Case Discussion: Vitamins and Micronutrients

Question 1

One of the main causes of B12 deficiency in infants is _____________.

Answer 1

undiagnosed pernicious anemia in the mother

Question 2

___________ deficiency can cause difficulty feeding in infants (such as frequent vomiting).

Answer 2

B12

Question 3

What is the prognosis of B12 deficiency in infants?

Answer 3

Unfortunately, the neurologic effects are often permanent and lead to developmental delays.

Question 4

Generally, what is a good way to differentiate micronutrient deficiencies and inborn errors of metabolism?

Answer 4

Inborn errors of metabolism are present at birth and will have a constant presentation, while most micronutrient deficiencies will present in previously healthy kids.

Question 5

Flaring of the wrists is a sign of __________.

Answer 5

rickets

Question 6

Retinol binding protein can be low due to vitamin A deficiency or __________.

Answer 6

inflammation (because it is a negative acute phase reactant)

Question 7

Trousseau sign’s results from ____________.

Answer 7

hypocalcemia

Question 8

What is Trousseau’s sign?

Answer 8

Flexion of the wrist with occlusion of the brachial artery.

Question 9

Why might you not give iron to someone with an infection?

Answer 9

Two reasons: (1) inflammatory states induce expression of hepcidin, which decreases iron absorption; and (2) bacteria need iron and can grow with excess iron supplementation

Question 10

What is Chovstek sign?

Answer 10

Facial nerve twitching with tapping, a sign of hypocalcemia similar to Trousseau’s sign