PEDIATRIC MALNUTRITION INDICATORS


MICRONUTRIENT EXAM: CLINICAL INTERPRETATION OF NUTRITION FOCUSED PHYSICAL EXAM FINDINGS SIGNS/SYMPTOMS


EYES (continued)


Xanthelasma yellowish deposits around eyelids


Corneal arcus (arcus senilis) lipid deposits: gray-white ring around edge of cornea


Other: Hyperlipidemia Other: Hypercholesteremia


Possible non–nutrition-related causes: Hypothyroidism • Diabetes mellitus • Medications


Additional information: Arcus senilis may be normal in adults >50 years old. • More common in people of African and Southeast Asian descent.


Possible non–nutrition-related causes: Aging • Alcoholism • Familial dyslipidemias • Lipid metabolism disorders • Atherosclerotic disease (could indicate under 50 years old) • Carotid artery stenosis (if unilateral)


MOUTH/LIPS


Angular stomatitis/Angular cheilitis (cheilosis) swollen, cracked, lesions at the corners of the mouth/lips


Sore, burning, swelling of the mouth and throat Excessive salivation


Pale mucosa GUMS


Gingivitis / Scorbutic gums swollen, spongy, redness, retracted, bleeding gums


Deficiency: Riboflavin • Vitamin B6 • Niacin • Biotin • Folate


Toxicity: Vitamin A Deficiency: Riboflavin Deficiency: Fluoride • Choline Anemia: Iron* • Vitamin B12* • Folate* Deficiency: Vitamin C • Niacin


Possible non–nutrition-related causes: Poor oral hygiene • Genetics • Smoking/chewing tobacco • Pregnancy • Diabetes mellitus • Medications


Possible non–nutrition-related causes: Excessive salivation due to ill-fitting dentures • Dry skin • Eczema • Dehydration • Herpes • Sjögren syndrome • HIV/AIDS • Oral candidiasis • Diabetes • Irritable bowel disease • Anorexia nervosa/bulimia • Certain medications


Possible non–nutrition-related cause: Oral candidiasis


33 POSSIBLE NUTRITION-RELATED CAUSES ADDITIONAL INFORMATION


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