Vitamins Question And Answers

Vitamins Question And Answers

Question 1. Classify various metabolic disorders. Discuss in detail avitaminosis related to oral cavity.
Answer.

Metabolic Disorders Classification 

• Defect in Calcium Metabolism
  • Hypocalcemia
  • Hypercalcemia
  • Hypoparathyroidism
  • Hyperparathyroidism
  • Osteitis fibrosa cystica
  • Pathologic calcification
    • Dystrophic calcification
    • Metastatic calcification
    • Calcinosis.
• Defect in Protein Metabolism
  • Kwashiorkor
  • Marasmus
  • Amyloidosis
  • Porphyria.
• Disturbance in Carbohydrate Metabolism
  • Hurler syndrome
  • Lipid Proteinosis.
• Disturbance in Lipid Metabolism
  • Lipid reticuloendotheliosis
  • Hand-Schüller-Christian disease
  • Eosinophilic granuloma.
• Disturbance in Hormone Metabolism
  • Hypopituitarism
  • Gignatism
  • Hypothyroidism
  • Hyperthyroidism
  • Addition’s disease
  • Diabetes mellitus.

Read And Learn More: Oral Medicine Question And Answers

Avitaminosis Related to Oral Cavity

Vitamin A

• Defective formation of enamel in teeth.
• Presence of hypoplasia of teeth.
• There is increased caries susceptibility.
• Eruption is delayed.
• Alveolar bone is retarded in formation.
• Major and minor salivary gland undergo typical keratinizing metaplasia.
• Gingival epithelium gets keratinized.

Vitamin B Complex

• Riboflavin
  • There is presence of angular cheilitis.
  • Atrophy of filiform papillae, fungiform papilla are engorged.
  • Tongue becomes coarsely granular and red.
  • In later stages, complete atrophy of tongue.
• Niacin
  • Stomatitis, glossitis, “bald tongue of sandwich”.
  • Oral mucosa is painful and fiery red.
  • Ulceration in interdental papilla spreads superimposed ANUG.
• Pyridoxine: Presence of cheilitis and glossitis.

Vitamin C

• Presence of scurvy.
• Generalized gingival swelling
• Spontaneous hemorrhage
• Presence of the ulceration of tongue as well as gingiva
• Tooth mobility is present
• Periodontal bone loss
• Foul odor
• There is presence of irregular dentin.
• Presence of heavy basophilic staining line between dentin and pulp.

Vitamin D

• Vitamin D deficient rickets:
  • Delayed eruption of teeth
  • Developmental defects in enamel and dentin
  • Wide predentin zone, and increased interglobular dentin.
• Osteomalacia:
  • Presence of severe periodontitis.

Question 2. Discuss oral manifestation of riboflavin deficiency.
Answer.

Oral Manifestation of Riboflavin Deficiency

Tongue

• Glossitis which begins with soreness of lip and lateral margins of tongue.
• Filiform papilla becomes atrophic while fungiform papilla remains normal or become engorged and mushroom- shaped giving the tongue a reddened coarsely granular appearance.
• In severe cases, tongue become glazed and smooth due to complete atrophy of papilla and exhibits magenta color.

Lips

• Lips become red and shiny because of desquamation
• Paleness of lips and cheilitis which is seen as laceration and fissuring at angle of mouth.
• As the disease progress, angular cheilitis spread to the cheek, the tissues bleed easily and are painful, if secondarily infected.

Question 3. Write short note on riboflavin deficiency.
Answer. Riboflavin deficiency is also known as vitamin B2 deficiency.

Riboflavin Deficiency Etiology

• Primary deficiency: It occurs because of inadequate diet and also inadequacy of other essential nutrients including vitamins and proteins.
• Secondary deficiency:
  • It can occur due to diseases of intestinal tract.
  • Prolong use of psychological drug that interfere with production of flavin monophosphate.
  • Chronic alcoholism, burn and trauma.

Riboflavin Deficiency Deficiency Symptoms

• There is presence of seborrheic dermatitis which affect the nasolabial fold as well as ala of nose which exhibit scaly grey dermatitis and has enlarged follicles around the side of nose which get plugged by dry sebaceous material.
• Various ocular changes are seen, i.e. corneal vasodilatation, photophobia and superficial and interstitial keratitis, itching and burning of eyes is also reported.
• Presence of dull and oily hair along with oily skin.
• Nails become split.
• Premature wrinkles are seen on arm and face.
• Adrenal glands undergo malfunction.
• There is also presence of anemia, vaginal itching and cataract.

Riboflavin Deficiency Oral Manifestations 

For details refer to Ans 2 of same chapter.

Riboflavin Deficiency Management 

Riboflavin 25,000 to 50,000 µg should be given daily in particular divided doses.

Question 4. Write short note on scurvy.
Answer. When there is prolonged deficiency of vitamin C, this leads to scurvy.

Scurvy Pathogenesis

• Formation of defective collagen: Defective collagen formation occurs in connective tissue due to failure of hydroxylation of proline to hydroxyproline.
• Increased capillary permeability: The increase in capillary fragility leads to hemorrhage, anemia, reduction in platelets and defective collagen formation.

Scurvy Clinical Features 

• Infant patient has got painful limbs, anorexia, lassitude and there is also enlargement of costochondral junction.
• Hair follicles get elevated above the skin and there is presence of perifollicular hemorrhages.
• Scorbutic child mostly assume frog-like position.
• Delayed wound healing is seen.
• Hemorrhage can occur in joint, in nerve sheath under the nails of conjunctiva. Petechial hemorrhage is seen in buttocks, arms, legs, abdomen, nail beds, ankles etc.
• In severe cases edema over face and limbs is seen.
• It can also lead to premature aging, thyroid insufficiency and body become infection prone.

Scurvy Oral Manifestations 

• Affects gingiva and periodontal region in oral cavity.
• Marginal as well as interdental gingiva become smooth, swollen, bright red and have shiny surface which produces an appearance called as scurvy bud.
• In advanced cases gingiva become boggy, ulcerated and bleeds very easily.
• Typical foul breath is present in patient’s mouth.
• Color of affected area becomes violaceous red.
• PDL membrane shows hemorrhage and swelling along with loss of bone and mobility of teeth.

Scurvy Diagnosis 

• Clinical diagnosis: Presence of scurvy bud with hemorrhagic tendency provide clue to diagnosis.
• Laboratory diagnosis: Biopsy reveals a wide zone of calcified but non-ossified matrix known as scorbutic lattice develop in metaphysis. As scorbutic lattice increases in width more fragile zone develops which leads to complete fracture of spicules with separation and deformity of cartilage shaft junction. Fracture of calcified matrix material lead to the classic picture of scurvy known as Trummerfeld zone.

Scurvy Treatment 

• Patient is advised to eat lot of citrus fruits.
• Vitamin C tablet 250 mg TDS should be given