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Old 06-27-2012
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Pediatrics Vitamin deficiency in a 9-month-old infant

A 9-month-old infant has failure to thrive. The examining physician elicits a history of prematurity and low birth weight. The parents who have two other children, admit they have difficulty providing food, clothing and medical care for their growing family. The infant is now at the 40th percentile for height and the 25th percentile for weight. He exhibits absent deep tendom reflexes, decreased vibration and pain sense, muscle weakness, and abnormalities of eye movement. Laboratory studies show hemoglobin of 9.2 g/dl, Hct 27.6%, MCV 86 microm3, PLT 208,000/mm3, WBC count 6080/mm3, total protein 6.4g/dl, glucose 70mg/dl, and creatinine 0.3mg/dl. A deficiency of which of the following vitamins is most likely to contribute to these findings?

a) vit.A
b) vit. B1
c) vit. B3
d) vit. B12
e) vit. C
f) vit. E
g) vit. K

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d) vit. B12 deficiency,

Neurological symptoms: Sensory or motor deficiencies (absent reflexes, diminished vibration or soft touch sensation), subacute combined degeneration of spinal cord, or even symptoms of dementia and or other psychiatric symptoms may be present. The presence of peripheral sensory-motor symptoms or subacute combined degeneration of spinal cord strongly suggests the presence of a B12 deficiency.
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vit b12

Neurological symptoms suggests the presence of a B12 deficiency :
Sensory or motor deficiencies (absent reflexes, diminished vibration or soft touch sensation),
subacute combined degeneration of cord or even symptoms of dementia and or other psychiatric symptoms may be present.
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Old 06-27-2012
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vit b12

neurological symptoms can occur in the absence of megaloblastic anemia
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Quote:
Originally Posted by Casandra View Post
A 9-month-old infant has failure to thrive. The examining physician elicits a history of prematurity and low birth weight. The parents who have two other children, admit they have difficulty providing food, clothing and medical care for their growing family. The infant is now at the 40th percentile for height and the 25th percentile for weight. He exhibits absent deep tendom reflexes, decreased vibration and pain sense, muscle weakness, and abnormalities of eye movement. Laboratory studies show hemoglobin of 9.2 g/dl, Hct 27.6%, MCV 86 microm3, PLT 208,000/mm3, WBC count 6080/mm3, total protein 6.4g/dl, glucose 70mg/dl, and creatinine 0.3mg/dl. A deficiency of which of the following vitamins is most likely to contribute to these findings?

a) vit.A
b) vit. B1
c) vit. B3
d) vit. B12
e) vit. C
f) vit. E
g) vit. K



I thinks it's VIT E. Abnormalities of eye movement aren't characteristic for B12 deficiency. Also anemia is Normocytic. and other cell (wbc/platelet) count seem to normal. Since B12 is important for all the cell they have to be decreased too... ?!
Anemia in this case would be due to Hemolysis from damaged RBC membrane.
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Loss of posterior coloumn sensation n normocytic anaemia... Vit E deficiency ..
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Vit E deficiency
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im confused between B1 def or vit E.....my final call--vit E def.....
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YES its VIT E deficiency
Vitamin E deficiency mainly arises from fat malabsorption. It causes neurological problems due to poor nerve conduction. Low birth weight can also cause vitamin E deficiency.

Vitamin E Deficiency Symptoms in Infants
Retrolental fibroplasia (an eye disease),Loss of weight and delayed growth Poor eating habits Developmental problems that include physical and mental problems

Vitamin E Deficiency Symptoms in Children
Chronic liver disease, causing neurological deficits,Gross lack of coordination of muscle movements with loss of deep tendon reflexes,Truncal and limb ataxia,Loss of vibration and position senses, Paralysis of extra-ocular muscles responsible for eye movements, Muscle weakness Ptosis (drooping upper eyelid) Dysarthria (motor speech disorder) Slow growth in children

Deficiency of Vitamin E Symptoms in Adults:

Mild anemia,nonspecific neurological deficits,Disorders related to reproduction and infertility, Fragile red blood cells ,age spots ,Cataracts, Certain neurological damage,Decrease in sex drive,Muscle, liver, bone marrow and brain function abnormalities.
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I say vitamin b12 cuz of the neurological symptoms!!!
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Quote:
Originally Posted by beka-CTS View Post
I thinks it's VIT E. Abnormalities of eye movement aren't characteristic for B12 deficiency. Also anemia is Normocytic. and other cell (wbc/platelet) count seem to normal. Since B12 is important for all the cell they have to be decreased too... ?!
Anemia in this case would be due to Hemolysis from damaged RBC membrane.
abnormalities in eye movement would be part of the Neurological symptoms in vitB12 deficiency.

also:
Quote:
Originally Posted by BritneySpears View Post
neurological symptoms can occur in the absence of megaloblastic anemia
also, this kid is not showing any of the typical vit E deficiency symptoms
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