Micronutrient Deficiency / Malnutrition

Kwashiorkor

inadequate protein intake with adequate calorie intake

In Kwashiorkor, visceral proteins below normal:

Albumin, Prealbumin, transferrin

Manifestations of Kwashiorkor

sparse hair, “flag sign” in hair, moon face, anemia, fatty liver, swollen abdomen , swelling of legs (edema)

Marasmus

inadequate calorie and protein intake.

cachetic appearance

Marasmus

Mixed

-        inadequate calorie and protein intake with increased nutritional requirements

Vit A deficiency

loss of appetite and taste; night blindness; bumpy or scaly skin

dark green, leafy or yellow-orange vegetables milk fat; egg yolk

Vit A Sources

Vit B1 Deficiency

paresthesia and peripheral neuropathic mental confusion; heart failure; edema

lean meats; egg yolk; legumes; enriched or whole grain cereals and bread

Vit B1 source

Thiamine

B1

Pyridoxine

B6

yeast; wheat germs; pork; liver; whole grain cereals; legumes

Vit B6 Sources

Vit B6 deficiency

sore, reddened tongue; paresthesia seborrhea-like dermatitis

Cobalamin

B12

beef; fish; silk; eggs; cheese

Vit b12 Source

Vit B12 Deficiency

sore, reddened tongue; atrophy of the tongue; megaloblastic anemias; paresthesia

Vit C Deficiency

gingivitis; dry mouth; alopecia; pruritus; ecchymotic lesions on the skin

Vit E Sources

sunflower, corn, or soybean oil; wheat germ oils

Iodine Deficiency

enlargement of the thyroid gland

Manganese Deficiency

magenta tongue; dermatitis

4 D's of Pellagra

Dermatitis

Diarrhea

Dilated cardiomyopathy

Dementia

Pellagra

Deficiency of Vit D3

Treatment for pellagra

Niacin/ Nicotinamide; give meat eggs, peanuts, protein

Stomatitis

- an inflammatory process of the mouth (mucosa and tissues surrounding teeth)

Aphthous Stomatitis (Canker Sores)

- Recurrent small ulcerated lesions of the soft tissues of the mouth (lips, tongue, inside the cheeks)

• Well circumscribed erythematous macule that undergoes necrosis

• pseudomembranous ulcer with erythematous borders (painful, contagious, heals within 1-2 weeks)

Aphthous Stomatitis (Canker Sores)

Steroids and Irritating foods

The collaborative Management for apthous stomatitis

Herpes Simplex (HSV)

Type 1-fever blister (Herpes Labialis "Cold sore"

-        viral infection - causes blisters in the mouth

and in the lips and tongue, appears coated.

-        it is contagious; lasts about a week

Mode of Contact for HSV

physical contact w virus - source, saliva, skin surfaces or around mouth

Vincent's Angina (Necrotizing Ulcerative Gingivitis, Trench mouth)

- acute bacterial infection of the gingival tissues

Vincent's Angina (Necrotizing Ulcerative Gingivitis, Trench mouth)

 ulcers covered with pseudo-membranes

 elevated WBC, foul taste, pain, choking sensation, fever, lymphadenopathy, thick secretions, anorexia,

Oral Candidiasis

(Oral Thrush) - caused by Candida albicans

Risk factor for oral candidiasis

immunosuppression prolonged antibiotic therapy

ORAL CANDIDIASIS (Oral Thrush)

 white patches on the tongue,

 palate, buccal mucosa ("milk curds")

Erythoplakia

- red-velvety-appearing patch, often indicative of early squamous cell carcinoma.

Squamous cell carcinoma

- arises from tiny flat squamous cell of the mucous membranes

- occurs on the lips, buccal mucosa, tongue, floor of the mouth, tonsils

- most common type of oral cancer