Clinical Assessment of Malnutrition

Clinical Assessment

• Clinical assessment is the evaluation of nutritional status through physical examination.
• Malnutrition is categorized into deficiency and toxicity.

Malnutrition

• Deficiency: Inadequate nutrient intake results in depletion of tissue reserves, decreased blood nutrient levels, insufficient nutrients available to cells, and impaired cellular functions. Physical signs and symptoms of deficiency result.
• Toxicity: Excessive nutrient intake leads to saturation of tissue reserves, elevated blood nutrient levels, excessive nutrients available to cells, and impaired cellular functions. Physical signs and symptoms of toxicity result.

Pallor

• Pallor is a deficiency in iron, folate, vitamin B12, vitamin B complex, or protein.

Depigmented

• Depigmented hair can indicate deficiencies in protein, zinc, or biotin.

Night blindness

• Night blindness is a symptom, often linked to vitamin A deficiency.

Bitot's spot

• A white, foamy lesion on the conjunctiva, often associated with vitamin A deficiency.

Angular Stomatitis

• Angular stomatitis (cleft mouth) may indicate vitamin B2 deficiency.

Gingivitis

• Gingivitis is gum inflammation, often a sign of vitamin C deficiency.

Swollen Bleeding Gums

• Swollen, bleeding gums can result from vitamin C deficiency or poor oral hygiene.

Glossitis

• Glossitis (inflammation of the tongue) is associated with vitamin B complex or vitamin C deficiency.

Goiter

• Goiter is thyroid gland enlargement, often associated with iodine deficiency.

Acanthosis Nigricans

• Acanthosis nigricans is characterized by darkened, thickened skin folds, particularly in areas like the neck, armpits, and groin. This condition frequently occurs in obese individuals with high insulin levels.

Petechial Hemorrhage

• Petechial hemorrhage, tiny red spots under the skin, may point to vitamin C deficiency.

Follicular Hyperkeratosis or Toad Skin

• Follicular hyperkeratosis, characterized by rough skin with small bumps, may be associated with vitamin A deficiency.

Ascites

• Ascites is fluid buildup in the abdominal cavity, sometimes linked to various medical conditions.

Koilonychia

• Koilonychia, a condition where the nails are thin and concave, often occurs with iron deficiency.

Leukonychia

• Leukonychia describes white spots or patches on the nails, potentially linked to several deficiencies or other issues.

Apparent Leukonychia

• Muehrcke's nails: Horizontal bands of white across the nails, may be due to low albumin levels.
• Beau's lines: Transverse grooves or depressions across the nail plate; related to temporary interruptions in nail growth.
• Terry's nails: Most of the nail plate is white, with a narrow pink or reddish-brown band at the tip; may be related to liver or cardiovascular disease.
• Lindsey nails: Loss of the lunula (the whitish half moon at the base of the nail), associated with various health issues, including kidney problems, HIV, and others

Bowed Legs

• Bowed legs can sometimes indicate vitamin D and/or calcium deficiency.

Rickets (Bowed Legs)

• Rickets, a condition that causes skeletal deformities, is often associated with vitamin D and calcium deficiency.

Beriberi

• Beriberi is caused by a thiamin (vitamin B1) deficiency. Symptoms include numbness and pain in the extremities.

Body Examination 10 Steps

• A detailed procedure including instructions about preparing the subject, measurements of height and weight, and observations of features like hair, eyes, and skin. Methods to assess posture, limb bending, and additional aspects of physical health are included.

General Health Screening

• Procedures for evaluating height, weight, vision, blood pressure, respiratory rate, and pulse are described, as well as other aspects of general health assessment.