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Nutritional disorders

Nutritional disorders. Premed 2 Pathophysiology Dr. ROOPA. PROTEIN-CALORIE MALNUTRITION. 1. Marasmus -deficiency of ALL nutrients -low proteins, vitamins, calories -less than 1 year old, not breastfed 2. Kwashiokor -deficiency of protein, calories OK -more than 1 year old

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Nutritional disorders

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  1. Nutritional disorders Premed 2 Pathophysiology Dr. ROOPA

  2. PROTEIN-CALORIE MALNUTRITION • 1. Marasmus -deficiency of ALL nutrients -low proteins, vitamins, calories -less than 1 year old, not breastfed • 2. Kwashiokor -deficiency of protein, calories OK -more than 1 year old -fatty liver , EDEMA, depigmented bands of hair and skin

  3. MARASMUS

  4. Kwashiorkor • Kwashiorkor sufferers show signs of thinning hair, edema, inadequate growth, and weight loss.

  5. MARASMUS Poor growth Loss of muscle Loss of subcutaneous fat KWASHIORKOR Poor growth Loss of muscle (+) subcutaneous fat

  6. Water soluble vitamins • B1 – Thiamine • B2 – Riboflavin • B3 – Niacin • B6 – Pyridoxine • B12 – Cobalamin • Folic acid • Vitamin C – Ascorbic acid

  7. Water soluble vitamins • Regular intake is necessary • B12 – stored in liver in large amounts - deficiency takes years to develop • Toxicity rare • Excreted in the urine • Sources: vegetables, cereals, grains, meat, dairy products, fruits

  8. Thiamine deficiency (B1) • Common in Western countries: alcoholism, diets • 1. Dry Beri-beri neuropathy of the peripheral limbs muscle atrophy • 2. Wet beri-beri dilated vessels, dilated heart High-output cardiac failure

  9. Thiamine deficiency (B1) • 3. Wernicke-Korsakoff deficiency - alcholism -brain stem, diencephalon degenerates -hemorrhage in the brain -Wernicke’s triad: confusion ataxia ophthalmoplegia -memory loss, confabulation

  10. RIBOFLAVIN (B2) • Rare deficiency • Always added to bread, cereal products • Deficiency: cheilosis (fissures at mouth angles) glossitis (inflammation of the tongue) increased blood vessels in the cornea seborrheic dermatitis

  11. NIACIN(B3) • Niacin, tryptophan deficiency • Important part of nicotinamide adenine dinucleotides (NAD, NADP) • PELLAGRA: dementia dermatitis diarrhea

  12. PYRIDOXINE (B6) • May lead to deficiency of GABA • Convulsions in kids • Seen also in alcoholism, antiTB drug use • Glutamate ( glutamic acid decarboxylase and pyridoxal phosphate as a cofactor)----GABA

  13. Cobalamin (B12) • Reduced DNA replication • Reduced cell division • Found almost always in MALABSORPTION: Pernicious anemia • Crohn’s disease, Fish tapeworm infection (Diphyllobotrium latum, vegetarians • MEGALOBLASTIC ANEMIA + NEUROLOGIC ABNORMALITIES

  14. FOLIC ACID • May be due to malabsorption or due to increase demand • Cancer therapy, alcoholic, dieters • MEGALOBLASTIC ANEMIA ONLY

  15. ASCORBIC ACID • Serves as cofactor of the synthesis of proline and hydroxyproline ---- collagen synthesis • SCURVY • Poor wound healing • Abnormal bleeding • Bone changes

  16. FAT-SOLUBLE VITAMINS • Vitamin A • Vitamin D ( calciferol) • Vitamin E (alpha-tocopherol) • Vitamin K • Toxicity common, hypervitaminosis

  17. Vitamin A • Retinoids • A part of rhodopsin (visual pigment) • Needed for good epithelium • Animal products, vegetables

  18. Vitamin A deficiency 1. Night blindness 2. Squamous metaplasia 3. Xeropthalmia (dry eyes) 4. Blindness 5.Keratomalacia (soft cornea) Vitamin A excess 1. alopecia (baldness) 2. liver damage 3. bone changes Vitamin A

  19. Vitamin D • Synthesized in the skin by exposure to sunlight • Food sources: milk, butter, eggs • Needed for calcium absorption in the intestines

  20. Vitamin D deficiency Rickets: children Osteomalacia: adults Vitamin D excess Poor growth Excessive calcium Hypercalciuria Nephrocalcinosis Renal calculi (stones) Vitamin D

  21. Vitamin E • Rare • Deficiency may cause neurologic abnormalities

  22. Vitamin K • Needed in the synthesis of clotting factors II, VII, IX, X (2, 7, 9, 10) • Synthesized by bacteria in our intestines • Food sources: vegetables, dairy products • Malabsorption, antibiotic use • Hemorrhagic diasthesis • Hemorrhagic disease of the newborn

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