Nutrient Deficiency

Question 1

Role of Vitamin A

Answer 1

Vital for epithelial proliferation, keratinisation and development

Question 2

Sources of Vitamin A

Answer 2

Animal - milk, liver, eggs, oily fish

Plant - green leafy veg, bright yellow/orange fruit and veg

Question 3

Presentation of Vitamin A deficiency

Answer 3

Keratotic follicular papules on the thighs, upper arms and dry skin

Question 4

How to diagnose Vitamin A deficiency

Answer 4

Measure serum Vitamin A

Question 5

Role of Vitamin K

Answer 5

Essential for several blood coagulation factors

Question 6

Sources of Vitamin K

Answer 6

Green leafy veg, liber, legumes, vegetable oils

Also produced by bacteria in the GI tract

Question 7

Presentation of Vitamin K deficiency

Answer 7

Bleeding tendency, seen in skin as purpura and easy bruising

Question 8

How to diagnose Vitamin K deficiency

Answer 8

Measure coagulation and serum Vitamin K

Question 9

What is Vitamin B2 also known as

Answer 9

Riboflavin

Question 10

What is the role of Vitamin B2?

Answer 10

Essential co-factor in numerous metabolic reactions

Question 11

What are the sources of Vitamin B2?

Answer 11

Milk, liver, meat, eggs, green leafy veg

Question 12

How does Vitamin B2 deficiency present

Answer 12

Lesions of the margins of the lips (cheilosis) and corners of the mouth (angular stomatitis).

Painful read and dry tongue

Question 13

How to diagnose Vitamin B2 deficiency

Answer 13

Measure the activity coefficient of erythrocyte glutathione reductase (EGR)

Question 14

What is Vitamin B3 also known as?

Answer 14

Niacin

Question 15

What is the role of Vitamin B3?

Answer 15

Essential co-factor in numerous metabolic reactions

Question 16

What are the sources of Vitamin B3?

Answer 16

Meat, fish, nuts, coffee

Also converted from dietary tryptophan (essential amino acid) in the body

Question 17

How does vitamin B3 deficiency present?

Answer 17

Pellagra

D-dermatitis, bilateral, symmetrical, itchy, red rash, worse on sun exposed areas

D-delirium, headaches, irritability, anxiety, depression and memory impairment

D-diarrhoea with abdominal pain, nausea, vomiting

D-death in 4-5 years if not treated

Question 18

How to diagnose Vitamin B3 deficiency

Answer 18

Clinical diagnosis, as difficult to measure levels

Nicotinamide supplementation brings rapid improvement

Question 19

What is the role of Vitamin B6?

Answer 19

Co-enzyme for many processes

Question 20

What are the sources of Vitamin B6?

Answer 20

Meat, cereals, milk, potatoes, bananas, nuts and pulses

Question 21

How does Vitamin B6 deficiency present?

Answer 21

Dermatitis of the face, scalp, neck, shoulders, buttocks and perineum, tongue inflammation (glossitis)

Question 22

How to diagnose Vitamin B6 deficiency

Answer 22

Measure serum or urinary Vitamin B6

Trial of supplement

Question 23

What is the role of Folate?

Answer 23

Critical co-enzyme in many processes with similar deficiency states

Question 24

What are the sources of Folate?

Answer 24

Liver, green leafy veg, beans, nuts and milk

Question 25

What is the presentation of folate deficiency?

Answer 25

Anaemia, angular stomatitis, glossitis, hair depigmentation, skin and mucous membrane pigmentation.

Question 26

How to diagnose folate deficiency?

Answer 26

Measure serum folate

Question 27

What is the role of Vitamin B12?

Answer 27

Critical co-enzymes in many processes with similar deficiency states

Question 28

What are the sources of Vitamin B12

Answer 28

Only found in foods of animal origin such as meat, milk, fish and eggs

Question 29

How does Vitamin B12 deficiency present?

Answer 29

Anaemia, angular stomatitis, glossitis, hair depigmentation, skin and mucous membrane pigmentation. Neurological symptoms

Question 30

What is the role of Biotin?

Answer 30

Essential co-factor for carboxylase enzymes

Question 31

What are the sources of biotin?

Answer 31

Cereals, milk, eggs, pulses, nuts. | Also produced by GI bacteria

Question 32

How does biotin deficiency present?

Answer 32

Rare - usually only seenin malabsorptive states or inadequate parenteral nutrition. Facial dermatitis, glossitis, alopecia

Question 33

How to diagnose biotin deficiency?

Answer 33

Measure serum biotin

Question 34

What is Vitamin C also known as?

Answer 34

Ascorbic acid

Question 35

What is the role of Vitamin C?

Answer 35

Essential co-factor in collagen formation

Question 36

What are the sources of vitamin C?

Answer 36

Citrus fruits, strawberries, blackcurrants, tomatoes, potatoes

Question 37

How does Vitamin C deficiency present?

Answer 37

Hyperkeratosis around hair follicles, bent hairs, inflamed gums, poor wound healing. Also fatigue, malaise, muscle and bone pain

Question 38

How to diagnose Vitamin C deficiency?

Answer 38

Usually clinical diagnosis

Question 39

What is the role of zinc?

Answer 39

Required for many metabolic pathways. Required for structure and function of skin and so vital for wound healing

Question 40

What are the sources of zinc?

Answer 40

Meat, fish, milk, eggs, cereals, nuts and pulses

Question 41

How does zinc deficiency present?

Answer 41

Genetic - Acrodermatitis enterpathica (autosomal recessive) caused by lack of zinc absorption. Infants develop diarrhoea, alopecia, dry / brittle hair, perioral, facial and acral (i.e. hands and feet) dermatitis. Acquired – more common, and may be due to increased elimination of zinc secondary to burns or infection. Dermatitic rash of hands and feet mainly, growth retardation in children

Question 42

How to diagnose zinc deficiency?

Answer 42

Measure the serum zinc

Question 43

What are the fat soluble vitamins?

Answer 43

Vitamin A and K

Question 44

What are the water soluble vitamins?

Answer 44

``` Vitamin B2 (Riboflavin) Bitamin B3 (Niacin) Vitamin B6 Folate Vitamin B12 Biotin Vitamin C (ascorbic acid) ```