bioguy
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so in the 5y kid's case, if he were copper deficient - no collagen synthesis at all so not even the 30% tensile strength will be there. but he is zinc deficienct so type III collagen (sufficient for 30% tensile strength) was formed and not remodelled to type I (100% tensile strength)
(sorry about my shorthand writing, hope its comprehensible)
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| hottie99
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oh no it's good, i was saying if u had more vitamin discussion questions, hahaha.. not to explain that one, i got those!! but thanx!
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| bioguy
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hottie99 wrote: ok so i looked it up, yes vit e overdose causes hemorrhage bc it decreases vit k dependent procoagulant factors; goljan says vit e excess is synergisitc effect with warfarin anticogulation... bc essentially it's doing the same thing rite, i mean warfarin also interferes with vit k-dependent factors.. so sorry bioguy i have to disagree with the last part of the statement about it being c/i in warfarin pts 
Oh, i totally missed this. What you said is absolutely right, but "sorry hottie i have to disagree with the last part of the statement about it NOT being c/i in warfarin pts"
Since warfarin and VitE have similar effects, VitE might potentiate the effects of warfarin leading to over-anticoagulation. thats why its contraindicated in pts on warfarin.
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| bioguy
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hottie99 wrote:
oh no it's good, i was saying if u had more vitamin discussion questions, hahaha.. not to explain that one, i got those!! but thanx!
to be honest, i couldn't figure out why zinc and why not copper in that 5y case until i got my thoughts together while writing the post - kinda thinking out loud
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| bioguy
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Direct from Kaplan bioch.
A 7m old infant presented in a "pithed frog" position, in which he lay on his back and made little attempt to lift the legs and arms because of pain. The infant cried when touched or moved, and there appeared to be areas of numerous swelling and bruising throughout the body. The mother informed the pediatrician that the infant was bottle-fed. However, the mother stated that she always boiled teh formula extensively, to ensure that it was sterile.
Diagnosis?
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| bioguy
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Infant position
and pithed frog
Attached Files:
Pithed.jpg (19 KB, 0 downloads)
frog.jpg (27 KB, 0 downloads)
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| hottie99
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hmm, ricketts???? like vit d deficiency? but the only thing is that with milk being exposed, i would think it's vitamin b2 (riboflavin) deficiency since the riboflavin is exposed to lite and therefore inactive.. not sure, rough one!!
also i agree with ur logic on the warfarin/vit e thing, i guess his notes state that it's syngergistic, so i just have too much trust in papi, hahaha.. but i get what ur saying, i totally agree with that as well, it is too much anticoagulating going on so it's gonna be a problem... hmm, why would papis notes say so??? 
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| bioguy
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oh, i totally forgot about this. sorry
the answer is Vitamin C deficiency
vitC is easily destroyed by excessive boiling.
vitC def causes weakening of capillaries - easy bleeing into skin (bruises) and into joint spaces (hemarthrosis) - causing painful joints, so the kid doesn't move them - leading to pithed frog position.
Ref: kaplan biochemistry
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| bioguy
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hottie99 wrote:also i agree with ur logic on the warfarin/vit e thing, i guess his notes state that it's syngergistic, so i just have too much trust in papi, hahaha.. but i get what ur saying, i totally agree with that as well, it is too much anticoagulating going on so it's gonna be a problem... hmm, why would papis notes say so???
Whoa!!! you might be right. i just verified this in RR Pathology by Goljan, and it just says - VitE toxicity - synergistic with warfarin. i dont remember where i read this and why its stuck in my mind that this is a case of contraindication.
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| hottie99
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yeah i would think synergistic effect, meaning they both do the same thing, so it should be contraindicated!! dont want pts bleeding out u kno!! too much vit e causes hemmorhage, and warfarin toxicity will do same, they'll internally bleed out, not good!
we'll leave it at that.. interesting on that vit c deficiency.. so boiling milk destroys the vit c?? hmm, i guess i dont think of milk being primary soure for vit c... that's why i thought vit d def..
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