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Questions and Answers
What is the primary cause of vitamin deficiencies?
What is the primary cause of vitamin deficiencies?
- Diet (correct)
- Metabolic disorders
- Tissue storage
- Malabsorption
What is the characteristic of fat-soluble vitamins?
What is the characteristic of fat-soluble vitamins?
- They are readily stored in fatty tissues (correct)
- They are often water-soluble
- They are not essential for health
- They are excreted in urine
What is the function of vitamin A in the body?
What is the function of vitamin A in the body?
- Cell growth and differentiation
- Lipid metabolism only
- Vision and immunity to infection
- All of the above (correct)
Which of the following is a characteristic of water-soluble vitamins?
Which of the following is a characteristic of water-soluble vitamins?
What can occur in cases of fat malabsorption disorders?
What can occur in cases of fat malabsorption disorders?
How many vitamins are necessary for health?
How many vitamins are necessary for health?
What is a common eye problem caused by vitamin A deficiency?
What is a common eye problem caused by vitamin A deficiency?
What is a skin problem that can occur due to vitamin A deficiency?
What is a skin problem that can occur due to vitamin A deficiency?
What is a respiratory tract problem that can occur due to vitamin A deficiency?
What is a respiratory tract problem that can occur due to vitamin A deficiency?
What is a common bone problem in growing children due to vitamin D deficiency?
What is a common bone problem in growing children due to vitamin D deficiency?
What is a common cause of vitamin D deficiency?
What is a common cause of vitamin D deficiency?
What is a function of vitamin D in the body?
What is a function of vitamin D in the body?
Which of the following is a complication of vitamin A deficiency in the urinary tract?
Which of the following is a complication of vitamin A deficiency in the urinary tract?
Which of the following is a complication of bulimia?
Which of the following is a complication of bulimia?
What is the endocrine finding associated with anorexia?
What is the endocrine finding associated with anorexia?
What is the term for bilateral parotid enlargement seen in bulimia patients?
What is the term for bilateral parotid enlargement seen in bulimia patients?
What is the electrolyte abnormality seen in anorexia and bulimia patients?
What is the electrolyte abnormality seen in anorexia and bulimia patients?
What is the term used to describe severe acute malnutrition seen in anorexia patients?
What is the term used to describe severe acute malnutrition seen in anorexia patients?
What is a common dental complication seen in bulimia patients?
What is a common dental complication seen in bulimia patients?
What is the term used to describe the pattern of eating seen in bulimia patients?
What is the term used to describe the pattern of eating seen in bulimia patients?
What is a potential complication of hypokalemia in anorexia and bulimia patients?
What is a potential complication of hypokalemia in anorexia and bulimia patients?
What is the difference between primary and secondary malnutrition?
What is the difference between primary and secondary malnutrition?
What is the main difference between marasmus and kwashiorkor?
What is the main difference between marasmus and kwashiorkor?
What is the main difference between acute and chronic malnutrition?
What is the main difference between acute and chronic malnutrition?
What are the consequences of severe acute malnutrition?
What are the consequences of severe acute malnutrition?
What is the underlying mechanism of cachexia?
What is the underlying mechanism of cachexia?
Which of the following is an intrinsic factor contributing to diffuse dental erosion?
Which of the following is an intrinsic factor contributing to diffuse dental erosion?
What is the primary management strategy for a patient with diffuse dental erosion?
What is the primary management strategy for a patient with diffuse dental erosion?
Which of the following is NOT a potential cause of diffuse dental erosion?
Which of the following is NOT a potential cause of diffuse dental erosion?
What is the term for the wasting of body mass, particularly muscle and fat, in patients with chronic illnesses?
What is the term for the wasting of body mass, particularly muscle and fat, in patients with chronic illnesses?
Which of the following is an extrinsic factor contributing to diffuse dental erosion?
Which of the following is an extrinsic factor contributing to diffuse dental erosion?
What is the primary reason for considering referral for medical and psychological evaluation in a patient with diffuse dental erosion?
What is the primary reason for considering referral for medical and psychological evaluation in a patient with diffuse dental erosion?
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Study Notes
Vitamin Deficiencies
- Primary: diet
- Secondary: malabsorption, metabolic disorders, tissue storage, liver disease
- 13 vitamins necessary for health:
- Fat soluble (ADEK): readily stored, but poorly absorbed in fat malabsorption disorders, and can be toxic
- Water soluble (Bs/C/Folate): excreted in urine, toxicity rare
- Often multiple vitamin deficiencies present
Vitamin A
- Retinol and related substances
- Functions:
- Vision (visual pigment)
- Cell growth and differentiation (mucus-secreting epithelia)
- Lipid metabolism
- Immunity to infection
- Ito cells (liver storage)
Anorexia and Bulimia
- Anorexia:
- Self-induced starvation
- Severe acute malnutrition
- Endocrine findings: amenorrhea, decreased thyroid hormone, electrolyte abnormalities
- Lack of consumption
- Hypokalemia → cardiac arrhythmia
- Anemia, lymphopenia, hypoalbuminemia
- Bulimia:
- Complications due to vomiting, laxatives, diuretics
- Hypokalemia → cardiac arrhythmia
- Pulmonary aspiration of gastric contents
- Esophageal and gastric rupture
- Sialadenosis (bilateral parotid enlargement)
Vitamin A Deficiency
- Eyes:
- Blindness (night/total)
- Xerophthalmia
- Corneal keratin plaques (Bitot's spots)
- Keratomalacia (corneal destruction/softening)
- Respiratory tract: squamous metaplasia, pulmonary infection
- Urinary tract: keratin debris → stones
- Skin: hyperkeratosis
- Immune deficiency
Vitamin D
- Functions:
- Maintenance of plasma Ca and P
- Bone development and mineralization
- Neuromuscular transmission
- Metabolic functions
- 2 sources:
- Endogenous synthesis in skin (UV light) – major source (~90% in light-skinned)
- Exogenous – diet
- Causes of deficiency:
- Inadequate sunlight
- Diet/malabsorption
- Liver disease
- Renal disorders (decreased synthesis of 1,25 (OH)2 vitamin D, phosphate depletion)
- Rickets (growing children):
- Craniotabes
- Rachitic rosary
- Bowing of legs
Malnutrition
- Primary: diet deficient in 1 or more components
- Secondary: supply OK, problem with absorption, storage, utilization, excessive loss, increased requirements
- Severe acute malnutrition:
- Weight for height ratio below 3 SD of WHO standards
- Developing countries: ~25% children affected, high death rates
- Developed countries: older/debilitated, children in poverty
Marasmus and Kwashiorkor
- Marasmus:
- Lack of nutrient
- Diet lacking in calories
- Somatic compartment (skeletal muscle wasting)
- Kwashiorkor:
- Lack of protein
- Protein deprivation > calorie reduction
- Visceral compartment (organ wasting, esp. liver)
Cachexia
- Secondary malnutrition as a complication of
- AIDS, cancer, other illnesses
- Catabolic processes cause emaciation due to lack of energy
- Morfactor (TNF and other cytokines secreted by tumor cells) → protein degradation/fat mobilization
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