Environment And Nutritional Diseases
Question 1. Write a note on vitamin A deficiency
Answer:
Causes of vitamin A deficiency
- In children: Infections
- In adults: Celiac disease, Crohn’s disease, Colitis
Read and Learn More Preparatory Manual of Pathology Question and Answers
Manifestations
- Night blindness, epithelial metaplasia, and keratinization
- Xerophthalmia (dry eye)
- Bitot spots: Opaque plaques on the corneal surface, which progress to erosion and result in keratomalacia and blindness
- Immune deficiency: Responsible for infections (measles, pneumonia, and diarrhea)
Question 2. Write a note on vitamin C deficiency.
Answer:
Risk factors
- Seen in chronic alcoholics, individuals with poor diets, older individuals, patients undergoing peritoneal dialysis and hemodialysis
Vitamin C deficiency (scurvy)
Results in impaired collagen formation, which leads to:
- Bleeding tendency
- Inadequate synthesis of osteoid
- Impaired wound healing
Question 3. Write a note on trace elements and their deficiency states.
Answer:
Question 4. Write a note on Kwashiorkor.
Answer:
Kwashiorkor
- The most common form of protein energy malnutrition (PEM)
- Most commonly seen in African nations
- Generalized or dependent edema: Due to marked protein loss
- Skin lesions: Alternating zones of hyperpigmentation, areas of desquamation, and hypopigmentation, giving a “flaky paint” appearance
- Hair changes: Loss of color or alternating bands of pale and darker hair
- Fatty liver
- Defects in immunity and secondary infections
Morphology
- Small bowel shows mucosal atrophy with loss of villi
- Bone marrow: Appears hypocellular
- Peripheral blood smear: Anemia can be microcytic, normocytic, or microcytic or anemia of chronic disease
- Brain: Cerebral atrophy
- Thy mic and lymphoid atrophy
- Parasitic and worm infestations
Question 5. Write a note on rickets.
Answer:
Rickets
- Normal reference range for circulating 25-hydroxycholecalciferol 25-(OH)-D is 20 to 100 ng/ml
- Concentrations of less than 20 ng/ml constitute vitamin D deficiency, termed rickets in growing children and osteomalacia in adults
Morphology of bones in Rickets
- Failure of the cartilage cells to mature, results in the deposition of immature cartilage (remineralized bone deposition), which predisposes to repeated fractures
- Frontal bossing of the head
- Rachitic rosary: Deformation of the chest wall (pigeon breast deformity)
- Lumbar lordosis and bowing of the legs
Note
- On microscopy, unmineralized osteoid stains pink in hematoxylin and rosin preparations, whereas normally mineralized trabeculae are more basophilic
Question 6. Write a note on obesity.
Answer:
Obesity
Predisposes to increased incidence of type 2 diabetes, dyslipidemias, cardiovascular disease, hypertension, and cancer
Important points to remember
- Individuals with a BMI of more than 30 kg/m2 are classified as obese
- Central obesity is associated with an increased incidence of a number of diseases
- Appetite and satiety are under the control of leptin, adiponectin, and gut hormones
- Gut hormones include ghrelin, pancreatic polypeptide, insulin, and amylin
- Ghrelin—produced in the stomach and hypothalamus—increases food intake
- Amylin—reduces food intake and weight gain
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