2823196
| Question | Answer |
| Marasmus | Severe calorie malnutrition -generalized loss of muscle and no subq fat Emaciated Loose, wrinkled skin -Loss of buccal and temporal fat pads -Hypothermia, bradycardia, hypotension |
| Kwashiorkor | Insufficient 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 |
| Protein-Calorie Malnutrition | Most common malnutrition in the US Severe edema of kwashiorkor, cachexia of marasmus |
| Scurvy Presentation | Ascorbic acid (C) deficiency 6 months-2years Follicular hyperkeratosis "corkscrew-coiled hairs" Gingival bleeding Normochromic, normocytic anemia |
| Scurvy pathogenesis | Collagin/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 |
| Scurvy x-ray findings | White 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 |
| Vitamin A deficiency | Night 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 |
| Vitamin A excess | Scaly skin Pseudotumor cerebri Hepatomegaly |
| Vitamin D supplementation in infants | 400 IU Vit D daily |
| Rickets findings | Poor growth Hypocalcemia Hypophosphatemia Tetany Skeletal deformation Bone pain |
| Lab findings in rickets | Decreased 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 |
| X-ray findings in rickets | Rarefied shafts Uneven, blurred ends |
| Vitamin E action and deficiency | Tocopherol Acts as an antioxidant Deficiency results in neurologic dysfunction, especialy neuroaxonal degeneration and loss of reflexes. Seen primarily in cystic fibrosis. |
| Vitamin K dependent factors | Prothrombin Factor VII Factor IX Factor X |
| Vitamin K sources | Dark leafy vegetables Cauliflower Soybeans Bacterial synthesis in gut |
| Folate deficiency | #2 nutritional cause of anemia Deficiency in mothers causes neural tube defects High MCV Correlated to goat's milk, ileal resection |
| B1 deficiency | Thiamin Beriberi: Paraesthesia, foot/wrist drop Wernicke encephalopathy: Ophthalmoplegia, ataxia, confusion |
| B2 deficiency | Riboflavin Cheilosis Sore tongue |
| B3 deficiency | Niacin Pellagra: Dermatitis, dementia, diarrhea |
| B6 deficiency | Pyridoxine Can cause seizures in infants with metabolic defects |
| B12 deficiency | Cobalamin Most common cause of deficiency is ileal disease B12 deficiency causes megaloblastic anemia |
| Zinc deficiency | Seen in chronic diarrhea Patients cannot properly form nucleic acids and proteins "don't grow", has diarrhea, acrodermatitis enteropathica, and hypogeusia (reduced taste) |
| Amino acids lacking in vegan diets | Methionine and lysine Requires grains or legumes to ensure these are present. |
| Essential supplementation in vegans | vitamin B12- animal origin only Iron Calcium Vitamin D Zinc deficiency |
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