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Questions and Answers
What is classified as primary malnutrition?
What is classified as primary malnutrition?
What characterizes Severe Acute Malnutrition (SAM)?
What characterizes Severe Acute Malnutrition (SAM)?
Which of the following is a symptom of Marasmus?
Which of the following is a symptom of Marasmus?
Which of these factors can lead to dietary insufficiency?
Which of these factors can lead to dietary insufficiency?
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What role do vitamins play in health?
What role do vitamins play in health?
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What is a common manifestation of Kwashiorkor?
What is a common manifestation of Kwashiorkor?
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How does dietary insufficiency affect immunity?
How does dietary insufficiency affect immunity?
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Which of the following is true about secondary malnutrition?
Which of the following is true about secondary malnutrition?
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What is the main vitamin synthesized in this reaction?
What is the main vitamin synthesized in this reaction?
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Which mechanism increases the production of 1,25-dihydroxyvitamin D in the kidney?
Which mechanism increases the production of 1,25-dihydroxyvitamin D in the kidney?
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Which condition is characterized by vitamin D deficiency in children?
Which condition is characterized by vitamin D deficiency in children?
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What is the normal reference range for circulating 25-(OH)-D?
What is the normal reference range for circulating 25-(OH)-D?
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What deficiency leads to an excess of unmineralized matrix in both adults and children?
What deficiency leads to an excess of unmineralized matrix in both adults and children?
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What is the long-term consequence of vitamin D deficiency in osteomalacia?
What is the long-term consequence of vitamin D deficiency in osteomalacia?
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Which skeletal change is associated with rickets in infants?
Which skeletal change is associated with rickets in infants?
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What factor contributes to vitamin D deficiency, leading to the conditions mentioned?
What factor contributes to vitamin D deficiency, leading to the conditions mentioned?
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What causes the deformation known as rachitic rosary?
What causes the deformation known as rachitic rosary?
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What is the primary effect of a vitamin D deficiency in children?
What is the primary effect of a vitamin D deficiency in children?
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Which of the following is a characteristic of scurvy due to vitamin C deficiency?
Which of the following is a characteristic of scurvy due to vitamin C deficiency?
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What anatomical feature is primarily affected by pigeon breast deformity?
What anatomical feature is primarily affected by pigeon breast deformity?
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Which population is most at risk for vitamin C deficiency?
Which population is most at risk for vitamin C deficiency?
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What aspect of collagen is primarily supported by vitamin C?
What aspect of collagen is primarily supported by vitamin C?
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What skeletal deformity is commonly associated with rickets?
What skeletal deformity is commonly associated with rickets?
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What is the major complication associated with anorexia nervosa?
What is the major complication associated with anorexia nervosa?
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What are the well-formed dark trabeculae in rickets indicative of?
What are the well-formed dark trabeculae in rickets indicative of?
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Which feature is considered pathognomonic for anorexia nervosa?
Which feature is considered pathognomonic for anorexia nervosa?
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In bulimia nervosa, what percentage of patients experience amenorrhea?
In bulimia nervosa, what percentage of patients experience amenorrhea?
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Which of the following vitamin deficiencies is most commonly associated with secondary factors?
Which of the following vitamin deficiencies is most commonly associated with secondary factors?
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Which condition has the highest death rate among psychiatric disorders?
Which condition has the highest death rate among psychiatric disorders?
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What is a significant effect of fat-soluble vitamin deficiencies in the body?
What is a significant effect of fat-soluble vitamin deficiencies in the body?
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Which electrolyte imbalance is a medical complication of bulimia due to inducing vomiting?
Which electrolyte imbalance is a medical complication of bulimia due to inducing vomiting?
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Which vitamin can be synthesized endogenously from precursor steroids?
Which vitamin can be synthesized endogenously from precursor steroids?
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What is a significant characteristic of kwashiorkor related to protein deprivation?
What is a significant characteristic of kwashiorkor related to protein deprivation?
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Which of the following symptoms is commonly associated with marasmus?
Which of the following symptoms is commonly associated with marasmus?
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What anatomical change is NOT associated with kwashiorkor?
What anatomical change is NOT associated with kwashiorkor?
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What histological change occurs in the small bowel of a child with kwashiorkor?
What histological change occurs in the small bowel of a child with kwashiorkor?
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What is the primary factor contributing to cachexia in chronic infections and neoplastic diseases?
What is the primary factor contributing to cachexia in chronic infections and neoplastic diseases?
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Which of the following is a common consequence of anorexia nervosa?
Which of the following is a common consequence of anorexia nervosa?
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What is a common complication of advanced cancers related to nutritional status?
What is a common complication of advanced cancers related to nutritional status?
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What specific effect does TNF have on energy balance in the body?
What specific effect does TNF have on energy balance in the body?
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Study Notes
Dietary Insufficiency and Malnutrition
- Dietary insufficiency arises from inadequate intake, digestion, or absorption of nutrients, leading to malnutrition.
- Malnutrition can be classified as primary (missing dietary components) or secondary (due to illnesses, absorption issues, or increased nutrient needs).
- Causes of dietary insufficiency include poverty, chronic illness, alcoholism, ignorance about nutrition, and self-imposed dietary restrictions.
Severe Acute Malnutrition (SAM)
- SAM is defined by a weight-for-height ratio that is three standard deviations below normal.
- It manifests in two primary forms: Marasmus and Kwashiorkor.
Marasmus
- Caused by severe calorie deficiency, leading to growth retardation and muscle mass loss.
- Depletion of visceral proteins is minimal; however, subcutaneous fat is catabolized for energy.
- Associated with low leptin levels, contributing to immune deficiencies and vitamin deficiencies.
Kwashiorkor
- Characterized by protein deprivation; muscle mass loss is less pronounced than in Marasmus.
- Results in hypoalbuminemia, edema, and fatty liver due to compromised protein synthesis.
- Symptoms include hair loss, flaky skin, and alternating skin pigmentation.
Morphological Changes in SAM
- Key physical changes include growth failure, peripheral edema in Kwashiorkor, and muscle atrophy in Marasmus.
- The liver in Kwashiorkor appears enlarged and fatty, while the small intestine shows mucosal atrophy.
- The brain may exhibit atrophy with reduced neuronal numbers in severely malnourished infants.
Cachexia and Eating Disorders
- Cachexia is a common complication in chronic diseases like AIDS and advanced cancers, leading to weight loss and anorexia.
- Anorexia Nervosa is marked by self-induced starvation, with high mortality rates and symptoms overlapping with SAM.
- Bulimia involves binge eating followed by purging and presents fewer severe health risks compared to anorexia.
Vitamins: Functions and Deficiencies
- Thirteen essential vitamins are classified as fat-soluble (A, D, E, K) and water-soluble.
- Fat-soluble vitamins can be stored in the body; deficiencies may arise from malabsorption.
- Vitamin deficiency can be primary (diet-related) or secondary due to absorption issues.
Vitamin D and Its Metabolism
- Vitamin D is essential for maintaining calcium and phosphorus homeostasis.
- Deficiency leads to rickets in children and osteomalacia in adults.
- The reference range for circulating vitamin D is 20 to 100 ng/mL; deficiency is defined as below 20 ng/mL.
Vitamin D Deficiency Symptoms
- Children with rickets show skeletal deformities, such as frontal bossing and the rachitic rosary.
- Adults with osteomalacia experience weak bones prone to fractures, particularly in the spine and hip.
Vitamin C (Ascorbic Acid) Functions and Deficiency
- Vitamin C is vital for collagen synthesis, neurotransmitter production, and immune response.
- Clinically significant deficiency leads to scurvy, characterized by bone disease, hemorrhages, and impaired healing.
- High-risk groups for deficiency include the elderly, chronic alcoholics, and those on restricted diets.
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