Nutritional disorders

Question 1

What vitamins can be directly measured?

Answer 1

folate, vitamin A, B12, D

vitamin C, niacin, thiamine, iron, ferritin, K, Mg, Zn

Question 2

What vitamins are not directly measured, because serum levels do not reflect body stores

Answer 2

calcium, sodium

Question 3

For what vitamin is a derivative measured to assess for deficiency?

Answer 3

B6- measure pyridoxal 5-PO4

Question 4

For what vitamin is a metabolic intermediate measured to assess for deficiency?

Answer 4

B12- measure homocysteine and MMA

Question 5

What vitamin is measured indirectly?

Answer 5

K- measure PT/INR

Question 6

What mineral is assessed through dietary history?

Answer 6

calcium

Question 7

Vitamin A deficiency primarily affects the _____

Answer 7

eyes

Question 8

List ocular manifestations of vitamin A deficiency

Answer 8

night blindness
xerophthalmia
Bitot’s spots
corneal xerosis, keratomalacia

Question 9

List skin changes of vitamin A deficiency

Answer 9

dry skin
flaky dermatitis
follicular hyperplasia

Question 10

Vitamin A deficiency usually occurs in the context of _____

Answer 10

fat malabsorption

Question 11

Vitamin B1 is also known as

Answer 11

thiamine

Question 12

Thiamin/ B1 deficiency is also known as

Answer 12

berberi

Question 13

Describe the findings in thiamine/ B1 deficiency

Answer 13

dry berberi: peripheral sensory and motor neuropathy, angular stomatosis

wet berberi: neuropathy + cardiomyopathy, CHF

Wernicke-Korsakoff syndrome: neurological complications

Question 14

Distinguish Wernicke’s encephalopathy from Korsakoff psychosis

Answer 14

Wernicke’s encephalopathy: acute confusion, delirium, disturbances of eye movements, ataxia, tremor

Korsakoff psychosis: chronic dementia, confabulation, memory impairment

Question 15

Thiamine/ B1 deficiency usually occurs in the context of ______

Answer 15

alcoholism

Question 16

Vitamin B3 is also known as

Answer 16

niacin

Question 17

Vitamin B3/ niacin deficiency is also known as

Answer 17

pellegra

Question 18

List the 4 D’s of niacin/ B3 deficiency

Answer 18

dermatitis on sun exposed areas
diarrhea, dysphagia
dementia
death

Question 19

Niacin/ B3 deficiency classically occurs in ______-based diets

Answer 19

corn

Question 20

List clinical findings in folate deficiency

Answer 20

macrocytic anemia
cheilosis
diarrhea 
depression
neural defects in fetus

Question 21

List clinical findings in B12 deficiency

Answer 21

macrocytic anemia, neurologic effects, cheilosis, anorexia, diarrhea, depression

Question 22

List signs of vitamin C deficiency

Answer 22

scurvy- impaired collagen synthesis
bleeding gums
perifollicular petechiae
bruising
hyperkeratosis
poor wound healing

Question 23

Vitamin D deficiency causes _____ in children and ____ in adults

Answer 23

rickets

osteomalacia

Question 24

Describe manifestations of rickets

Answer 24

defective mineralization at growth plates–> short stature, classic bony deformities

Question 25

Describe manifestations of osteomalacia

Answer 25

impaired mineralization of bone matrix | decreased bone density, increased fractures, bone pain, muscle weakness

Question 26

Vitamin D deficiency can occur in the setting of:

Answer 26

fat malabsorption | northern climates

Question 27

In addition to true fractures, ____ may be seen in osteomalacia

Answer 27

pseudofractures

Question 28

Pica and pagophagia suggest ____ deficeincy

Answer 28

iron

Question 29

Pallor due to anemia is seen in deficiencies of what three vitamins/ minerals

Answer 29

vitamin B12 folate iron

Question 30

Poor wound healing suggests what deficiencies (2)?

Answer 30

vitamin C, zinc

Question 31

Flaky dermatitis suggests what deficiency?

Answer 31

vitamin A

Question 32

Follicular hyperplasia suggests what deficiency (2)?

Answer 32

vitamin A, vitamin C

Question 33

Perifollicular petechiae suggests what deficiency?

Answer 33

vitamin C

Question 34

Easy bruising suggests what deficiencies (2)?

Answer 34

vitamin C, vitamin K

Question 35

Dermatitis of sun exposed areas suggests deficiency of _____

Answer 35

niacin (vitamin B3)

Question 36

Spooning of nails (koilonychia) suggests ____ deficiency

Answer 36

iron

Question 37

Abnormal eye movements are seen in ____ deficiency

Answer 37

B1/ thiamine

Question 38

Vitamin B deficiencies all tend to involve the ____

Answer 38

mouth

Question 39

Magenta tongue is specifically seen in _____ deficiency

Answer 39

B2/ riboflavin

Question 40

Decreased or altered taste suggests ____ deficiency

Answer 40

zinc

Question 41

Tooth decay suggests _____ deficiency

Answer 41

fluoride

Question 42

Arrhythmias suggests ____ deficiency

Answer 42

potassium

Question 43

Muscle spasm/ tetany suggests what deficiencies (2)?

Answer 43

Calcium, magnesium

Question 44

Decreased vibratory and position sense is seen in ____ deficiency

Answer 44

B12

Question 45

Paresthesia and ataxia are seen in ______ deficiencies (2)?

Answer 45

vitamin B12, thiamine

Question 46

Muscle weakness is seen in what deficiencies (2)?

Answer 46

potassium, vitamin D

Question 47

What nutrients are most likely missing from a strict vegan diet?

Answer 47

B12, zinc, calcium, vitamin D

Question 48

What groups are at risk for a generally inadequate diet?

Answer 48

neglected children, mentally disabled, elderly, eating disorders, anorexia form medical conditions

Question 49

What nutrients are most likely missing from the diet of alcoholics?

Answer 49

B6, folate, B12, vitamin C, poor absorption of thiamine and folate

Question 50

____ deficiency is usually due to slow GI bleeds or heavy menses

Answer 50

iron

Question 51

____ deficiency is usually due to chronic diarrhea or diuretic use

Answer 51

potassium

Question 52

______ deficiency is usually due to loss in the urine in alcoholics, people on diuretics, or with uncontrolled diabetes

Answer 52

magnesium

Question 53

People with celiac disease often have deficiencies of:

Answer 53

Folate, B12 fat soluble vitamins esp D, K calcium iron

Question 54

People with ileal resection or gastrectomy often have ____ deficiency

Answer 54

B12

Question 55

People who have undergone gastric bypass surgery should have what nutrients supplemented?

Answer 55

B12, vitamin D, calcium, iron

Question 56

In the setting of blind loop syndrome, there is likely to be deficiencies of ___ and _____ vitamins

Answer 56

B12 and fat soluble

Question 57

Pregnant women need supplements of:

Answer 57

folic acid | iron

Question 58

Drugs like corticosteroids or anticonvulsants increase the risk of deficiencies in:

Answer 58

vitamin D calcium folate

Question 59

Sulfasalazine, TMP/sulfa, and methotrexate all impair ____ absorption

Answer 59

folate

Question 60

People taking PPIs have lower gastric acidity and are at risk of what deficiencies?

Answer 60

B12, Mg, Ca, iron

Question 61

What healthy people should consider vitamin/ mineral supplements?

Answer 61

``` pregnant or lactating women strict vegans people on weight reduction diets elderly northern climates ```

Question 62

Many vitamin/ mineral deficiencies are _____ and can be anticipated and monitored for

Answer 62

iatrogenic