Signs and Symptoms in Deficiency States

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Deficiency

Signs

Symptoms

Vitamin A (see Fig. 5-6)

Hyperkeratinization of the skin

Night blindness

Keratinizing metaplasia in the

Retarded growth (children)

linings of the respiratory,

Xerophthalmia

gastrointestinal, and

Xeroderma

genitourinary tracts

Metaplasia of the endocrine,

salivary, sebaceous, and lacrimal

glands

Vitamin D (rickets,

Craniotabes

Irritability

osteomalacia)

Rachitic rosary*

Restlessness

Bowing of the legs

Dental problems

Knock-knee

Coughing

Pigeon chest deformity

Pulmonary infections

Harrison's grooves{

Seizures

Scoliosis

Compression of affected vertebrae

Carpopedal spasms

Generalized spasticity

Convulsive seizures

Thiamine (beriberi)

Bilateral, symmetric peripheral

Lack of initiative

neuropathy (distal parts of lower

Anorexia

extremities first)

Mental depression

Decreased perception of light

Irritability

touch

Poor memory

Calf muscle tenderness

Easy fatigability

Loss of vibration sense

Inability to concentrate

Loss of normal reflexes

Vague abdominal problems

Motor weakness

Paresthesias of the toes

Secondary muscle atrophy

Burning sensation in the lower

Cardiac enlargement

extremities

Congestive heart failure

Dyspnea

Wide pulse pressure

Palpitations

Arrhythmias

Peripheral edema

Polyneuropathy

Riboflavin

Vitamin C (scurvy)

Protein-calorie (kwashiorkor) (see Fig. 5-5)

Calcium

Iron

Signs

Extensive dermatitis (common on parts of body exposed to sunlight or mechanical trauma; often bilateral and symmetric) Glossitis Stomatitis

Chronic hypertrophy with induration of skin Pigmentation on pressure points Skin fissuring Atrophic skin changes Scaling of skin

Cheilosis

Angular stomatitis Glossitis

Seborrheic dermatitis, especially in the nasolabial region, around the eyes, behind the ears, and on the scrotum Ocular manifestations

Defective collagen formation Ecchymoses

Subperiosteal hematomas Follicular hyperkeratoses Petechial hemorrhages (lower extremities) Gingival hemorrhages Hemarthroses Hemorrhages Anemia

Scorbutic rosary{

Retarded growth Edema

Hyperpigmentation of skin Depigmentation of skin Hepatomegaly Severe tissue wasting Loss of subcutaneous fat Functional dehydration

Anemia

Stomatitis

Glossitis

Osteoporosis Osteomalacia

Anemia

Koilonychia}

Glossitis

Symptoms

Skin rashes Swollen tongue Increased salivation Burning sensation in mouth Poor digestion

Diarrhea (often foul smelling;

sometimes bloody) Gaseous distention Eructation Vomiting Disorientation Confusion Hallucinations Delirium Paranoia Depression

Photophobia

Burning sensation in eyes Itching of eyes Skin rashes Fissuring of mouth

Impaired wound healing Failure to thrive, irritability, and frequent crying (children) Bleeding tendencies Painful joints Weight loss

Nonspecific aches and pains Brown pigmentation Curling of hair Keratoconjunctivitis sicca§ Emotional changes

Apathy

Anorexia

Edema

Changes in hair color and consistency Changes in skin color Abdominal enlargement Diarrhea Steatorrhea

Pallor

Weakness

Diarrhea

Bone fractures

Pallor

Weakness

Fatigability

Dyspnea on exertion

Headache

Palpitations

Fissuring at corners of mouth Painful tongue

*Beading of the ribs at the costochondral junction. {Lateral thoracic depressions at the sites of attachment of the diaphragm. {Beading of the ribs at the costochondral junction.

§A condition of marked hyperemia of the conjunctiva, lacrimal deficiency, thickening of the corneal epithelium, itching and burning of the eye, and reduced visual acuity. }Spoon nail.

Deficiency

Iodine

Magnesium

Signs

Goiter

Growth retardation Hypogonadism Delayed sexual maturation Seborrheic dermatitis

Vertical nystagmus

Potassium

Sodium

Arrhythmias

Dehydration signs

Symptoms

Swelling of neck Hypothyroid symptoms (see Chapter 9, The Head and Neck)

Loss of taste Anorexia

Behavioral problems Skin rashes Hair loss

Decreased libido Decreased fertility Diarrhea

Muscle tremor

Choreiform movements

Convulsions

Weakness

Paralysis

Dysphagia

Diarrhea Weakness Nervous irritability Disorientation Palpitations

Confusion

Coma

Vomiting

Lethargy

Anorexia

Nausea

Headache

Obtundation

Seizures

*Beading of the ribs at the costochondral junction.**Lateral thoracic depressions at the sites of attachment of the diaphragm. {Beading of the ribs at the costochondral junction.

{A condition of marked hyperemia of the conjunctiva, lacrimal deficiency, thickening of the corneal epithelium, itching and burning of the eye, and reduced visual acuity. §Spoon nail.

Nail Beading And Hypothyroidism

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