f29f-4a82-be07-0cb235ce1314
encoding: FLOAT32
metadata:
{"original_content": "Many other test results\nmay be abnormal: eg, decreased levels of hormones, vitamins, lipids, cholesterol, prealbumin, insulin\ngrowth factor-1, fibronectin, and retinol-binding protein.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies indicated by decreased levels of prealbumin and retinol-binding protein?  \n2. How can low levels of insulin growth factor-1 and fibronectin be linked to malnutrition or metabolic disorders?  \n3. What dietary interventions might address decreased levels of vitamins, lipids, and cholesterol in individuals with nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 14423552-fd87-4db4-96e3-6648b3bd26f4
encoding: FLOAT32
metadata:
{"original_content": "Urinary creatine and methylhistidine levels can be\nused to gauge the degree of muscle wasting.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can urinary creatine levels indicate the severity of muscle wasting in individuals with metabolic disorders?  \n2. What role does methylhistidine measurement play in assessing muscle protein breakdown in cases of dietary deficiencies?  \n3. Can urinary biomarkers like creatine and methylhistidine help monitor the progression of muscle wasting in obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b0279c26-cb07-450c-b8e3-1b15e851efdf
encoding: FLOAT32
metadata:
{"original_content": "Because protein catabolism slows, urinary urea level also\ndecreases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does a decrease in protein catabolism affect urinary urea levels in individuals with metabolic disorders?  \n2. What role does protein catabolism play in the management of dietary deficiencies?  \n3. Can changes in urinary urea levels serve as an indicator for protein metabolism issues in nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 29d8fe1a-928c-40f7-b130-0937a0a46349
encoding: FLOAT32
metadata:
{"original_content": "These findings rarely affect treatment.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How do findings that rarely affect treatment influence the management of dietary deficiencies?  \n2. In what ways might metabolic disorders be addressed if certain findings are deemed clinically insignificant?  \n3. Can vitamin and mineral imbalances be effectively treated without considering findings that rarely impact treatment?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7b74262b-7640-40c1-a233-8500394faf19
encoding: FLOAT32
metadata:
{"original_content": "Laboratory tests are required to identify causes of suspected secondary PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What laboratory tests are commonly used to diagnose the underlying causes of secondary Protein-Energy Undernutrition (PEU)?  \n2. How can laboratory tests help differentiate secondary PEU from primary nutritional deficiencies?  \n3. What metabolic or dietary factors are typically investigated through lab tests in cases of suspected secondary PEU?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5e4cdf5-1ab9-4fb8-b066-da6d3ae3ea20
encoding: FLOAT32
metadata:
{"original_content": "C-reactive protein or\nsoluble interleukin-2 receptor should be measured when the cause of undernutrition \nis unclear; these\nmeasurements can help determine whether there is cytokine excess.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can measuring C-reactive protein or soluble interleukin-2 receptor help identify the underlying cause of undernutrition?  \n2. What role does cytokine excess play in the development of undernutrition?  \n3. When should biomarkers like C-reactive protein and soluble interleukin-2 receptor be considered in the assessment of nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9353bec-5a38-4a8d-af1d-bf6e607b847e
encoding: FLOAT32
metadata:
{"original_content": "Thyroid function tests may also be\ndone.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can thyroid function tests help diagnose metabolic disorders related to nutrition?  \n2. What role do thyroid function tests play in identifying dietary deficiencies or imbalances?  \n3. Can thyroid function tests detect vitamin or mineral deficiencies contributing to obesity or other health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f76b6ca0-0782-4f53-b069-60503597b7f2
encoding: FLOAT32
metadata:
{"original_content": "Other laboratory tests can detect associated abnormalities that may require treatment.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What laboratory tests can identify abnormalities linked to vitamin and mineral imbalances?  \n2. How can associated abnormalities detected through lab tests influence the treatment of metabolic disorders?  \n3. What role do laboratory tests play in diagnosing dietary deficiencies and related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6e391910-0d74-4030-9e41-2f013b73a32c
encoding: FLOAT32
metadata:
{"original_content": "Serum\nelectrolytes, BUN, glucose, and possibly levels of Ca, Mg, and phosphate should be measured.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How can abnormal serum electrolyte levels indicate a potential nutritional or metabolic disorder?  \n2. What role do calcium, magnesium, and phosphate levels play in diagnosing dietary deficiencies?  \n3. How might elevated BUN and glucose levels relate to obesity or other nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9999a043-6573-4be1-82af-f5c033676275
encoding: FLOAT32
metadata:
{"original_content": "Levels of\nserum glucose, electrolytes (especially K, occasionally Na), phosphate, Ca, and Mg are usually low.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the potential nutritional or metabolic causes of low serum glucose and electrolyte imbalances?  \n2. How do deficiencies in phosphate, calcium, and magnesium contribute to metabolic disorders?  \n3. What dietary interventions can address simultaneous deficiencies in potassium, sodium, and magnesium?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 04721b52-22d5-4f88-8f2a-37744b4bd0b1
encoding: FLOAT32
metadata:
{"original_content": "BUN\nis often low unless renal failure is present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does renal failure influence blood urea nitrogen (BUN) levels in the context of metabolic disorders?  \n2. Can low BUN levels indicate a nutritional or dietary deficiency in individuals without renal failure?  \n3. What role does BUN play in diagnosing protein metabolism issues related to nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a3247ef6-1b52-404c-8bc7-464a7924895a
encoding: FLOAT32
metadata:
{"original_content": "Metabolic acidosis may be present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. How does metabolic acidosis relate to dietary deficiencies or imbalances in macronutrients?  \n2. What role do specific vitamins or minerals play in preventing or managing metabolic acidosis?  \n3. Can obesity or related metabolic disorders increase the risk of developing metabolic acidosis?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7ea69e37-2550-46e0-a401-6acdb82c4a41
encoding: FLOAT32
metadata:
{"original_content": "CBC is usually obtained;\nnormocytic anemia (usually due to protein deficiency) or microcytic anemia (due to simultaneous iron\ndeficiency) is usually present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What types of anemia are commonly associated with protein and iron deficiencies?  \n2. How can a CBC help identify nutritional deficiencies related to anemia?  \n3. What are the distinguishing features of normocytic anemia versus microcytic anemia in the context of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 80af78f3-8ef2-4152-9a6b-4548ce0516fe
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency, and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity, and what treatment options are recommended?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e5441128-a7d2-4005-a7e7-c98b3fbd7e9d
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n64", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 11, "type": "text ", "chroma:document": "1. What are the primary causes and health impacts of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4daf69a7-d31b-43ec-9259-2bcf44a79992
encoding: FLOAT32
metadata:
{"original_content": "Stool cultures should be obtained and checked for ova and parasites if diarrhea is severe or does not\nresolve with treatment.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can stool cultures help identify parasitic infections contributing to severe diarrhea in cases of malnutrition or dietary deficiencies?  \n2. What role do ova and parasites play in exacerbating metabolic disorders or nutrient absorption issues?  \n3. When should persistent diarrhea in individuals with suspected vitamin or mineral imbalances prompt further diagnostic testing?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d847d754-8322-44f0-85a1-daf4675b514e
encoding: FLOAT32
metadata:
{"original_content": "Sometimes urinalysis, urine culture, blood cultures, tuberculin testing, and a chest\nx-ray are used to diagnose occult infections because people with PEU may have a muted response to\ninfections.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can protein-energy undernutrition (PEU) affect the body's response to infections?  \n2. What diagnostic tests are commonly used to identify infections in individuals with nutritional deficiencies like PEU?  \n3. Why might individuals with PEU require additional diagnostic measures such as chest x-rays or tuberculin testing?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b63776d8-a255-43c9-9ee9-d39d5ad209ce
encoding: FLOAT32
metadata:
{"original_content": "Prognosis\nChildren:\n In children, mortality varies from 5 to 40%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What is the mortality rate range for children affected by certain nutritional disorders?  \n2. How does the prognosis of nutritional disorders in children vary in terms of mortality?  \n3. What percentage of children with specific dietary deficiencies or metabolic disorders face mortality risks?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4f7b5e7e-cdb8-4ecd-9e4d-4752d7e3eb59
encoding: FLOAT32
metadata:
{"original_content": "Mortality rates are lower in children with mild PEU\nand those given intensive care.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How does the severity of Protein-Energy Undernutrition (PEU) impact mortality rates in children?  \n2. What role does intensive care play in improving outcomes for children with mild PEU?  \n3. Are children with mild PEU more likely to survive compared to those with severe PEU when provided with medical intervention?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4de1792c-8230-472a-a876-68f5bf663bd2
encoding: FLOAT32
metadata:
{"original_content": "Death in the first days of treatment is usually due to electrolyte deficits,\nsepsis, hypothermia, or heart failure.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What role do electrolyte deficits play in the mortality of patients with severe nutritional disorders during initial treatment?  \n2. How can hypothermia be a complication in the early treatment of malnutrition or metabolic disorders?  \n3. What dietary or nutritional interventions can help prevent heart failure in patients undergoing treatment for severe malnutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 79900a22-95ee-4379-aa32-00164a9aca9e
encoding: FLOAT32
metadata:
{"original_content": "Impaired consciousness, jaundice, petechiae, hyponatremia, and\npersistent diarrhea are ominous signs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could lead to symptoms such as impaired consciousness, jaundice, and petechiae?  \n2. How might persistent diarrhea contribute to hyponatremia and other metabolic disturbances in the context of a nutritional disorder?  \n3. What dietary interventions could help address the combination of symptoms like jaundice, petechiae, and hyponatremia in patients with suspected nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2cac2c8c-e328-4bcb-9f42-6111d370d04b
encoding: FLOAT32
metadata:
{"original_content": "Resolution of apathy, edema, and anorexia is a favorable sign.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the signs of recovery in individuals suffering from nutritional deficiencies?  \n2. How can the resolution of apathy, edema, and anorexia indicate improvement in a metabolic disorder?  \n3. What role do dietary interventions play in addressing symptoms like apathy, edema, and anorexia in nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4ceebb45-58e9-413e-a446-0043e651e3a9
encoding: FLOAT32
metadata:
{"original_content": "Recovery is more rapid in kwashiorkor than in marasmus.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. Why is recovery typically faster in kwashiorkor compared to marasmus?  \n2. What are the key differences in the nutritional deficiencies underlying kwashiorkor and marasmus?  \n3. How do treatment approaches differ between kwashiorkor and marasmus to facilitate recovery?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ec51ba56-da16-4f6e-b0c6-a9624e9d5407
encoding: FLOAT32
metadata:
{"original_content": "Long-term effects of PEU in children are not fully documented.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the potential long-term health consequences of protein-energy undernutrition (PEU) in children?  \n2. How does protein-energy undernutrition (PEU) impact the growth and development of children over time?  \n3. Are there specific dietary interventions that can mitigate the long-term effects of protein-energy undernutrition (PEU) in children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 94fe1279-cf74-450d-9121-f23fb209eef0
encoding: FLOAT32
metadata:
{"original_content": "Some children develop chronic\nmalabsorption and pancreatic insufficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the nutritional implications of chronic malabsorption in children?  \n2. How does pancreatic insufficiency affect the absorption of essential vitamins and minerals?  \n3. What dietary interventions can help manage chronic malabsorption in children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6b67deaa-69c9-47ee-acb4-d4b818368eec
encoding: FLOAT32
metadata:
{"original_content": "In very young children, mild intellectual disability may develop\nand persist until at least school age.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can nutritional deficiencies in early childhood contribute to mild intellectual disability?  \n2. What specific dietary imbalances are linked to developmental delays in young children?  \n3. Are there metabolic disorders that manifest as intellectual disabilities in very young children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 83e56df4-d049-4c82-87a5-889f7aa337ba
encoding: FLOAT32
metadata:
{"original_content": "Permanent cognitive impairment may occur, depending on the\nduration, severity, and age at onset of PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How does the age at onset of Protein-Energy Undernutrition (PEU) influence the risk of permanent cognitive impairment?  \n2. What role does the severity of PEU play in determining long-term cognitive outcomes?  \n3. Can the duration of PEU directly impact the likelihood of developing cognitive impairments?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 83091ec0-01ce-4a0e-a3c4-60a5064cb57e
encoding: FLOAT32
metadata:
{"original_content": "Adults:\n In adults, PEU can result in morbidity and mortality (eg, progressive weight loss increases\nmortality rate for elderly patients in nursing homes).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How does progressive weight loss in elderly patients with Protein-Energy Undernutrition (PEU) impact their mortality rates in nursing homes?  \n2. What are the potential health consequences of Protein-Energy Undernutrition (PEU) in adult populations?  \n3. How does Protein-Energy Undernutrition (PEU) contribute to morbidity in elderly adults?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 47501521-6e0a-481a-86aa-fd7ea7ba750b
encoding: FLOAT32
metadata:
{"original_content": "In elderly patients, PEU increases the risk of\nmorbidity and mortality due to surgery, infections, or other disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How does Protein-Energy Undernutrition (PEU) impact the recovery outcomes of elderly patients undergoing surgery?  \n2. What role does PEU play in increasing susceptibility to infections in elderly individuals?  \n3. Why does PEU elevate the risk of mortality in elderly patients with other underlying health disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 21a41984-7a52-4a37-8ff6-0c7313ecb13b
encoding: FLOAT32
metadata:
{"original_content": "Except when organ failure occurs,\ntreatment is uniformly successful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the treatment outcomes for nutritional disorders when organ failure is not present?  \n2. How does the presence of organ failure impact the success rate of treating metabolic disorders?  \n3. Are there specific dietary deficiencies or imbalances that lead to organ failure, making treatment less effective?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 50be3542-76f3-419c-b4b1-89d87cb31839
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Usually, oral feeding\n\u2022 Possibly avoidance of lactose (eg, if persistent diarrhea suggests lactose intolerance)\n\u2022 Supportive care (eg, environmental changes, assistance with feeding, orexigenic drugs)\n\u2022 For children, feeding delayed 24 to 48 h\nWorldwide, the most important preventive strategy is to reduce poverty and improve nutritional education\nand public health measures.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What dietary adjustments can be made for individuals with lactose intolerance experiencing persistent diarrhea?  \n2. What supportive care measures can assist in managing nutritional disorders?  \n3. How can poverty reduction and public health measures help prevent nutritional deficiencies globally?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e28defba-efa9-4c36-9a57-9121c684a4b0
encoding: FLOAT32
metadata:
{"original_content": "Mild or moderate PEU, including brief starvation, can be treated by providing a balanced diet, preferably\norally.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can mild or moderate Protein-Energy Undernutrition (PEU) be effectively treated?  \n2. What is the recommended method of dietary intervention for brief starvation?  \n3. Why is oral administration preferred for addressing mild or moderate PEU?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5ef5f101-7329-4660-ae20-2f24a050a608
encoding: FLOAT32
metadata:
{"original_content": "Liquid oral food supplements (usually lactose-free) can be used when solid food cannot be\nadequately ingested.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can liquid oral food supplements help individuals with metabolic disorders who struggle to ingest solid food?  \n2. Are lactose-free liquid oral food supplements suitable for patients with dietary deficiencies caused by lactose intolerance?  \n3. What role do liquid oral food supplements play in managing nutrition for individuals with severe vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5669fee4-9ba7-414a-b24b-51310d40f252
encoding: FLOAT32
metadata:
{"original_content": "Diarrhea often complicates oral feeding because starvation makes the GI tract more\nlikely to move bacteria into Peyer's patches, facilitating infectious diarrhea.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How does starvation impact the gastrointestinal tract's susceptibility to infectious diarrhea?  \n2. What role do Peyer's patches play in the development of diarrhea during nutritional deficiencies?  \n3. Why might oral feeding be complicated in individuals experiencing starvation-related gastrointestinal issues?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e20e190d-5e8b-4b54-8a56-d0bdbca0b352
encoding: FLOAT32
metadata:
{"original_content": "If diarrhea persists\n(suggesting lactose intolerance), yogurt-based rather than milk-based formulas are given because people\nwith lactose intolerance can tolerate yogurt.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. Why is yogurt recommended over milk for individuals with lactose intolerance?  \n2. How does lactose intolerance contribute to persistent diarrhea?  \n3. What dietary modifications can help manage symptoms of lactose intolerance?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 128c7644-63a8-4137-839c-8424d49a8845
encoding: FLOAT32
metadata:
{"original_content": "Patients should also be given a multivitamin supplement.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. Why might a multivitamin supplement be recommended for patients with dietary deficiencies?  \n2. How can multivitamin supplements support recovery in individuals with metabolic disorders?  \n3. What role do multivitamin supplements play in addressing vitamin and mineral imbalances in patients?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ea39a01f-47a7-4e59-a8e3-8d91134b684a
encoding: FLOAT32
metadata:
{"original_content": "Severe PEU or prolonged starvation requires treatment in a hospital with a controlled diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the recommended treatment protocols for severe Protein-Energy Undernutrition (PEU) in a hospital setting?  \n2. How should a controlled diet be structured for patients recovering from prolonged starvation?  \n3. What are the potential risks of improper dietary management in cases of severe nutritional disorders like PEU?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b5e9b549-937d-4db0-b3ea-db46249929e6
encoding: FLOAT32
metadata:
{"original_content": "The first\npriority is to correct fluid and electrolyte abnormalities (see \nCh.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. How can fluid and electrolyte imbalances be managed in patients with nutritional disorders?  \n2. What are the initial steps in treating metabolic disorders related to dietary deficiencies?  \n3. How do electrolyte abnormalities impact the progression of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c5f9f70f-3129-4c35-ab70-a0eca2444b96
encoding: FLOAT32
metadata:
{"original_content": "97\n) and treat infections. Next is to supply\nmacronutrients orally or, if necessary (eg, when swallowing is difficult), through a feeding tube, a\nnasogastric tube (usually), or a gastrostomy tube.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the methods for providing macronutrients to patients with swallowing difficulties due to a nutritional disorder?  \n2. How can feeding tubes be utilized in the treatment of severe dietary deficiencies?  \n3. What role does infection management play in addressing metabolic disorders or malnutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dcf8e2af-960d-4c88-a951-a93d1785cd0c
encoding: FLOAT32
metadata:
{"original_content": "Parenteral nutrition is indicated if malabsorption is\nsevere (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the indications for using parenteral nutrition in cases of severe malabsorption?  \n2. How does severe malabsorption impact the decision to implement parenteral nutrition?  \n3. What criteria determine the severity of malabsorption requiring parenteral nutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ce2c3ec0-19bd-40a3-b6df-3958062b08b6
encoding: FLOAT32
metadata:
{"original_content": "23\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in essential vitamins and minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with prolonged obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ede66c3b-02ef-4c04-8fb6-8bbbc7712b7d
encoding: FLOAT32
metadata:
{"original_content": "Other treatments may be needed to correct specific deficiencies, which may become evident as weight\nincreases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What specific deficiencies might emerge during weight gain in individuals recovering from a nutritional disorder?  \n2. What treatments are commonly used to address dietary deficiencies associated with metabolic disorders?  \n3. How can vitamin and mineral imbalances be corrected during the management of obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8054c683-3f6a-446e-9ab8-482802b00600
encoding: FLOAT32
metadata:
{"original_content": "To avoid deficiencies, patients should take micronutrients at about twice the recommended\ndaily allowance (RDA) until recovery is complete.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What is the recommended dosage of micronutrients for patients recovering from a nutritional deficiency?  \n2. How can doubling the RDA of micronutrients aid in recovery from dietary deficiencies?  \n3. What role do micronutrients play in addressing vitamin and mineral imbalances during recovery?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6c5375e6-6d8c-496d-a843-04b5464c6472
encoding: FLOAT32
metadata:
{"original_content": "Children:\n Underlying disorders should be treated.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What underlying disorders could contribute to nutritional deficiencies in children?  \n2. How can treating underlying metabolic disorders improve a child's nutritional health?  \n3. What role do underlying health conditions play in the development of obesity in children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ac33fc50-1b6d-49fc-bd28-49e6b0891e73
encoding: FLOAT32
metadata:
{"original_content": "For children with diarrhea, feeding may be delayed 24\nto 48 h to avoid making the diarrhea worse; during this interval, children require oral or IV rehydration.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. Why is feeding delayed for children with diarrhea, and how does this impact their nutritional needs?  \n2. What role does oral or IV rehydration play in managing nutritional imbalances during diarrhea in children?  \n3. How can delaying feeding for 24 to 48 hours affect the recovery process in children with diarrhea-related metabolic disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 118b05b5-db92-4952-b14b-c4b886eca4c2
encoding: FLOAT32
metadata:
{"original_content": "Feedings are given often (6 to 12 times/day) but, to avoid overwhelming the limited intestinal absorptive\ncapacity, are limited to small amounts (< 100 mL).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. Why is it important to limit feeding volumes in individuals with reduced intestinal absorptive capacity?  \n2. How does frequent small feedings help manage certain nutritional or metabolic disorders?  \n3. What are the potential risks of exceeding 100 mL per feeding in patients with limited intestinal absorption?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d02345ec-1f6e-4b79-ba99-9fd3c6202766
encoding: FLOAT32
metadata:
{"original_content": "During the first week, milk-based formulas with\nsupplements added are usually given in progressively increasing amounts; after a week, the full amounts\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for infants with nutritional deficiencies during their first week of life?  \n2. How can milk-based formulas with supplements help address metabolic disorders in newborns?  \n3. What is the appropriate progression of formula supplementation for infants with vitamin or mineral imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2d452100-dc44-41dc-b6e2-c99c216ef504
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n65", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 12, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d7730213-6558-484b-b0f2-f148f5957bc1
encoding: FLOAT32
metadata:
{"original_content": "of 175 kcal/kg and 4 g of protein/kg can be given.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What is the recommended caloric intake per kilogram for individuals with specific nutritional disorders?  \n2. How much protein per kilogram is suggested for managing certain dietary deficiencies?  \n3. What dietary guidelines are appropriate for addressing metabolic disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cb6c39cd-4206-4bd6-b784-42a66d3060b0
encoding: FLOAT32
metadata:
{"original_content": "Twice the RDA of micronutrients should be given,\nusing commercial multivitamin supplements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can doubling the RDA of micronutrients through multivitamin supplements impact individuals with vitamin and mineral deficiencies?  \n2. Is providing twice the RDA of micronutrients effective in managing metabolic disorders related to nutrient imbalances?  \n3. What are the potential risks and benefits of using commercial multivitamin supplements to address dietary deficiencies in patients with obesity?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 62649a73-864c-4e00-8ab6-0f5c40472949
encoding: FLOAT32
metadata:
{"original_content": "After 4 wk, the formula can be replaced with whole milk plus\ncod liver oil and solid foods, including eggs, fruit, meats, and yeast.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can cod liver oil supplementation help address vitamin D deficiency in infants transitioning to solid foods?  \n2. What role do eggs, fruit, and meats play in preventing nutritional deficiencies during early childhood development?  \n3. Could the replacement of formula with whole milk contribute to any metabolic or dietary imbalances in young children?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: faf82139-685c-4fd3-a59d-484a462b0d73
encoding: FLOAT32
metadata:
{"original_content": "Energy distribution among macronutrients should be about 16% protein, 50% fat, and 34% carbohydrate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How might an imbalance in macronutrient distribution contribute to the development of obesity?  \n2. Could a diet with insufficient protein (less than 16% of energy) lead to muscle wasting or other protein deficiency-related disorders?  \n3. What are the potential metabolic consequences of consuming a diet with excessive fat (more than 50% of energy)?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c803dff4-77d8-48e7-b154-c9d99c60a41e
encoding: FLOAT32
metadata:
{"original_content": "An example is a combination of powdered cow's skimmed milk (110 g), sucrose (100 g), vegetable oil (70\ng), and water (900 mL).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can a powdered milk-based formula be used to address dietary deficiencies in individuals with malnutrition?  \n2. What role does sucrose play in managing energy requirements for patients with metabolic disorders?  \n3. Can the combination of vegetable oil and skimmed milk in this formula help prevent vitamin deficiencies in individuals with fat-soluble vitamin absorption issues?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 98a78808-a4ca-44ca-bc3c-32ae59c97cd2
encoding: FLOAT32
metadata:
{"original_content": "Many other formulas (eg, whole [full-fat] fresh milk plus corn oil and maltodextrin)\ncan be used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can whole fresh milk, corn oil, and maltodextrin be combined to address specific dietary deficiencies?  \n2. What role does maltodextrin play in managing metabolic disorders or energy imbalances?  \n3. Can full-fat fresh milk-based formulas be effective in treating certain nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 11fdb377-7b77-439e-a619-f3cd3d604cb9
encoding: FLOAT32
metadata:
{"original_content": "Milk powders used in formulas are diluted with water.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How does the dilution of milk powders in formulas impact the risk of nutritional deficiencies in infants?  \n2. Can improper dilution of milk powder formulas lead to metabolic disorders in young children?  \n3. What are the potential health consequences of vitamin and mineral imbalances caused by incorrectly prepared milk powder formulas?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1d630d32-7cc3-4e18-b0d8-c6350010abbc
encoding: FLOAT32
metadata:
{"original_content": "Usually, supplements should be added to formulas:\n\u2022 Mg 0.4 mEq/kg/day IM is given for 7 days.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What is the recommended magnesium supplementation dosage for addressing deficiencies in nutritional disorders?  \n2. How long should magnesium supplementation be administered in cases of dietary deficiencies?  \n3. What is the appropriate route of administration for magnesium in treating metabolic disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 33da9c8d-8d2c-4239-93d1-93f16263437b
encoding: FLOAT32
metadata:
{"original_content": "\u2022 B-complex vitamins at twice the RDA are given parenterally for the first 3 days, usually with vitamin A,\nphosphorus, zinc, manganese, copper, iodine, fluoride, molybdenum, and selenium.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can parenteral administration of B-complex vitamins and trace elements help address severe nutritional deficiencies?  \n2. What role do trace minerals like zinc, copper, and selenium play in managing metabolic disorders?  \n3. Why might vitamin A supplementation be included alongside B-complex vitamins in treating certain nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 04a25a63-a1c9-4f9c-8054-8f9545a339de
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Because absorption of oral iron is poor in children with PEU, oral or IM iron supplementation may be\nnecessary.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. Why is oral iron absorption poor in children with Protein-Energy Undernutrition (PEU)?  \n2. When should intramuscular (IM) iron supplementation be considered for children with PEU?  \n3. What are the potential challenges of addressing iron deficiency in children with PEU?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff0fb2c0-594e-4b3d-b988-c497f658be20
encoding: FLOAT32
metadata:
{"original_content": "Parents are taught about nutritional requirements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can parents identify and address vitamin and mineral deficiencies in their children?  \n2. What dietary guidelines should parents follow to prevent obesity and related health conditions in their children?  \n3. How can parents ensure their child\u2019s diet supports proper metabolic function and prevents nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f472b2b9-fb0a-4da5-b920-9c9bbb1a9f83
encoding: FLOAT32
metadata:
{"original_content": "Adults:\n Underlying disorders should be treated. For example, if AIDS or cancer results in excess cytokine\nproduction, megestrol acetate or medroxyprogesterone may improve food intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can megestrol acetate or medroxyprogesterone be used to improve food intake in adults with nutrition disorders caused by AIDS or cancer?  \n2. What role do excess cytokines play in the development of nutrition-related disorders in adults with underlying conditions like cancer or AIDS?  \n3. What treatment strategies are recommended for addressing nutrition disorders in adults with chronic illnesses?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1ec9c04e-9fb0-443b-9a19-7a8e94c37cfe
encoding: FLOAT32
metadata:
{"original_content": "However, because\nthese drugs dramatically decrease testosterone in men (possibly causing muscle loss), testosterone\nshould be replaced.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How does decreased testosterone due to certain drugs impact muscle loss in men with metabolic disorders?  \n2. What role does testosterone replacement play in managing muscle loss associated with nutritional or hormonal imbalances?  \n3. Are there specific dietary or nutritional strategies to support testosterone levels in men undergoing treatment with testosterone-lowering drugs?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a1cf47db-d5c2-436c-8dee-4f367458bbfb
encoding: FLOAT32
metadata:
{"original_content": "Because these drugs can cause adrenal insufficiency, they should be used only\nshort-term (< 3 mo).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How does adrenal insufficiency caused by certain drugs impact metabolic disorders?  \n2. What are the nutritional implications of short-term drug use for managing adrenal-related conditions?  \n3. Are there dietary strategies to mitigate the effects of adrenal insufficiency caused by medication?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a1e881f2-bef7-485e-9bac-eee0f31e5d76
encoding: FLOAT32
metadata:
{"original_content": "In patients with functional limitations, home delivery of meals and feeding assistance are key.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can home-delivered meals support patients with functional limitations in managing dietary deficiencies?  \n2. What role does feeding assistance play in addressing malnutrition in individuals with metabolic disorders?  \n3. Can home meal delivery services help prevent vitamin and mineral imbalances in patients with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab5bfbad-747f-424a-a0a6-06e98c30afde
encoding: FLOAT32
metadata:
{"original_content": "An orexigenic drug, such as the cannabis extract dronabinol, should be given to patients with anorexia\nwhen no cause is obvious or to patients at the end of life when anorexia impairs quality of life.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What are the potential uses of orexigenic drugs like dronabinol in managing anorexia related to nutritional disorders?  \n2. How can anorexia at the end of life impact nutritional status and quality of life?  \n3. When is it appropriate to administer orexigenic drugs for anorexia with no identifiable cause?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 12a3a6a3-0b55-4df9-a0ca-bc471ec2cd0b
encoding: FLOAT32
metadata:
{"original_content": "An\nanabolic steroid (eg, enanthate, nandrolone, testosterone) or growth hormone can benefit patients with\ncachexia due to renal failure and possibly elderly patients (eg, by increasing lean body mass or possibly\nby improving function).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can anabolic steroids or growth hormones help manage cachexia in patients with renal failure?  \n2. What potential benefits do anabolic steroids or growth hormones offer to elderly patients in terms of lean body mass and functional improvement?  \n3. Are anabolic steroids or growth hormones effective interventions for addressing muscle wasting in nutrition-related disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d3b48c78-3c19-4c73-a64b-a2d4496d689a
encoding: FLOAT32
metadata:
{"original_content": "Correction of PEU in adults generally resembles that in children; feedings are often limited to small\namounts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How should feedings be managed in adults with Protein-Energy Undernutrition (PEU)?  \n2. Are there similarities in the dietary correction of PEU between adults and children?  \n3. Why are small amounts of food recommended when addressing PEU in adults?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1fe6ffa8-02b2-46d1-8a5b-cf84e7b9493d
encoding: FLOAT32
metadata:
{"original_content": "However, for most adults, feeding does not need to be delayed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. Under what circumstances might feeding need to be delayed for adults with specific nutritional disorders?  \n2. How does the timing of feeding impact adults with metabolic disorders or dietary deficiencies?  \n3. Are there exceptions to the recommendation of not delaying feeding for adults with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 370a5d95-632d-40bf-b61d-4b0a121256c4
encoding: FLOAT32
metadata:
{"original_content": "A commercial formula for oral\nfeeding can be used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What are the nutritional benefits of using a commercial formula for oral feeding in patients with dietary deficiencies?  \n2. How can commercial oral feeding formulas help manage metabolic disorders in individuals with specific nutrient needs?  \n3. Are commercial oral feeding formulas effective in addressing vitamin and mineral imbalances in patients with malabsorption issues?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3958a34c-1d9a-424d-a602-075985f0f522
encoding: FLOAT32
metadata:
{"original_content": "Daily nutrient supply should be given at a rate of 60 kcal/kg and 1.2 to 2 g of\nprotein/kg.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can daily caloric and protein intake recommendations help manage metabolic disorders in individuals with specific nutritional needs?  \n2. What role does protein intake play in addressing dietary deficiencies in patients with malnutrition?  \n3. How can adjusting caloric and protein intake per kilogram of body weight aid in the treatment of obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 96156937-5b31-4f69-a7a7-e15582ad8109
encoding: FLOAT32
metadata:
{"original_content": "If liquid oral supplements are used with solid food, they should be given at least 1 h before\nmeals so that the amount of food eaten at the meal is not reduced.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can the timing of liquid oral supplements impact food intake in individuals with dietary deficiencies?  \n2. What is the recommended timing for administering liquid oral supplements to prevent reduced solid food consumption in patients with metabolic disorders?  \n3. Could improper timing of liquid oral supplements contribute to malnutrition or vitamin and mineral imbalances in individuals with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 97c525dd-3746-4d10-b126-34d1528a2c29
encoding: FLOAT32
metadata:
{"original_content": "Treatment of institutionalized elderly patients with PEU requires multiple interventions:\n\u2022 Environmental measures (eg, making the dining area more attractive)\n\u2022 Feeding assistance\n\u2022 Changes in diet (eg, use of food enhancers and caloric supplements between meals)\n\u2022 Treatment of depression and other underlying disorders\n\u2022 Use of orexigenics, anabolic steroids, or both\nThe long-term use of gastrostomy tube feeding is essential for patients with severe dysphagia; its use in\npatients with dementia is controversial.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What dietary interventions can be implemented to address protein-energy undernutrition (PEU) in institutionalized elderly patients?  \n2. How can environmental and psychological factors, such as depression, impact the treatment of nutritional disorders in elderly patients?  \n3. What are the considerations for using gastrostomy tube feeding in elderly patients with severe dysphagia or dementia?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: afb64a34-8df5-43e9-b592-f4cc5a218ea4
encoding: FLOAT32
metadata:
{"original_content": "Increasing evidence supports the avoidance of unpalatable\ntherapeutic diets (eg, low salt, diabetic, low cholesterol) in institutionalized patients because these diets\ndecrease food intake and may cause severe PEU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. How can unpalatable therapeutic diets contribute to the development of protein-energy undernutrition (PEU) in institutionalized patients?  \n2. What are the potential risks of implementing low-salt or low-cholesterol diets in patients with pre-existing nutritional deficiencies?  \n3. Why might diabetic diets in institutionalized settings lead to decreased food intake and exacerbate metabolic disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a633f974-271d-4732-a2a9-8071fdab0884
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health complications associated with long-term obesity and how can they be mitigated?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9cfa3b92-2eda-4e24-adc2-edb9757fc3bf
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n66", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 13, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 43589cb5-c28e-499a-bfaf-b3c4e256f8c1
encoding: FLOAT32
metadata:
{"original_content": "Complications of treatment:\n Treatment of PEU can cause complications (refeeding syndrome),\nincluding fluid overload, electrolyte deficits, hyperglycemia, cardiac arrhythmias, and diarrhea.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential complications associated with the treatment of Protein-Energy Undernutrition (PEU)?  \n2. How does refeeding syndrome impact electrolyte balance in individuals with nutritional deficiencies?  \n3. What cardiac risks are associated with refeeding in patients recovering from severe malnutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 59f82547-cddd-42f5-a70a-ad787a981e4e
encoding: FLOAT32
metadata:
{"original_content": "Diarrhea is\nusually mild and resolves; however, diarrhea in patients with severe PEU occasionally causes severe\ndehydration or death.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does severe Protein-Energy Undernutrition (PEU) contribute to the severity of diarrhea?  \n2. What are the potential health outcomes of diarrhea in individuals with severe nutritional deficiencies?  \n3. Why is dehydration a critical risk in patients with severe PEU experiencing diarrhea?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e9909ebd-18fe-470d-9400-3cb6b416d2c2
encoding: FLOAT32
metadata:
{"original_content": "Causes of diarrhea (eg, sorbitol used in elixir tube feedings, \nClostridium difficile\n if\nthe patient has received an antibiotic) may be correctable.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How can the use of sorbitol in tube feedings contribute to diarrhea in patients?  \n2. What role does Clostridium difficile play in causing diarrhea after antibiotic use?  \n3. Are there correctable dietary factors that can prevent diarrhea in patients receiving tube feedings?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b56e306b-84d6-4f70-b1bb-9b32079b99e1
encoding: FLOAT32
metadata:
{"original_content": "Osmotic diarrhea due to excess calories is rare\nin adults and should be considered only when other causes have been excluded.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential causes of osmotic diarrhea in adults related to dietary intake?  \n2. How can excess calorie consumption contribute to osmotic diarrhea in rare cases?  \n3. Why should other causes be excluded before diagnosing osmotic diarrhea due to excess calories in adults?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fd51c305-5bc4-48fd-9725-a9a7e40e8113
encoding: FLOAT32
metadata:
{"original_content": "Because PEU can impair cardiac and renal function, hydration can cause intravascular volume overload.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does protein-energy undernutrition (PEU) affect cardiac and renal function?  \n2. What are the risks of intravascular volume overload in individuals with PEU?  \n3. Why is hydration management critical for patients with protein-energy undernutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 474618a9-d4ca-4fa2-ac28-b9347ae3af87
encoding: FLOAT32
metadata:
{"original_content": "Treatment decreases extra-cellular K and Mg.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does the treatment of a nutritional disorder affect extracellular potassium (K) and magnesium (Mg) levels?  \n2. What are the potential risks of decreasing extracellular potassium and magnesium in patients with metabolic disorders?  \n3. Can dietary interventions help mitigate the effects of treatments that lower extracellular potassium and magnesium?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f68bac7c-8a2a-45d2-a8ad-1d7f7a2dc1b3
encoding: FLOAT32
metadata:
{"original_content": "Depletion of K or Mg may cause arrhythmias. Carbohydrate metabolism that occurs during treatment stimulates insulin release, which drives phosphate\ninto cells.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How can potassium or magnesium depletion contribute to the development of arrhythmias?  \n2. What role does insulin release play in phosphate imbalances during carbohydrate metabolism?  \n3. How might dietary deficiencies in potassium, magnesium, or phosphate impact heart health?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9fbd0862-f284-4fcd-b427-afaf3bfb2c49
encoding: FLOAT32
metadata:
{"original_content": "Hypophosphatemia can cause muscle weakness, paresthesias, seizures, coma, and\narrhythmias.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does hypophosphatemia contribute to muscle weakness and neurological symptoms?  \n2. What are the potential health risks associated with phosphate deficiency in the diet?  \n3. Can hypophosphatemia-induced arrhythmias be linked to other metabolic imbalances?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: baa337dd-605c-46fe-aa73-80c1340d269f
encoding: FLOAT32
metadata:
{"original_content": "Because phosphate levels can change rapidly during parenteral feeding, levels should be\nmeasured regularly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. Why is it important to monitor phosphate levels during parenteral feeding in patients with metabolic disorders?  \n2. How can rapid changes in phosphate levels during parenteral feeding impact nutritional balance and health?  \n3. What are the potential risks of not regularly measuring phosphate levels in patients receiving parenteral nutrition?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c6c33f51-2ed8-40cc-a36c-08fef245c3b5
encoding: FLOAT32
metadata:
{"original_content": "During treatment, endogenous insulin may become ineffective, leading to hyperglycemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does the ineffectiveness of endogenous insulin contribute to hyperglycemia in metabolic disorders?  \n2. What dietary interventions can help manage hyperglycemia caused by insulin resistance?  \n3. Are there specific nutritional deficiencies that exacerbate the ineffectiveness of endogenous insulin?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 33908d74-6903-4f1c-9b75-f041b503206b
encoding: FLOAT32
metadata:
{"original_content": "Dehydration\nand hyperosmolarity can result.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does dehydration contribute to the development of hyperosmolarity in the body?  \n2. What are the potential nutritional or metabolic causes of dehydration leading to hyperosmolarity?  \n3. How can dietary interventions help prevent dehydration and its associated hyperosmolarity?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 68e6fb1b-c674-42be-b8fe-7336275c0a8f
encoding: FLOAT32
metadata:
{"original_content": "Fatal ventricular arrhythmias can develop, possibly caused by a\nprolonged QT interval.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to the development of prolonged QT intervals and fatal ventricular arrhythmias?  \n2. What role do electrolyte imbalances, such as low potassium or magnesium levels, play in the risk of prolonged QT intervals?  \n3. Are there specific nutritional interventions that can help prevent fatal ventricular arrhythmias associated with metabolic disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 37310ff0-f9b1-42af-a7da-f38d0ce5ec07
encoding: FLOAT32
metadata:
{"original_content": "Carnitine Deficiency\nCarnitine deficiency results from inadequate intake of or inability to metabolize the amino acid\ncarnitine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential causes of carnitine deficiency in individuals?  \n2. How does the inability to metabolize carnitine affect the body's metabolic processes?  \n3. What dietary sources can help prevent carnitine deficiency?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 09d43276-c2e3-4dd4-8ea2-7ca16b7ac177
encoding: FLOAT32
metadata:
{"original_content": "It can cause a heterogeneous group of disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are some examples of heterogeneous disorders caused by nutritional deficiencies?  \n2. How can metabolic disorders be classified as part of a heterogeneous group of nutritional disorders?  \n3. What role do vitamin and mineral imbalances play in contributing to heterogeneous nutritional disorders?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b16db984-68d8-4d5b-9a47-5416e275caee
encoding: FLOAT32
metadata:
{"original_content": "Muscle metabolism is impaired,\ncausing myopathy, hypoglycemia, or cardiomyopathy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does impaired muscle metabolism contribute to the development of hypoglycemia in metabolic disorders?  \n2. What nutritional deficiencies or imbalances can lead to cardiomyopathy associated with muscle metabolism impairment?  \n3. Are there specific dietary interventions that can help manage myopathy caused by impaired muscle metabolism?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a4aebd7f-80eb-4419-a641-8e7502d47969
encoding: FLOAT32
metadata:
{"original_content": "Infants typically present with\nhypoglycemic, hypoketotic encephalopathy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential nutritional or metabolic causes of hypoglycemic, hypoketotic encephalopathy in infants?  \n2. How might dietary deficiencies contribute to the development of hypoglycemic, hypoketotic encephalopathy?  \n3. What role do metabolic disorders play in the presentation of hypoglycemia and lack of ketone production in infants?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c813576f-cc52-4499-ba52-1abdfed3e83b
encoding: FLOAT32
metadata:
{"original_content": "Most often, treatment consists of dietary L-\ncarnitine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What role does dietary L-carnitine play in the treatment of specific metabolic disorders?  \n2. How does a deficiency in L-carnitine affect the body's ability to metabolize fats?  \n3. What are the symptoms of a nutritional disorder that requires dietary L-carnitine for treatment?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 805e99a0-1e59-4a05-8bf2-d7194621a81c
encoding: FLOAT32
metadata:
{"original_content": "The amino acid carnitine is required for the transport of long-chain fatty acyl coenzyme A (CoA) esters\ninto myocyte mitochondria, where they are oxidized for energy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does a deficiency in carnitine impact the metabolism of long-chain fatty acids in individuals with metabolic disorders?  \n2. Can carnitine supplementation improve energy production in patients with mitochondrial dysfunction?  \n3. What role does carnitine play in preventing energy deficits in individuals with dietary deficiencies affecting fatty acid oxidation?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 007e4439-8bba-4ca7-944d-92df3609a365
encoding: FLOAT32
metadata:
{"original_content": "Carnitine is obtained from foods,\nparticularly animal-based foods, and via endogenous synthesis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How does a deficiency in carnitine affect metabolic disorders related to fatty acid oxidation?  \n2. Can a lack of animal-based foods in the diet lead to carnitine deficiency and associated health conditions?  \n3. What role does endogenous synthesis of carnitine play in preventing dietary deficiencies?  "}


created_at: 2025-03-03 11:15:22
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 51533f52-3b82-4693-a189-942b54b5f6d9
encoding: FLOAT32
metadata:
{"original_content": "Causes of carnitine deficiency include the following:\n\u2022 Inadequate intake (eg, due to fad diets, lack of access, or long-term TPN)\n\u2022 Inability to metabolize carnitine due to enzyme deficiencies (eg, carnitine palmitoyltransferase deficiency,\nmethylmalonicaciduria, propionicacidemia, isovalericacidemia)\n\u2022 Decreased endogenous synthesis of carnitine due to a severe liver disorder\n\u2022 Excess loss of carnitine due to diarrhea, diuresis, or hemodialysis\n\u2022 A hereditary disorder in which carnitine leaks from renal tubules\n\u2022 Increased requirements for carnitine when ketosis is present or demand for fat oxidation is high (eg,\nduring a critical illness such as sepsis or major burns; after major surgery of the GI tract)\n\u2022 Decreased muscle carnitine levels due to mitochondrial impairment (eg, due to use of zidovudine)\n\u2022 Use of valproate\nThe deficiency may be generalized (systemic) or may affect mainly muscle (myopathic).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential causes of carnitine deficiency related to dietary intake and metabolic disorders?  \n2. How can critical illnesses or medical treatments like hemodialysis and valproate use contribute to carnitine deficiency?  \n3. What hereditary and enzymatic conditions can lead to impaired carnitine metabolism or loss?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4c52db37-356b-45aa-9055-ae19a56adb89
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nSymptoms and the age at which symptoms appear depend on the cause.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. How do the symptoms of nutritional disorders vary depending on the underlying cause?  \n2. At what age do symptoms of dietary deficiencies typically begin to manifest?  \n3. What are the common signs associated with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1a13235e-f9f4-4924-acc8-442a2c8b2c96
encoding: FLOAT32
metadata:
{"original_content": "Carnitine deficiency may cause\nmuscle necrosis, myoglobinuria, lipid-storage myopathy, hypoglycemia, fatty liver, and hyperammonemia\nwith muscle aches, fatigue, confusion, and cardiomyopathy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the potential symptoms and complications associated with carnitine deficiency?  \n2. How does carnitine deficiency contribute to lipid-storage myopathy and fatty liver?  \n3. What metabolic effects can carnitine deficiency have on muscle and cardiac health?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b22d0f46-3943-4313-ae52-bedafb302ed1
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bbc726ad-e2a7-47fc-95a1-d737c8fe0507
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n67", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 14, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3aad5be9-3956-42bc-b2e8-707d5cd92f81
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\nIn neonates, carnitine palmitoyltransferase deficiency is diagnosed using mass spectrometry to screen\nblood.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How is carnitine palmitoyltransferase deficiency diagnosed in neonates?  \n2. What role does mass spectrometry play in identifying metabolic disorders in newborns?  \n3. Can blood screening detect carnitine-related deficiencies in neonates?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c4471535-d28c-478e-930a-06fc9cab61af
encoding: FLOAT32
metadata:
{"original_content": "Prenatal diagnosis may be possible using amniotic villous cells.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How can prenatal diagnosis using amniotic villous cells help identify metabolic disorders in a fetus?  \n2. Can amniotic villous cell analysis detect vitamin or mineral imbalances during pregnancy?  \n3. What role does prenatal diagnosis play in managing hereditary nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5320f970-d26a-4dcf-9552-4a9b678f13c1
encoding: FLOAT32
metadata:
{"original_content": "In adults, the definitive diagnosis is\nbased on acylcarnitine levels in serum, urine, and tissues (muscle and liver for systemic deficiency;\nmuscle only for myopathic deficiency).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How are acylcarnitine levels used to diagnose systemic deficiencies in adults?  \n2. What role do muscle and liver tissues play in identifying myopathic versus systemic deficiencies?  \n3. What diagnostic markers are evaluated in serum and urine for metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 13da91dd-d23a-4754-ae6b-14379de9bd3c
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Avoidance of fasting and strenuous exercise\n\u2022 Dietary interventions, based on cause\nCarnitine deficiency due to inadequate dietary intake, increased requirements, excess losses, decreased\nsynthesis, or (sometimes) enzyme deficiencies can be treated by giving L-carnitine 25 mg/kg po q 6 h.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What dietary interventions are recommended for managing carnitine deficiency?  \n2. How can carnitine deficiency caused by enzyme deficiencies be treated?  \n3. What is the recommended dosage of L-carnitine for addressing carnitine deficiency?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 372ff584-470a-4e03-8c47-1fb9c9bdbd4c
encoding: FLOAT32
metadata:
{"original_content": "All patients must avoid fasting and strenuous exercise.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. Why is fasting contraindicated for patients with certain metabolic disorders?  \n2. How does strenuous exercise impact individuals with dietary deficiencies or vitamin imbalances?  \n3. What are the potential risks of fasting for patients with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dc66b36b-5f4f-4cce-bd76-b62e50f3dd9f
encoding: FLOAT32
metadata:
{"original_content": "Consuming uncooked cornstarch at bedtime\nprevents early morning hypoglycemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How does consuming uncooked cornstarch at bedtime help manage hypoglycemia in individuals with metabolic disorders?  \n2. Can uncooked cornstarch be used as a dietary intervention for preventing nocturnal hypoglycemia in patients with glycogen storage diseases?  \n3. What are the potential nutritional or metabolic risks associated with using uncooked cornstarch as a treatment for early morning hypoglycemia?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7e73495e-337c-46f6-aa83-a8bbb3918bec
encoding: FLOAT32
metadata:
{"original_content": "Some patients require supplementation with medium-chain\ntriglycerides and essential fatty acids (eg, linoleic acid, linolenic acid).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. Why might patients with certain metabolic disorders require supplementation with medium-chain triglycerides?  \n2. What role do essential fatty acids like linoleic acid and linolenic acid play in addressing dietary deficiencies?  \n3. How can supplementation with medium-chain triglycerides benefit individuals with fat malabsorption issues?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48ebf075-5cc7-4887-a49d-d45994b051a6
encoding: FLOAT32
metadata:
{"original_content": "Patients with a fatty acid oxidation\ndisorder require a high-carbohydrate, low-fat diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. Why is a high-carbohydrate, low-fat diet recommended for patients with fatty acid oxidation disorders?  \n2. How does a fatty acid oxidation disorder affect the body's ability to metabolize fats?  \n3. What are the potential health risks of not following a specialized diet for fatty acid oxidation disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9b1b657-0703-4759-9241-2bb05e5926c4
encoding: FLOAT32
metadata:
{"original_content": "Essential Fatty Acid Deficiency\nEssential fatty acid (EFA) deficiency is rare, occurring most often in infants fed diets deficient in\nEFAs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the primary dietary causes of essential fatty acid deficiency in infants?  \n2. How does a deficiency in essential fatty acids manifest in terms of metabolic health?  \n3. What are the potential health consequences of prolonged essential fatty acid deficiency?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3b062d61-2781-4fe1-b5ac-a3cb1800edb2
encoding: FLOAT32
metadata:
{"original_content": "Signs include scaly dermatitis, alopecia, thrombocytopenia, and, in children, growth\nretardation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What nutritional deficiencies can lead to symptoms such as scaly dermatitis, alopecia, and thrombocytopenia?  \n2. How does a lack of specific nutrients contribute to growth retardation in children?  \n3. Which dietary interventions can address the symptoms of scaly dermatitis and alopecia caused by a nutritional disorder?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 699f2f97-4c4d-4043-ba22-7e7675325a76
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How can a clinical diagnosis be used to identify specific vitamin or mineral deficiencies?  \n2. What clinical signs are typically observed in patients with metabolic disorders?  \n3. How does clinical diagnosis differentiate between various nutritional disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c2f35756-46d5-47a9-aa8e-77d2cf29f7f6
encoding: FLOAT32
metadata:
{"original_content": "Dietary replenishment of EFAs reverses the deficiency. The EFAs linoleic and linolenic acid are substrates for the endogenous synthesis of other fatty acids that\nare needed for many physiologic processes, including maintaining the integrity of skin and cell\nmembranes and synthesizing prostaglandins and leukotrienes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How does a deficiency in essential fatty acids (EFAs) affect the integrity of skin and cell membranes?  \n2. What role do linoleic and linolenic acids play in the synthesis of prostaglandins and leukotrienes?  \n3. Can dietary replenishment of EFAs reverse physiological issues caused by their deficiency?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e217cf1a-01a7-4588-8797-babe3f58ad22
encoding: FLOAT32
metadata:
{"original_content": "For example, eicosapentaenoic acid and\ndocosahexaenoic acid, synthesized from EFAs, are important components of the brain and retina.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How do deficiencies in essential fatty acids (EFAs) impact brain and retina health?  \n2. What role do eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play in preventing nutritional disorders?  \n3. Can a lack of dietary EFAs contribute to metabolic disorders affecting the nervous system?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 152fb3cc-08cd-4b02-8ea4-bdd6145966ed
encoding: FLOAT32
metadata:
{"original_content": "For EFA deficiency to develop, dietary intake must be very low.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the dietary conditions necessary for essential fatty acid (EFA) deficiency to occur?  \n2. How does a very low dietary intake contribute to the development of EFA deficiency?  \n3. What are the potential health consequences of prolonged EFA deficiency caused by insufficient dietary intake?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 970d7dbc-a3f0-4841-95b5-28b78d521e2c
encoding: FLOAT32
metadata:
{"original_content": "Even small amounts of EFAs can prevent\nEFA deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How can small amounts of essential fatty acids (EFAs) help prevent EFA deficiency?  \n2. What are the potential health consequences of EFA deficiency in relation to metabolic disorders?  \n3. What dietary sources provide sufficient EFAs to avoid nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c448f7b9-db7e-4a94-952b-1666bbe66208
encoding: FLOAT32
metadata:
{"original_content": "Cow's milk has only about 25% of the linoleic acid in human milk, but when ingested in\nnormal amounts, it has enough linoleic acid to prevent EFA deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How does the linoleic acid content in cow's milk compare to human milk in preventing essential fatty acid (EFA) deficiency?  \n2. Can consuming normal amounts of cow's milk provide sufficient linoleic acid to avoid dietary deficiencies related to EFAs?  \n3. What role does linoleic acid play in preventing nutritional disorders associated with fatty acid imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e4dc988d-d2ab-4c99-b0d4-63199e0ea70d
encoding: FLOAT32
metadata:
{"original_content": "Total fat intake of people in many\ndeveloping countries may be very low, but the fat is often vegetable based, with large amounts of linoleic\nacid and enough linolenic acid to prevent EFA deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How does a diet high in linoleic acid and sufficient in linolenic acid prevent essential fatty acid (EFA) deficiency?  \n2. What are the potential health implications of very low total fat intake in developing countries?  \n3. Can a vegetable-based fat diet mitigate the risk of nutritional disorders related to fat deficiency?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b3b8fcfb-2ca4-41d4-a1d4-e6128e5df420
encoding: FLOAT32
metadata:
{"original_content": "Babies fed a formula low in linoleic acid, such as a skim-milk formula, can develop EFA deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the potential health consequences of feeding infants a formula low in linoleic acid?  \n2. How does a deficiency in essential fatty acids (EFA) manifest in infants?  \n3. Why is linoleic acid important in preventing nutritional disorders in babies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e3d89a59-58b0-4845-b467-df396c5ba7b9
encoding: FLOAT32
metadata:
{"original_content": "EFA\ndeficiency used to result from long-term TPN if fat was not included.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the potential consequences of excluding fat from long-term total parenteral nutrition (TPN)?  \n2. How does essential fatty acid (EFA) deficiency develop in patients relying on TPN?  \n3. What role do essential fatty acids play in preventing nutritional disorders during TPN therapy?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9a6c3f7e-9d8d-47b0-954a-2701ab436018
encoding: FLOAT32
metadata:
{"original_content": "But now, most TPN solutions include\nfat emulsions to prevent EFA deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How do fat emulsions in TPN solutions help prevent essential fatty acid (EFA) deficiency?  \n2. What are the potential health consequences of EFA deficiency in patients receiving TPN?  \n3. Why are fat emulsions an important component of TPN for addressing nutritional disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2accf2ee-3a15-4269-95a3-80a6c11b9681
encoding: FLOAT32
metadata:
{"original_content": "In patients with fat malabsorption or increased metabolic needs\n(eg, because of surgery, multiple trauma, or burns), laboratory evidence of EFA deficiency may be\npresent without clinical signs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the potential laboratory indicators of essential fatty acid (EFA) deficiency in patients with fat malabsorption?  \n2. How do increased metabolic needs, such as those caused by trauma or burns, contribute to the risk of EFA deficiency?  \n3. Can EFA deficiency occur without visible clinical symptoms in patients with specific metabolic or absorption disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b17f9dca-92e6-4378-8354-817a747854ab
encoding: FLOAT32
metadata:
{"original_content": "Dermatitis due to EFA deficiency is generalized and scaly; in infants, it can resemble congenital\nichthyosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the dermatological manifestations of essential fatty acid (EFA) deficiency in infants?  \n2. How can EFA deficiency-related dermatitis be differentiated from congenital ichthyosis?  \n3. What role do essential fatty acids play in preventing generalized scaly dermatitis?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7b4f30e1-bc00-4edc-b019-deedc8ff6f95
encoding: FLOAT32
metadata:
{"original_content": "The dermatitis increases water loss from the skin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How does increased water loss from the skin due to dermatitis affect hydration levels in individuals with nutritional deficiencies?  \n2. Can dietary deficiencies exacerbate skin conditions like dermatitis that lead to increased water loss?  \n3. What role do vitamin and mineral imbalances play in the development or worsening of dermatitis-related water loss?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d36b83e5-24b5-4ff3-9387-33c113e2a3b2
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical; however, laboratory assays are now available in large research centers.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. How can clinical diagnosis be supplemented with laboratory assays for identifying specific nutritional disorders?  \n2. What advancements in laboratory assays have improved the detection of vitamin and mineral imbalances?  \n3. Are laboratory assays for diagnosing metabolic disorders widely accessible outside of large research centers?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 969f3eab-65b9-43dc-b2c3-7d14b6f70a06
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of dietary EFAs, reversing the deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What dietary changes can help reverse essential fatty acid (EFA) deficiencies?  \n2. How does an EFA deficiency manifest as a nutritional disorder?  \n3. What are the health implications of untreated EFA deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ac9da8ef-a602-4361-81ae-41bdac3aaec8
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency, and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity, and what treatment options are recommended?  "}


