Nutritional and Metabolic Deficiencies

Question 1

What is the gold standard test for celiac spur?

Answer 1

IgA tissue transglutaminase (tTG) antibody

Question 2

What is the gold standard test for lactose intolerance?

Answer 2

hydrogen breath test

Question 3

Lactose restriction may lead to?

Answer 3

Osteoporosis

Question 4

Cystic fibrosis test?

Answer 4

Chloride sweat test

Question 5

Result of pancreatic disease in CF?

Answer 5

Autodigestion of pancreas = cystic fibrosis-related diabetes.

Question 6

Pancreatic disease in CF vitamin deficiencies?

Answer 6

A, D, E, K (fat-soluble vitamins)

Question 7

What is MC in pts with hepatobiliary disease in CF?

Answer 7

Focal biliary cirrhosis

Question 8

Vitamin A Deficiency clinical manifestations?

Answer 8

• Night blindness (MC)
• Bitot spots: white patches on conjunctiva
• Keratomalacia: corneal ulcers and necrosis
• Squamous metaplasia

Question 9

Another name of Vitamin B1?

Answer 9

Thiamine

Question 10

Vitamin B1 Deficiency advanced clinical manifestations (wet)?

Answer 10

Wet Beriberi (AKA CHF)

• peripheral vasodilation
• High-output HF w/ cardiomegaly
• Dyspnea
• Tachypnea
• Pulmonary and peripheral edema
• warm extremities (looks like cellulitis)

Question 11

Vitamin B1 Deficiency advanced clinical manifestations (dry)?

Answer 11

Dry Beriberi

• CNS and PNS
• Wernicke encephalopathy
• Korsakoff syndrome

Question 12

What are sxs of Wernicke encephalopathy?

Answer 12

Nystagmus –> ophthalmolegia, truncal ataxia, confusion

Question 13

What are sxs of Korsakoff syndrome which is caused by B1 deficiency?

Answer 13

• Amnesia
• Confabulation
• Impaired learning/memory
• Delusions

Question 14

Clinical manifestations of Vitamin B2 (Riboflavin)?

Answer 14

• cheilosis
• angular stomatitis
• glossitis

Question 15

Disease of Vitamin B3 (Niacin)?

Answer 15

Pellagra

Question 16

Clinical manifestation of advanced Vitamin B3 (Niacin) specifically the 3 Ds?

Answer 16

Dermatitis (symetrical)
Diarrhea
Dementia

Question 17

Vitamin B6 (Pyridoxine) MC’ly given with what?

Answer 17

Isoniazid (INH)

Question 18

Vitamin B12 (Cyanocobalamin) is bound to what?

Answer 18

Intrinsic factor to be absorbed by the terminal ileum

Question 19

MC of B12 (Cyanocobalamin) deficiency in the westen hemisphere?

Answer 19

pernicious anemia

Question 20

Clinical features of B12 (Cyanocobalamin) deficiency?

Answer 20

Neuropathy

Question 21

Folate deficiency is very similar to B12 except for the fact that…?

Answer 21

No neurological sxs —> i.e neuropathy

Question 22

Disease caused by Vitamin C deficiency?

Answer 22

Scurvy

Question 23

Vitamin C deficiency “SHADES” pneumonic stands for?

Answer 23

• Skin discoloration and bruising
• Hemorrhage
• Anemia
• Dental Issues (specifically gums)
• Exhaustion/fatigue
• Swelling of joints

Question 24

Vitamin D deficiency MCC in adults?

Answer 24

Osteomalacia

Question 25

Vitamin D deficiency MCC in pediatrics?

Answer 25

Rickets

Question 26

Vitamin E deficiency causes what in children?

Answer 26

Biliary atresia

Question 27

What is Wilson disease?

Answer 27

AKA: hepatolenticular degeneration

• rare autosomal recessive disorder
• excessive copper deposition within the liver and brain

Question 28

Pathognomonic manifestation of Wilson disease?

Answer 28

Kayser-Fleischer ring

- browning or gray-green ring around the periphery of the cornea.

Question 29

Gold standard diagnostic testing for Wilson disease?

Answer 29

Liver biopsy

Question 30

Tx for Wilson disease?

Answer 30

• Oral Penicillamine- chelating agent

- Trientine (Triethylenetatramine)

Question 31

Name used for stool containing high fat?

Answer 31

Steatorrhea

Question 32

Vitamin K deficiency tx and antidote for warfarin OD?

Answer 32

Phytonadione