Vitamin A: Functions and Deficiencies

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Questions and Answers

What is the most bioactive form of vitamin A?

Alpha-tocopherol

All-trans retinoic acid (correct)

11-cis retinal

Retinol binding protein

What is the primary function of vitamin E in the body?

Regulation of transcription

Prevention of free radical injury (correct)

Vision regulation

Cell differentiation

What is the consequence of protein-energy malnutrition on vitamin A?

Impaired synthesis of retinol binding protein (correct)

Increased synthesis of retinol binding protein

Decreased vitamin A storage

Increased vitamin A absorption

What is the primary symptom of hypervitaminosis A?

All of the above Signup and view all the answers

What is the treatment for vitamin E deficiency?

Vitamin E supplementation Signup and view all the answers

What is the likely diagnosis for a 2-year-old girl with high-grade fever and maculopapular rashes?

Measles Signup and view all the answers

What is the percentage of birth weight occupied by the corneal ulcer depicted in the image?

7% Signup and view all the answers

What is an indicator of inadequate breastfeeding in an infant?

Weight loss of >7-10 % of birth weight Signup and view all the answers

How many times a day should a breastfed neonate feed?

What is recommended by the Baby-friendly Hospital Initiative?

Rooming-in (allow mothers and infants to remain together 24 hour/day) Signup and view all the answers

What is celebrated from 1-7 August every year?

World Breastfeeding Week Signup and view all the answers

What is the disorder depicted in the clinical image?

Bitot spots Signup and view all the answers

How often should an infant urinate according to the indicators of inadequate breastfeeding?

What is the normal epithelial type of the bulbar conjunctiva?

Stratified, columnar non-keratinized Signup and view all the answers

What is the term for the deposition of calcium in the conjunctiva?

Conjunctival concretions Signup and view all the answers

What is the cause of scarring of the conjunctiva?

Chlamydial infection Signup and view all the answers

What is the term for excessive growth of conjunctival tissue?

Pterygium Signup and view all the answers

What is the classification of the stage of vitamin A deficiency in the given image?

Bitot spots Signup and view all the answers

How long can breast milk be stored in the refrigerator?

24 hours Signup and view all the answers

What is found in higher amounts in human milk compared to cow's milk?

Lactose Signup and view all the answers

What should not be done to thawed breast milk?

Microwave it Signup and view all the answers

How long can breast milk be frozen at -20°C?

3 months Signup and view all the answers

Why is it important to coordinate discharge?

So parents and infants have timely access to ongoing support and care Signup and view all the answers

What should mothers be counseled on?

The use and risks of feeding bottles, teats, and pacifiers Signup and view all the answers

What is the main objective of World Breastfeeding Week?

To highlight the benefits of breastfeeding for maternal and infant health Signup and view all the answers

What is the theme for World Breastfeeding Week 2020?

Support Breastfeeding for a healthier planet, Covid-19 is an opportunity to strengthen action on breastfeeding Signup and view all the answers

What is the first step in the Ten Steps to Successful Breastfeeding?

Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions Signup and view all the answers

What should not be provided to breastfed newborns, unless medically indicated?

Any food or fluids other than breast milk Signup and view all the answers

What is the primary goal of the Baby-Friendly Hospital Initiative?

To support and facilitate breastfeeding practices Signup and view all the answers

Study Notes

Vitamin A Deficiency

Bitot spots are triangular, frequently bilateral, and present on the bulbar conjunctiva, caused by keratinization of the conjunctival epithelium.
In vitamin A deficiency, there is squamous metaplasia of the conjunctival epithelium, resulting in a dry, scaly patch with a foamy appearance.

Conjunctival Abnormalities

Deposition of calcium in the conjunctiva is termed conjunctival concretions, usually occurring over the palpebral conjunctiva in chronic inflammatory conditions of the eye.
Scarring of the conjunctiva is seen in chlamydial infection of the eye.
Excessive growth of conjunctival tissue is seen in pterygium of the eye.

Breastfeeding

Inadequate breastfeeding indicators in an infant:
- Weight loss >7-10% of birth weight
- Lethargy (sleeping longer than 2-3 hours)
- Delayed stooling (less than 4 times/day)
- Decreased urine output (urinating less than 5-7 times/day)
- Hypernatremic dehydration
- Inconsolable crying and increased hunger
Breastfed neonates usually feed 8-12 times a day, with a minimum of 8 times per day, and should be breastfed on demand.
The Baby-friendly Hospital Initiative recommends rooming-in (allowing mothers and infants to remain together 24 hours/day).

Vitamin A and Fat-Soluble Vitamins

All-trans retinoic acid is the most bioactive form of vitamin A, required for cell differentiation and transcription regulation.
11-cis retinal is required for vision.
Protein-energy malnutrition can cause vitamin A deficiency due to impaired synthesis of retinol binding protein (RBP).
Hypervitaminosis A causes headache, vomiting, desquamation of the skin, and hyperostosis of long bones.
Vitamin E is the most important antioxidant in the body, preventing free radical injury.

Breast Milk and Storage

Breast milk stored in the refrigerator should be used within 24 hours.
Refrigerated or frozen milk should be thawed rapidly by holding under running tepid water and used completely within 24 hours after thawing.
Milk should never be microwaved.
Expressed breast milk can be stored for:
- 6 hours at room temperature
- 24 hours in the refrigerator
- 3 months when frozen

Human Milk vs Cow's Milk

Lactose is present in a higher percentage in human milk compared to cow's milk.

World Breastfeeding Week

The theme for 2020 is "Support Breastfeeding for a healthier planet, Covid-19 is an opportunity to strengthen action on breastfeeding"
The week aims to highlight the benefits of breastfeeding for both babies and maternal health.

Baby-Friendly Hospital Initiative

Ten steps to successful breastfeeding (Revised 2018) include:
- Complying with the International Code of Marketing of Breast-milk Substitutes
- Having a written infant feeding policy
- Establishing ongoing monitoring and data-management systems
- Ensuring staff has sufficient knowledge, competence, and skills to support breastfeeding
- Discussing the importance and management of breastfeeding with pregnant women and their families
- Facilitating immediate and uninterrupted skin-to-skin contact and supporting mothers to initiate breastfeeding as soon as possible after birth
- Supporting mothers to initiate and maintain breastfeeding and manage common difficulties
- Not providing breastfed newborns any food or fluids other than breast milk, unless medically indicated
- Enabling mothers and their infants to remain together and to practice rooming-in 24 hours a day

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Description

Test your knowledge about the functions of vitamin A, its deficiency causes and effects, and the consequences of excessive intake. Learn about the roles of all-trans retinoic acid and 11-cis retinal in the body.