Community Nutrition

COMMUNITY NUTRITION 3 (1+2)

Lesson 4 : Clinical Assessment of Nutritional Status

Guide to the interpretation of Groupings of clinical signs

Protein - energy deficiency

• Edema
• Muscle wasting
• Low - body weight
• Psychomotor change
• Dyspigmentation of the hair
• Easy plukability of the hair
• Moon - face
• Flaky paint dermatosis
• Diffuse depigmentation of the skin

Vitamin A deficiency

• Xerosis of skin
• Follicular hyperkeratosis, type 1
• Xerosis conjunctiva
• Keratomalacia
• Bitot's spots

Thiamine deficiency

• Loss of ankle jerks
• Loss of knee jerks
• Sensory loss and motor weakness
• Calf - muscle tenderness
• Cardiovascular dysfunction
• Oedema

Riboflavin deficiency

• Angular stomatitis; angular scars
• Cheilosis
• Magenta tongue
• Central atrophy of lingular papillae
• Naso - labial dyssebacea
• Angular palpebritis
• Scrotal and vulval dermatosis
• Corneal vascularization

Niacin deficiency

• Pellagrous dermatosis
• Scarlet and raw tongue
• Tongue fissuring
• Atrophic lingual papillae
• Molar and supra orbital

Pigmentation

Vitamin C deficiency

• Spongy and bleeding gums
• Follicular hyperkeratosis, type 2
• Petechiae
• Ecchymoses
• Intramuscular or subperiosteal

Haematoma

• Epiphyseal enlargement ( painful)

Vitamin D deficiency

• Active rickets ( in children)
  Epiphyseal enlargement (over 6 months of age), painless beading of ribs Craniotabes(under 1 year of age) Muscular hypotonia.

• Healed rickets(in children or adults)
  Frontal and parietal bossing, Knock-knees or bow-legs, deformities of thorax.

• Osteomalacia( in adults) Local or generalized skeletal deformities.

Iron deficiency

• Pallor of mucous membranes
• Koilonychia
• Atrophic lingual papillae.

Iodine deficiency Enlargement of thyroid
Excess of fluorine (Fluorosis)

Mottled dental enamel, (difficult to distinguish in early stages from enamel hypoplasia).