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Nutritional Deficiencies
Fichas del conjunto (24)
- 1MarasmusSevere calorie malnutrition
-generalized loss of muscle and no subq fat
Emaciated
Loose, wrinkled skin
-Loss of buccal and temporal fat pads
-Hypothermia, bradycardia, hypotension - 2KwashiorkorInsufficient intake of protein
-Soft, pitting, painless edema in feet or legs
-Skin rashes due to desquamation
-Dry, brittle, yellow hair
"Flag sign"- normal hair alternating with depigmented hair
-Large livers with fat
-Increased risk of infection - 3Protein-Calorie MalnutritionMost common malnutrition in the US
Severe edema of kwashiorkor, cachexia of marasmus - 4Scurvy PresentationAscorbic acid (C) deficiency
6 months-2years
Follicular hyperkeratosis
"corkscrew-coiled hairs"
Gingival bleeding
Normochromic, normocytic anemia - 5Scurvy pathogenesisCollagin/chondroitin sulfate deficiency
No collagen- fragile capillaries, hemorrhage
No chondroitin sulfate- osteoblasts do not make osteoid
Abnormalities are found at metaphyseal zone of tubular bones - 6Scurvy x-ray findingsWhite line of Frankel- dense band at growing metaphyseal end, involving provisional zone of calicification
Wimberger ring: Small epiphysis surrounded by sharp, sclerotic rim
Trummerfeld zone of lucency: radiolucency beneath the dense zone of provisional calcification
Pelkan spur: marginal spur formation
Corner sign: Subphyseal infarction sign - 7Vitamin A deficiencyNight blindness
Bitot spots- keratinization of cornea
Xerophthalmia- dry eyes
Corneal opacities
Growth failure
Increased susceptibility to infection
**If patient has clouding of cornea, and Vitamin A deficiency, the patient needs large parenteral doses of vit A - 8Vitamin A excessScaly skin
Pseudotumor cerebri
Hepatomegaly - 9Vitamin D supplementation in infants400 IU Vit D daily
- 10Rickets findingsPoor growth
Hypocalcemia
Hypophosphatemia
Tetany
Skeletal deformation
Bone pain - 11Lab findings in ricketsDecreased calcium
Decreased phosphorus
Increased alk phos
Decreased 25-OH vit D3 levels
1,25-(OH)2 vit D3 levels decreased, increased, or normal
Increased PTH - 12X-ray findings in ricketsRarefied shafts
Uneven, blurred ends - 13Vitamin E action and deficiencyTocopherol
Acts as an antioxidant
Deficiency results in neurologic dysfunction, especialy neuroaxonal degeneration and loss of reflexes.
Seen primarily in cystic fibrosis. - 14Vitamin K dependent factorsProthrombin
Factor VII
Factor IX
Factor X - 15Vitamin K sourcesDark leafy vegetables
Cauliflower
Soybeans
Bacterial synthesis in gut - 16Folate deficiency#2 nutritional cause of anemia
Deficiency in mothers causes neural tube defects
High MCV
Correlated to goat's milk, ileal resection - 17B1 deficiencyThiamin
Beriberi: Paraesthesia, foot/wrist drop
Wernicke encephalopathy: Ophthalmoplegia, ataxia, confusion - 18B2 deficiencyRiboflavin
Cheilosis
Sore tongue - 19B3 deficiencyNiacin
Pellagra: Dermatitis, dementia, diarrhea - 20B6 deficiencyPyridoxine
Can cause seizures in infants with metabolic defects - 21B12 deficiencyCobalamin
Most common cause of deficiency is ileal disease
B12 deficiency causes megaloblastic anemia - 22Zinc deficiencySeen in chronic diarrhea
Patients cannot properly form nucleic acids and proteins
"don't grow", has diarrhea, acrodermatitis enteropathica, and hypogeusia (reduced taste) - 23Amino acids lacking in vegan dietsMethionine and lysine
Requires grains or legumes to ensure these are present. - 24Essential supplementation in vegansvitamin B12- animal origin only
Iron
Calcium
Vitamin D
Zinc deficiency