Nutritional deficiencies Flashcards
Nutritional Deficiencies (General)
Low iron level
● Electromyography = sensory and motor polyneuropathy
Primary Vs Secondary Nutritional Deficiency
Primary = inadequate diet
o Missing vital nutrients
● Secondary
o Insufficient intake
o Malabsorption
o Impaired ability to store o Excess loss
o Extra need for nutrients
Causes of nutritional deficiency
● Poverty
● Infection
● Illness
● Alcohol
● Ignorance
● Diet (vegan)
● Malabsorb syndrome
● Drugs
● Genetic disease
Marasmus
● Global starvation
o Protein and carbs missing
o Low food in general
● Intellectual deficits
● Growth failure
o Low body weight
o Low fat
o NO EDEMA
o Diarrhea
Kwashiorkor
LOW PROTEIN
o Leads to EDEMA because of low osmotic pressure
● Growth low
● Edema, fatty liver, hepatomegaly
DEPIGMENTATION OF HAIR o THINK OF MAX
● “flaky paint” dermatitis
why does Kwashiorkor lead to edema
low protein leads to low osmotic pressure which causes edema
Anorexia nervosa
Self-induced starvation
● Weight loss
● Amenorrhea
o Low GNRH Low LH, FSH
● Low T3/4
● Cardiac arrhythmia sudden death
o Hypokalemia
what is amenorrhea
LowGNRHLowLH,FSH
anorexia nervosa
anorexigenic vs orexigenic
Anorexigenic
o Appetite suppressing
o POMC = mineralocorticoid
o MSH makes anorexic st00f
o High TRH and CRH
● Orexigenic
o Appetite stimulating
o Neuropeptide Y
o MCH = melanin-concentrating hormone
leptin
Made by fat cells
o Ob/ob gene controls this
▪ Missing this gene makes mice fat
what controls leptin
o Ob/ob gene controls this
what is adiponectin
o “fat burning molecule”
o “guardian angel against obesity”
o Lowers influx of fat in liver
o Lowers production of glucose in liver o Increase insulin sensitivity
what is the guardian angel against obesity
adiponectin
● Adipose tissue produces
▪ TNF
▪ IL1,6,18
▪ Steroid hormones
▪ Chemokines
▪ APPLE SHAPE = WORSE
● Associated diseases of obesity
Type II diabetes mellitus
▪ NOT type I!!!!
▪ Leads to ischemic strokes
o Pickwickian syndrome
▪ Irregular breathing
▪ Cyanosis
▪ hypertension
Vitamin A
For eye sight
● Component of rhodopsin
• Squamous metaplasia Glandular epithelium
● Also in mucosa of epithelial cells!!
● Clinical st00f
o Conjunctiva
o Xerophthalmia
o Keratomalacia
o NIGHT BLINDNESS = #1 FIRST SIGN
▪ Headache
▪ Hyperexcitation
night blindness is first sign of what deficiency
vitamin A
Vitamin B1 (thiamine) deficiency diseases
Dry beriberi
wet bereberi
wernickes syndrome
korsakoff syndrome
dry vs wet beriberi
Dry beriberi = BRAIN/spine!
o Neuromuscular symptoms
o Muscle weakness
o Atrophy of extermities
● Wet beriberi = HEART
o Cardiac failure
o Edema
o CHF
Vitamin B2 (riboflavin)
Corneal interstitial keratitis
● Seborrheic dermatitis
● Sore throat
● Cracks/red near corners of mouth
Vitamin B3 (niacin) (3Ds)
Pellagra
o 3D’s!
▪ Dementia
▪ Diarrhea
▪ Dermatitis
▪ And 4th = death
Vitamin B6 (pyridoxine)
Amino and lipids metabolism ,gluconeogenesis, and the production of red blood cells (Heme
group)
Maintain B/T cells
● NO PATHOGNOMIC CLINICAL FEATURES
● CNS
o Depression o Confusion o Convulsions
convulsions due to vitamin B6 role in formation of NT GABA
Vitamin B9 (cyanobalamine) (folate)
Megaloblastic anemia
o Impaired DNA formation
o Impaired B12 absorption
folate is important for pregnancy.
spina bifida
anencephaly
what nutrient is important for pregnant women
vitamin B9 (cyanobalamine) (folate)
B12 (Cyanocobalamine)
Pernicious anemia
o Lack of intrinsic factor in stomach
o Parasitization of small intestine
▪ Fish tape worm = diphyllobothriumlatum
decreased B12 is associated with megaloblastic anemia
Vitamin C
Impaired Collagen synthesis
o Losing teeth
o Gingivitis
o Poor wound healing
o Kids skeletons don’t grow
● Hemorrhagic diathesis
Vitamin D
Adults = osteomalacia
o Soft bone
o “rachitic rosary”
● Kids = rickets
● Low light = cause
● Chronic liver failure
● Helps absorb calcium
● Hypervitaminosis D = TOO MUCH
o Calcium in other organs
vitamin D: kids vs adults
● Adults = osteomalacia
o Soft bone
o “rachitic rosary”
● Kids = rickets
Vitamin E
antioxidant
children have mutation in alpha tocopherol transfer proteins
Vitamin K
● Fat malabsorption
● Sprue
● Clotting factors bad
● Severe bleeding
Iron
microcytic hypochromic anemia
Zinc
hypogonoadal dwarf in boys
Copper
● Deficiency = Megaloblastic changes/anemia
● Wilson disease = copper deposits in brain
o Too much!
Iodine Deficiency
Goiter
o Hyper/hypothyroidism
Lead
● Flaking lead paint in kids mouth
● Mines, batteris, spray paints
● >45 microgram/dL = TREAT ASAP
Symptoms
o Abdominal pain o Jaundice
o Constipation
o Weight loss
too much lead: kids vs adults
Lead encephalopathy (KIDS) = CNS
▪ Ataxia
▪ Coma
▪ Convulsions
o Lead Neurotoxicity (ADULTS) = PNS
▪ Wrist drop
▪ Foot drop
▪ Lead colic
what occurs with lead deficiency
Interferes with heme synthesis
● Anemia
● Basophilic stripping
o Basophils look like strips
● Lead lines
o Deposits of lead in bone
o Dense metaphyseal lines
● Lead overexposure
o Metal flakes in organs
o Gingival dark lines (Burton Line)
what causes gingival dark lines
lead deficiency
Mercury: nephrotoxicity vs neurotoxicity
● Nephrotoxicity = dead kidneys
Neurotoxicity
o Vision field bad
o Paresthesia o Hearing loss
Arsenic
● Accidental usually
● CNS toxicity
● Encephalopathy
● Peripheral neuropathy
Effects of Smoking
● Coronary heart disease
● Brain st00f
o Ischemic stroke
● Lung cancer
● Thromboangiitis obliterans o Buerger disease
o Occlusive inflammatory disease
Wernicke encephalopathy
Wernicke encephalopathy (treat with thiamine)
o Low thiamine (too much drinking)
o Progressive dementia
o Ataxia
o Opthalmoplegia
o Mammillary bodies are affected
Korsakoff psychosis
Korsakoff psychosis (treat with thiamine)
o Retroagrade amnesia
o Confabulatory symptoms
o Anemia
● Fetal alcohol syndrome
o Smooth philtrum
o Epicanthal folds
o Strabismus
o Vertebral column fucked
● Cerebrovascular disease drugs
○ Cocaine
○ Amphetamines
○ MDMA
○ Ecstacy
○ Opioids
○ Heroin
● EtOH abuse
○ Interference with normal clotting
○ Increased risk of hemorrhage
○ Traumatic brain injury
○ Hypertension
● Reye syndrome
○ Aspirin in children with viral illness
