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Clinical neuro > Nutritional deficiencies > Flashcards

Nutritional deficiencies Flashcards

1
Q

Nutritional Deficiencies (General)

A

Low iron level

● Electromyography = sensory and motor polyneuropathy

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2
Q

Primary Vs Secondary Nutritional Deficiency

A

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

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3
Q

Causes of nutritional deficiency

A

● Poverty

● Infection

● Illness

● Alcohol

● Ignorance

● Diet (vegan)

● Malabsorb syndrome

● Drugs

● Genetic disease

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4
Q

Marasmus

A

● 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

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5
Q

Kwashiorkor

A

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

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6
Q

why does Kwashiorkor lead to edema

A

low protein leads to low osmotic pressure which causes edema

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7
Q

Anorexia nervosa

A

Self-induced starvation

● Weight loss

● Amenorrhea

o Low GNRH Low LH, FSH

● Low T3/4

● Cardiac arrhythmia sudden death

o Hypokalemia

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8
Q

what is amenorrhea

A

LowGNRHLowLH,FSH

anorexia nervosa

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9
Q

anorexigenic vs orexigenic

A

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

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10
Q

leptin

A

Made by fat cells

o Ob/ob gene controls this
▪ Missing this gene makes mice fat

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11
Q

what controls leptin

A

o Ob/ob gene controls this

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12
Q

what is adiponectin

A

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

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13
Q

what is the guardian angel against obesity

A

adiponectin

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14
Q

● Adipose tissue produces

A

▪ TNF

▪ IL1,6,18

▪ Steroid hormones

▪ Chemokines

▪ APPLE SHAPE = WORSE

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15
Q

● Associated diseases of obesity

A

Type II diabetes mellitus

▪ NOT type I!!!!

▪ Leads to ischemic strokes

o Pickwickian syndrome

▪ Irregular breathing

▪ Cyanosis

▪ hypertension

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16
Q

Vitamin A

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

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17
Q

night blindness is first sign of what deficiency

A

vitamin A

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18
Q

Vitamin B1 (thiamine) deficiency diseases

A

Dry beriberi

wet bereberi

wernickes syndrome

korsakoff syndrome

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19
Q

dry vs wet beriberi

A

Dry beriberi = BRAIN/spine!
o Neuromuscular symptoms

o Muscle weakness

o Atrophy of extermities

● Wet beriberi = HEART

o Cardiac failure

o Edema

o CHF

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20
Q

Vitamin B2 (riboflavin)

A

Corneal interstitial keratitis

● Seborrheic dermatitis

● Sore throat

● Cracks/red near corners of mouth

21
Q

Vitamin B3 (niacin) (3Ds)

A

Pellagra
o 3D’s!

▪ Dementia

▪ Diarrhea

▪ Dermatitis

▪ And 4th = death

22
Q

Vitamin B6 (pyridoxine)

A

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

23
Q

Vitamin B9 (cyanobalamine) (folate)

A

Megaloblastic anemia
o Impaired DNA formation

o Impaired B12 absorption

folate is important for pregnancy.

spina bifida

anencephaly

24
Q

what nutrient is important for pregnant women

A

vitamin B9 (cyanobalamine) (folate)

25
Q

B12 (Cyanocobalamine)

A

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

26
Q

Vitamin C

A

Impaired Collagen synthesis

o Losing teeth

o Gingivitis
o Poor wound healing
o Kids skeletons don’t grow

● Hemorrhagic diathesis

27
Q

Vitamin D

A

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

28
Q

vitamin D: kids vs adults

A

● Adults = osteomalacia

o Soft bone

o “rachitic rosary”

● Kids = rickets

29
Q

Vitamin E

A

antioxidant

children have mutation in alpha tocopherol transfer proteins

30
Q

Vitamin K

A

● Fat malabsorption

● Sprue

● Clotting factors bad

● Severe bleeding

31
Q

Iron

A

microcytic hypochromic anemia

32
Q

Zinc

A

hypogonoadal dwarf in boys

33
Q

Copper

A

● Deficiency = Megaloblastic changes/anemia

● Wilson disease = copper deposits in brain

o Too much!

34
Q

Iodine Deficiency

A

Goiter
o Hyper/hypothyroidism

35
Q

Lead

A

● 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

36
Q

too much lead: kids vs adults

A

Lead encephalopathy (KIDS) = CNS

▪ Ataxia
▪ Coma
▪ Convulsions

o Lead Neurotoxicity (ADULTS) = PNS

▪ Wrist drop

▪ Foot drop

▪ Lead colic

37
Q

what occurs with lead deficiency

A

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)

38
Q

what causes gingival dark lines

A

lead deficiency

39
Q

Mercury: nephrotoxicity vs neurotoxicity

A

● Nephrotoxicity = dead kidneys

Neurotoxicity
o Vision field bad

o Paresthesia o Hearing loss

40
Q

Arsenic

A

● Accidental usually

● CNS toxicity

● Encephalopathy

● Peripheral neuropathy

41
Q

Effects of Smoking

A

● Coronary heart disease

● Brain st00f

o Ischemic stroke

● Lung cancer

● Thromboangiitis obliterans o Buerger disease

o Occlusive inflammatory disease

42
Q

Wernicke encephalopathy

A

Wernicke encephalopathy (treat with thiamine)

o Low thiamine (too much drinking)

o Progressive dementia
o Ataxia
o Opthalmoplegia

o Mammillary bodies are affected

43
Q

Korsakoff psychosis

A

Korsakoff psychosis (treat with thiamine)

o Retroagrade amnesia
o Confabulatory symptoms

o Anemia

44
Q

● Fetal alcohol syndrome

A

o Smooth philtrum

o Epicanthal folds
o Strabismus
o Vertebral column fucked

45
Q

● Cerebrovascular disease drugs

A

○ Cocaine

○ Amphetamines

○ MDMA
○ Ecstacy
○ Opioids

○ Heroin

46
Q

● EtOH abuse

A

○ Interference with normal clotting

○ Increased risk of hemorrhage
○ Traumatic brain injury
○ Hypertension

47
Q

● Reye syndrome

A

○ Aspirin in children with viral illness

48
Q
A

Clinical neuro (3 decks)

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