Download - 2. vitamin deficiency dr. sinhasan, mdzah
“Vitamins are organic substances which
cannot be synthesized within the body and
are essential for maintenance of normal
structure and function of cells”.
1. FAT-SOLUBLE: Vit A,D,E,K.
2. WATER –SOLUBLE: Vit C & B complex group.
VITAMINS
Retinol- transport form;
Retinol ester- storage form;
Retinal (aldehyde form)- visual pigment;
Retinoic acid
VITAMIN A forms:
Maintaining normal vision in reduced light. (Rhodopsin
in rods, iodopsins in cones).
Differentiation of specialized epithelial cells, mainly
mucous secreting cells. Def. leads to squamous
metaplasia.
Enhancing immunity to infections (measles)
Anti-oxidant
NXBK:
Night blindness: impaired vision in night
Xerophthalmia: Dry eyes, dryness of conjunctiva (xerosis).
Bitot spots: Small opaque plaques with keratin debris.
Keratomalacia: Erosion of roughened corneal surface with
softening and destruction of cornea and total blindness.
A. Night blindness
B. Xerophthalmia
C. Bitot spots
D. Keratomalacia
Which of the following is first sign of Vit A deficiency ?
Major function of Vit D: maintenance of normal plasma levels
of Calcium and Phosphorus.
Deficiency:
Rickets in growing children
Osteomalacia in adults
Hypocalcemic Tetany
Vit-D2:: Available in Food or Fortified form.
Vit-D3:: 7-Dehydrocholesterol in Skin converted in the
skin by UV light Exposure.
Vit D2 or Vit D3 must be made Biologically active
Activated in 2 process- Liver & Kidney.
1,25 (OH)2 Dehydrocholesterol is active.
Vitamin-D Terminologies
Inadequate synthesis/ dietary deficiency:
-inadequate sun exposure, poor intake.
Decreased absorption: Cholestatic liver ds, Pancreatic
insufficiency, Biliary tract obstruction, Small bowel ds.
Derangements in metabolism: diffuse liver ds, Advanced
renal ds.
Phosphate depletion: Antacid abuse.
PREDISPOSING FACTORS FOR DEFICIENCY:
Excess of unmineralised matrix.
Inadequate calcification of epiphyseal cartilage.
Overgrowth of epiphyseal cartilage due to inadequate
calcification.
Failure of cartilage cells to mature and disintegrate.
Weak/ poorly formed bones- microfractures, stress fractures.
Deformation of the skeleton.
RICKETS & OSTEOMALACIA:
HEAD: softened occipital bones become flattened
with inward buckling of parietal bones.
Squared appearance of the head.
CHEST: ‘ due to overgrowth of cartilage at
costochondral jn.
antr. Protrusion of the sternum-
weakened ribs subjected to pull by respiratory muscles.
due to inward pull at the margin of the
diaphragm.
Antioxidant property.
Inhibits formation of atheromas by reducing oxidation of
LDL.
Def: Neurological manifestations- absent tendon reflexes,
ataxia, loss of position and vibration sense, loss of pain
sensation, spinocerebellar degenaration, muscle
weakness-ophthalmoplagia.
Infertility.
Required for clotting factor synthesis & Post
translational modification :F-II, VII, IX, X: Protein C & S.
Def: Bleeding diathesis, hemorrhagic ds of newborn,
hematomas, hematuria, melena, ecchymosis, gum
bleedings.
Routine Prophylactic dose for newborns.
SCURVY:
Hemorrhages: Gingival swelling, bacterial periodontal
infections, subperiosteal hematomas, bleeding into joint
spaces, perifollicular, hyperkeratotic papular rash.
IMPAIRED WOUND HEALING: due to deranged collagen
synthesis.
Skeletal changes: soft bones, growth retardation.
A. Vitamin A
B. Vitamin B1
C. Vitamin C
D. Vitamin D
Perifollicular hemorrhages seen with deficiency of which of the following?
Wet Beriberi: edema due to heart failure
Dry Beriberi: CNS and PNS system involved::::-----
a) Korsakoff syndrome: Psychosis with confusion, loss of
memory.
b) Wernicke’s encephalopathy: mental confusion with
ophthalmoplagia, nystagmus and ataxia.
Cheliosis:
Glossitis: Magenta red tongue.
Interstitial keratitis
Scaly dermatitis
Erythroid hyperplasia of BM