Nutritional Disorders Slides PDF

NUTRITIONAL DISORDERS UNDERNUTRITION: Types of undernutrition: 1-Total (starvation) 2-Selective as: • vitamin deficiency. • protein deficiency (protein calorie undernutrition). VITAMIN DEFICIENCIES VITAMIN D DEFICIENCY I) RICKETS :DEFINITION Rickets is a disease of infants characterized by defe...

NUTRITIONAL DISORDERS UNDERNUTRITION: Types of undernutrition: 1-Total (starvation) 2-Selective as: • vitamin deficiency. • protein deficiency (protein calorie undernutrition). VITAMIN DEFICIENCIES VITAMIN D DEFICIENCY I) RICKETS :DEFINITION Rickets is a disease of infants characterized by defective bone mineralization (calcium & phosphate) resulting in bone .softening and abnormalities of bone growth AETIOLOGY: 1-Vitamin D deficiency ;commonly due to lack of exposure to sun. 2-Chronic renal disease (renal rickets). 3-Deficiency of calcium & phosphorus 4-Hereditary (X-linked dominant) vitamin D resistant rickets. Rare. PATHOLOGY: 1-Skeletal Lesions: • Skull: Delayed closure of fontanelles, delayed eruption of teeth, craniotabes, bossing of frontal and parietal bones. • Vertebrae: Dorsal kyphosis, lumbar lordosis, scoliosis. • Chest: Rosary Chest, Harrison’s sulcus, Pigeon Chest. • Long bones: Bowing of weight-bearing bones and pathological fractures, rachitic metaphysis. • Pelvis: Narrowed contracted trifoil pelvis. COMPLICATIONS OF RICKETS: 1-Bone deformities. 2-Pathological fracture. 3-Infections due to low immunity. 4-Future labour problems in female patients (narrow pelvis). VITAMIN A DEFICIENCY Vitamin A deficiency results in: 1-Skin & mucous membranes: a)Hyperkeratosis of skin (appears dry & scaly). b)Squamous metaplasia. 2-Eye: a)Night blindness. b)Xerophthalmia (dry eyes due to keratinization of lacrimal glands). c) Keratomalacia (softening of the cornea). 3-Retarded growth in children This woman had a dry oral mucosa, a beefy red tongue, an erythematous throat without exudates, angular stomatitis bilaterally. The skin displayed a blanching maculopapular scaling rash on the extremities with some punctate erythematous lesions MICROSCOPIC DESCRIPTION: There is focal, patchy parakeratosis with follicular plugging, a focally thickened granular cell layer, and a hyperplastic epidermis. There was a minimal perivascular dermal VITAMIN K DEFICIENCY Aetiology: 1-Prolonged use of broad spectrum antibiotics. 2-Obstructive jaundice. 3-Temporarry deficiency in newly born infants. Pathological effects: Vitamin K deficiency leads to defective formation of prothrombin which leads to: 1-Hemorrhagic tendency e.g. interstitial hemorrhage due to minimal trauma. 2-Prolonged bleeding e.g. prolonged post operative hemorrhage VITAMIN C DEFICIENCY( SCURVY). Vitamin C deficiency is rare. It leads to defective formation of ground substance and collagen resulting in: 1-Bone : Bone weakening, fractures and defective bone healing. 2-Teeth: Defective formation of teeth in children associated with teeth loosening 3-Wound healing : Defective wound healing 4-Hemorrhage: hemorrhages are common which may be mild ( petechial) , mostly in the gums , but may be severe hemorrhage from node, GIT or subcutaneous tissue. Repeated hemorrhages lead to anemia.. VITAMIN B DEFICIENCY I)PELLAGRA Definition : Pellagra (which means rough skin) is a disease caused mainly by nicotinic acid deficiency. Aetiology: Nicotinic acid deficiency mainly occurs in people who depend on maize as the main source of starch, since maize is deficient in tryptophane from which nicotinic acid is synthesized. Pathology: 3Ds 1-Skin: Dermatitis. 2-GIT lesions: Painful inflamed tongue and Diarrhea due to colonic inflammation. 3-CNS: a)Demyelination of lateral and posterior columns (subacute combined degeneration). b)Degeneration of nerve cell leads to dementia. II) BERI BERI Defintion & Aetiology: A disease caused by deficiency of vitamin B1. Pathology: 1-Dry beri-beri: Peripheral neuritis affect the cranial and spinal sensory and motor nerves due to degeneration of myelin and axis cylinders. 2-Wet beri-beri:. The heart, mainly the right side is affected and shows fatty change and dilatation. Congestive heart failure may occur leading to generalized oedema (& hence the name wet beriberi) III)VITAMIN B12 AND/OR FOLIC ACID DEFICIENCY Causing macrocytic anemia.