Nutritional Deficiencies

Joe Dario
Flashcards by Joe Dario, updated more than 1 year ago More Less
Joe Dario
Created by Joe Dario over 4 years ago


Board review fundamentals

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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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