Pellagra

Pellagra

Q. 1

Excess of leucine causes:

 A Pellagra
 B Constipation
 C Hypervitarninosis
 D Progeria
Q. 1

Excess of leucine causes:

 A Pellagra
 B Constipation
 C Hypervitarninosis
 D Progeria
Ans. A

Explanation:

Pellagra


Q. 2

Maize contains the vitamin niacin. Pellagra is a disease that results from niacin deficiency.

Assertion: Consumption of maize may aggravate Pellagra.

Reason: Some strains of maize contains excess of Leucine which interferes in the conversion of Tryptophan into Niacin.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 2

Maize contains the vitamin niacin. Pellagra is a disease that results from niacin deficiency.

Assertion: Consumption of maize may aggravate Pellagra.

Reason: Some strains of maize contains excess of Leucine which interferes in the conversion of Tryptophan into Niacin.

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. A

Explanation:

Pellagra is caused by Niacin deficiency and anything that interferes in the absorption or production of Niacin will aggravate the condition.

Ref: Park’s Textbook of Preventive Medicine, 17th Edition, Page 427.

Q. 3

Consumption of which of the following may lead to pellagra?

 A

Jowar

 B

Ragi

 C

Bajra

 D

All of the above

Q. 3

Consumption of which of the following may lead to pellagra?

 A

Jowar

 B

Ragi

 C

Bajra

 D

All of the above

Ans. A

Explanation:

Certain varieties of Jowar have high concentrations of leucine and may lead to pellagra.
 
Ref: Park, 22nd edition pg: 582

 


Q. 4

A 10 year old child is suspected of having pellagra because of chronic symptoms including diarrhea, a red scaly rash, and mild cerebellar ataxia. However, his diet is not deficient in protein and he appears to be ingesting adequate amounts of niacin. A sister has a similar problem. Chemical analysis of his urine demonstrates large amounts of free amino acids. Which of the following is the most likely diagnosis?

 A

Alkaptonuria

 B

Carcinoid syndrome

 C

Ehlers-Danlos syndrome

 D

Hartnup’s disease

Q. 4

A 10 year old child is suspected of having pellagra because of chronic symptoms including diarrhea, a red scaly rash, and mild cerebellar ataxia. However, his diet is not deficient in protein and he appears to be ingesting adequate amounts of niacin. A sister has a similar problem. Chemical analysis of his urine demonstrates large amounts of free amino acids. Which of the following is the most likely diagnosis?

 A

Alkaptonuria

 B

Carcinoid syndrome

 C

Ehlers-Danlos syndrome

 D

Hartnup’s disease

Ans. D

Explanation:

The child has Hartnup’s disease.
This condition clinically resembles pellagra (“diarrhea, dementia, and dermatitis”), and may be misdiagnosed as this nutritional (niacin) deficiency. In fact, niacin therapy may actually be helpful in controlling the symptoms.
The underlying problem is a defect in the epithelial transport of neutral amino acids, including tryptophan, which can act as a precursor of niacin. The defective amino acid transport leads to poor absorption of dietary amino acids as well as excess amino acid secretion in the urine.
Alkaptonuria  is characterized by urine that turns black upon standing and a debilitating arthritis.
 
Carcinoid syndrome is seen in patients with carcinoid tumor. It is characterized by episodes of flushing, diarrhea, hypertension, and bronchoconstriction.
 
Ehlers-Danlos syndrome is a disease characterized by abnormal collagen formation leading to very elastic skin, joint problems, and fragility of some blood vessels and the intestines.
 
Ref: Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds),Harper’s Illustrated Biochemistry, 29e.

Q. 5

Development of pellagra like skin lesion in carcinoid syndrome is due to:

 A

Inadequate conversion of Tryptophan to Niacin

 B

Dietary Niacin deficiency

 C

Serotonin induced skin rash mimicking pellagra

 D

Paraneoplastic manifestation

Q. 5

Development of pellagra like skin lesion in carcinoid syndrome is due to:

 A

Inadequate conversion of Tryptophan to Niacin

 B

Dietary Niacin deficiency

 C

Serotonin induced skin rash mimicking pellagra

 D

Paraneoplastic manifestation

Ans. A

Explanation:

One of the main secretory products of carcinoid tumors involved in the carcinoid syndrome is serotonin which is synthesized from tryptophan. Up to 50% of dietary tryptophan can be used in this synthetic pathway by tumor cells, and this can result in inadequate supplies for conversion to niacin; hence, some patients (2.5%) develop pellagra-like lesions.


Reference:
Harrisons Principles of Internal Medicine, 18th Edition, Page 3063


Q. 6

Patient presenting with pellagra, parkinsonism, convulsions, anemia and kidney stones has deficiency of

 A

Coenzyme A

 B

FADH

 C

Niacin

 D

Pyridoxal phosphate

Q. 6

Patient presenting with pellagra, parkinsonism, convulsions, anemia and kidney stones has deficiency of

 A

Coenzyme A

 B

FADH

 C

Niacin

 D

Pyridoxal phosphate

Ans. D

Explanation:

D i.e. Pyridoxal phosphate


Q. 7

Photosensitive dermatitis is/are :

 A

Psoriasis

 B

Pellagra

 C

Pemphigus

 D

All

Q. 7

Photosensitive dermatitis is/are :

 A

Psoriasis

 B

Pellagra

 C

Pemphigus

 D

All

Ans. D

Explanation:

All i.e. Psoriasis, Pellagra, Pemphigus, SLE, Congenital erythropoietic porphyria


Q. 8

Casal’s paint necklace is caused by:

 A

Lichen planus

 B

Pellagra

 C

Pernicious anemia

 D

SLE

Q. 8

Casal’s paint necklace is caused by:

 A

Lichen planus

 B

Pellagra

 C

Pernicious anemia

 D

SLE

Ans. B

Explanation:

B i.e. Pellagra


Q. 9

Niacin deficiency cause –

 A

Pellagra

 B

Scurvy

 C

Rickets

 D

Lathyrism

Q. 9

Niacin deficiency cause –

 A

Pellagra

 B

Scurvy

 C

Rickets

 D

Lathyrism

Ans. A

Explanation:

Ans. is ‘a’ i.e., Pellagra 


Q. 10

Pellagra in jowar eating population is due to ‑

 A

Niacin in bound form

 B

Deficiency of tryptophan

 C

Excess of leucine

 D

High consumption of milk and milk products

Q. 10

Pellagra in jowar eating population is due to ‑

 A

Niacin in bound form

 B

Deficiency of tryptophan

 C

Excess of leucine

 D

High consumption of milk and milk products

Ans. C

Explanation:

Ans. is ‘c’ i.e., Excess of leucine 


Q. 11

In South India pellagra is reported in population eating 

 A

Ragi

 B

Jowar

 C

Baird

 D

Minor millets

Q. 11

In South India pellagra is reported in population eating 

 A

Ragi

 B

Jowar

 C

Baird

 D

Minor millets

Ans. B

Explanation:

Ans. is ‘b’ i.e., Jowar 


Q. 12

A person fed on only maize diet will develop:

March 2013 (a, c, d, e, g, h)

 A

Beri Beri

 B

Scurvy

 C

Pellagra

 D

Epidemic dropsy

Q. 12

A person fed on only maize diet will develop:

March 2013 (a, c, d, e, g, h)

 A

Beri Beri

 B

Scurvy

 C

Pellagra

 D

Epidemic dropsy

Ans. C

Explanation:

Ans. C i.e. Pellagra

The nutritional disease pellagra, which is caused by a deficiency in niacin , is associated with maize-based diets in the Americas and Africa.

While niacin is readily available in corn, it exists in a bound form (niacytin) that is not biologically available to monogastric (single-stomach) animals.


Q. 13

3-D’s are associated with:         

March 2013 (a, b, e, f)

 A

Rickets

 B

Scurvy

 C

Beri-Beri

 D

Pellagra

Q. 13

3-D’s are associated with:         

March 2013 (a, b, e, f)

 A

Rickets

 B

Scurvy

 C

Beri-Beri

 D

Pellagra

Ans. D

Explanation:

Ans. D i.e. Pellagra

Persons suffering from pellagra usually appear to be poorly nourished, and they are often weak and underweight. They also exhibit dermatitis, diarrhea, and dementia.

If untreated, pellagra can result in death.


Q. 14

Pellagra is due to deficiency of:

September 2006, 2009

 A

Riboflavin

 B

thiamine

 C

Niacin

 D

Pyridoxine

Q. 14

Pellagra is due to deficiency of:

September 2006, 2009

 A

Riboflavin

 B

thiamine

 C

Niacin

 D

Pyridoxine

Ans. C

Explanation:

Ans. C: Niacin

Pellagra is caused by a chronic lack of niacin (vitamin B3) in the diet.

It can be caused by decreased intake of niacin or tryptophan, and possibly by excessive intake of leucine. It may also result from alterations in protein metabolism in disorders such as carcinoid syndrome.

A deficiency of the amino acid lysine can lead to a deficiency of niacin as well, meaning that another potential cause of pellagra is lysine deficiency


Q. 15

Hartnup disease is related to ‑

 A

Rickets symptoms

 B

Pellagra symptoms

 C

Burning foot syndrome

 D

Angular stomatitis

Q. 15

Hartnup disease is related to ‑

 A

Rickets symptoms

 B

Pellagra symptoms

 C

Burning foot syndrome

 D

Angular stomatitis

Ans. B

Explanation:

 

Hartnup disease

It is an inherited disorder in the metabolism of tryptophan.

It is due to defective transport of tryptophan and other neutral amino acids in the intestine and kidney.

This results in deficiency of tryptophan leading to decreased synthesis of niacin and serotonin.

Thus there are pellagra (niacin deficiency), neurological symptoms (serotonin deficiency) and amino aciduria due to defective transport of amino acids in kidney.


Q. 16

Disease associated with excessive maize diet ‑

 A

Wernicke’s encephalopathy

 B

Pellagra

 C

Beri-Beri

 D

Scurvy

Q. 16

Disease associated with excessive maize diet ‑

 A

Wernicke’s encephalopathy

 B

Pellagra

 C

Beri-Beri

 D

Scurvy

Ans. B

Explanation:

Ans. is ‘b’ i.e., Pellagra

Excess of Leucine interferes in conversion of Tryptophan into Niacin, and aggravates the pallagrogenic action of maize.

Similar to maize, Jowar also contains excess of leucine.

Leucine interferes with conversion of tryptophan to niacin.

Pellagra has been reported in India in Telangana area of Andhra Pradesh because of Jower (Sorghum vulgare) consumption.


Q. 17

In pellagra, all are seen except ‑

 A

Diarrhoea

 B

Dermatitis

 C

Delusion

 D

Dementia

Q. 17

In pellagra, all are seen except ‑

 A

Diarrhoea

 B

Dermatitis

 C

Delusion

 D

Dementia

Ans. C

Explanation:

Ans. is ‘c’ i.e., Delusion

Pellagra

  • Niacin (Vit B3) def.

Triad of –

  • Dermatitis
  • Diarrhea
  • Dementia

Q. 18

Not seen in pellagra ‑

 A

Diarrhea

 B

Dyspepsia

 C

Dementia

 D

Dermatitis

Q. 18

Not seen in pellagra ‑

 A

Diarrhea

 B

Dyspepsia

 C

Dementia

 D

Dermatitis

Ans. B

Explanation:

Ans. is ‘b’ i.e., Dyspepsia

  • Pellagra is a disease that occurs due to deficiency of Niacin (Vitamin-B3).
  • It is characterized by classical triad of3Ds :-
  1. Diarrhea
  2. Dermatitis
  3. Dementia

Skin (Dermatitis)

cIT

Neurological

Manifestations of Pellagra

First sign is reddened skin with superficial scaling.

Itching or burning sensation.

Skin is thick, hard, scaly and cracked.

Bleeding from blackened crusts.

There may be peeling of lips, tongue.

Diarrhea is seen in 50%.

Poor appetite, nausea, vomiting, abdominal pain.

Difficulty to eat.

Malnutrition.

Initially apathy and mild depression.

Headache, confusion, irritability, anxiety, restlessness.

Delusions, disoriention and psychosis.

Dementia



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