Nutrition for Health

Question 1

Marasmus

Answer 1

DRY (thin, desiccated)
Grossly underweight, gross muscle wasting, abdominal distension, no fat hungry, old man’s face, no oedema, normal hair.

Caused by a diet low in protein and calories.

Question 2

Kwashiorkor

Answer 2

WET (oedematous, swollen)
Oedema (feet first, then generalised), ‘moon’ face, anorexia, hair pale and thinned, apathetic, skin changes.

Causes: a diet low in protein with some carbohydrate, leading to hypoalbuminaemia.

Question 3

Micronutrient Deficiencies: Vitamin A (beta-carotene/retinol)

Answer 3

Night blindness

Eye disease as dryness with keratinisation of the conjunctivae and cornea.

Growth retardation in children.

Question 4

Micronutrient Deficiencies: Vitamin B1 (thiamine)

Answer 4

Beriberi: dry (neuropathy) or wet (heart failure)

Wernicke–Korsakoff syndrome (typically in alcoholics).

Question 5

Micronutrient Deficiencies: Vitamin B2 (riboflavin)

Answer 5

Growth retardation
Dry scaly skin
Angular cheilitis

Question 6

Micronutrient Deficiencies: Vitamin B3 (niacin, nicotinic acid)

Answer 6

Pellagra
Triad: diarrhoea, dementia, dermatitis ± neuropathy

Question 7

Micronutrient Deficiencies: Vitamin B6 (pyridoxine)

Answer 7

Oral soreness
Anaemia
CNS dysfunction

Question 8

Micronutrient Deficiencies: Vitamin B12 (cobalamin)

Answer 8

Pernicious anaemia.
Triad: Neuropathy, glossitis and memory dysfunction.

Question 9

Micronutrient Deficiencies: Vitamin C (
ascorbic acid)

Answer 9

Scurvy: muscle weakness, malaise, fatigue, bleeding swollen inflamed gums, atraumatic haemarthrosis, cachexia, oedema, impaired wound healing, impaired bone growth.

Sign: Hyperkeratotic hair follicle with surrounding hyperaemia.

Diagnosis by decreased plasma ascorbic acid and X-rays of bones and joints.

Question 10

Micronutrient Deficiencies: Vitamin D (calciferol)

Answer 10

Rickets

Children: impaired growth, skeletal deformities (bow legs, pelvis, ‘rachitic rosary’), inability to walk, bone pain (arms, legs, spine, pelvis), dental deformities, muscle weakness.

Adults: osteomalacia (muscle weakness, bone pain, bowing of long bones.

Diagnosis:
Low plasma 25(OH)D3 and phosphate
Elevated PTH and alkaline phosphatase
X-rays of joints and long bones of the leg

Question 11

Micronutrient Deficiencies: Folic acid

Answer 11

Pernicious anaemia
Neural tube defects in the fetus

Question 12

Micronutrient Deficiencies: Iodine

Answer 12

Iodine-deficient areas have high rates of: Stillbirths, congenital hypothyroidism, cretinism, goitre and hypothyroidism.

Adequate intake 150 mcg/day
Pregnancy 220 mcg/day
Breastfeeding 290 mcg/day

Question 13

Micronutrient Deficiencies: Zinc

Answer 13

Affects taste, smell and the skin.