Balanced Diet And Nutritional Disorders Question and Answers

Balanced Diet And Nutritional Disorders Important Notes

1. Marasmus
   • It is a common form of protein energy malnutrition
   • Mostly occurs 6-12 months postnatally
   • Clinical features
     • Large head
     • Distended abdomen
     • Diarrhea
     • Stick like limbs
     • Reduced body weight
2. Kwashiorkor
   • It is a disease of protein energy malnutrition occurring in the second year of life
   • Clinical features
     • Generalized edema
     • Change in color of hair
     • Diarrhea
     • Palpable liver
     • Pigmentation of skin and ulceration
3. Fat-soluble vitamins
   • Vitamin A
   • Vitamin D
   • Vitamin E
   • Vitamin K
4. Water soluble vitamin
   • Vitamin B complex
   • Vitamin C

Balanced Diet And Nutritional Disorders Long Essays

Question 1. Describe the various manifestations of avitaminosis with particular reference to the oral cavity. How will you treat them?

Answer: 

The various manifestations of avitaminosis with particular reference to the oral cavity

• Vitamins are essential for growth and normal body functions
• A deficiency of vitamins causes various clinical manifestations as follows

Question 2. Describe the etiology, clinical features, diagnosis, and treatment of scurvy
Answer:

Scurvy Etiology:

• Vitamin C deficiency results in scurvy.

Scurvy Clinical Features:

• Lesions and clinical manifestations of Vitamin C deficiency are seen more commonly in two extreme age groups i.e., early childhood and geriatric patients.

The following manifestations are seen in vitamin C deficiency.

1. Hemorrhage diathesis – A marked tendency to bleed which is the characteristic of scurvy. There may be hemorrhages in the skin, mucous membranes, gums, muscles, joints, and underneath the periosteum.
2. Skeletal lesions – There is a deranged formation of osteoid matrix but not deranged mineralization. Growing tubular bones as well as flat bones are affected.
3. Delayed wound healing.
4. Anaemia Normocytic normochromic type.
5. Skin rash Hyperkeratotic and follicular rash may occur.
6. Lesions in teeth and gums – Scurvy may interfere with the development of dentin.
   • The gums are soft and swollen, may bleed easily, and get infected commonly.

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Scurvy Diagnosis:

• Through clinical features

Scurvy Treatment:

• 250 mg of vitamin C orally three times a day
• Removal of the underlying cause

Question 3. Describe the etiology, clinical features, diagnosis, and treatment of thiamine deficiency

Answer:

Thiamine Deficiency:

• Occurs due to vitamin B1
• It leads to beriberi

Thiamine Deficiency Types:

1. Wet beriberi
   • Characterized by edema of legs, face, trunk, and serous cavities
2. Dry beriberi
   • Associated with neurological manifestations
3. Infantile beriberi
   • Seen in infants

Thiamine Deficiency Clinical Features:

• Loss of appetite
• Weakness
• Constipation
• Nausea
• Mental depression
• Peripheral neuropathy
• Irritability
• Numbness in tire legs

Thiamine Deficiency Diagnosis:

• Diagnosis is made from clinical manifestations

Thiamine Deficiency Treatment:

• The initial dose of 50 mg intramuscularly is given for several days then 2.5-5 mg is given daily by mouth

Balanced Diet And Nutritional Disorders Short Essays

Question 1. Malnutrition

Answer:

Malnutrition

• Malnutrition occurs due to absolute or relative deficiency of energy and protein

Malnutrition Clinical Features:

• Mild growth retardation
• Loss of weight
• Thirst
• Weakness
• Feeling cold
• Nocturia
• Amenorrhoea
• Pale and dry skin
• Thinning of hair
• Cold extremities
• Muscle wasting
• Oedema
• Subnormal body temperature
• Distended abdomen
• Diminished tendon jerks
• Apathy
• Depression
• Susceptibility to infections

Malnutrition Management:

• Extra feeding
• Repletion of proteins, energy, vitamins, and micronutrients

Question 2. Beriberi-types and clinical features

Answer:

Beriberi Types:

1. Wet beriberi
   • Characterized by edema of legs, face, trunk, and serous cavities
2. Dry beriberi
   • Associated with neurological manifestations
3. Infantile beriberi
   • Seen in infants

Beriberi Clinical Features:

• Loss of appetite
• Weakness
• Constipation
• Nausea
• Mental depression
• Peripheral neuropathy
• Irritability
• Numbness in the legs

Question 3. Vitamin A deficiency

Answer:

Lesions in Vitamin A deficiency:

1. Ocular lesions:
   • Night blindness
   • Xerophthalmia, dry and scaly sclera, conjunctiva
   • Keratomalacia due to infections of corneal ulcers,
   • Pilots spots are focal triangular areas of opacities due to the accumulation of keratinized epithelium.
   • Blindness due to infection, scarring, and opacities.
2. Cutaneous lesions: Xeroderma/toad-like appearance of skin because of papular lesions due to follicular hyperkeratosis and keratin plugging in the sebaceous glands.
3. Other lesions:
   • Squamous metaplasia of
   • Respiratory epithelium,
   • Pancreatic ductal epithelium,
   • Urothelium
   • Long-standing metaplasia may progress to anaplasia.
   • Immune dysfunction,
   • Pregnant women may have an increased risk of maternal infection, mortality, and impaired embryonic development.

Question 4. Night blindness

Answer:

Night blindness

• Night blindness is a common symptom of vitamin A deficiency. It is a defective dark adaptation due to defective synthesis of rhodopsin in rods
• It is supported by low plasma retinol concentration
• If untreated the condition progresses with loss of the normal mucous cells from the cornea leading to xerophthalmia

Question 5. Pellagra

Answer:

Pellagra

• Niacin deficiency causes Pellagra i.e., rough skin
• The cardinal manifestations of pellagra are referred to as the three Ds ie, dermatitis, diarrhea, and dementia and if not treated may lead to 4th D i.e., death.
• Dermatitis: Sun-exposed areas of skin developed erythemia resembling sunburn which may progress to chrome type with blister formation.
• Diarrhoea This is seen along with stomatitis, glossitis, enteritis, nausea, and vomiting
• Dementia: Degeneration of neurons of the brain of the spinal tract results in neurological symptoms such as dementia, peripheral neuritis, ataxia, and visual and auditory disturbances.
• Oral findings include:
  • Bald tongue of sandwich,
  • Raw beefy tongue
  • Mucosa becomes fiery red and painful
  • Profuse salivation
• Chronic alcoholics are at high risk of developing pellagra because, in addition to dietary deficiency, niacin absorption is impaired in them.

Question 6. Vitamin B12

Answer:

Vitamin B12

• It is cyanocobvilamine

Coenzyme Forms:

• 5 Deoxyadenosyl cobalamin
• Methylcobalamin

Coenzyme Functions:

1. Synthesis of methionine from homocysteine
   • Vitamin B12 is used as methylcobalamin in this reaction
2. Isomerization of methyl malonyl CoA to succinyl CoA
   • It occurs m the presence of vitamin B12 coenzyme, deoxy adenosylcobalamin

Coenzyme Daily Requirements:

• Adults- 3 micrograms/day
• Children -0.5-1.5 micrograms/ day
• During pregnancy and lactation- 4 micrograms/day

Coenzyme Deficiency Manifestation:

• Cyanocobalamine or vitamin B12 deficiency leads to

1. Pernicious anemia
   • Characterized by low hemoglobin levels, decreased number of erythrocytes, and neurological manifestations
2. Neuronal degeneration
3. Demyelination of the nervous system

Question 7. Riboflavin deficiency

Answer:

Riboflavin deficiency

• Riboflavin deficiency symptoms include

1. Cheilosis
   • The presence of fissures at the corner of the mouth
2. Glossitis
   • The tongue appears smooth and purplish
3. Dermatitis

Question 1. Balanced diet

Answer:

Balanced diet

• It is defined as a diet that contains different types of foods possessing the nutrients- carbohydrates, fats, proteins, vitamins, and minerals in a proportion to meet the requirements of the body
• It supplies a little more of each nutrient than the minimum requirement to keep the body in a state of good health and protect against leanness
• Its basic composition varies from country to country
• Indian balanced diet is composed of
  • Cereals
  • Pulses
  • Roots and tubers
  • Fruits
  • Milk and milk products
  • Fats and oils
  • Sugar
  • Groundnuts
• Meat, fish, and eggs in non-vegetarians
• Additional amounts of milk and pulses in vegetarians

Question 2. Scurvy

Answer:

Scurvy Etiology:

• Vitamin C deficiency results in scurvy.

Scurvy Clinical Features:

• Lesions and clinical manifestations of Vitamin C deficiency are seen more commonly in two extreme age groups i.e., early childhood and geriatric patients.
• The following manifestations are seen in vitamin C deficiency.

1. Hemorrhage diathesis – A marked tendency to bleed which is characteristic of scurvy. There may be hemorrhages in the skin, mucous membranes, gums, muscles, joints, and underneath the periosteum.
2. Skeletal lesions – There is a deranged formation of the osteoid matrix but not deranged mineralization. Growing tubular bones as well as flat bones are affected.
3. Delayed wound healing.
4. Anaemia Normocytic normochromic type.
5. Skin rash Hyperkeratotic and follicular rash may occur.
6. Lesions in teeth and gums Scurvy may interfere with the development of dentin.
   • The gums are soft and swollen, may bleed easily, and get infected commonly.

Question 3. Rickets

Answer:

Rickets

• Rickets is a clinical disorder seen in growing children from 6 months to 2 years of age due to a deficiency of Vitamin D.

Rickets Clinical Features:

• The gross skeletal changes depend on the severity of the rachitic process, its duration, and in particular the stresses to which individual bones are subjected.
• Craniotabes, are the earliest bony lesions due to small round unossified areas in the membranous bones of the skull.
• Harrisons sulcus occurs due to in drawing of soft ribs on inspiration.
• Pigeon chest deformity
• Bow legs occur In ambulatory children due to weak bones of lower logs.
• Knocked knees may occur due to enlarged ends of the femur, tibia, and fibula.
• Lower epiphyses of the radius may be enlarged.
• Lumbar lordosis due to involvement of the spine and pelvis.

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Question 4. Niacin

Answer:

Niacin

• It is vitamin M3
• It is a pyridine derivative

Coenzyme Forms:

• Nicotinamide adenine dinucleotide, NAD+
• Nicotinamide adenine dinucleotide phosphate, NADP+

Niacin Functions:

• Involved in an oxidation-reduction reaction
• Participates in almost all the metabolism

Niacin Deficiency Manifestation:

• Pellagra

Question 5. Vitamin D

Answer:

Vitamin D

• It is a fat-soluble vitamin
• It resembles sterols in structure
• Its best source is sunlight
• Its active form is calcitriol
• It is involved in calcium metabolism
• Required in bone formation
• Its daily requirement is 400 IU
• Its deficiency leads to rickets in children and osteomalacia in adults

Question 6. Vitamin C

Answer:

Vitamin C

• It Is a water-soluble vitamin
• It plays an important role in human health and disease
• It is readily absorbed by the intestines and excreted in urine
• About 60-70 mg of vitamin C is required per day Citrus fruits are the main sources of vitamin C
• Its deficiency leads to scurvy

Question 7. Vitamin E

Answer:

Vitamin E

• Vitamin E is a fat-soluble vitamin

Vitamin E Sources:

• Vegetable oils
• Meal
• Milk
• Butler
• Eggs

Vitamin E Requirements:

• Males-10 mg
• Females- 8

Vitamin E Deficiency Manifestations:

• Neurological dysfunction

Question 8. Bitot’s spots

Answer:

Bitot’s spots

• Bitot’s spot may appear as glistening white plaques of desquamated thickened conjunctival epithelium, usually triangular and firmly adherent to the underlying triangular and firmly adherent to the underlying conjunctival.
• It occurs due to vitamin A deficiency.

Bitot’s Spots Treatment:

• Oral administration of retinol 30 mg daily for 3 days
• In advanced cases, vitamin A is given in the dose of 50,000 IU parenterally for three days

Bitot’s Spots Prevention:

• Good nutrition
• Intake of fresh leafy green vegetables
• Intake of vitamin A

Question 9. Vitamin B12

Answer:

Vitamin B12

• It is cyancvohalamine

Vitamin B12 Coenzyme Forms:

• 5-Deoxyadenosyl cobalamin
• Methylcobalamin

Vitamin B12 Functions:

1. Synthesis of methionine from homocysteine
   • Vitamin B12 is used as methylcobalamin in this reaction
2. Isomerization of methyl malonyl CoA to succinyl CoA
   • It occurs in the presence of vitamin B12 coenzyme, deoxy adenosylcobalamin

Vitamin B12 Daily Requirements:

• Adults- 3 micrograms/day
• Children -0.5-1.5 micrograms/day
• During pregnancy and lactation- 4 micrograms/day

Question 10. Vitamin A deficiency

Answer:

Vitamin A deficiency

• Vitamin A deficiency leads to

1. Night blindness
2. Xerophthalmia
3. Keratomalacia
4. Retarded growth

Question 11. Vitamin K

Answer:

Vitamin K

• It is fat soluble vitamin

Vitamin K Sources:

1. Animal sources
   • Egg yolk, meat, liver, cheese, and dairy products
2. Plant sources
   • Cabbage, cauliflower, tomatoes, alfalfa, spinach

Vitamin K Functions:

• Helps in coagulation
  • Daily Requirement- 70-140 micrograms/day

Vitamin K Deficiency Symptoms:

• Diminished blood clotting
• Increased prothrombin time

Question 12. Vitamin B6

Answer:

Vitamin B6 Sources:

• Milk
• Liver
• Meat
• Legumes
• Whole grains
• Cereals
• Nuts
• Vegetables

Vitamin B6 Functions:

• Acts as a cofactor for several enzymes involved in amino acid metabolism
• Involved in the metabolism of fat, carbohydrates, and several vitamins
• Involved in heme synthesis

Question 13. Pyridoxine deficiency

Answer:

Pyridoxine deficiency Symptoms:

• Glossitis
• Cheilosis
• Weakness
• Peripheral neuropathy
• Depression
• Irritability
• Microcytic, hypochromic anemia
• Seizures

Pyridoxine deficiency Treatment:

• Oral administration of vitamin B6 in the dosage of 10-20 mg/day

Question 14. Cyanocobalamine deficiency

Answer:

Cyanocobalamine deficiency

Cyanocobalamine or vitamin B12 deficiency leads to

1. Pernicious anemia
   • Characterized by low hemoglobin levels, decreased number of erythrocytes, and neurological manifestations
2. Neuronal degeneration
3. Demyelination of the nervous system

VIVA VOCE

1. Scurvy occurs due to vitamin C deficiency.
2. Vitamin D deficiency leads to rickets and osteomalacia.
3. Bitot’s spots occur in vitamin A deficiency.
4. Pernicious anemia occurs due to vitamin B12 deficiency.
5. Pellagra occurs due to vitamin B6 deficiency.
6. Thiamine deficiency leads to beriberi.
7. Vitamin A is an antioxidant.
8. Warfarin antagonizes vitamin K.
9. Craniotabes is the earliest bony lesion seen in infants with rickets.
10. Starvation is severe undernutrition resulting from prolonged inadequacy of food.
11. Undernutrition is a state of negative energy balance.