SIGNS/SYMPTOMS


EYES Pale conjunctiva


Night blindness (nyctalopia)


Bitot’s spots frothy white or gray spots on conjunctiva


Corneal xerosis dry, cloudy


Keratomalacia corneal softening


Ophthalmoplegia paralysis/weakness of eye muscles


Deficiency: Thiamin • Vitamin E


Additional information: Finding often associated with Wernicke encephalopathy


Possible non–nutrition-related causes: Multiple sclerosis • Stroke • Kearns-Sayre syndrome


Less common causes: Arnold-Chiari malformation • Neurosyphilis • Lyme disease • Tumor • Head trauma • Pernicious anemia • Drug intoxication • Graves disease


Kayser-Fleischer rings copper-colored ring around the iris


Corneal vascularization blood vessels in the clear covering of the eye


Other: Excess copper deposition Deficiency: Riboflavin


POSSIBLE NUTRITION-RELATED CAUSES Anemia: Iron • Vitamin B12 • Folate Deficiency: Vitamin A Deficiency: Vitamin A Deficiency: Vitamin A


ADDITIONAL INFORMATION


Possible non–nutrition-related cause: Non-nutritional anemia (eg, blood loss)


Risk for deficiency: Fat malabsorption • Alcoholism • Gastric bypass surgery • Upper gastrointestinal surgery • Irritable bowel disease • Pancreatitis


Risk for deficiency: Alcoholism • Fat malabsorption (eg, cystic fibrosis)


Possible non–nutrition-related causes: After measles infection or episodes of diarrhea


MICRONUTRIENT EXAM: CLINICAL INTERPRETATION OF NUTRITION FOCUSED PHYSICAL EXAM FINDINGS PEDIATRIC MALNUTRITION INDICATORS


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