Vitamin Deficiencies from exam 1

Question 1

what vitamin deficiency can cause peripheral neuropathy & paresthesias?

Answer 1

thiamin (B1)- beriberi

Question 2

thiamin (B1) is destroyed by what?

Answer 2

pasteurization & sterilization

Question 3

what is infantile beriberi

Answer 3

1-4 mo old

breastfed by alcoholic mother whom is deficient in Vit. B1 (thiamin)

Question 4

what are the s/sx of infantile beriberi

Answer 4

anorexia, apathy, vomiting, restless, pallor
prgresses to dyspnea, cyanosis & CHF
aphonic cry

Question 5

s/sx of riboflavin (B2) deficiency- ariboflavinosis

Answer 5

angular stomatitis
glossitis
cheilosis
seborrehic dermatitis (nose & mouth)
photophobia
corneal vascularization
reduced tearing
cataracts

Question 6

s/sx of niacin (B3) deficiency

Answer 6

pellagra
weakness, lassitude, dermatitis, photosensitivity, mucosal inflammation, vomiting, diarrhea, dysphage & dementia ( in severe cases)

Question 7

s/sx of pyridoxine (B6) deficiency

Answer 7

destroyed by heating

microcytic anemia, diarrhea, FTT, seizures, irritability & listlessness

Question 8

what binds pyridoxine

Answer 8

isoniazid &penicillamine

Question 9

ascorbic acid (C) deficiency is known as?

Answer 9

scurvy

Question 10

scurvy s/sx

Answer 10

irritability
bone tenderness w/ swelling
pseudoparalysis of the legs
subperiosteal hemorrhage
gingival bleeding
petechaie, hyperkeratosis, mental status changes, anemia, poor iron absorption

Question 11

what is the only water soluble vitamin stored in the liver?

Answer 11

B12

Question 12

what deficiency leads to xerophthalmia?

Answer 12

retinol & retinoids (A)
night blindness
xerosis of conjunctiva & cornea

Question 13

what causes rickets & osteomalacia?

Answer 13

ergocalciferol (D3) deficiency

Question 14

what type of D2 is made in the skin?

Answer 14

cholecalciferol

Question 15

what directly promotes calcium absorption & inhibits parathyroid activity

Answer 15

vit D3

Question 16

s/sx of rickets

Answer 16

craniotabes- thin skull, feels like a ping pong ball
enlarged fontanelle
enlarged costochondral junctions (rachitic rosary)
thickening at long bone metaphyses
greenstick fx, scoliosis, lordosis, & bowlegs in older CH

Question 17

antioxidants & free radical scavengers

Answer 17

alpha-tocopherol & others (E)

Question 18

phylloquinone (phytonadione, K1) necessary for synthesis of what?

Answer 18

plasma factors II, VII, IX, X
proteins C & S
osteolcalcin

Question 19

s/sx of hemorrhagic dz of newborn d/t K1 deficiency

Answer 19

generalized ecchymoses
GI bleeding
bleeding from circumcision/umbilical stump
intracranial hemorrhage

Question 20

what vit is recommended for all newborns after delivery?

Answer 20

phylloquinone (phytonadione, K1)

Question 21

acrodermatitis enterohepatica

Answer 21

congenital deficiency of zinc absorption

occurs in 1st month after weaning from breast milk

Question 22

caloric & water needs/ wt of 3-10 kg baby

Answer 22

100 kcal/kg

100 mL of H2O/kg

Question 23

caloric & H2O needs for 11-20 kg baby

Answer 23

1000 kcal + 50 for each kg > 10kg

for both calories &H2O

Question 24

caloric & H2O needs for > 20 kg

Answer 24

1500 kcal + 20 kcal/kg for each kg >20 kg

Question 25

mild dehydration

Answer 25

<5% body wt loss

Question 26

moderated dehydration

Answer 26

6-10% body wt loss

Question 27

severe dehydration

Answer 27

> 10% body wt loss

Question 28

clinical signs of mild dehydration

Answer 28

nml skin turgor, color, pulse, BP, perfusion 
dry mucous membranes
cap refill < 2 seconds
mild oliguria
no acidosis
\+/- tears

Question 29

clinical signs of moderate dehydration

Answer 29

skin turgor +/-
color pale/mottled
dry mucous membranes
slight increase in pulse
cap refill 2-4 secs
BP & perfusion nml
oliguria
acidosis present
tears decreased

Question 30

clinical signs of sever dehydration

Answer 30

poor skin turgor
pasty color
mottled/grey mucous membranes
tachycardia
cap refill > 4 secs
BP low
perfusion circulatory collapse
anuria
severe acidosis
absent tears

Question 31

volume correct by wt

Answer 31

% of dehydration x .70 x wt (kg)= total replenishment

Question 32

CH have greater surface area to mass ration, and thus greater_________losses d/t skin losses

Answer 32

insensible

Question 33

fluid resuscitation in CH is done in?

Answer 33

2 stages

Question 34

what are the 2 stages of fluid resuscitation in CH?

Answer 34

bolus to address perfusion & hemodynamic stability

correct Na+ imbalances over 24-48 hrs

Question 35

hypernatremic correction done slowly to avoid?

Answer 35

cerebral edema

Question 36

hyponatremic correction done to?

Answer 36

avoid seizures