Case Study - Alcoholic with Folate Deficiency (8pts) Mr. Murdock, a 64-year-old

Question

Case Study - Alcoholic with Folate Deficiency (8pts) 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 markedly pale, confused, and undernourished with jaundice of the conjunctiva and skin. His lab results showed that he was profoundly anemic with elevated liver enzymes and low albumin and was 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. 1. What symptoms of folate deficiency did Mr. Murdock exhibit? 2. How did his alcohol addiction contribute to the folate deficiency? Wtor groupias ae athigherrisk for folate deficieney? Why are they at risk? 4. What are the best food sources of folate?

Explanation / Answer

1)He was markedly pale and had yellow conjunctiva and skin. He was also confused and undernourished which is also a classic symptom of anaemia due to extreme deficiency of folate. His laboratory results showed anaemia.

2)Extreme consumption of alcohol and binge drinking induces some changes in the digestive tract which inhibits the absorption of micro nutrients in the blood stream, reduces liver intake and absorption and increases urinary excretion of folate.

3)Risk : pregnant and breastfeeding women- due to rapid tissue growth and losses through milk without adequate intake to compensate these losses.

- alcoholism

- eating overcooked foods which destroys the nutrients.

- sickle cell anemia

- medication ( nitrofurantoin, antidieuratic,methotrexate) It impaired the cellular availability of folate.

4)Food sources :

Dark leafy vegetable ( spinach , lettuce)

Asparagus

Broccoli

Citrus fruits

Beans ( lentils,kidney beans)

Okra

Avocado

Brussels

Beets

Corn

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