Biochemistry (Nursing)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson title: PROTEINS (Protein Energy Malnutrition

and Natural Peptides) Materials: Book, pen and notebook
Learning Targets:
At the end of the module, students will be able to:
1. Understand the concept of PEM;
2. Classify PEM; References:
3. Identify and describe the clinical manifestations of PEM and Espino-Cabatit (1988) Biochemistry 12th ed.
its complications; and, UST Press, Manila
4. Identify the source or function of some common natural
peptides.
https://www.unicef.org/nutrition/training/2.3/2.h
tml
https://www.msdmanuals.com/professional/nu
tritional-disorders/undernutrition/protein-
energy-undernutrition-peu

A. LESSON PREVIEW/ REVIEW

Watch a short video documentary about malnutrition in the Philippines.

Here’s the link for the short video documentary: https://www.youtube.com/watch?v=bADncQkgiB8
Other useful video link: https://www.youtube.com/watch?v=-FLdNtrLDzQ

Answer the question:

As future healthcare provider, identify strategies that can contribute to make a difference when it comes to
malnutrition.

B. MAIN LESSON

MALNUTRITION
● Caused by a deficiency or excess in one or more essential nutrients in the diet
● Characterized by a wide array of health problems including weight loss, stunted growth, weakness,
resistance to infection and impairment of intellect
● Severe cases may lead to death

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 Biochemistry (Nursing)
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Types of Undernutrition:
● Underweight: underweight for one’s age (weight for age)
● Stunted: A chronic malnutrition manifested by being too short for one’s age (height for age)
● Wasted: An acute malnutrition manifested by being dangerously thin (weight for height)
There are two major types of malnutrition:
A. Protein-energy malnutrition: resulting from deficiencies in any or all nutrients
B. Micronutrient deficiency diseases: resulting from a deficiency of specific micronutrients.
PROTEIN-ENERGY MALNUTRITION
● Due to the foods people eat which are low in protein
● Also known as protein energy undernutrition
● No protein at all
● Body is not able to synthesize CHON to produce energy
● Most common nutritional disorder of developing countries.
● Food gap is the chief cause of PEM
o it is not only the deficiency of proteins but inappropriate food (low in energy density, protein and
micronutrients - Vitamin A, Iron, Zinc)
o poor both quantitatively and qualitatively
Protein Energy
1. KWASHIORKOR
● A form of malnutrition due to a diet deficient in protein and energy-producing foods
● Alco called the wet, swollen, or edematous form
● This condition usually appears at the age of about 12 months when breastfeeding is discontinued, but it
can develop at any time during a child’s formative years.
● The disease that the first child gets when the new child comes.
● SYMPTOMS:
- Generalized edema (accumulation - Loss of appetite
of H2O in the cells) - Diarrhea
- Breaking down of skin - General discomfort
- Preservation of subcutaneous fat - Apathy
and gross enlargement of the liver - Gastrointestinal infection (in some)
with fatty infiltration
● COMPLICATIONS
● If treatment comes too late, a child may have permanent physical and mental disabilities.
● If left untreated, the condition can lead to coma, shock, or death.
2. MARASMUS
● Severe lack of protein intake and other nutrients
● Alco called the dry form of protein-energy malnutrition.
● In developing countries, marasmus is the most common form of PEM in children.
● Means “to waste away” or “dying away”.
● SYMPTOMS:
- No edema - Looks “old”
- Muscle ad fat are wasted - Pallid
- Liver is shrunk - Apathetic
- Scaling of skin
● COMPLICATIONS
● Complications of untreated marasmus can be serious and may include:
o Growth problems in o Loss of strength
children o Loss of vision and blindness
o Joint deformity and o Organ failure or dysfunction
destruction o Unconsciousness and comas

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 Biochemistry (Nursing)
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

●
ATROPHY
- also known as “muscle wasting”; due to aging or protein deficiency
- cells are more likely to shrink because no energy is sustaining them
- the body assumes a “kin-bone” appearance” or like that of a living mummy
3. SICKLE-CELL DISEASE – a.k.a “depranocytosis”
- A hereditary blood disease caused by a deficiency in protein globulin found in RBC
- It is characterized by the production of an abnormal type of hemoglobin- SICKLE CELL HEMGLOBIN (HbS)-
in the RBC
- HbS becomes insoluble when the blood is deprived of O2 and precipitates forming elongated crystals that
distort the blood cell into the characteristic sickle-shape
SOME COMMON NATURAL PEPTIDES

NAME SOURCE OR FUNCTION

Glutathione Most Living Cells(stimulates tissue growth)

TRH HypothalmicNeurohormone(governs release of thyrotropin)

Angiotensin II Pressor Agent(acts on the adrenal gland)

Bradykinen Hypotensive Vasodilator(acts on smooth muscle)

Oxytocin Uterus-Contracting Hormone(also stimulates lactation)

Somatostatin Inhibits Growth Hormone Release(used to treat ulcers)

Endothelin Potent Vasoconstrictor(structurally similar to some snake venoms

Gucagon Hyperglycemic Factor(used as an anti-diabetic)

Insulin Pancreatic Hormone(used in treatment of diabetes)

Melittin Honey Bee Venom(used to treat rheumatism)

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 20 minutes for this activity:

1. The inadequate absorption or availability of proteins and energy in body is known as:
A. Protein-energy malnutrition C. Pepsin energy malnutrition
B. Pepsin-enzyme malnutrition D. Protein excess malnutrition

ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
2. The following are symptoms of kwashiorkor, EXCEPT:
I. Generalized Edema

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 Biochemistry (Nursing)
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

II. No edema
III. Looks old
IV. Liver is shrunk
V. Diarrhea
A. I and III
B. II and III
C. I, II, and III
D. II, III, and IV
E. III, IV, and V
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
3. Obesity is also a form of malnutrition.

A. True
B. False
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
4. Low weight for height.
A. Stunting
B. Wasting
C. Undernutrition
D. PEM
ANSWER: ________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
5. The following are symptoms of marasmus, EXCEPT:
I. Dry skin and wrinkled
II. Ribs clearly visible through the skin
III. Loss of appetite
IV. Thin and bony face
V. Sunken eye
A. I and III
B. III only
C. II and IV
D. I, II, and IV
E. None of the choices
ANSWER: _________
RATIO:___________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

This document is the property of PHINMA EDUCATION 4 of 5

 Biochemistry (Nursing)
Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

C. LESSON WRAP-UP

CAT 3-2-1

After the lesson, record three things that you learned from the lesson. Next, record two things that you found interesting and
that you like to learn more about or if you still have something to ask or clarify about the topic.

Three things you learned:

1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________

Two things that you’d like to learn more about:

1. ________________________________________________________________________________________
2. ________________________________________________________________________________________

One question you still have:

1.________________________________________________________________________________________

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