A patient presents to ED with chest pain and this trace. What would you do?
Interpretation management
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Vitamin | Deficiency |
A | Xerophthalmia (dry conjunctiva); night blindness |
D | Rickets/osteomalacia |
E | Haemolysis; neurological defects; retinopathy |
K | Coagulopathy (vitamin K required for factors II, VII, IX, X and protein C/S) |
B1 (thiamine) | Dry beriberi (peripheral neuropathy); wet beriberi (heart failure) |
B1 (thiamine) | Wernickeβs encephalopathy (ophthalmoplegia + ataxia + confusion) |
B1 (thiamine) | Korsakoff syndrome (amnesia, confabulation, apathy) |
B3Β (niacin) | Pellagra (4Ds:Β Diarrhoea,Β Dermatitis,Β Dementia, Death) |
B6 (pyridoxine) | Dermatitis, glossitis, neuropathy, conjunctivitis |
B12 | Macrocytic anaemia; polyneuropathy; subacute combined degeneration of the cord; glossitis; pancytopenia |
C | Scurvy (listlessness, gingivitis, bleeding gums/hair follicles, rough dry scaly skin, anorexia, bruising) |
What is refeeding syndrome?
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Which electrolyte abnormalities are observed in refeeding syndrome and what is the reason for them?
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What are the normal requirements for energy, protein and fluid (per kg/day)?
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Picture references
Pellagra: Herbert L. Fred, MD, Hendrik A. van Dijk – book: Images of Memorable Cases – 50 years at the bedside ISBN 978-0-89263-000-4 http://cnx.org/content/m14940/latest/Case_2-pres1-1.jpg. Licenced under the Creative Commons Attribution-Share Alike 3.0 Unported license (https://creativecommons.org/licenses/by-sa/3.0/deed.en).
Corneal arcus: 2008 Loren A Zech Jr and Jeffery M Hoeg; Β© 2008 Zech and Hoeg; licensee BioMed Central Ltd; licensed under the Creative Commons Attribution 2.0 Generic license (https://creativecommons.org/licenses/by/2.0/deed.en), edited. Sourced from: https://commons.wikimedia.org/wiki/File:Four_representative_slides_of_corneal_arcus.jpg
Glossitis: 2011. Grook Da Oger. Licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license (https://creativecommons.org/licenses/by-sa/3.0/deed.en). Sourced from: https://commons.wikimedia.org/wiki/File:Glossite.jpg
A patient presents to ED with chest pain and this trace. What would you do?
Interpretation management