Micronutrients Flashcards
Hepcidin (blocks or increases) iron absorption?
Blocks. Hepcidin is increased in inflammatory states, and downregulated in a state of iron deficiency.
Iron deficiency that has NOT progressed to anemia has permanent cognitive effects in infants. True or false.
True.
Breast milk contains lots of zinc. True or false.
Both. Starts high, but by 6-10 months, there is almost no zinc in breast milk.
Breast milk contains lots of iron. True or false.
False. There is very little iron in any milk (unless fortified).
Infant formula has a bunch of iron.
What are the symptoms of zinc deficiency?
Dermatitis
Immune dysfunction
Anorexia
Delayed sexual maturation
What is acrodermatitis enteropathica?
A heridable defect in zinc absorption. Get a wicked skin rash/dermatitis.
What are the differences in zinc vs iron secretion and absorption?
Fe absorption: controlled strongly at the level of absorption (hepcidin).
Fe excretion: cannot excrete.
Zn absorption: Not well controlled. You will absorb most of what you eat
Zn secretion: well controlled. If you eat too much zinc, you will poop it out.
What might cause the “worst diaper rash you’ve ever seen”?
Zinc deficiency. Could result from acrodermatitis enteropathica. Easily fixed by repleting the zinc.
What is a result of mild zinc deficiency in a growing child?
Stunting.
**Zn supplementation also decreases the incidence of diarrhea, pneumonia, and overall deaths (4th overall most effective way to prevent). SO, supplementing zinc in developming countries seems like a good idea.
What is the risk of zinc toxicity as compared to iron?
Very low.
A 12 m/o infant with failure to thrive is at risk of which micronutrient deficiency(s)?
Zinc and iron.
What are the four micronutrients you should monitor when re-feeding someone who is extremely malnourished?
Magnesium
Thiamine
Phosphorus
Potassium
Magnesium
Thiamine
Phosphorus
Potassium
Serum levels will do what in re-feeding syndrome? State why for each.
Mg will drop (needed for ATPase, so increases w/metabolism)
Thiamine will drop (glycolysis)
Phosphorus will drop (Insulin drives into cells)
Potassium will drop (Insulin drives into cells)
Skin changes are associated with Marasmus or Kwashikor?
Kwashikor. Erythematous, hyperpigmentation, “Flaky Paint”
rash.
What two findings, aside from a skin rash, absolutely differentiate Kwashikor from Marasmus?
What metabolic disturbance creates this difference?
Hepatomegaly
Edema
Kwashikor is associated with high levels of insulin. The kid is eating, so insulin is high. You wind up with a fatty, enlarged liver and subsequent hypoalbuminemia.
