Question

1. Read the following case study, “Alcoholic with Folate Deficiency”, and answer the following questions.

Mr. Murdock, a 64-year-old male, was brought to the emergency room in an inebriated state after being found lying in the street. He was confused, markedly pale, and undernourished with jaundice of the conjunctiva and skin. His lab results revealed pernicious anemiawith elevated liver enzymes and low albumin, and he’s suffering from a folate deficiency. When the patient became articulate after a few days, he reported heavy alcohol drinking for several years, consuming at least a pint of whisky daily on intermittent binges. During these times, his food intake was reduced and limited to bread and occasionally chicken but no fresh vegetables and rarely red meat or fish.

a.​What symptoms of folate deficiency did Mr. Murdock exhibit?

b.​How did his alcohol addiction contribute to the folate deficiency?

c.​What other groups of individuals (besides alcoholics)are at higher risk for folate deficiency? Why?

d.​What are the best food sources of folate?

e.​What’s the relationship between folate and Vitamin B12?

f.​Based on Mr. Murdock’s medical and diet histories, what would you expect his B12 status to be?  Why?

2. Read the following case study, “Osteoporotic Elderly Woman”, and answer the following questions.

Mrs. Thomson is a 78 year-old woman whose doctor recently recommended that she have a DXA scan in order to determine her bone mineral density. The scan results indicate low bone mineral density. Mrs. Thompson refuses to take pills or supplements and is, therefore, referred to a dietitian for nutritional counseling.

​a.​With Mrs. Thompson’s diagnosis of osteopenia, intake of which micronutrients will be most critical components in her nutrition plan?

​b.​What physiological role do these micronutrients play that makes them so important for her nutrition plan?

​c.​What foods will be included in her diet plan as good sources of these micronutrients?

​d.​What other lifestyle changes can Mrs. Thompson make to try to slow the advancement of her osteopenia?

3. Read the following case study, “Adolescent Female with Iron Deficiency Anemia”, and answer the following questions.

Maria is a 15-year-old adolescent; her mother has accompanied her to her pediatrician’s office for a well-child visit. Maria appears pale and has a hemoglobin 10.8 g/dL. Maria’s mother states that she has been more tired lately, often taking a nap after school, and has had a hard time concentrating. When asked about her diet, Maria acknowledges that she often skips breakfast, eats a PB&J sandwich and milk for lunch at school, and has a hot meal (meat, vegetables and starch) for dinner at home with her family. Maria is diagnosed with iron-deficiency anemia, and an iron supplement is prescribed. Her mother says that she had considered starting Maria on “vitamins” with an iron supplement, but decided to wait because she was scheduled for her well-child check-up.   

a.​Why is iron-deficiency anemia relatively common in adolescent girls?

b.​What are the symptoms of iron-deficiency anemia?

c.​Does Maria have any of these symptoms? If so, which ones?

d.​Why should Maria’s mother be praised for notstarting her daughter on an iron supplement before visiting her doctor?

e.​What is/are the daily iron recommendation(s) for women of childbearing age?

f.​What iron-rich food sources can you recommend to Maria and her mother?

g.​What tips can you share with Maria and her mother about how to maximize iron bioavailability from foods?

Answer 1

Date : Case Study 1 as Symptoms of folete deffunny : pale skin, empesion , pale conjunction b) Alcohol contribute to foloke defren as there is reduced foloke absorption by small intestine reduction of liver folete metabolism & Storage in addition to hireased Winery excretion of folafe. people at use of folefe deficiency are- • Prefront womew • Elderly Patient of sickle cell o reen Person taking overcooked fool 4 vitame for det cs Scanned with CamScanner

Date : food sources of flafe: - Legumes, asparegus, egge, Leety green vegetables, Beetroot, citrus freete, Brocolli - As both are requied for Red blood cell formation They together produce s- adenosylmeth- The which is moolved in immune function ay mood. I Defriency of vit B12 con lead to folefe defriency. By defuery is expected in the patient as metabolism of both is interreleted. They both love some defriency Scanned_sarith CamScanner