Breastmilk

Category: generalpediatrics-Nutrition

Findings: casein protein, cholesterol

Notes: Formula has whey protein and no cholesterol. Both breastmilk and infant milk formula have lactose as main carbohydrate.

Question: What substance has the following? (breastmilk or formula)

Cyanocobalamin (B12) Deficiency

Category: generalpediatrics-Nutrition

Findings: paresthesias, ataxia, macrocytic anemia, neural tube defects in fetus

Notes: Differentiate from folate (B9) deficiency as vitamin B12 deficiency leads to neurological symptoms and increased methylmalonic acid. It also is caused by gastric surgery, intrinsic factor deficiency where folate deficiency is more often nutritionally related, caused by anti-folate drugs like isoniazid, or caused by hemolysis or pregnancy.

Question: What vitamin problem causes these findings?

Essential Fatty Acid Deficiency

Category: generalpediatrics-Nutrition

Findings: decreased growth, failure to thrive, poor wound healing, thrombocytopenia, alopecia, dry scaly rash

Notes: Treat with IV lipids

Question: Which macronutrient deficiency is associated with these findings?

Familial Hypophosphatemic Rickets

Category: generalpediatrics-Nutrition

Findings: normal calcium, low phosphorus, normal PTH, normal vitamin D 25, high alkaline phosphatase

Notes: Defect in kidney conversion from 25-vitamin D to 1,25 Vitamin D. Initial Vitamin D deficiency will also have normal calcium and low phosphorus, but will have a low vitamin D level and increased PTH.

Question: Which disease is associated with these findings?

Folate (B9) Deficiency

Category: generalpediatrics-Nutrition

Findings: swollen tongue, macrocytic anemia, may cause neural tube defects in fetus

Notes: Can be caused by goat milk in diet or vegetarian diet.

Question: What vitamin problem causes these findings?

Kwashiorkor

Category: generalpediatrics-Nutrition

Findings: pitting edema, protruding abdomens, hepatomegaly, rash

Notes: Caused by protein deficiency

Marasmus

Category: generalpediatrics-Nutrition

Findings: muscle wasting, thin, no edema

Notes: Caused by lack of all nutrients.

Question: Which disease is associated with these findings?

Niacin (B3) Deficiency

Category: generalpediatrics-Nutrition

Findings: diarrhea, dermatitis, dementia, death

Notes: Also known as pellagra

Question: What vitamin problem causes these findings?

Pyridoxine (B6) Deficiency

Category: generalpediatrics-Nutrition

Findings: depression, confusion, swollen tongue, cracked corners of mouth, seizures, microcytic anemia, impaired immune system

Question: What vitamin problem causes these findings?

Riboflavin (B2) Deficiency

Category: generalpediatrics-Nutrition

Findings: cracking of corners of mouth, inflamed and swollen tongue, seborrheic dermatitis

Notes: May be caused by phototherapy

Question: What vitamin problem causes these findings?

Thiamine (B1) Deficiency

Category: generalpediatrics-Nutrition

Findings: ataxia, nystagmus, paresthesias, high output cardiac failure, wrist and foot drop

Question: What vitamin problem causes these findings?

Vitamin A Deficiency

Category: generalpediatrics-Nutrition

Findings: night blindness, bitot spots, dry eyes, growth failure, corneal opacities

Question: What vitamin problem causes these findings?

Vitamin A Excess

Category: generalpediatrics-Nutrition

Findings: headache, nausea, bulging fontanelle, visual abnormalities

Notes: Increased intracranial pressure due to excess vitamin A. It may also be caused by isotretinoin, thyroxine, and tetracycline.

Question: What vitamin problem causes these findings?

Vitamin B7 (biotin) deficiency

Category: generalpediatrics-Nutrition

Findings: insomnia, depression, swollen tongue, alopecia, scaly erythematous dermatitis, coma

Question: What vitamin problem causes these findings?

Vitamin C Deficiency

Category: generalpediatrics-Nutrition

Findings: normocytic anemia, anorexia, follicular hyperkeratosis, gingival bleeding, curved screwed hairs, bone pain, myalgias

Question: What vitamin problem causes these findings?

Vitamin D Excess

Category: generalpediatrics-Nutrition

Findings: hypercalcemia, hyperphosphatemia, polyuria, polydipsia, nausea and vomiting, nephrolithiasis

Notes: Treat with IV fluids and furosemide to remove excess calcium

Question: What vitamin problem causes these findings?

Vitamin E Deficiency

Category: generalpediatrics-Nutrition

Findings: impaired reflexes, muscle weakness, jaundice, hemolytic anemia, peripheral edema, thrombocytosis

Question: What vitamin problem causes these findings?

Zinc Deficiency

Category: generalpediatrics-Nutrition

Findings: scaly erythematous dermatitis in perioral and perianal area, alopecia, loss of taste

Question: What mineral problem causes these findings?