Conjunctiva
white area of the eyes.
Cornea
The clear tissue that covers the front of the eye.
Retina
The light-sensitive inner surface of the eye.
What are the clinical/physical signs of Vitamin A deficiency?
Bitot's Spots, Conjunctival Xerosis, Corneal Xerosis, Corneal ulceration, Keratomalacia and
Follicular hyperkeratosis, type 2.
Bitot's spots
Foamy plaque (keratin buildup) on the cornea that are a sign of vitamin A deficiency.
Conjunctival xerosis
dryness of the eye surface (white) related to deficiency in vitamin A.
Corneal xerosis
dryness of the cornea due to vitamin A deficiency.
Corneal ulceration
Surface depression on the cornea due to deficiency of vitamin A.
Keratomalacia
Softening of the cornea as a result of vitamin A deficiency.
Follicular hyperkeratosis
Dry, bumpy skin associated with vitamin A deficiency.
What are the clinical/physical signs of Riboflavin deficiency?
Nasolabial dyssebacea,
Corneal vascularization, angular blepharitis,
Angular stomatitis,
Angular scars,
Cheilosis, Atrophic lingual papillae, Stages of glossitis leading to magenta tongue, Glossitis, Scrotal dermatitis.
Nasolabial dyssebacia
Rash on the nose and lips caused by riboflavin deficiency.
Corneal vascularization
Blood vessel growth in the cornea caused by riboflavin deficiency.
Angular Blepharitis
Inflammation of the outer corners of the eyelids caused by riboflavin deficiency.
Angular stomatitis
inflammation and cracking of the skin at the corners of the mouth; a symptom of riboflavin deficiency.
Angular scars
...
Cheilosis
Crack-like sores at the corners of the mouth caused by riboflavin deficiency.
Atrophic lingual papillae
glossitis
inflammation of the tongue.
Magenta tongue
Last stage of glossitis caused by riboflavin deficiency.
Scrotal dermatitis
Severe itching, erythema, and scaling of the scrotal skin caused by riboflavin deficiency.
What are the clinical/physical signs of Thiamin Deficiency?
Edema and foot drop
What is another name for thiamin deficiency/
Beriberi
Edema
Puffy swelling of tissue from the accumulation of fluid caused by thiamin deficiency.
Foot drop
A weakness of muscles in the feet and ankles that causes problems with the ability to flex the ankles and walk normally caused by thiamin deficiency.
Pellagra
Niacin deficiency
What are the four D's of niacin deficiency?
dermatitis, diarrhea, dementia, death.
What are the clinical/physical signs of Niacin Deficiency?
Pellagrous dermatitis, Casal's collar and Pellagrous dermatitis
Pellagrous dermatitis
Rashes on the limbs caused by Niacin deficiency.
Casal's collar
Rash around the neck caused by Niacin deficiency.
Scurvy
Vitamin C deficiency
What are the clinical/physical signs of Vitamin C Deficiency?
Spongy bleeding gums and
Classical scorbutic position.
Spongy, bleeding gums
Classical Scorbutic Position
What are the clinical/physical signs of Vitamin D Deficiency?
Swollen epiphyses
, Rickety/rachitic rosary, Harrison's sulcus and Bow legs.
Swollen epiphyses
Swelling of the section between the ends of long bones caused by Vitamin D deficiency.
Rickety/Rachitic rosary
Expansion of the anterior rib ends caused by Vitamin D deficiency.
Harrison's sulcus
Protruding stomach due to Vitamin D deficiency
Bow legs
Rounding "c" shape of legs caused by vitamin D deficiency.
What are the clinical/physical signs of Iodine Deficiency?
Enlarged thyroid gland
Enlarged thyroid gland
What are the clinical/physical signs of Protein-energy Malnutrition?
Dyspigmentation, easy pluckability, sparseness and straightness of hair
Flag sign on hair
Moon face
diffuse pigmentation of skin
Flaky paint dermatosis and edema.
Flag sign on hair
alternating bands of depigmented and normal-colored hair representing alternating periods of poor protein intake and normal protein intake.
What deficiency causes moon face?
Protein-energy Malnutrition
What deficiency causes flaky paint dermatosis?
Protein-energy Malnutrition
What deficiency causes edema?
Protein-energy Malnutrition
Nutritional Marasmus
disease caused by deficiency of all food groups; basically a form of
starvation
Biochemical assessment
Measurement of levels of nutrients or metabolites of nutrients in body fluids and tissues.
Fasting blood sample
No intake of food, beverages (except water) for 8-12 hours before the blood is drawn.
Why are fasting blood samples taken?
To eliminate the impact of recent dietary intake.
low serum albumin
Indicative of a prolonged protein deficiency.
Low serum transferrin
More sensitive indicator of changes in protein status than serum albumin.
Low prealbumin
Most sensitive indicator of protein status (preferred).
Parameters used for Iron:
-Serum ferritin
-Total iron binding capacity (TIBC)
-Stainable iron in bone marrow
-Transferrin saturation
-Free erythrocyte protoporphyrin(FEP)
-Serum soluble transferrin receptor (sTfR)
-(Hemoglobin concentration)
Low serum ferritin
Iron stores in liver, spleen, and bone marrow.
Increased Total iron binding capacity (TIBC)
Level increased when serum iron falls.
Low transferrin saturation
iron deficiency
[Serum iron (�mol/L) � TIBC (�mol/L)] X 100
Increased free erythrocyte porphyrin (FEP)
Level increases because of a lack of iron to combine with protoporphyrin to form heme.
Increased serum soluble transferrin receptor
With a fall of cellular iron more transferrin receptors appear on cell membranes to trap more iron from blood.
low hemoglobin
Long term iron deficiency.
What is stage 1 of iron deficiency?
Depletion of iron stores start.
What are the parameters of stage 1 iron deficiency?
Low serum ferritin, Increased TIBC and Little stainable iron in bone marrow.
What is stage 2 of iron deficiency?
Iron stores become fully depleted.
What are the parameters of stage 2 iron deficiency?
Low transferrin saturation, Increased FEP and Increased sTfR.
What is stage 3 of iron deficiency?
Iron deficiency anemia
What are the parameters of stage 3 iron deficiency?
Low hemoglobin concentration and All other parameters are abnormal.
What parameter is used to determine zinc deficiency?
Low hair zinc (limited)
What parameter is used to determine iron deficiency?
Low urinary iodine (UI)
What is the complication with low urinary iodine?
Requires a 24-hour urine collection and it is difficult to ensure complete 24-hour urine collection
What parameters are used to determine vitamin A deficiency?
Low plasma retinol (most commonly used), Increased relative dose response (RDR) and Low plasma retinol-binding protein (RBP).
What parameter is used to determine vitamin D deficiency?
Low serum 25-hydroxyvitamin D [25(OH)D]
What parameters are used to determine vitamin C deficiency?
Low serum (or plasma) vitamin C (most commonly used) and Low leukocyte vitamin C.
Who are more susceptible to varying serum vitamin C?
Smokers (low) and females (high)
What parameters are used to determine folate deficiency?
Low serum folate and Low red blood cell (RBC) folate
What parameters are used to determine Vitamin B12 deficiency?
Low serum/plasma vitamin B12, Low serum/plasma holo-transcobalamin II, Increased urinary/serum methylmalonic acid, Increased plasma total homocysteine (tHcy).
What is the complication with low serum/plasma vitamin B12?
Levels decreased in pregnancy and folate deficiency
Levels increased in advanced renal failure
What is the complication with Low serum/plasma holo-transcobalamin II?
Levels increased in advanced renal failure
What is the complication with Increased urinary/serum methylmalonic acid?
Levels increased in folate deficiency, and impaired renal function
What is the complication with Increased plasma total homocysteine (tHcy)?
Levels increased in folate, vitamin B6 deficiencies, and impaired renal function