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FM4 > Nutritional disorders > Flashcards

Nutritional disorders Flashcards

1
Q

What vitamins can be directly measured?

A

folate, vitamin A, B12, D

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

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2
Q

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

A

calcium, sodium

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3
Q

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

A

B6- measure pyridoxal 5-PO4

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4
Q

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

A

B12- measure homocysteine and MMA

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5
Q

What vitamin is measured indirectly?

A

K- measure PT/INR

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6
Q

What mineral is assessed through dietary history?

A

calcium

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7
Q

Vitamin A deficiency primarily affects the _____

A

eyes

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8
Q

List ocular manifestations of vitamin A deficiency

A

night blindness
xerophthalmia
Bitot’s spots
corneal xerosis, keratomalacia

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9
Q

List skin changes of vitamin A deficiency

A

dry skin
flaky dermatitis
follicular hyperplasia

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10
Q

Vitamin A deficiency usually occurs in the context of _____

A

fat malabsorption

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11
Q

Vitamin B1 is also known as

A

thiamine

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12
Q

Thiamin/ B1 deficiency is also known as

A

berberi

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13
Q

Describe the findings in thiamine/ B1 deficiency

A

dry berberi: peripheral sensory and motor neuropathy, angular stomatosis

wet berberi: neuropathy + cardiomyopathy, CHF

Wernicke-Korsakoff syndrome: neurological complications

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14
Q

Distinguish Wernicke’s encephalopathy from Korsakoff psychosis

A

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

Korsakoff psychosis: chronic dementia, confabulation, memory impairment

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15
Q

Thiamine/ B1 deficiency usually occurs in the context of ______

A

alcoholism

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16
Q

Vitamin B3 is also known as

A

niacin

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17
Q

Vitamin B3/ niacin deficiency is also known as

A

pellegra

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18
Q

List the 4 D’s of niacin/ B3 deficiency

A

dermatitis on sun exposed areas
diarrhea, dysphagia
dementia
death

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19
Q

Niacin/ B3 deficiency classically occurs in ______-based diets

A

corn

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20
Q

List clinical findings in folate deficiency

A 
macrocytic anemia
cheilosis
diarrhea 
depression
neural defects in fetus
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21
Q

List clinical findings in B12 deficiency

A

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

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22
Q

List signs of vitamin C deficiency

A 
scurvy- impaired collagen synthesis
bleeding gums
perifollicular petechiae
bruising
hyperkeratosis
poor wound healing
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23
Q

Vitamin D deficiency causes _____ in children and ____ in adults

A

rickets

osteomalacia

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24
Q

Describe manifestations of rickets

A

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

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25
Q

Describe manifestations of osteomalacia

A

impaired mineralization of bone matrix

decreased bone density, increased fractures, bone pain, muscle weakness

26
Q

Vitamin D deficiency can occur in the setting of:

A

fat malabsorption

northern climates

27
Q

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

A

pseudofractures

28
Q

Pica and pagophagia suggest ____ deficeincy

A

iron

29
Q

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

A

vitamin B12
folate
iron

30
Q

Poor wound healing suggests what deficiencies (2)?

A

vitamin C, zinc

31
Q

Flaky dermatitis suggests what deficiency?

A

vitamin A

32
Q

Follicular hyperplasia suggests what deficiency (2)?

A

vitamin A, vitamin C

33
Q

Perifollicular petechiae suggests what deficiency?

A

vitamin C

34
Q

Easy bruising suggests what deficiencies (2)?

A

vitamin C, vitamin K

35
Q

Dermatitis of sun exposed areas suggests deficiency of _____

A

niacin (vitamin B3)

36
Q

Spooning of nails (koilonychia) suggests ____ deficiency

A

iron

37
Q

Abnormal eye movements are seen in ____ deficiency

A

B1/ thiamine

38
Q

Vitamin B deficiencies all tend to involve the ____

A

mouth

39
Q

Magenta tongue is specifically seen in _____ deficiency

A

B2/ riboflavin

40
Q

Decreased or altered taste suggests ____ deficiency

A

zinc

41
Q

Tooth decay suggests _____ deficiency

A

fluoride

42
Q

Arrhythmias suggests ____ deficiency

A

potassium

43
Q

Muscle spasm/ tetany suggests what deficiencies (2)?

A

Calcium, magnesium

44
Q

Decreased vibratory and position sense is seen in ____ deficiency

A

B12

45
Q

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

A

vitamin B12, thiamine

46
Q

Muscle weakness is seen in what deficiencies (2)?

A

potassium, vitamin D

47
Q

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

A

B12, zinc, calcium, vitamin D

48
Q

What groups are at risk for a generally inadequate diet?

A

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

49
Q

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

A

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

50
Q

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

A

iron

51
Q

____ deficiency is usually due to chronic diarrhea or diuretic use

A

potassium

52
Q

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

A

magnesium

53
Q

People with celiac disease often have deficiencies of:

A

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

54
Q

People with ileal resection or gastrectomy often have ____ deficiency

A

B12

55
Q

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

A

B12, vitamin D, calcium, iron

56
Q

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

A

B12 and fat soluble

57
Q

Pregnant women need supplements of:

A

folic acid

iron

58
Q

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

A

vitamin D
calcium
folate

59
Q

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

A

folate

60
Q

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

A

B12, Mg, Ca, iron

61
Q

What healthy people should consider vitamin/ mineral supplements?

A 
pregnant or lactating women
strict vegans
people on weight reduction diets
elderly
northern climates
62
Q

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

A

iatrogenic

FM4 (6 decks)

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