Malnuitrition

Question 1

What is the consequence of lack of vitamin C

Answer 1

Scurvy

Question 2

What are the signs of vitamin C deficiency?

Answer 2

1) - listless (showing little interest)
- anorexia
- cachexia

2) - gingivitis
- loose teeth
- bad breath (halitosis)

3) bleeding from gums, nose, hair follicles or into joints, bladder, gut
4) Muscle pain / weakness
5) Oedema

Question 3

What is the treatment for vitamin C deficiency

Answer 3

• dietary education

- ascorbic acid 250mg/daily PO

Question 4

What is beriberi a sign of

Answer 4

Vitamin B1 deficiency (thiamine)

Question 5

What does vitamin B1 / thiamine deficiency cause?

Answer 5

Beri beri

• heart failure with oedema (wet beri beri)
• neuropathy (dry beri beri)

Wernicke’s enchephalopathy

• confusion
• ataxia
• opthalmoplegia

Question 6

What causes wernicke’s encephalopathy?

Answer 6

Vitamin B1 / thiamine deficiency

• decreased intake
• decreased absorption

Question 7

What are the causes of decreased vitamin b1 / thiamine?

Answer 7

• alcoholism
• eating disorders
• malnutrition
• prolonged vomiting (chemo, GI malignancy)

Question 8

Why is urgent replacement of thiamine/vit b1 needed in wernicke’s encephalopathy?

Answer 8

urgent replacement of vit b1 to prevent irreversible korsakoff’s syndrome (chronic memory disorder)

Question 9

what nutritional disorder is this triad classical of:

• diarrhoea
• dementia
• dermatitis

Answer 9

Pellagra - lack of nicotinic acid leads to
1) diarrhoea
2) dementia
3) dermatitis
and
neuropathy, depression, insomnia, tremor, rigidity, ataxia, fits.

Question 10

What deficiency causes xeropthalmia?

Answer 10

Vitamin A deficiency
cause of blindness.
conjunctiva become dry and develop oval spots
corneas become soft and cloudy

Question 11

why are so many hsp patients malnourished?

Answer 11

1) increased requirements (burns, sepsis, surgery)
2) increased nutritional losses (malabsorption, stoma)
3) decreased intake (dysphagia, sedation, coma)
4) effect of treatment (nausea, diarrhoea)
5) enforced starvation (nil by mouth)
6) missing meals for procedures
7) difficulty feeding (no one to assist)
8) unappetizing food

Question 12

What would indicate a malnourished patient on history?

Answer 12

• weight loss
• recent reduced intake
• diet change
• nausea vomiting
• pain
• diarrhoea

Question 13

What signs on examination would indicate a malnourished patient?

Answer 13

• dehydrated (reduced skin turgor)
• skin hanging off muscle
• no fat between skin folds
• hair rough and wiry
• pressure sores
• sores at corner of mouth
• low BMI