according to the Centers for Disease Control and prevention, although less than 10% of the U.S. population is undernourished. However, the incidence rate varies from age, gender and race, and some people can be more than 30%. More than half of children (6 months to 5 years old) worldwide have one or more micronutrient deficiencies. How much do you know about nutritional deficiency? Which of the following is usually considered to be the first symptom of IDD?

A. dry skin

B. diffuse goiter

C. periorbital edema

D. delayed deep tendon reflex

A. skin dryness

B. diffuse goiter

C. periorbital edema

delayed deep tendon reflex

iodine deficiency patients often come from endemic areas of IDD. The first manifestation of iodine deficiency is usually diffuse enlargement of the thyroid gland, which will progress to multiple nodular lesions over time. Severe iodine deficiency can lead to hypothyroidism, with dry skin, periorbital edema and delayed deep tendon reflex. So choose B. Which organ system is more susceptible to magnesium deficiency?

A. blood system

B. cardiovascular system

C. urogenital system

D. gastrointestinal system

magnesium is important for the maintenance of normal cell function. Symptomatic magnesium deficiency is usually associated with a variety of biochemical abnormalities, including hypokalemia, hypocalcemia and metabolic acidosis. Therefore, hypomagnesemia is sometimes difficult to determine by specific clinical manifestations.

and

are often affected by magnesium deficiency in cardiovascular system, central and peripheral nervous system. The skeletal system, blood system, gastrointestinal system and genitourinary system were less affected. ECG abnormalities and arrhythmias may occur in the cardiovascular system when magnesium deficiency occurs:

● nonspecific T wave changes: U wave

● QT and Qu interval prolongation

● repolarization alternation

● ventricular premature beat: monomorphic ventricular tachycardia

● ventricular premature beat The results showed that

and

of torsade de pointes, ventricular fibrillation

,

and

were increased by digitalis. Which of the following statements about vitamin A deficiency is accurate?

A. pregnant women should routinely supplement vitamin A

,

B., serum retinol binding protein (RBP), and the incidence rate of death is 1-6.

subclinical vitamin A deficiency may not cause any symptoms, but the risk of respiratory tract infection and diarrhea is increased. The patients may have a history of infection, infertility secondary to spermatogenesis disorder or spontaneous abortion secondary to embryo development impairment. Vitamin A deficiency anemia may increase fatigue.

and

pregnant women do not need to increase vitamin a supplement. In fact, the conclusion that excessive vitamin A supplementation before pregnancy and in a short period of gestation leads to cranial neural crest defects and other malformations lacks evidence. Compared with the determination of serum retinol, the determination of serum RBP is easy to perform and cheap. Because RBP is a protein, it can be detected by immunoassay. RBP is more stable than retinol. However, the accuracy of RBP level is not good. A review of 43 randomized trials (215633 children) in

and

confirmed that vitamin A supplementation reduced mortality in children aged 6 months to 5 years. However, there is no evidence that vitamin A supplementation can reduce the mortality and incidence rate of children in 1-6 months. Therefore, C is selected. Which of the following statements about calcium deficiency test is accurate?

A. most cases of hypocalcemia found

according to the clinical manifestations of physical examination. B. parathyroid hormone (PTH)

should be determined after routine laboratory measurement and imaging examination. C. blood urea nitrogen (BUN) and serum creatinine levels in patients with calcium deficiency usually decrease

D It is necessary to determine serum albumin level

,

,

in patients with hypocalcemia, in order to distinguish true hypocalcemia, the determination of serum albumin is necessary. The serum calcium level of patients with true hypocalcemia decreased, while the total calcium level of pseudo hypocalcemia decreased, but the level of calcium did not.

and

patients with typical clinical manifestations of acute hypocalcemia need immediate resuscitation and clinical evaluation. However, most cases of hypocalcemia are found by clinical suspicion and appropriate laboratory tests. The PTH levels of

and

should be checked as soon as possible. Parathyroid hormone levels were lower than normal in patients with hereditary or acquired hypoparathyroidism and severe hypomagnesemia. Bun and serum creatinine levels should be measured as elevated levels may indicate renal insufficiency. Therefore, D is chosen. Which of the following statements is accurate about the treatment of vitamin D deficiency? In order to determine the necessity of vitamin D supplementation, most children and the elderly should routinely screen for

and

C. many vegetables are good sources of vitamin D Vitamin D intake and vitamin D from sunlight exposure have the same duration in blood. Vitamin D deficiency is defined as 25 (OH) d levels below 15 or 20 ng / ml. The ideal level of intestinal calcium absorption was above 30-32 ng / ml.

,

the 2011 edition of “clinical evaluation, treatment and prevention of vitamin D deficiency” published by the American endocrine society, the endocrinology and metabolism society of Canada and the American Osteoporosis FoundationIt is recommended that vitamin D screening should be conducted only in high-risk groups with vitamin D deficiency, including patients with osteoporosis or malabsorption syndrome, black and Hispanic populations, obese people and people with multiple diseases.

and

vegetables are not good sources of vitamin D. Vitamin D produced by appropriate light, especially between 10 a.m. and 3 p.m., lasts twice as long in the blood as vitamin D obtained by ingestion. So choose a. The above content of

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