EX: 2Physical Focused Examination

Question 1

Identify parts of the body where signs of malnutrition appear the most rapidly

Answer 1

Hair, skin, digestive tract (including the mouth and tongue); parts of the body where high cell replacement occurs

Question 2

Vitamin D deficiency syndromes

Answer 2

1) Rickets (children) 2) Osteoporosis (dowagers hump/kyphosis) in adults

Question 3

Goiter

Answer 3

Marked by iodine deficiency, helps with thyroid hormone production, symptoms enlarged thyroid and decreased thyroid hormone synthesis.

Question 4

What percentage of the worlds population live in areas where soil is deficient in iodine?

Answer 4

29%; ridiculous. Iodine only costs $0.04 to add to salt/person

Question 5

Xanthomas

Answer 5

Hyperlipidemia

Question 6

What three nutrient deficiencies are easily visible upon examination?

Answer 6

Iodine- goiter; xanthomas - hyperlipidemia ; and vitamin d (osteoporosis (kyphosis/dowagers hump) adults and rickets in children

Question 7

What macromolecules are associated with hair abnormalities?

Answer 7

Protein mostly, calories, and biotin

Question 8

Physical abnormalities with hair associated with malnutrition

Answer 8

Dull/dry; dyspigmented; flag sign; easliy plucked ; thin/alopecia

Question 9

What macromolecules are associated with skin abnormalities when malnourished?

Answer 9

Protein, fatty acids, minerals, and vitamins

Question 10

What nutrient causes a change in pallor in skin and lips?

Answer 10

Iron

Question 11

What effect does a vitamin C deficiency have on the skin?

Answer 11

Vitamin C rash or perifollicular hemorrhage

Question 12

What nutrient deficiency causes scaly dermatitis?

Answer 12

Fatty acids/vitamin A

Question 13

What deficiency causes follicular hyperkeratosis?

Answer 13

Vitamin A/fatty acids

Question 14

What nutrient deficiency causes pellagra?

Answer 14

Niacin; skin abnormality

Question 15

Nasolabial seborrhea

Answer 15

Seborrhoeic dermatitis; reddening and scaling of skin adjacent to the nose

Question 16

What deficiency is implicated in the formation of pressure ulcers?

Answer 16

Protein, zinc, and vitamin c

Question 17

What is one of the first regions to show evidence of vitamin deficiencies?

Answer 17

The lips and mouth

Question 18

What types of nutrients are implicated in the pathology of the mouth/lips?

Answer 18

The B vitamins

Question 19

What nutrient is implicated in angular cheilosis?

Answer 19

Riboflavin; the mouth; the joker syndrome

Question 20

Vitamin C deficiency mouth

Answer 20

Gums/ bleeding/swollen/ (Scurvy)

Question 21

Lips, Gums, Tongue macromolecules

Answer 21

Lips - B vitamins/Iron Tongue - B vitamins Gums - Vitamin C

Question 22

Magenta tongue macromolecule

Answer 22

riboflavin (kool-aid tongue)

Question 23

Scarlet, Raw, painful tongue

Answer 23

Niacin, folic acid, Vit B12

Question 24

Fissuring edema

Answer 24

Tongue - niacin

Question 25

pallor and geographic tongue

Answer 25

biotin

Question 26

Filiform papillary atrophy/glossitis

Answer 26

folic acid, B12, Niacin

Question 27

Kolionychia

Answer 27

(spoon-shaped nail) - iron

Question 28

Splinter hemorrhages

Answer 28

nails, vitamin C

Question 29

White spots/beau’s lines

Answer 29

nails, Zinc deficiency

Question 30

onycholysis

Answer 30

loss of the nail, caused by fungal infection

Question 31

What macromolecules are associated with eye pathology?

Answer 31

Vit A/ protein-calorie malnutriton

Question 32

Limitations of physical examination

Answer 32

1) Practice/experience 2) knowledge, skill, clinical judgment 3) knowing non-nutritional causes 4) Need to use lab work sometimes