Vitamins & Vitamins Deficiency

Question 1

What is Vitamin A?

Answer 1

Vitamin A is a fat-soluble vitamin that is essential for normal growth and development, normal function and integrity of epithelial tissues, formation of visual pigment, and normal tooth and bone development.

Sources: Butterfat, egg yolks, and cod liver oil are rich sources. The vitamin is also found in liver, green leafy and yellow vegetables, prunes, pineapples, oranges, limes, and cantaloupes.

Question 2

What is Vitamin A deficiency?

Answer 2

Vitamin A deficiency causes interference with growth, reduced resistance to infections, and interference with nutrition of the cornea, conjunctiva, trachea, hair follicles and renal pelvis. Vitamin A deficiency also interferes with the ability of the eyes to adapt to darkness (night blindness) and impairs visual acuity.

See: xeorpthalmia, Bitot spots, keratomalacia, follicular hyperkeratosis

Question 3

What is xeropthalmia?

Answer 3

Xeropthalmia is conjunctival dryness with keratinization of the epithelium following chronic conjunctivitis or a disease caused by Vitamin A deficiency.

Question 4

What is keratomalacia?

Answer 4

Keratomalacia is softening of the cornea, typically as a result of Vitamin A deficiency. It may occur in childhood or result from severe malnutrition in adults.

Question 5

What are Bitot spots?

Answer 5

Bitot spots are triangular shiny gray spots on the conjunctiva seen in Vitamin A deficiency.

Question 6

What is follicular hyperkeratosis?

Answer 6

Follicular hyperkeratosis is a condition characterized by excessive dryness, wrinkling, and scaling of skin sometimes seen in vitamin deficiencies.

Question 7

What is Vitamin D?

Answer 7

Vitamin D is a fat-soluble vitamin that is essential for the metabolism of calcium and phosphorous and therefore is necessary for the normal development of bones and teeth.

Sources: Butterfat, cod liver oil, salmon and cod livers, and egg yolk containing Vitamin D. Ergosterol in the skin, when activated by sunlight or ultraviolet radiation, has the potency of vitamin D.

Actions/Uses: Vitamin D is used to treat and prevent infantile rickets, spasmophilia (infantile tetany), and softening of bone. Vitamin D is also important in normal growth and mineralization of skeleton and bone.

Question 8

What is Vitamin E?

Answer 8

Vitamin E is a fat-soluble antioxidant found in many common foods, such as vegetables and seed oils.

Vitamin E deficiency is rare, but it is associated with hemolytic anemia, ataxia, and peripheral neuropathy.

Question 9

What is Vitamin K?

Answer 9

Vitamin K is an anti hemorrhagic, fat-soluble factor that is found in broccoli, collards, beets, and greens. Vitamin K is necessary for synthesis of clotting factors VII, IX, X, and prothrombin by the liver. It’s deficiency prolongs blood clotting time and causes bleeding. In the newborn, the colon is sterile until food is ingested and bacteria colonize the site. Because this bacterial source of Vitamin K is not immediately available, an intramuscular injection of Vitamin K is recommended for all newborns.

Question 10

What is Vitamin B1 (thiamine)?

Answer 10

Vitamin B1 (thiamine) is a water-soluble vitamin that affects growth, nutrition and carbohydrate metabolism.

Sources: Whole grains, wheat embryo, brewer’s yeast, legumes, nuts, egg yolk, fruits, and vegetables.

Vitamin B1 (thiamine) deficiency can cause Beri-Beri syndrome, Wernicke encephalopathy, and Wernicke Korsakoff syndrome.

Question 11

What is beri-beri syndrome?

Answer 11

Beri-Beri syndrome is a disease marked by peripheral neurological, cerebral, and cardiovascular abnormalities and caused by lack of thiamine. Early deficiency produces fatigue, irritability, poor memory, sleep disturbances, chest pain, anorexia, abdominal discomfort, and constipation. Beriberi is endemic in Asia, the Philippines, and other islands of the Pacific.

Treatment: Treatment consists of oral or parenteral administration of thiamine and eating a balanced diet.

Question 12

What is Vitamin B2 (riboflavin)?

Answer 12

Vitamin B2 (riboflavin) is a water-soluble vitamin that is found in brewer’s yeast, liver, meat, especially pork and fish, poultry, eggs, milk and green vegetables. Riboflavin affects growth and cellular metabolism.

Vitamin B (riboflavin deficiency) causes glossitis and stomatitis.

Question 13

What is glossitis?

Answer 13

Glossitis is inflammation of the tongue.

Question 14

What is stomatitis?

Answer 14

Stomatitis is inflammation of the mouth (including the lips, tongue and mucous membranes).

Question 15

What is Vitamin B3 (niacin)?

Answer 15

Vitamin B3 (niacin) is a water-soluble vitamin that is found in brewer’s yeast, liver, meat, poultry, and green vegetables.

Vitamin B3 (niacin) deficiency can lead to pellagra.

Question 16

What is pellagra?

Answer 16

Pellagra is the clinical consequences of profound Vitamin B3 (niacin) deficiency characterized by cutaneous, gastrointestinal, mucosal, and neurological symptoms.

Pellagra is often associated with restricted or limited diets in which a single cereal grain, especially corn, is consumed without adequate consumption of wheat, eggs, beef, poultry, or other foods rich in niacin or tryptophan. The condition is often found in chronic alcoholism.

Symptoms: In advanced cases of pellagra, stomatitis, glossitis, diarrhea, dermatitis, and central nervous system involvement occur. Cutaneous lesions include erythema followed by vesiculation, crusting, and desquamation. Nausea, vomiting, and diarrhea occur, the last being a characteristic clinical manifestation. Involvement of the central nervous system is first manifested by neurasthenia, followed by organic psychosis characterized by disorientation, memory impairment, and confusion. Later, delirium and clouding of consciousness may occur.

Treatment: The disease is treated by following a diet adequate in all vitamins, minerals, and amino acids supplemented by niacin-amide.

Question 17

What is Vitamin B9 (folate)?

Answer 17

Vitamin B9 (folate) is a water-soluble vitamin that is found in leafy green vegetables, organ meats, lean beef and veal, and wheat cereals.

Sources: Fruits and vegetables.

Deficiencies in Vitamin B9 (folate) can cause neural tube defects and macrocytic anemia.

Question 18

What is Vitamin B12 (cobalamin)?

Answer 18

Vitamin B12 (cobalamin) is a water-soluble vitamin that is essential for the formation of red blood cells. Deficiency of Vitamin B12 (cobalamin) results in pernicious anemia.

Question 19

What is pernicious anemia?

Answer 19

Pernicious anemia is a chronic macrocytic anemia marked by achlorhydria.

Etiology: Pernicious anemia is an autoimmune disease. The parietal cells of the stomach lining fail to secrete enough intrinsic factor to ensure intestinal absorption of Vitamin B12 (cobalamin), the extrinsic factor. This is the result of atrophy of the glandular mucosa of the fundus of the stomach and is associated with the absence of hydrochloricacid.

Symptoms: Symptoms include weakness, sore tongue, paresthesias (tingling and numbness) of the extremities and gastrointestinal symptoms such as diarrhea, nausea, vomiting, and pain; in severe anemia, there may be signs of cardiac failure.

Treatment: Vitamin B12 (cobalamin) is given parenterally or, in patients who respond, intranasally or orally.

Question 20

What is Vitamin C (ascorbic acid)?

Answer 20

Vitamin C (ascorbic acid) is a water-soluble vitamin that occurs naturally in fresh fruits, especially citrus, and vegetables. It is necessary for the formation of collagen in connective tissues and in maintenance of integrity of intercellular cement in many tissues, especially capillary walls.

Sources: Vitamin C is found in raw cabbage, young carrots, orange juice, lettuce, celery, onions, tomatoes, radishes, and green peppers. Citrus fruits and rutabagas are especially rich in this vitamin.

Deficiency Disorders: Vitamin C (ascorbic acid) deficiency causes scurvy, imperfect prenatal skeletal formation, defective teeth, pyorrhea, anorexia, and anemia. It also leads to under nutrition injury to bone, cells, and blood vessels.

Question 21

What is scurvy?

Answer 21

Scurvy is a disease caused by a vitamin deficiency resulting from inadequate consumption of ascorbic acid (Vitamin C) from the diet.

Symptoms & Signs: Symptoms include fatigue, bleeding from the skin, joints, and gums, impaired wound healing; wearing of bones and impairment of bone growth; dry skin; edema in the lower extremities; follicular hyperkeratosis; anemia; and coiling of body hairs.

Question 22

What is koilonychia?

Answer 22

Koilonuchia is dystrophy of the fingernails in which they are thin and concave with raised edges. This condition is sometimes associated with iron-deficiency anemia. It is often called “spooning of the nails”.

Question 23

What is pica?

Answer 23

Pica is an eating disorder manifested by a craving to ingest material not normally considered food, e.g. starch, clay, ashes, crayons, cotton, grass, cigarette butts, soap, wood, paper, of plaster. Pica may be associated with iron-deficiency anemia.

Question 24

What are the symptoms of iodine deficiency?

Answer 24

Iodine deficiency in the diet may lead to simple goiter characterized by thyroid enlargement and hypothyroidism. In young children, this deficiency may result in retardation of physical, sexual, and mental development, a condition called cretinism.

Question 25

What is acrodermatitis enteropathica?

Answer 25

Acrodermatitis enteropathica is a rare disease in children aged 3 weeks to 18 months that may be fatal if untreated. The generally determined cause of the disease is malabsorption of zinc. Onset is insidious with failure to thrive, diarrhea, loss of hair, development of of vesiculobullous lesions, particularly around body orifices. The treatment for acrodermatitis enteropathica is oral zinc sulfate.

Question 26

What is refeeding syndrome?

Answer 26

Reseeding syndrome is the potentially fatal metabolic response of a starved individual to feeding, either enterally or parenterally. The correction of electrolyte imbalances is imperative before gradual refeeding to prevent hypophosphatemia, rhabdomyolysis, and other life-threatening complications.

Question 27

What is cheilitis?

Answer 27

Cheilitis is inflammation or chapping of the lips, especially at their corners. This condition may be caused by exposure to sun, wind, or other elements or it may result from habitual lip smacking.

Cheilitis can also result from deficiency of vitamin B2 (riboflavin).

Question 28

What is keratitis?

Answer 28

Keratitis is inflammation of the cornea, usually associated with decreased visual acuity and, if untreated, sometimes resulting in blindness. Pain in the eye, tearing, sensitivity to light, and impaired vision are the most common symptoms.

Etiology: It is often caused by contact lenses, but it may also result from drugs, microorganisms, immunodefi- ciency, trauma, vitamin A deficiency, or vitamin B2 (riboflavin) deficiency.

TreatmentL Therapy depends upon the cause. Bacterial infections respond to antibacterial medications (typically administered in drops); herpes simplex viral infection requires antiviral agents; fungal keratitis is treated with antifungal agents; exposure keratitis, as in Bell palsy, is preventable with topical lubricants.

Question 29

What is rickets?

Answer 29

Rickets is a disease of linear bone formation in children, most commonly the result of vitamin D deficiency, marked by inadequate mineralization of developing cartilage and newly formed bone, causing abnormalities in the shape, structure, and strength of the skeleton. This condition can be prevented by exposure to ultraviolet light (sunlight or artificial light) and administration of vitamin D in quantities that provide 400 I.U. of vitamin D activity per day.

Causes: Rickets has many causes, including diseases that affect vitamin D or phosphorus intake, absorption, and metabolism; renal tubular disorders; and diseases in which the child is chronically acidotic, among others.

Findings: Affected children are often lethargic, and may have flaccid musculature and decreased muscular strength. On physical examination, multiple bony abnormalities are present, including frontal bossing, bowing of the long bones, flattening of the sides of the thoracic cavity, kyphosis, scoliosis, or lordosis.

Treatment: Treatment and prognosis depend on the correction of the underlying cause. Supplemental vitamin D therapy is appropriate for some patients.

Question 30

What is nyctalopia?

Answer 30

Nyctalopia is the inability to see well in faint light or at night. The condition occurs in retinitis pigmentosa and choroidoretinis. It may also be due to Vitamin A deficiency.

Question 31

What is cheilosis?

Answer 31

Cheilosis is a disorder marked by fissures and epithelial desquamation at the corners of the mouth, especially seen in children. The condition may be due to oral candidiasis or may be a symptom of dietary deficiency, especially riboflavin deficiency.