Musculoskeletal - Nutritional Therapies

Question 1

Vitamins

Answer 1

• organic substances required for metabolic processes

- fat soluble - A, D, E, K, water soluble - B, C

Question 2

Vitamin A - Retinol

Answer 2

• needed for normal retinal function, normal growth of epithelium
• main sources - liver, dairy products, egg yolk, fatty fish
• used orally & topically to manage acne or psoriasis
• deficiency - dry, rough skin, night blindness
• toxic - if taken in excess - excessive skin peeling, hyperlipidaemia, hypercalcaemia, hepatotoxicity

Question 3

Vitamin B1 - Thiamine

Answer 3

• needed for normal nerve function
• main sources - pork, beef, liver, unrefined grain products, yeast products, nuts
• deficiency - beri-beri (loss of motor control in the periphery)
• malabsorption common in patients with alcoholism, cirrhosis, GIT diseases

Question 4

Vitamin B2 - Riboflavin

Answer 4

• broken down into coenzymes; important in fat, carbohydrate & protein metabolism
• main sources - dairy products, liver, yeast products, almonds, plant products
• deficiency - cheilosis, stomatitis, glossitis, reduced resistance to infection

Question 5

Vitamin B3 - Nicotinic Acid

Answer 5

• forms co-enzymes necessary for tissue respiration
• main sources - liver, yeast products, peanuts, wholegrain cereals, fish
• deficiency - pellagra (rough skin)
• excessive intake - hypotension, headache, dizziness
• administered orally to manage pellagra, hypercholesterolaemia, peripheral vascular diease

Question 6

Folic Acid

Answer 6

• necessary for RBC maturation, DNA synthesis & mitosis
• main sources - all plant products
• deficiency - megaloblastic anaemia, associated with neural tube defects
• administered orally for prophylaxis for pregnancy or to treat megaloblastic anaemia

Question 7

Vitamin B12 - Hydrocobalamin

Answer 7

• needed for normal cell growth, epithelial cell production, haemopoiesis, maintenance of myelin throughout nervous system
• main sources - animal products, including dairy products & eggs
• deficiency - megaloblastic anaemia due to malabsorption in ileum or possibly in vegans

Question 8

Vitamin C - Ascorbic Acid

Answer 8

• antioxidant - necessary for iron absorption, wound healing, resistance to infection, production of RBC and collagen (connective tissue), maintenance of teeth, bone & capillary walls
• main sources: capsicum, guava, kiwi fruit, citrus fruits, some vegetables
• deficiency - scurvy (degeneration of connective tissue)
• excessive amounts - oxalate kidney stones, diarrhoea, gastritis

Question 9

Vitamin D

Answer 9

• produced from exposure to UV radiation on skin; converted to calcitriol to regulate calcium and phosphate in the body
• other sources - fish or fish products
• deficiency - rickets - long bones do not grow and bend outwards = bow legs & deformities
• excess - one of the most dangerous vitamins, hypercalcaemia, renal damage, permanent neurological impairment, death
• administered orally for rickets, osteomalacia, osteoporosis

Question 10

Vitamin K

Answer 10

• needed for blood coagulation
• K1 - phylloquinone (plants) or phytomenadione (konakion) (synthetic), K2 - menaquinone
• deficiency - increased prothrombin time leading to bleeding and haemorrhage
• newborns are susceptible to a lack of vitamin K until intestinal flora is established - given prophylactic vitamin K following birth (konakion)

Question 11

Minerals - Calcium

Answer 11

• major component of inorganic parts of bone, needed for clotting, nerve impulse transmission, muscle contraction
• forms: calcium carbonate (caltrate) - oral supplement

Question 12

Minerals - Magnesium

Answer 12

• co-enzyme in many biochemical reactions
• magnesium sulphate - administered IV or IM in pre-eclampsia to prevent seizures, severe hypomagnesaemia
• during IV administration - need to observe for severe respiratory depression and heart block

Question 13

Minerals - Sodium, Potassium, Chloride

Answer 13

• main body electrolytes, maintain osmotic balance
• excess sodium - dehydration, hypertension, water retention
• potassium deficiency - cardiac dysrhythmias
• preparations - potassium: oral, slow K, chlorvescent, parenteral: potassium chloride - sodium chloride: salt tablets, sodium bicarbonate

Question 14

Minerals - Iron

Answer 14

• needed for formation of haemoglobin
• main sources - meats, legumes, shellfish, whole grains
• supplements - empty stomach or with orange juice, not milk or near antacids
• can cause constipation & black stools
• preperations - ferrous sulphate: fefol, ferro-gradumet, iron polymaltrose: ferrum H injection