# embeddings_queue

created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f2e7f557-ab56-45e1-bb60-a4967810e7bb
encoding: FLOAT32
metadata:
{"original_content": "Undernutrition\n68", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 15, "type": "text ", "chroma:document": "1. What are the primary causes and health consequences of undernutrition?  \n2. How does undernutrition affect the body's ability to metabolize essential nutrients?  \n3. What dietary interventions can help address vitamin and mineral deficiencies associated with undernutrition?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 909a9e8d-05d1-4cc4-aa75-9b1428f97baf
encoding: FLOAT32
metadata:
{"original_content": "Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors that can lead to obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 418531b9-67ed-404a-97ec-8d7a771c2144
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\nIntroduction\nMany undernourished patients need nutritional support, which aims to increase lean body mass.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can nutritional support help increase lean body mass in undernourished patients?  \n2. What role does nutritional support play in addressing dietary deficiencies in undernourished individuals?  \n3. Can nutritional support be used to manage vitamin and mineral imbalances in patients with metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4f57b93e-2cb7-4a05-a7da-9bb692c01800
encoding: FLOAT32
metadata:
{"original_content": "Oral\nfeeding can be difficult for some patients with anorexia or with eating or absorption problems.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can oral feeding challenges in patients with anorexia be addressed to improve nutritional intake?  \n2. What strategies can be used to manage absorption problems in patients with dietary deficiencies?  \n3. How do eating difficulties impact the treatment of metabolic disorders and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bda2d7ef-3da0-4d6b-b439-0b0c55fd812a
encoding: FLOAT32
metadata:
{"original_content": "Behavioral\nmeasures that sometimes enhance oral intake include the following:\n\u2022 Encouraging patients to eat\n\u2022 Heating or seasoning foods\n\u2022 Providing favorite or strongly flavored foods\n\u2022 Encouraging patients to eat small portions\n\u2022 Scheduling around meals\n\u2022 Assisting patients with feeding\nIf behavioral measures are ineffective, nutritional support\u2014oral, enteral tube, or parenteral nutrition\u2014is\nindicated, except sometimes for dying or severely demented patients (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. What behavioral strategies can be implemented to improve oral intake in patients with dietary deficiencies or metabolic disorders?  \n2. When should nutritional support methods like enteral tube feeding or parenteral nutrition be considered for patients with severe nutritional disorders?  \n3. How can meal scheduling and portion control aid in managing nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ee1f1850-6809-4cd7-b868-dfd05a7cd5dc
encoding: FLOAT32
metadata:
{"original_content": "25\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific vitamins and minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with obesity and its connection to nutritional imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0bc2fedb-fb12-4a6f-89ab-3fd9ae208708
encoding: FLOAT32
metadata:
{"original_content": "Predicting Nutritional Requirements\nNutritional requirements are predicted so that interventions can be planned. Requirements can be\nestimated by formulas or measured by indirect calorimetry.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can indirect calorimetry be used to determine the nutritional needs of individuals with metabolic disorders?  \n2. What formulas are commonly used to estimate dietary requirements for patients with obesity?  \n3. How can predicted nutritional requirements guide interventions for vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8964fb6d-b8c7-497f-9fe5-7819858d5b82
encoding: FLOAT32
metadata:
{"original_content": "Indirect calorimetry requires use of a metabolic\ncart (a closed rebreathing system that determines energy expenditure based on total CO\n2\n production),\nwhich requires special expertise and is not always available.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can indirect calorimetry be utilized to assess energy expenditure in individuals with metabolic disorders?  \n2. What are the limitations of using a metabolic cart for evaluating energy needs in patients with obesity?  \n3. Why might indirect calorimetry not be a feasible option for diagnosing or managing certain nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d76447b6-b53d-44f2-aaf4-d1f74f367d8c
encoding: FLOAT32
metadata:
{"original_content": "Thus, total energy expenditure (TEE) and\nprotein requirements usually are estimated.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can total energy expenditure (TEE) be calculated to address dietary deficiencies in individuals with metabolic disorders?  \n2. What role do protein requirements play in managing obesity and related health conditions?  \n3. How can estimating TEE and protein needs help in correcting vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 833671e0-efd3-4f69-aaba-2489114576f7
encoding: FLOAT32
metadata:
{"original_content": "Energy expenditure:\n TEE varies based on the patient's weight, activity level, and degree of metabolic\nstress (metabolic demands); TEE ranges from 25 kcal/kg/day for people who are sedentary and not under\nstress to about 40 kcal/kg/day for people who are critically ill.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How does metabolic stress influence the total energy expenditure (TEE) in patients with metabolic disorders?  \n2. What is the recommended caloric intake for individuals with obesity who are sedentary and not under metabolic stress?  \n3. How does activity level impact the caloric needs of patients with dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 137e7669-5858-4441-aef9-0caf89029dc4
encoding: FLOAT32
metadata:
{"original_content": "TEE equals the sum of\n\u2022 Resting metabolic rate (RMR, or resting energy expenditure rate), which is normally about 70% of TEE\n\u2022 Energy dissipated by metabolism of food (10% of TEE)\n\u2022 Energy expended during physical activity (20% of TEE)\nUndernutrition can decrease RMR up to 20%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How does undernutrition impact the resting metabolic rate (RMR) and total energy expenditure (TEE)?  \n2. What proportion of total energy expenditure (TEE) is typically attributed to physical activity, and how might this be affected in individuals with metabolic disorders?  \n3. How does the energy dissipated by the metabolism of food contribute to TEE, and could this process be altered in cases of dietary deficiencies or undernutrition?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c15a8030-5307-4ffd-b9cc-f75a151d2413
encoding: FLOAT32
metadata:
{"original_content": "Conditions that increase metabolic stress (eg, critical\nillness, infection, inflammation, trauma, surgery) can increase RMR but rarely by > 50%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How do conditions like critical illness or trauma affect resting metabolic rate (RMR) in individuals with metabolic disorders?  \n2. Can increased metabolic stress from surgery or infection contribute to dietary deficiencies or nutrient imbalances?  \n3. What is the maximum percentage increase in RMR typically observed in patients experiencing metabolic stress due to inflammation?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1b1e7354-74ca-4f9c-8cc9-29cd57df107c
encoding: FLOAT32
metadata:
{"original_content": "The Mifflin-St.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can the Mifflin-St. Jeor Equation be used to calculate caloric needs for individuals with obesity to manage their weight effectively?  \n2. What role does the Mifflin-St. Jeor Equation play in determining energy requirements for patients with metabolic disorders?  \n3. How can the Mifflin-St. Jeor Equation assist in creating dietary plans for individuals with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fb542b70-9c7b-4937-9d05-e686430be829
encoding: FLOAT32
metadata:
{"original_content": "Jeor equation estimates RMR more precisely and with fewer errors than the commonly\nused Harris-Benedict equation, usually providing results that are within 20% of those measured by\nindirect calorimetry.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How does the accuracy of the Jeor equation in estimating RMR impact dietary planning for individuals with obesity?  \n2. Can the Jeor equation be used to better manage metabolic disorders compared to the Harris-Benedict equation?  \n3. What role does precise RMR estimation play in addressing nutritional deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 70147367-e3c2-434e-9f40-472b2e52fb7c
encoding: FLOAT32
metadata:
{"original_content": "The Mifflin-St.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can the Mifflin-St. Jeor Equation be used to calculate caloric needs for individuals with obesity to create a weight management plan?  \n2. What role does the Mifflin-St. Jeor Equation play in assessing energy requirements for patients with metabolic disorders?  \n3. How can the Mifflin-St. Jeor Equation help in determining dietary adjustments for individuals with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d79aca77-5ab6-4cea-99f5-7eb5b3f43ac2
encoding: FLOAT32
metadata:
{"original_content": "Jeor equation estimates RMR as follows:\nMen\n: kcal / day = 66 + (13.7 \u00d7 wt[kg]) + (5 \u00d7 height[cm]) - (6.8 \u00d7 age)\nWomen\n: kcal / day = 665 + (9.6 \u00d7 wt[kg]) + (1.8 \u00d7 height[cm]) - (4.7 \u00d7 age)\nTEE can be estimated by adding about 10% (for sedentary people) to about 40% (for people who are\ncritically ill) to RMR.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How can the Harris-Benedict equation be used to estimate caloric needs for individuals with obesity to create a weight management plan?  \n2. What adjustments to caloric intake should be made for a patient with a metabolic disorder who is critically ill?  \n3. How does age-related metabolic decline affect the estimated caloric needs for individuals with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 68850e0f-0c8f-4c84-a5cd-7452ad08a059
encoding: FLOAT32
metadata:
{"original_content": "Protein requirements:\n For healthy people, protein requirements are estimated at 0.8 g/kg/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. How might insufficient protein intake contribute to the development of dietary deficiencies or malnutrition?  \n2. What role does meeting the daily protein requirement play in managing metabolic disorders?  \n3. Can inadequate protein consumption exacerbate obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 07b432c7-f7cc-411b-a280-ace9ef38fc30
encoding: FLOAT32
metadata:
{"original_content": "However, for patients with metabolic stress or kidney failure and for elderly patients, requirements may be\nhigher (see\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. What are the nutritional requirements for patients experiencing metabolic stress or kidney failure?  \n2. How do dietary needs change for elderly patients with metabolic disorders?  \n3. What guidelines does The Merck Manual provide for managing vitamin and mineral imbalances in patients with chronic health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d03cd6a9-0280-45f8-8faa-fc4aa58a5172
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n69", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 16, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0ddbea31-04a8-4068-814d-6b5919417e17
encoding: FLOAT32
metadata:
{"original_content": "Table 3-1\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. What are the common symptoms associated with specific vitamin and mineral deficiencies?  \n2. How do dietary imbalances contribute to the development of metabolic disorders?  \n3. What are the nutritional factors linked to the onset of obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5fee3959-c61b-4059-b92c-906d74876852
encoding: FLOAT32
metadata:
{"original_content": "Assessing Response to Nutritional Support\nThere is no gold standard to assess response.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can the effectiveness of nutritional support interventions be evaluated in patients with dietary deficiencies?  \n2. What methods can be used to monitor progress in individuals receiving treatment for vitamin and mineral imbalances?  \n3. What are the challenges in assessing the response to nutritional support in patients with metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 70b37af2-dd9b-4568-90bb-61cdc38704c5
encoding: FLOAT32
metadata:
{"original_content": "Clinicians commonly use indicators of lean body mass\nsuch as the following:\n\u2022 Body mass index (BMI)\n\u2022 Body composition analysis\n\u2022 Body fat distribution (see pp.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can body mass index (BMI) be used to assess the risk of obesity-related health conditions?  \n2. What role does body composition analysis play in identifying nutritional deficiencies or imbalances?  \n3. How does body fat distribution impact the diagnosis of metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d04b23f5-b0b9-43bb-973f-bd2d601cf38b
encoding: FLOAT32
metadata:
{"original_content": "11\n and \n58\n)\nNitrogen balance, response to skin antigens, muscle strength measurement, and indirect calorimetry can\nalso be used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can nitrogen balance be used to assess protein metabolism in individuals with dietary deficiencies?  \n2. What role does response to skin antigens play in evaluating immune function in patients with vitamin and mineral imbalances?  \n3. How can indirect calorimetry help determine energy expenditure in individuals with obesity or metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 93b0399d-338e-413a-80a5-e7e53d9f7cdc
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 3-1. Estimated Adult Daily Protein Requirement]\nNitrogen balance,\n which reflects the balance between protein needs and supplies, is the difference\nbetween amount of nitrogen ingested and amount lost.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can nitrogen balance be used to assess protein deficiency in individuals with metabolic disorders?  \n2. What is the estimated daily protein requirement for adults to prevent dietary deficiencies?  \n3. How does nitrogen loss impact the management of nutrition-related health conditions like obesity?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8e29ae04-0890-4642-8842-dd346207d281
encoding: FLOAT32
metadata:
{"original_content": "A positive balance (ie, more ingested than lost)\nimplies adequate intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How does a positive nutrient balance indicate adequate dietary intake in individuals with metabolic disorders?  \n2. What role does nutrient balance play in diagnosing vitamin and mineral deficiencies?  \n3. Can a positive nutrient balance help in managing obesity-related nutritional imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4d7c45a7-8815-4a66-980f-8b9d671449b2
encoding: FLOAT32
metadata:
{"original_content": "Precise measurement is impractical, but estimates help assess response to\nnutritional support.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can estimates of nutritional intake be used to evaluate the effectiveness of dietary interventions in patients with metabolic disorders?  \n2. What role do approximate measurements play in monitoring recovery from vitamin and mineral deficiencies?  \n3. How can estimated assessments guide nutritional support for individuals with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e01285ea-ecdf-447e-8960-d81907bc416f
encoding: FLOAT32
metadata:
{"original_content": "Nitrogen intake is estimated from protein intake: nitrogen (g) equals protein (g)/6.25.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can nitrogen balance be assessed in individuals with protein-energy malnutrition?  \n2. What is the relationship between dietary protein intake and nitrogen levels in patients with metabolic disorders?  \n3. How does inadequate protein consumption contribute to nitrogen deficiency in individuals with chronic illnesses?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1764d11a-26e5-48a3-be14-2573a530d020
encoding: FLOAT32
metadata:
{"original_content": "Estimated nitrogen losses consist of urinary nitrogen losses (estimated by measuring urea nitrogen\ncontent of an accurately obtained 24-h urine collection) plus stool losses (estimated at 1 g/day if stool is\nproduced; negligible if stool is not produced) plus insensible and other unmeasured losses (estimated at\n3 g).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can estimated nitrogen losses be calculated in patients with metabolic disorders?  \n2. What role does stool production play in determining nitrogen losses in individuals with dietary deficiencies?  \n3. How are insensible nitrogen losses accounted for in patients with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 92d906a6-9d0f-482f-9600-7524521ae78d
encoding: FLOAT32
metadata:
{"original_content": "Response to skin antigens\n, a measure of delayed hypersensitivity, often increases to normal as\nundernourished patients respond to nutritional support.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How does nutritional support impact the immune response in undernourished patients?  \n2. Can delayed hypersensitivity reactions serve as an indicator of recovery in patients with nutritional deficiencies?  \n3. What role does skin antigen response play in assessing the effectiveness of dietary interventions for malnourished individuals?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a032882b-7a4e-43bd-944d-60121210830f
encoding: FLOAT32
metadata:
{"original_content": "However, other factors can affect response to\nskin antigens.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How do nutritional deficiencies influence the body's response to skin antigen tests?  \n2. Can vitamin or mineral imbalances alter immune reactions observed through skin antigen testing?  \n3. What role do metabolic disorders play in modifying the outcomes of skin antigen responses?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0f973f07-902c-4c48-8fca-50568d09b012
encoding: FLOAT32
metadata:
{"original_content": "Muscle strength\n indirectly reflects increases in lean body mass.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How does an increase in lean body mass impact muscle strength in individuals with nutritional disorders?  \n2. Can dietary deficiencies or metabolic disorders affect the relationship between muscle strength and lean body mass?  \n3. What role do vitamin and mineral imbalances play in the development of lean body mass and its effect on muscle strength?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fc991ed1-0ea5-4be5-8551-53b5dfc4ec40
encoding: FLOAT32
metadata:
{"original_content": "It can be measured quantitatively, by\nhand-grip dynamometry, or electrophysiologically (typically by stimulating the ulnar nerve with an\nelectrode).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How can hand-grip dynamometry be used to assess muscle function in individuals with nutritional disorders?  \n2. What role does ulnar nerve stimulation play in diagnosing muscle weakness caused by dietary deficiencies?  \n3. Can electrophysiological measurements help identify metabolic disorders linked to vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 86cd21c8-1781-4dae-8519-b4afac0452d6
encoding: FLOAT32
metadata:
{"original_content": "Levels of acute-phase reactant\n serum proteins (particularly short-lived proteins such as prealbumin\n[transthyretin], retinol-binding protein, and transferrin) sometimes correlate with improved nutritional\nstatus, but these levels correlate better with inflammatory conditions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. How do levels of acute-phase reactant serum proteins like prealbumin and transferrin correlate with nutritional status in individuals with dietary deficiencies?  \n2. Can changes in retinol-binding protein levels serve as an indicator of recovery in patients with vitamin A deficiency?  \n3. What role do inflammatory conditions play in altering serum protein markers used to assess nutritional disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 97ef838b-b99e-4a74-8f25-e12d81332b3c
encoding: FLOAT32
metadata:
{"original_content": "Enteral Tube Nutrition\nEnteral tube nutrition is indicated for patients who have a functioning GI tract but cannot ingest enough\nnutrients orally because they are unable or unwilling to take oral feedings.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. What are the indications for using enteral tube nutrition in patients with dietary deficiencies?  \n2. How does enteral tube nutrition address vitamin and mineral imbalances in patients unable to consume food orally?  \n3. Can enteral tube nutrition be used to manage metabolic disorders in patients with a functioning GI tract?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2660e9de-0aa4-4161-b6cd-b44f199c5f52
encoding: FLOAT32
metadata:
{"original_content": "Compared with parenteral\nnutrition, enteral nutrition has the following advantages:\n\u2022 Better preservation of the structure and function of the GI tract\n\u2022 Lower cost\n\u2022 Probably fewer complications, particularly infections\nSpecific indications\n for enteral nutrition include the following:\n\u2022 Prolonged anorexia\n\u2022 Severe protein-energy undernutrition\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. What are the advantages of enteral nutrition over parenteral nutrition in managing severe protein-energy undernutrition?  \n2. How does enteral nutrition help preserve the structure and function of the gastrointestinal tract in patients with prolonged anorexia?  \n3. Why might enteral nutrition result in fewer infection-related complications compared to parenteral nutrition in patients with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 970a89b5-cc6c-46b7-9fa8-9ebe668d621a
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n70", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 17, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48fa14c6-6508-4c93-9c9e-401c2048f495
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Coma or depressed sensorium\n\u2022 Liver failure\n\u2022 Inability to take oral feedings due to head or neck trauma or neurologic disorders\n\u2022 Critical illnesses (eg, burns) causing metabolic stress\nOther indications may include bowel preparation for surgery in seriously ill or undernourished patients,\nclosure of enterocutaneous fistulas, and small-bowel adaptation after massive intestinal resection or in\ndisorders that may cause malabsorption (eg, Crohn's disease).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can nutritional support be managed in patients with liver failure to prevent further metabolic complications?  \n2. What dietary interventions are recommended for patients with Crohn's disease experiencing malabsorption?  \n3. What nutritional strategies are appropriate for critically ill patients, such as those with burns, to address metabolic stress?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e6bfa2d7-d746-4679-8bed-708b67a4f3ad
encoding: FLOAT32
metadata:
{"original_content": "Procedure:\n If tube feeding is needed for \u2264 4 to 6 wk, a small-caliber, soft nasogastric or nasoenteric (eg,\nnasoduodenal) tube made of silicone or polyurethane is usually used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What type of feeding tube is recommended for short-term nutritional support in patients with metabolic disorders?  \n2. How does the choice of feeding tube material impact the management of dietary deficiencies?  \n3. What is the appropriate duration for using nasogastric or nasoenteric tubes in patients with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d3f83764-b0ac-486f-b94d-051fef0a2278
encoding: FLOAT32
metadata:
{"original_content": "If a nasal injury or deformity makes\nnasal placement difficult, an orogastric or other oroenteric tube can be placed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can alternative feeding methods be utilized for patients with nasal injuries to address nutritional deficiencies?  \n2. What are the implications of using orogastric tubes for managing malnutrition in individuals with nasal deformities?  \n3. How does the placement of oroenteric tubes support dietary needs in patients with metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dbb6e768-018d-44ef-a30f-65e50b776479
encoding: FLOAT32
metadata:
{"original_content": "Tube feeding for > 4 to 6 wk usually requires a gastrostomy or jejunostomy tube, placed endoscopically,\nsurgically, or radiologically.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What are the long-term nutritional considerations for patients requiring tube feeding for more than 4 to 6 weeks?  \n2. How does the placement method of gastrostomy or jejunostomy tubes impact the management of metabolic disorders?  \n3. What are the potential risks of vitamin and mineral imbalances in patients on prolonged tube feeding?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f0f37d43-af01-427a-aba3-5f77ea0ceda5
encoding: FLOAT32
metadata:
{"original_content": "Choice depends on physician capabilities and patient preference.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can a physician's capabilities influence the treatment plan for a patient with a metabolic disorder?  \n2. What role does patient preference play in managing dietary deficiencies or vitamin and mineral imbalances?  \n3. How might treatment options for obesity be tailored based on both physician expertise and patient choices?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 20e0e269-f4e8-4c33-865b-8b331d8b35c4
encoding: FLOAT32
metadata:
{"original_content": "Jejunostomy tubes are useful for patients with contraindications to gastrostomy (eg, gastrectomy, bowel\nobstruction proximal to the jejunum).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What are the nutritional implications of using a jejunostomy tube in patients with gastrectomy?  \n2. How does a jejunostomy tube address dietary deficiencies in patients with bowel obstructions proximal to the jejunum?  \n3. What metabolic considerations should be taken into account when providing nutrition through a jejunostomy tube?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: baf8d13e-0540-416f-8298-482e3f8d3760
encoding: FLOAT32
metadata:
{"original_content": "However, these tubes do not pose less risk of tracheobronchial\naspiration than gastrostomy tubes, as is often thought.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How does the use of gastrostomy tubes compare to other feeding tubes in terms of the risk of tracheobronchial aspiration in patients with nutritional disorders?  \n2. What are the implications of tracheobronchial aspiration risks for managing dietary deficiencies in patients requiring tube feeding?  \n3. Are gastrostomy tubes a safer option for addressing malnutrition in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 01c050dc-4cd0-4afb-bf91-c44f82ff8d28
encoding: FLOAT32
metadata:
{"original_content": "Jejunostomy tubes are easily dislodged and are\nusually used only for inpatients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How does the use of jejunostomy tubes impact the management of nutritional disorders in hospitalized patients?  \n2. What are the potential risks of jejunostomy tube dislodgement in patients with severe dietary deficiencies?  \n3. In what scenarios are jejunostomy tubes preferred for addressing metabolic disorders in inpatient settings?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1b7aea62-70ab-4fda-9229-17a7757a838c
encoding: FLOAT32
metadata:
{"original_content": "Feeding tubes are surgically placed if endoscopic and radiologic placement is unavailable, technically\nimpossible, or unsafe (eg, because of overlying bowel).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Under what circumstances might surgical placement of a feeding tube be necessary for patients with severe nutritional disorders?  \n2. How do anatomical or safety concerns impact the method of feeding tube placement in individuals with metabolic or dietary deficiencies?  \n3. What are the risks associated with overlying bowel in the context of feeding tube placement for patients with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff394962-004d-40ea-9914-50aece363d11
encoding: FLOAT32
metadata:
{"original_content": "Open or laparoscopic techniques can be used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How do open and laparoscopic techniques compare in the surgical management of obesity-related health conditions?  \n2. What role do surgical interventions play in addressing severe metabolic disorders caused by dietary deficiencies?  \n3. Can laparoscopic techniques be used to treat complications arising from vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d0d4d1f6-c6ef-4df0-a6ca-bfbcc5e8f938
encoding: FLOAT32
metadata:
{"original_content": "Formulas:\n Liquid formulas commonly used include feeding modules and polymeric or other specialized\nformulas.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What types of liquid formulas are recommended for managing dietary deficiencies in individuals with metabolic disorders?  \n2. How can specialized formulas be utilized to address vitamin and mineral imbalances in patients with nutrition-related health conditions?  \n3. What role do polymeric formulas play in the dietary management of obesity or other nutrition disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: add16d87-0d01-427e-a87a-5b5b747003a5
encoding: FLOAT32
metadata:
{"original_content": "Feeding modules\n are commercially available products that contain a single nutrient, such as proteins,\nfats, or carbohydrates.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can feeding modules be used to address protein deficiencies in individuals with malnutrition?  \n2. What role do carbohydrate-based feeding modules play in managing metabolic disorders like glycogen storage disease?  \n3. Can fat-based feeding modules help in the dietary management of individuals with fat malabsorption disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c27f693-1d1b-47d3-87a2-04c57e952db5
encoding: FLOAT32
metadata:
{"original_content": "Feeding modules may be used individually to treat a specific deficiency or\ncombined with other formulas to completely satisfy nutritional requirements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can feeding modules be used to address specific dietary deficiencies in patients with metabolic disorders?  \n2. What combinations of feeding formulas are effective in treating vitamin and mineral imbalances?  \n3. Can feeding modules be tailored to fully meet the nutritional needs of individuals with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 840b86b7-f2af-4a89-af1a-88f556dcd976
encoding: FLOAT32
metadata:
{"original_content": "Polymeric formulas\n (including blenderized food and milk-based or lactose-free commercial formulas)\nare commercially available and generally provide a complete, balanced diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can polymeric formulas be used to manage dietary deficiencies in individuals with metabolic disorders?  \n2. Are lactose-free commercial formulas suitable for patients with lactose intolerance and related nutritional disorders?  \n3. Can blenderized food-based polymeric formulas provide a balanced diet for individuals with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8dac6099-fd99-490d-a390-0fd3549322fc
encoding: FLOAT32
metadata:
{"original_content": "For oral or tube feedings,\nthey are usually preferred to feeding modules.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Why are complete oral or tube feeding formulas preferred over feeding modules for managing dietary deficiencies in patients with metabolic disorders?  \n2. How do complete feeding formulas address vitamin and mineral imbalances in individuals with nutrition-related health conditions?  \n3. What are the advantages of using complete oral or tube feedings for patients with obesity-related dietary needs compared to modular feeding approaches?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 72220661-e590-4719-a841-3609fa922cd1
encoding: FLOAT32
metadata:
{"original_content": "In hospitalized patients, lactose-free formulas are the most\ncommonly used polymeric formulas.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Why are lactose-free formulas preferred for hospitalized patients with lactose intolerance or malabsorption issues?  \n2. How do lactose-free polymeric formulas benefit patients with metabolic disorders related to carbohydrate digestion?  \n3. Are lactose-free formulas effective in managing symptoms of dietary deficiencies caused by lactose intolerance?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7462571c-731f-496a-adc4-674ff036d889
encoding: FLOAT32
metadata:
{"original_content": "However, milk-based formulas tend to taste better than lactose-free\nformulas.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How does the taste of milk-based formulas compare to lactose-free formulas in managing lactose intolerance?  \n2. Could the preference for milk-based formulas over lactose-free formulas impact adherence to dietary recommendations for individuals with lactose intolerance?  \n3. What role does formula taste play in addressing nutritional deficiencies in infants with metabolic disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dade476c-cc9b-4514-b527-00956bde1de7
encoding: FLOAT32
metadata:
{"original_content": "Patients with lactose intolerance may be able to tolerate milk-based formulas given slowly by\ncontinuous infusion.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Can patients with lactose intolerance tolerate milk-based formulas if administered via continuous infusion?  \n2. What are the potential benefits of using continuous infusion for lactose-intolerant individuals?  \n3. How does the method of formula administration impact tolerance in patients with lactose intolerance?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 788ee914-6589-4754-b900-461267074fad
encoding: FLOAT32
metadata:
{"original_content": "Specialized formulas\n include hydrolyzed protein or sometimes amino acid formulas, which are used for\npatients who have difficulty digesting complex proteins.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What types of specialized formulas are recommended for patients with protein digestion difficulties?  \n2. How do hydrolyzed protein formulas benefit individuals with metabolic disorders affecting protein digestion?  \n3. When might amino acid-based formulas be necessary for managing dietary deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5e026d78-2b6a-4478-80e9-7abcf53d2d2e
encoding: FLOAT32
metadata:
{"original_content": "However, these formulas are expensive and\nusually unnecessary.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Why might specialized nutritional formulas be considered unnecessary for certain dietary deficiencies?  \n2. What are the potential drawbacks of relying on expensive nutritional formulas for managing metabolic disorders?  \n3. In what situations could the cost of nutritional formulas outweigh their benefits for addressing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ebf3cfe5-61b6-4761-aa8c-f4a667dcbe72
encoding: FLOAT32
metadata:
{"original_content": "Most patients with pancreatic insufficiency, if \ngiven enzymes, and most patients with\nmalabsorption can digest complex proteins.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How do enzyme supplements aid in the digestion of complex proteins for patients with pancreatic insufficiency?  \n2. Can patients with malabsorption effectively process dietary proteins with appropriate treatment?  \n3. What role do digestive enzymes play in managing nutritional deficiencies caused by pancreatic insufficiency?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 28c10123-ec43-45fa-93fc-75e42cb85b8c
encoding: FLOAT32
metadata:
{"original_content": "Other specialized formulas (eg, calorie- and protein-dense\nformulas for patients whose fluids are restricted, fiber-enriched formulas for constipated patients) may be\nhelpful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What type of specialized formula is recommended for patients with fluid restrictions due to a metabolic disorder?  \n2. How can fiber-enriched formulas assist patients suffering from constipation related to dietary deficiencies?  \n3. Are calorie- and protein-dense formulas beneficial for managing malnutrition in patients with specific nutritional disorders?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c20a2fdd-a0b7-4058-8fec-e849234f75be
encoding: FLOAT32
metadata:
{"original_content": "Administration:\n Patients should be sitting upright at 30 to 45\u00b0 during tube feeding and for 1 to 2 h\nafterward to minimize incidence of nosocomial aspiration pneumonia and to allow gravity to help propel\nthe food.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can proper patient positioning during tube feeding help prevent complications like aspiration pneumonia in individuals with nutritional disorders?  \n2. What role does gravity play in the administration of tube feeding for patients with dietary deficiencies or metabolic disorders?  \n3. Why is it important to maintain an upright position after tube feeding in patients with obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 23c25647-cd9f-4544-95c4-d96d41125504
encoding: FLOAT32
metadata:
{"original_content": "Tube feedings are given in boluses several times a day or by continuous infusion.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How can continuous infusion tube feedings help manage metabolic disorders in patients with impaired digestion?  \n2. What are the nutritional benefits of bolus tube feedings for individuals with vitamin and mineral deficiencies?  \n3. In what ways can tube feeding methods be tailored to address obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 503279a6-0149-410e-831d-136e57730da4
encoding: FLOAT32
metadata:
{"original_content": "Bolus feeding\nis more physiologic and may be preferred for patients with diabetes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. How does bolus feeding impact blood sugar management in patients with diabetes?  \n2. Why might bolus feeding be considered more physiologic for individuals with metabolic disorders?  \n3. What are the potential benefits of bolus feeding for patients with dietary deficiencies or imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 148a88d7-2b4e-4f78-94c7-8cb2163ffc9a
encoding: FLOAT32
metadata:
{"original_content": "Continuous infusion is necessary if\nboluses cause nausea.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. Why might continuous infusion be preferred over boluses in managing nausea related to nutritional disorders?  \n2. How can the method of nutrient delivery impact symptoms like nausea in patients with metabolic disorders?  \n3. What are the potential benefits of continuous infusion for individuals with dietary deficiencies experiencing adverse reactions to bolus feeding?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d50b9cdd-f8bd-4bc5-a0ee-e881beb5067b
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 3-2. Complications of Enteral Tube Nutrition]\nFor bolus feeding, total daily volume is divided into 4 to 6 separate feedings, which are injected through\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What are the potential complications associated with enteral tube nutrition in patients with metabolic disorders?  \n2. How does the division of total daily volume into multiple feedings impact the management of dietary deficiencies in bolus feeding?  \n3. What are the risks of vitamin and mineral imbalances when using enteral tube nutrition as a primary feeding method?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7f36c453-79dc-40f4-ab2c-c7eaa45c9ca1
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n71", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 18, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 31cf8923-ed09-454c-9869-1569bb62a5ec
encoding: FLOAT32
metadata:
{"original_content": "the tube with a syringe or infused by gravity from an elevated bag.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can tube feeding be utilized to manage severe malnutrition in patients with dietary deficiencies?  \n2. What are the benefits of using gravity-fed infusion for individuals with metabolic disorders requiring enteral nutrition?  \n3. In what scenarios is a syringe method preferred for administering nutrients to patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9d13919a-6e8c-4334-90bd-bf9003bfc891
encoding: FLOAT32
metadata:
{"original_content": "After feedings, the tube is flushed with\nwater to prevent clogging.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can proper tube flushing techniques help prevent complications in patients with metabolic disorders requiring enteral feeding?  \n2. What role does water play in maintaining the functionality of feeding tubes for individuals with dietary deficiencies?  \n3. Are there specific guidelines for flushing feeding tubes in patients with vitamin and mineral imbalances to ensure effective nutrient delivery?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a3e494f2-f092-4fc3-9c39-2816e8d4a923
encoding: FLOAT32
metadata:
{"original_content": "Nasogastric or nasoduodenal tube feeding\n often causes diarrhea initially; thus, feedings are usually\nstarted with small amounts of dilute preparations and increased as tolerated.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the potential gastrointestinal side effects of initiating nasogastric or nasoduodenal tube feeding in patients with nutritional disorders?  \n2. How can the risk of diarrhea be managed when starting tube feeding in individuals with metabolic or dietary deficiencies?  \n3. Why is it recommended to begin with small amounts of dilute preparations in tube feeding for patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 09f4029d-564f-4e1b-b790-f383f1eeb728
encoding: FLOAT32
metadata:
{"original_content": "Most formulas contain 0.5,\n1, or 2 kcal/mL.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can the caloric density of a formula impact the management of malnutrition in patients with dietary deficiencies?  \n2. What role does the kcal/mL concentration of a formula play in addressing metabolic disorders requiring precise caloric intake?  \n3. How might formulas with varying kcal/mL concentrations be used to support weight management in individuals with obesity?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: df4e9eee-a88e-41d4-818a-5ade1285d1c4
encoding: FLOAT32
metadata:
{"original_content": "Formulas with higher caloric concentration (less water per calorie) may cause decreased\ngastric emptying and thus higher gastric residuals than when more dilute formulas with the same number\nof calories are used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How does the caloric concentration of enteral formulas impact gastric emptying in patients with metabolic disorders?  \n2. Can higher-calorie formulas contribute to complications in individuals with obesity-related gastrointestinal issues?  \n3. What role does formula dilution play in managing gastric residuals for patients with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:25
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3f66fe8a-d002-4c77-9a41-d500ba376418
encoding: FLOAT32
metadata:
{"original_content": "Initially, a 1-kcal/mL commercially prepared solution may be given undiluted at 50\nmL/h or, if patients have not been fed for a while, at 25 mL/h.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How should the feeding rate be adjusted for patients with a nutritional disorder who have not been fed for an extended period?  \n2. What is the recommended initial concentration and rate of a 1-kcal/mL solution for patients with dietary deficiencies?  \n3. How can the feeding protocol for metabolic disorder patients be safely initiated using a commercially prepared solution?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a50ac23f-4844-412b-b056-7df91f3e1baa
encoding: FLOAT32
metadata:
{"original_content": "Usually, these solutions do not supply\nenough water, particularly if vomiting, diarrhea, sweating, or fever has increased water loss.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can increased water loss due to vomiting or diarrhea impact hydration in individuals with nutritional disorders?  \n2. What are the risks of inadequate water intake in managing metabolic disorders during periods of excessive sweating or fever?  \n3. Why might standard solutions fail to address hydration needs in cases of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f707991b-e070-4e82-9ca7-2e19b8c70d15
encoding: FLOAT32
metadata:
{"original_content": "Extra water\nis supplied as boluses via the feeding tube or IV.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How is additional hydration managed in patients with metabolic disorders who require feeding tubes?  \n2. What role does intravenous hydration play in addressing dietary deficiencies in individuals with impaired nutrient absorption?  \n3. In cases of severe vitamin and mineral imbalances, how is extra water administered to support recovery?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9e3c1dcb-1521-455d-834e-9f4dfae47c5a
encoding: FLOAT32
metadata:
{"original_content": "After a few days, the rate or concentration can be\nincreased as needed to meet caloric and water needs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can caloric and water needs be adjusted in patients with metabolic disorders?  \n2. What is the recommended approach for gradually increasing nutrient intake in individuals with dietary deficiencies?  \n3. How does the rate of nutrient administration impact recovery in cases of severe malnutrition?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a2fdf159-ce8b-4708-a195-5159b02c899f
encoding: FLOAT32
metadata:
{"original_content": "Jejunostomy tube feeding\n requires greater dilution and smaller volumes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. Why is greater dilution necessary for jejunostomy tube feeding in patients with metabolic disorders?  \n2. How does the volume of jejunostomy tube feeding impact nutrient absorption in individuals with dietary deficiencies?  \n3. What are the potential risks of improper dilution in jejunostomy tube feeding for patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b3b6a3ce-df85-437c-9899-7d00b2696aff
encoding: FLOAT32
metadata:
{"original_content": "Feeding usually begins at a\nconcentration of \u2264 0.5 kcal/mL and a rate of 25 mL/h.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What is the recommended initial feeding concentration and rate for patients with metabolic disorders requiring nutritional support?  \n2. How should feeding be initiated in individuals with severe dietary deficiencies or malabsorption issues?  \n3. What are the guidelines for starting enteral nutrition in patients with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2f46b848-e25c-420b-988f-11d17f6c9328
encoding: FLOAT32
metadata:
{"original_content": "After a few days, concentrations and volumes can\nbe increased to eventually meet caloric and water needs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can caloric and water needs be gradually met in patients recovering from a nutritional deficiency?  \n2. What is the recommended approach to increasing nutrient concentrations for individuals with metabolic disorders?  \n3. How should hydration levels be adjusted for patients with vitamin and mineral imbalances during recovery?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b4d410e8-34ac-4ce6-acff-f982a519b0bd
encoding: FLOAT32
metadata:
{"original_content": "Usually, the maximum that can be tolerated is\n0.8 kcal/mL at 125 mL/h, providing 2400 kcal/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What is the maximum caloric intake that can be tolerated per day for patients with specific nutritional disorders?  \n2. How does the rate of nutrient infusion impact caloric delivery in individuals with metabolic disorders?  \n3. What are the recommended infusion rates for managing dietary deficiencies in clinical settings?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0264471f-729f-4357-a820-a4448b0d7dfa
encoding: FLOAT32
metadata:
{"original_content": "Complications:\n Complications are common and can be serious (see \nTable 3-2\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the potential complications associated with specific nutritional disorders?  \n2. How do dietary deficiencies contribute to serious health complications?  \n3. What are the common complications linked to vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0769d0ff-3c49-4d33-8293-c4870b6ccd5d
encoding: FLOAT32
metadata:
{"original_content": "Total Parenteral Nutrition\nParenteral nutrition is by definition given IV. Partial parenteral nutrition\n supplies only part of daily nutritional requirements, supplementing oral\nintake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What is the difference between total parenteral nutrition and partial parenteral nutrition in managing dietary deficiencies?  \n2. How does total parenteral nutrition address severe metabolic disorders when oral intake is not possible?  \n3. In what scenarios is partial parenteral nutrition used to supplement oral intake for patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 06a37be1-a4b1-49c6-bbd7-279cb85251cc
encoding: FLOAT32
metadata:
{"original_content": "Many hospitalized patients are given dextrose or amino acid solutions by this method.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How does the administration of dextrose solutions impact patients with metabolic disorders?  \n2. What role do amino acid solutions play in addressing dietary deficiencies in hospitalized patients?  \n3. Can the use of intravenous dextrose contribute to imbalances in blood sugar levels in patients with obesity?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c2bca6d0-a15b-4382-8962-6167280fb85e
encoding: FLOAT32
metadata:
{"original_content": "Total parenteral nutrition\n (TPN) supplies all daily nutritional requirements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can total parenteral nutrition (TPN) address severe malnutrition in patients unable to consume food orally or enterally?  \n2. What role does TPN play in managing vitamin and mineral deficiencies in individuals with gastrointestinal disorders?  \n3. Can TPN be used to prevent metabolic imbalances in patients with chronic absorption issues?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3773621c-d6f5-4645-b50a-61241fc333f8
encoding: FLOAT32
metadata:
{"original_content": "TPN can be used in the\nhospital or at home.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can Total Parenteral Nutrition (TPN) be utilized to address severe dietary deficiencies in hospitalized patients?  \n2. What role does TPN play in managing metabolic disorders that prevent nutrient absorption?  \n3. Can TPN be an effective solution for correcting vitamin and mineral imbalances in patients unable to consume food orally?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b00e173f-5ab5-402a-bea0-211155b0d8dd
encoding: FLOAT32
metadata:
{"original_content": "Because TPN solutions are concentrated and can cause thrombosis of peripheral\nveins, a central venous catheter is usually required.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. Why is a central venous catheter preferred over peripheral veins for administering TPN solutions in patients with severe nutritional disorders?  \n2. What are the risks associated with using peripheral veins for delivering concentrated TPN solutions in individuals with metabolic imbalances?  \n3. How does the concentration of TPN solutions impact the management of dietary deficiencies in patients requiring intravenous nutrition?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fa94b5ff-9cc6-460f-a5a3-b6a93bed726b
encoding: FLOAT32
metadata:
{"original_content": "Parenteral nutrition should not be used routinely in patients with an intact GI tract.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. Why is parenteral nutrition not recommended for patients with a functioning gastrointestinal (GI) tract?  \n2. What are the potential risks or complications of using parenteral nutrition in patients who do not require it?  \n3. How does the use of parenteral nutrition impact the management of metabolic disorders or nutrient imbalances in patients with an intact GI tract?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6cb540b5-f64a-43cb-aceb-5b6900acc535
encoding: FLOAT32
metadata:
{"original_content": "Compared with enteral\nnutrition, it causes more complications, does not preserve GI tract structure and function as well, and is\nmore expensive.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the potential complications associated with parenteral nutrition compared to enteral nutrition in managing nutritional disorders?  \n2. How does parenteral nutrition impact the preservation of gastrointestinal tract structure and function in patients with dietary deficiencies?  \n3. Why is parenteral nutrition considered more expensive than enteral nutrition in the treatment of metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c7654be7-572f-4dfe-9642-34c2551edd21
encoding: FLOAT32
metadata:
{"original_content": "Indications:\n TPN may be the only feasible option for patients who do not have a functioning GI tract or\nwho have disorders requiring complete bowel rest, such as the following:\n\u2022 Some stages of Crohn's disease or ulcerative colitis\n\u2022 Bowel obstruction\n\u2022 Certain pediatric GI disorders (eg, congenital GI anomalies, prolonged diarrhea regardless of its cause)\n\u2022 Short bowel syndrome due to surgery\nNutritional content:\n TPN requires water (30 to 40 mL/kg/day), energy (30 to 60 kcal/kg/day, depending\non energy expenditure), amino acids (1 to 2.0 g/kg/day, depending on the degree of catabolism), essential\nfatty acids, vitamins, and minerals (see\nTable 3-3\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the nutritional requirements for patients with short bowel syndrome who rely on TPN?  \n2. How does TPN address vitamin and mineral deficiencies in patients with congenital GI anomalies?  \n3. What dietary considerations are necessary for managing prolonged diarrhea in pediatric patients through TPN?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 88545da7-c36d-4887-a7d4-fe0cba76ef36
encoding: FLOAT32
metadata:
{"original_content": "Children who need TPN may have different fluid requirements and need more energy (up to\n120 kcal/kg/day) and amino acids (up to 2.5 or 3.5 g/kg/day).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the energy and amino acid requirements for children requiring Total Parenteral Nutrition (TPN)?  \n2. How do fluid requirements differ for children with nutritional disorders who are on TPN?  \n3. What is the recommended daily protein intake for children with metabolic disorders requiring TPN?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6c77ea0f-09de-4094-a4c7-84feef433d4f
encoding: FLOAT32
metadata:
{"original_content": "Basic TPN solutions are prepared using sterile techniques, usually in liter batches according to standard\nformulas.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How are Total Parenteral Nutrition (TPN) solutions formulated to address specific dietary deficiencies or metabolic disorders?  \n2. What sterile techniques are essential in preparing TPN solutions for patients with severe vitamin and mineral imbalances?  \n3. How do standard TPN formulas cater to the nutritional needs of individuals with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a4afa251-9a6b-4ada-8bc5-6a2c93b733f0
encoding: FLOAT32
metadata:
{"original_content": "Normally, 2 L/day of the standard solution is needed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How does the standard solution requirement of 2 L/day relate to managing specific nutritional disorders?  \n2. What are the potential consequences of consuming less than 2 L/day of the standard solution for individuals with dietary deficiencies?  \n3. Can exceeding the 2 L/day standard solution intake lead to complications in metabolic disorders or vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d0be7958-55d2-4697-8436-e5d14ac19bec
encoding: FLOAT32
metadata:
{"original_content": "Solutions may be modified based on\nlaboratory results, underlying disorders, hypermetabolism, or other factors.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How can laboratory results influence the dietary modifications needed for a patient with a nutritional disorder?  \n2. What role does hypermetabolism play in determining nutritional interventions for individuals with metabolic disorders?  \n3. How do underlying health conditions affect the management of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f2b5517d-e2ea-4226-9f85-e4018ec1aa41
encoding: FLOAT32
metadata:
{"original_content": "Most calories are supplied as carbohydrate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. How does a carbohydrate-dominant diet impact individuals with metabolic disorders such as diabetes?  \n2. Can excessive carbohydrate intake contribute to obesity and related health conditions?  \n3. What are the potential nutritional deficiencies associated with a diet where most calories are supplied as carbohydrates?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e4df47df-dca2-4680-aee1-fd4f450e1734
encoding: FLOAT32
metadata:
{"original_content": "Typically, about 4 to 5 mg/kg/day of dextrose is given.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What is the recommended daily dosage of dextrose for managing metabolic disorders?  \n2. How does the administration of 4 to 5 mg/kg/day of dextrose impact patients with dietary deficiencies?  \n3. Can dextrose supplementation at this dosage help address energy imbalances in individuals with obesity-related conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a15fdbfe-571f-43b3-aa36-7dc5c32c7bcf
encoding: FLOAT32
metadata:
{"original_content": "Standard solutions contain up to about 25% dextrose, but the amount and concentration depend on other\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What factors determine the appropriate concentration of dextrose in standard nutritional solutions for patients with metabolic disorders?  \n2. How does the concentration of dextrose in nutritional solutions impact the management of dietary deficiencies?  \n3. What role does dextrose play in addressing vitamin and mineral imbalances in clinical nutrition therapy?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4f0f53ba-6482-46e5-90ff-e33d0154746e
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n72", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 19, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 607aad6b-faef-4e9d-8df2-9290ecadf6fc
encoding: FLOAT32
metadata:
{"original_content": "factors, such as metabolic needs and the proportion of caloric needs that are supplied by lipids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How do metabolic needs influence the proportion of caloric intake that should be supplied by lipids in individuals with metabolic disorders?  \n2. What role do lipids play in addressing dietary deficiencies and preventing related nutritional disorders?  \n3. Can an imbalance in lipid intake contribute to obesity or other nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1fa5eb98-502a-4d4d-8172-b44899eaee99
encoding: FLOAT32
metadata:
{"original_content": "Commercially available lipid emulsions are often added to supply essential fatty acids and triglycerides;\n20 to 30% of total calories are usually supplied as lipids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How do commercially available lipid emulsions help address essential fatty acid deficiencies in patients with metabolic disorders?  \n2. What role do lipid emulsions play in managing dietary imbalances in individuals with malnutrition?  \n3. Can supplying 20 to 30% of total calories as lipids help prevent complications related to triglyceride deficiencies in patients with nutrition disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2236e108-07c2-43ca-bb65-656ffc652e75
encoding: FLOAT32
metadata:
{"original_content": "However, withholding lipids and their calories\nmay help obese patients mobilize endogenous fat stores, increasing insulin sensitivity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How does withholding dietary lipids impact the mobilization of endogenous fat stores in obese patients?  \n2. Can reducing lipid intake improve insulin sensitivity in individuals with obesity-related metabolic disorders?  \n3. What role do dietary lipids play in the management of obesity and related nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 23ea894f-8afa-42a0-afe0-1a8026f6d1b0
encoding: FLOAT32
metadata:
{"original_content": "Solutions:\n Many solutions are commonly used.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the common dietary solutions for addressing vitamin and mineral deficiencies?  \n2. How can metabolic disorders be managed through nutritional interventions?  \n3. What dietary strategies are effective in combating obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 23b24e5d-6831-4e13-a523-ca677a36a702
encoding: FLOAT32
metadata:
{"original_content": "Electrolytes can be added to meet the patient's needs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can electrolyte supplementation help address imbalances caused by metabolic disorders?  \n2. What role do electrolytes play in managing dietary deficiencies in patients with chronic health conditions?  \n3. Can adding electrolytes to a patient's diet improve outcomes in cases of severe vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fe0654a4-0c0d-4580-8fd4-b12e33b9302b
encoding: FLOAT32
metadata:
{"original_content": "Solutions vary depending on other disorders present and patient age, as for the following:\n\u2022 For renal insufficiency not being treated with dialysis or for liver failure: Reduced protein content and a\nhigh percentage of essential amino acids\n\u2022 For heart or kidney failure: Limited volume (liquid) intake\n\u2022 \nFor respiratory failure: A lipid emulsion that provides most of nonprotein calories to minimize CO\n2\nproduction by carbohydrate metabolism\n\u2022 For neonates: Lower dextrose concentrations (17 to 18%)\nBeginning TPN administration:\n Because the central venous catheter needs to remain in place for a\nlong time, strict sterile technique must be used during insertion and maintenance.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How should protein content be adjusted in the diet of a patient with renal insufficiency not undergoing dialysis?  \n2. What type of lipid emulsion is recommended for patients with respiratory failure to minimize CO2 production?  \n3. What are the appropriate dextrose concentrations for neonates requiring total parenteral nutrition (TPN)?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 33982869-024d-4ac3-bad7-943a1044e98a
encoding: FLOAT32
metadata:
{"original_content": "The TPN line should\nnot be used for any other purpose.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. Why is it important to avoid using the TPN line for purposes other than delivering total parenteral nutrition in patients with severe dietary deficiencies?  \n2. How could improper use of a TPN line impact the management of metabolic disorders or vitamin and mineral imbalances?  \n3. What are the potential risks to patients with nutrition-related health conditions if the TPN line is contaminated or repurposed?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9742868b-f130-4d39-bdff-1469d3c123ad
encoding: FLOAT32
metadata:
{"original_content": "External tubing should be changed every 24 h with the first bag of the\nday.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How often should external tubing be replaced to prevent complications in patients with metabolic disorders requiring enteral nutrition?  \n2. What is the recommended protocol for managing external tubing in patients with dietary deficiencies receiving tube feeding?  \n3. How does the 24-hour tubing replacement guideline help reduce risks of infection in individuals with nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0b5d37da-6d97-4cde-a70a-2d5d0d0fe1bb
encoding: FLOAT32
metadata:
{"original_content": "In-line filters have not been shown to decrease complications.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How effective are in-line filters in preventing complications related to parenteral nutrition?  \n2. Can in-line filters reduce the risk of metabolic imbalances in patients receiving intravenous nutrition?  \n3. Are in-line filters beneficial in managing vitamin or mineral deficiencies during intravenous feeding?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 87d56978-956c-477b-bbc1-eb178c3f18de
encoding: FLOAT32
metadata:
{"original_content": "Dressings should be kept sterile and\nare usually changed every 48 h using strict sterile techniques.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "[]"}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 04b2decc-55ed-49be-b710-e72817efc249
encoding: FLOAT32
metadata:
{"original_content": "If TPN is given outside the hospital,\npatients must be taught to recognize symptoms of infection, and qualified home nursing must be\narranged.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the potential risks of infection associated with administering Total Parenteral Nutrition (TPN) at home?  \n2. What training should patients receive to safely manage TPN outside of a hospital setting?  \n3. How can home nursing support help prevent complications related to TPN in patients with nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a9ae3670-c28d-42af-a65c-d9499b294b9e
encoding: FLOAT32
metadata:
{"original_content": "The solution is started slowly at 50% of the calculated requirements, using 5% dextrose to make up the\nbalance of fluid requirements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How should fluid and caloric requirements be adjusted when initiating treatment for a nutritional disorder?  \n2. What role does 5% dextrose play in managing fluid balance in patients with dietary deficiencies?  \n3. Why is it recommended to start nutritional solutions at 50% of calculated requirements in metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6ca4f925-c771-4195-ba91-d070bef092c5
encoding: FLOAT32
metadata:
{"original_content": "Energy and nitrogen should be given simultaneously.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. Why is it important to provide energy and nitrogen simultaneously in the management of protein-energy malnutrition?  \n2. How does the simultaneous administration of energy and nitrogen impact recovery in patients with metabolic disorders?  \n3. What are the potential risks of providing energy without nitrogen in individuals with severe dietary deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f40d30bd-f8f3-4482-80e3-3006e1ba5464
encoding: FLOAT32
metadata:
{"original_content": "The amount of\nregular insulin given (added directly to the TPN solution) depends on the plasma glucose level; if the\nlevel is normal and the final solution contains 25% dextrose, the usual starting dose is 5 to 10 units of\nregular insulin/L of TPN fluid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How is the dosage of regular insulin adjusted in a TPN solution for patients with normal plasma glucose levels?  \n2. What is the recommended starting dose of regular insulin per liter of TPN fluid when the solution contains 25% dextrose?  \n3. How does the dextrose concentration in a TPN solution influence insulin administration for managing plasma glucose levels?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c6e1e353-7186-4d4f-b259-f5e53d1c0c2b
encoding: FLOAT32
metadata:
{"original_content": "Monitoring:\n Progress should be followed on a flowchart.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can a flowchart be utilized to track the progress of a patient with a vitamin deficiency?  \n2. What steps should be included in a flowchart to monitor the management of obesity?  \n3. How can a flowchart help in assessing the effectiveness of dietary interventions for metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a09fd109-27fd-40f1-b2b0-638b90d99a77
encoding: FLOAT32
metadata:
{"original_content": "An interdisciplinary nutrition team, if available,\nshould monitor patients. Weight, CBC, electrolytes, and BUN should be monitored often (eg, daily for\ninpatients).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How frequently should weight and laboratory parameters like CBC, electrolytes, and BUN be monitored in inpatients with nutrition-related disorders?  \n2. What role does an interdisciplinary nutrition team play in managing patients with dietary deficiencies or metabolic imbalances?  \n3. Why is daily monitoring of specific health metrics important for inpatients with severe nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 27e4b18f-b5f6-4f7e-b99f-0dbb8e9f2c15
encoding: FLOAT32
metadata:
{"original_content": "Plasma glucose should be monitored every 6 h until patients and glucose levels become\nstable.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How frequently should plasma glucose levels be monitored in patients with unstable glucose levels due to a metabolic disorder?  \n2. What is the recommended monitoring protocol for managing glucose levels in patients with dietary deficiencies or related health conditions?  \n3. How can regular plasma glucose monitoring help stabilize patients with nutrition-related metabolic imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: af62d27c-6108-42c2-a025-702733a87d0a
encoding: FLOAT32
metadata:
{"original_content": "Fluid intake and output should be monitored continuously.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How does monitoring fluid intake and output help manage electrolyte imbalances in patients with metabolic disorders?  \n2. What role does fluid balance play in the treatment of dietary deficiencies and related health conditions?  \n3. Why is continuous monitoring of fluid intake and output critical for individuals with obesity-related complications?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a5225526-664f-4263-a712-fe1289b8447b
encoding: FLOAT32
metadata:
{"original_content": "When patients become stable, blood\ntests can be done much less often.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How frequently should blood tests be conducted for monitoring vitamin and mineral imbalances in stable patients?  \n2. What criteria determine when a patient with a metabolic disorder is considered stable enough for less frequent blood tests?  \n3. How does the frequency of blood tests impact the management of dietary deficiencies in long-term care?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c4847259-2fea-41ed-87e6-a9a72f09d230
encoding: FLOAT32
metadata:
{"original_content": "Liver function tests should be done.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can liver function tests help diagnose metabolic disorders related to obesity?  \n2. What role do liver function tests play in identifying vitamin and mineral imbalances?  \n3. Can liver function tests detect dietary deficiencies that contribute to liver-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 60e61a99-3ba9-4760-8365-ecb5c4b2c979
encoding: FLOAT32
metadata:
{"original_content": "Plasma proteins (eg, serum albumin, possibly transthyretin or retinol-\nbinding protein), PT, plasma and urine osmolality, and Ca, Mg, and phosphate should be measured\ntwice/wk.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can plasma protein levels, such as serum albumin, indicate the presence of a nutritional deficiency or metabolic disorder?  \n2. What role do calcium, magnesium, and phosphate measurements play in diagnosing vitamin and mineral imbalances?  \n3. Why is it important to monitor plasma and urine osmolality in patients with suspected dietary deficiencies or metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3b133fbf-0502-426d-8c93-4749c23c6d1b
encoding: FLOAT32
metadata:
{"original_content": "Changes in transthyretin and retinol-binding protein reflect overall clinical status rather than\nnutritional status alone.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How do changes in transthyretin and retinol-binding protein correlate with the progression of metabolic disorders?  \n2. Can transthyretin and retinol-binding protein levels be used to differentiate between nutritional deficiencies and other clinical conditions?  \n3. What role do transthyretin and retinol-binding protein play in assessing vitamin A status in patients with obesity or related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 062864f0-5ca8-4a41-9be0-61b560207a44
encoding: FLOAT32
metadata:
{"original_content": "If possible, blood tests should not be done during glucose infusion.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. Why is it recommended to avoid blood tests during glucose infusion in the context of diagnosing metabolic disorders?  \n2. How might glucose infusion interfere with the accuracy of blood test results for detecting vitamin or mineral imbalances?  \n3. What are the potential implications of conducting blood tests during glucose infusion for diagnosing dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ef29ebe1-759a-4bb7-b09f-9e5796cfbc26
encoding: FLOAT32
metadata:
{"original_content": "Full nutritional\nassessment (including BMI calculation and anthropometric measurements\u2014see pp.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can anthropometric measurements help identify obesity-related health risks?  \n2. What role does BMI calculation play in diagnosing nutritional deficiencies or imbalances?  \n3. How can a full nutritional assessment detect vitamin and mineral deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c1da618f-ee43-40f8-9aa2-aa372aea05d0
encoding: FLOAT32
metadata:
{"original_content": "11\n and \n58\n) should be\nrepeated at 2-wk intervals.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What is the recommended frequency for monitoring nutritional deficiencies in patients with specific dietary imbalances?  \n2. How often should follow-up evaluations be conducted for individuals undergoing treatment for a metabolic disorder?  \n3. What is the suggested interval for reassessing vitamin or mineral levels in cases of suspected deficiency?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ed2dac11-630c-4855-b747-4b14c971df10
encoding: FLOAT32
metadata:
{"original_content": "Complications:\n About 5 to 10% of patients have complications related to central venous access.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the potential complications associated with central venous access in the treatment of nutritional disorders?  \n2. How does central venous access impact the management of severe dietary deficiencies or metabolic disorders?  \n3. What precautions can be taken to minimize complications from central venous access in patients with vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 384e61ff-3594-4115-9748-7d8339d3f151
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 3-3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the common dietary deficiencies associated with specific metabolic disorders?  \n2. How do vitamin and mineral imbalances contribute to the development of obesity-related health conditions?  \n3. What are the nutritional interventions recommended for managing specific vitamin deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 513f67b5-ad47-4369-80bc-429d256e21c0
encoding: FLOAT32
metadata:
{"original_content": "Basic Adult Daily Requirements for Total Parenteral Nutrition]\nCatheter-related sepsis occurs in about \u2265 50% of patients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the basic daily nutritional requirements for adults receiving total parenteral nutrition?  \n2. How does catheter-related sepsis impact the nutritional management of patients on total parenteral nutrition?  \n3. What adjustments in total parenteral nutrition might be necessary to address complications like catheter-related sepsis?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f3a11801-6159-43c3-9e52-e025c0f0b9bb
encoding: FLOAT32
metadata:
{"original_content": "Glucose abnormalities (hyperglycemia or\nhypoglycemia) or liver dysfunction occurs in > 90% of patients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How do glucose abnormalities like hyperglycemia or hypoglycemia relate to liver dysfunction in patients with metabolic disorders?  \n2. What dietary interventions can help manage glucose abnormalities in patients with liver dysfunction?  \n3. Are there specific nutritional deficiencies that exacerbate the relationship between liver dysfunction and glucose regulation issues?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f430fb1f-c230-4274-860d-aa0027723446
encoding: FLOAT32
metadata:
{"original_content": "Glucose abnormalities\n are common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the potential dietary causes of glucose abnormalities?  \n2. How do glucose abnormalities relate to metabolic disorders like diabetes?  \n3. What nutritional interventions can help manage or prevent glucose abnormalities?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 329aa6ee-cb4c-4ab3-b461-6d4a69e44bc4
encoding: FLOAT32
metadata:
{"original_content": "Hyperglycemia can be avoided by monitoring plasma glucose\noften, adjusting the insulin dose in the TPN solution and giving subcutaneous insulin as needed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How can hyperglycemia be managed in patients receiving total parenteral nutrition (TPN)?  \n2. What role does insulin play in preventing hyperglycemia in individuals with metabolic disorders?  \n3. Why is frequent plasma glucose monitoring important for patients with nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 154558fd-ded4-4a99-8165-dfb7d5d4acaf
encoding: FLOAT32
metadata:
{"original_content": "Hypoglycemia can be precipitated by suddenly stopping constant concentrated dextrose infusions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the potential consequences of abruptly discontinuing concentrated dextrose infusions in patients with metabolic disorders?  \n2. How does the sudden cessation of dextrose infusions contribute to the development of hypoglycemia?  \n3. What nutritional management strategies can prevent hypoglycemia when stopping dextrose infusions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 787e210c-5dca-4294-95cb-fd5a44cf24cc
encoding: FLOAT32
metadata:
{"original_content": "Treatment depends on the degree of hypoglycemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. How does the severity of hypoglycemia influence the choice of treatment?  \n2. What dietary adjustments are recommended for managing different levels of hypoglycemia?  \n3. Are there specific nutritional interventions for mild versus severe hypoglycemia?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f717d692-b184-43c5-9337-28d97e451dea
encoding: FLOAT32
metadata:
{"original_content": "Short-term hypoglycemia may be reversed with 50%\ndextrose IV; more prolonged hypoglycemia may require infusion of 5 or 10% dextrose for 24 h before\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What is the recommended treatment for short-term hypoglycemia in a clinical setting?  \n2. How should prolonged hypoglycemia be managed using dextrose infusions?  \n3. What are the differences in dextrose concentration used for short-term versus prolonged hypoglycemia treatment?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d404ff61-898b-4132-8163-9848b8521f69
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n73", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 20, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c765c2b-4534-496f-9a41-998b8d43c442
encoding: FLOAT32
metadata:
{"original_content": "resuming TPN via the central venous catheter.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential risks of resuming total parenteral nutrition (TPN) in patients with severe vitamin or mineral imbalances?  \n2. How does the use of a central venous catheter for TPN address metabolic disorders caused by dietary deficiencies?  \n3. What precautions should be taken when resuming TPN in patients with obesity-related complications?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3f0d4b4a-1e4e-4891-bfa6-4b045c22ea7d
encoding: FLOAT32
metadata:
{"original_content": "Hepatic complications\n include liver dysfunction, painful hepatomegaly, and hyperammonemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does liver dysfunction impact the metabolism of nutrients in individuals with hepatic complications?  \n2. What dietary interventions can help manage hyperammonemia in patients with liver-related nutritional disorders?  \n3. Can vitamin or mineral imbalances contribute to the development of painful hepatomegaly in metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0fa55d04-3eed-4af6-a4bb-700c135f69f2
encoding: FLOAT32
metadata:
{"original_content": "They can\ndevelop at any age but are most common among infants, particularly premature ones (whose liver is\nimmature).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. Why are premature infants more susceptible to certain nutritional disorders?  \n2. How does an immature liver in infants contribute to the development of metabolic disorders?  \n3. What specific nutritional deficiencies are most common in premature infants?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4dcd9657-56fe-4aab-9c14-90963e3a8bfc
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Liver dysfunction may be transient, evidenced by increased transaminases, bilirubin, and alkaline\nphosphatase; it commonly occurs when TPN is started.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the common biochemical markers indicating liver dysfunction when Total Parenteral Nutrition (TPN) is initiated?  \n2. How does the initiation of TPN contribute to transient liver dysfunction in patients?  \n3. What role do elevated transaminases, bilirubin, and alkaline phosphatase play in diagnosing nutrition-related liver disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5cef6501-38ba-43b9-899f-218a9501f8b6
encoding: FLOAT32
metadata:
{"original_content": "Delayed or persistent elevations may result\nfrom excess amino acids.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can excess amino acids contribute to delayed or persistent elevations in metabolic disorders?  \n2. What are the potential health risks associated with prolonged elevated amino acid levels in the body?  \n3. Could dietary imbalances leading to excess amino acids result in specific nutritional or metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fee020c2-cb78-43bf-ab1c-7d48ee99ed6d
encoding: FLOAT32
metadata:
{"original_content": "Pathogenesis is unknown, but cholestasis and inflammation may contribute.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How might cholestasis contribute to the development of nutritional disorders?  \n2. What role does inflammation play in the progression of metabolic disorders?  \n3. Could cholestasis and inflammation together lead to vitamin or mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 51a0175a-560d-417c-a188-5837e801e008
encoding: FLOAT32
metadata:
{"original_content": "Progressive fibrosis occasionally develops.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to the development of progressive fibrosis in certain nutritional disorders?  \n2. What role do vitamin and mineral imbalances play in the progression of fibrosis in metabolic disorders?  \n3. Are there specific nutritional interventions that can prevent or slow the progression of fibrosis in obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c2f338e9-6ff7-49a3-b0bf-2ddba0df7bfe
encoding: FLOAT32
metadata:
{"original_content": "Reducing protein delivery may help.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can reducing protein intake impact the management of certain metabolic disorders?  \n2. Are there specific nutritional disorders where lowering protein consumption is recommended?  \n3. What role does protein reduction play in addressing imbalances caused by dietary deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ac49858e-1809-4aa7-8922-9595571ca30b
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Painful hepatomegaly suggests fat accumulation; carbohydrate delivery should be reduced.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does reducing carbohydrate intake help manage fat accumulation in the liver associated with painful hepatomegaly?  \n2. What dietary adjustments are recommended for individuals experiencing painful hepatomegaly due to fat accumulation?  \n3. What is the relationship between carbohydrate delivery and liver fat accumulation in metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 70061a3b-eef6-43f4-a566-702efe190e7a
encoding: FLOAT32
metadata:
{"original_content": "\u2022 Hyperammonemia can develop in infants, causing lethargy, twitching, and generalized seizures.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential metabolic causes of hyperammonemia in infants?  \n2. How can dietary management help prevent or treat hyperammonemia in infants?  \n3. What are the nutritional implications of seizures caused by hyperammonemia in infants?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f678537d-2c1c-4989-a2a6-3d6853d354bf
encoding: FLOAT32
metadata:
{"original_content": "Arginine\nsupplementation at 0.5 to 1.0 mmol/kg/day can correct it.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can arginine supplementation be used to address specific nutritional or metabolic disorders?  \n2. What is the recommended dosage of arginine supplementation for correcting certain dietary deficiencies?  \n3. Are there specific health conditions related to arginine deficiency that can be managed with supplementation at 0.5 to 1.0 mmol/kg/day?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 86e2eebe-2c69-4126-816d-10d99bd57c97
encoding: FLOAT32
metadata:
{"original_content": "If infants develop any hepatic complication, limiting amino acids to 1.0 g/kg/day may be necessary.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does limiting amino acid intake to 1.0 g/kg/day impact infants with hepatic complications?  \n2. What are the potential risks of excessive amino acid consumption in infants with liver disorders?  \n3. Are there specific amino acids that should be prioritized or avoided in the diet of infants with hepatic complications?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1af4380c-1cbf-41cb-975f-228034f216f1
encoding: FLOAT32
metadata:
{"original_content": "Abnormalities of serum electrolytes and minerals\n should be corrected by modifying subsequent\ninfusions or, if correction is urgently required, by beginning appropriate peripheral vein infusions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can abnormalities in serum electrolytes and minerals be corrected in patients with nutritional disorders?  \n2. What is the role of peripheral vein infusions in addressing urgent mineral imbalances?  \n3. How should infusion protocols be modified to manage electrolyte abnormalities in metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4d9e9f93-169a-4aa2-adbc-f3e0d6405da5
encoding: FLOAT32
metadata:
{"original_content": "Vitamin\nand mineral deficiencies are rare when solutions are given correctly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can proper solutions prevent vitamin and mineral deficiencies?  \n2. What are the potential outcomes of addressing dietary deficiencies correctly?  \n3. Why are vitamin and mineral deficiencies considered rare when appropriate interventions are applied?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4b07d35f-96d8-480e-9b4d-cda99c54df05
encoding: FLOAT32
metadata:
{"original_content": "Elevated BUN may reflect\ndehydration, which can be corrected by giving free water as 5% dextrose via a peripheral vein.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can elevated BUN levels caused by dehydration be managed nutritionally?  \n2. What role does 5% dextrose play in addressing dehydration-related metabolic imbalances?  \n3. How does dehydration impact nutritional and metabolic health markers like BUN?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ba1821f6-f858-49c1-993c-ef61a74823a4
encoding: FLOAT32
metadata:
{"original_content": "Volume overload\n (suggested by > 1 kg/day weight gain) may occur when patients have high daily\nenergy requirements and thus require large fluid volumes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can high daily energy requirements contribute to volume overload in patients?  \n2. What are the potential risks of rapid weight gain (>1 kg/day) in individuals with nutritional disorders?  \n3. How should fluid volumes be managed in patients with high energy needs to prevent volume overload?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9b0024ce-79f3-40fe-b046-de5a3c68c702
encoding: FLOAT32
metadata:
{"original_content": "Metabolic bone disease\n, or bone demineralization (osteoporosis or osteomalacia), develops in some\npatients given TPN for > 3 mo.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies associated with long-term total parenteral nutrition (TPN) that could lead to metabolic bone disease?  \n2. How does prolonged TPN use contribute to the development of osteoporosis or osteomalacia?  \n3. What dietary or supplemental interventions can help prevent bone demineralization in patients receiving TPN for more than three months?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2ee7d222-64b7-4ee7-a0bd-360ba3d8cadc
encoding: FLOAT32
metadata:
{"original_content": "The mechanism is unknown.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential unknown mechanisms behind certain vitamin and mineral imbalances?  \n2. How might unidentified mechanisms contribute to the development of metabolic disorders?  \n3. Could an unknown mechanism explain the link between dietary deficiencies and specific health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b76053d0-e58f-40b1-bed5-02cdec1f887f
encoding: FLOAT32
metadata:
{"original_content": "Advanced disease can cause severe\nperiarticular, lower-extremity, and back pain.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can advanced nutritional deficiencies contribute to severe periarticular and lower-extremity pain?  \n2. What role do vitamin or mineral imbalances play in the development of back pain associated with advanced disease?  \n3. Could metabolic disorders linked to poor nutrition exacerbate pain in the lower extremities and back?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2eed9e9b-d155-4181-ad1c-917a67a9b3ac
encoding: FLOAT32
metadata:
{"original_content": "Temporarily or permanently stopping TPN is the only known\ntreatment.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential treatments for complications arising from Total Parenteral Nutrition (TPN)?  \n2. How can stopping TPN impact the management of metabolic disorders?  \n3. Are there any dietary alternatives to TPN for addressing severe nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 39817016-287c-4c53-aa31-f50e0b2e005d
encoding: FLOAT32
metadata:
{"original_content": "Adverse reactions to lipid emulsions\n (eg, dyspnea, cutaneous allergic reactions, nausea, headache,\nback pain, sweating, dizziness) are uncommon but may occur early, particularly if lipids are given at > 1.0\nkcal/kg/h.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential adverse reactions to lipid emulsions when administered at high infusion rates?  \n2. How does the infusion rate of lipid emulsions influence the likelihood of adverse reactions in patients?  \n3. What symptoms might indicate an adverse reaction to lipid emulsions in patients with metabolic or nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 05f29016-ab2c-4c7c-918c-b494151f9892
encoding: FLOAT32
metadata:
{"original_content": "Temporary hyperlipidemia may occur, particularly in patients with kidney or liver failure;\ntreatment is usually not required.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does kidney or liver failure contribute to temporary hyperlipidemia?  \n2. Why is treatment usually not required for temporary hyperlipidemia in patients with kidney or liver failure?  \n3. What are the potential nutritional or metabolic implications of temporary hyperlipidemia in patients with organ failure?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c4e1011-c78a-4e2a-8953-64f031fd9a77
encoding: FLOAT32
metadata:
{"original_content": "Delayed adverse reactions to lipid emulsions include hepatomegaly, mild\nelevation of liver enzymes, splenomegaly, thrombocytopenia, leukopenia, and, especially in premature\ninfants with respiratory distress syndrome, pulmonary function abnormalities.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the potential delayed adverse effects of lipid emulsions in premature infants with respiratory distress syndrome?  \n2. How can lipid emulsions contribute to hepatomegaly and mild elevation of liver enzymes in patients?  \n3. What is the relationship between lipid emulsions and hematological abnormalities such as thrombocytopenia and leukopenia?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5d8858fa-2c4c-4af0-9b5b-6346330fee1b
encoding: FLOAT32
metadata:
{"original_content": "Temporarily or permanently\nslowing or stopping lipid emulsion infusion may prevent or minimize these adverse reactions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can adjusting lipid emulsion infusion rates help manage adverse reactions in patients with metabolic disorders?  \n2. What are the potential risks of lipid emulsion infusions in individuals with dietary deficiencies or imbalances?  \n3. In what scenarios should lipid emulsion infusions be temporarily or permanently stopped to prevent complications in nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 003460a8-32e9-41a3-9697-5bc6f69fd46e
encoding: FLOAT32
metadata:
{"original_content": "Gallbladder complications\n include cholelithiasis, gallbladder sludge, and cholecystitis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can gallbladder sludge be influenced by dietary habits or nutritional deficiencies?  \n2. What role do metabolic disorders play in the development of cholelithiasis?  \n3. Are there specific vitamin or mineral imbalances that contribute to the risk of cholecystitis?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a0653a63-e6e0-4f68-ab47-d1d299f680b7
encoding: FLOAT32
metadata:
{"original_content": "These\ncomplications can be caused or worsened by prolonged gallbladder stasis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does prolonged gallbladder stasis contribute to the development of nutritional deficiencies or malabsorption disorders?  \n2. Can gallbladder stasis lead to metabolic imbalances or exacerbate conditions like obesity?  \n3. What role does gallbladder stasis play in the disruption of fat-soluble vitamin absorption (e.g., vitamins A, D, E, and K)?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 27459646-bea7-4db0-a58e-598b640a2ca9
encoding: FLOAT32
metadata:
{"original_content": "Stimulating contraction by\nproviding about 20 to 30% of calories as fat and stopping glucose infusion several hours a day is helpful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does providing 20 to 30% of calories as fat impact metabolic disorders related to glucose metabolism?  \n2. Why is stopping glucose infusion for several hours beneficial in managing certain nutritional or metabolic disorders?  \n3. What role does dietary fat play in stimulating muscle contraction in individuals with specific nutritional imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a81d0050-d380-4dba-ab68-f6867b049ef3
encoding: FLOAT32
metadata:
{"original_content": "Oral or enteral intake also helps. Treatment with metronidazole, ursodeoxycholic acid, phenobarbital, or\ncholecystokinin helps some patients with cholestasis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can oral or enteral intake support patients with cholestasis?  \n2. What role does metronidazole play in the treatment of cholestasis?  \n3. Are there specific dietary or pharmacological interventions for managing cholestasis-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 818dabfa-8001-47b4-accb-49dd42b92336
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support for Dying or Severely Demented Patients\nAnorexia or loss of appetite is common among dying patients (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the nutritional considerations for managing anorexia in dying patients?  \n2. How can dietary support be tailored for patients with severe dementia experiencing appetite loss?  \n3. What are the potential risks of vitamin and mineral imbalances in patients with advanced illness?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c8f0ea28-1a5a-4b0a-89b2-74998a857971
encoding: FLOAT32
metadata:
{"original_content": "3485\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of dietary deficiencies in specific vitamins or minerals?  \n2. How do metabolic disorders impact the body's ability to process nutrients effectively?  \n3. What are the potential health risks associated with prolonged vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 10b0e516-7b51-4835-8122-290c426f7d69
encoding: FLOAT32
metadata:
{"original_content": "Behavioral measures (eg,\nusing flexible feeding schedules, feeding slowly, giving small portions or favorite or strongly flavored\nfoods) can often increase oral intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can flexible feeding schedules help improve oral intake in individuals with nutritional disorders?  \n2. What role do strongly flavored foods play in managing dietary deficiencies?  \n3. Are small portion sizes effective in addressing feeding challenges associated with metabolic disorders?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cee85147-a6d5-470f-8e0a-cfa30c777877
encoding: FLOAT32
metadata:
{"original_content": "A small amount of a favorite alcoholic drink, given 30 min before\nmeals, may also help.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can small amounts of alcohol consumed before meals impact appetite in individuals with nutritional disorders?  \n2. Is moderate alcohol consumption beneficial for managing certain metabolic disorders or dietary deficiencies?  \n3. Can alcohol play a role in improving nutrient absorption or digestion in cases of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6fbf5f51-32e5-4036-b0c4-0dda146796d2
encoding: FLOAT32
metadata:
{"original_content": "Certain antidepressants, megestrol acetate, and dronabinol may stimulate appetite.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How can certain medications like antidepressants influence appetite in individuals with nutritional disorders?  \n2. Could megestrol acetate be used to address appetite loss in patients with metabolic disorders or dietary deficiencies?  \n3. What role does dronabinol play in managing appetite-related issues in individuals with obesity or vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3de0371c-8725-4b00-91a9-ab9a3712a105
encoding: FLOAT32
metadata:
{"original_content": "Metoclopramide enhances gastric emptying, but it may take 1 to 2 wk to reach peak effectiveness.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. How does delayed gastric emptying impact the management of nutritional disorders?  \n2. Can metoclopramide be used to address malnutrition caused by gastroparesis?  \n3. What is the timeline for metoclopramide to improve nutrient absorption in patients with gastric motility issues?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3f7debd5-298b-4f7f-982d-41baacf22176
encoding: FLOAT32
metadata:
{"original_content": "Advanced dementia eventually leads to inability to eat; sometimes affected patients are given tube\nfeedings.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the nutritional implications of advanced dementia leading to an inability to eat?  \n2. How does tube feeding address dietary deficiencies in patients with advanced dementia?  \n3. What are the potential risks of vitamin and mineral imbalances in dementia patients who rely on tube feeding?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2514f4ff-2f09-4a3f-9849-3370d5ccdf72
encoding: FLOAT32
metadata:
{"original_content": "However, there is no convincing evidence that tube feedings prolong life, provide comfort,\nimprove function, or prevent complications (eg, aspiration, pressure ulcers).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. Do tube feedings help prevent complications such as aspiration or pressure ulcers in patients with nutritional disorders?  \n2. Can tube feedings improve functional outcomes in individuals with dietary deficiencies or metabolic disorders?  \n3. Is there evidence that tube feedings provide comfort or prolong life in patients with severe vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b7792970-fc33-4d38-896b-c6cd4ee4a514
encoding: FLOAT32
metadata:
{"original_content": "Tube feedings and parenteral nutrition cause discomfort and are usually not indicated for patients who\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the specific conditions under which tube feedings and parenteral nutrition are contraindicated in patients with metabolic disorders?  \n2. How do dietary deficiencies influence the decision to avoid tube feedings or parenteral nutrition in certain patients?  \n3. What alternative nutritional strategies are recommended for patients with vitamin and mineral imbalances who cannot tolerate tube feedings or parenteral nutrition?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bd71e991-2df6-43d4-95d1-4dd296257ecf
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n74", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 21, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1999339e-a23c-4b84-8f23-ae9664135ca5
encoding: FLOAT32
metadata:
{"original_content": "are dying or too demented to eat.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. What are the nutritional consequences of severe dementia on a person's ability to maintain a balanced diet?  \n2. How does the inability to eat due to advanced illness contribute to vitamin and mineral deficiencies?  \n3. What metabolic disorders can arise in individuals who are unable to consume adequate nutrition due to physical or cognitive decline?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d7444976-d427-4926-b735-bbc34aa9e290
encoding: FLOAT32
metadata:
{"original_content": "Forgoing nutritional support may be difficult for family members to\naccept, but they should understand that patients are usually more comfortable eating and drinking as they\nchoose.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. How can family members support a patient with a nutritional disorder in making their own dietary choices?  \n2. What are the potential benefits of allowing patients with metabolic disorders to eat and drink according to their preferences?  \n3. How does forgoing nutritional support impact the comfort and well-being of patients with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:28
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0df00f6e-1025-4c17-ad7e-9f8a76997377
encoding: FLOAT32
metadata:
{"original_content": "Sips of water and easy-to-swallow foods may be useful. Supportive care, including good oral\nhygiene (eg, brushing the teeth, moistening the oral cavity with swabs and ice chips as needed, applying\nlip salve), can physically and psychologically comfort the patients and the family members who provide\nthe care.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. How can supportive care practices like oral hygiene and hydration aid patients with nutritional disorders?  \n2. What dietary strategies can help individuals with difficulty swallowing due to a nutritional or metabolic disorder?  \n3. How can family members provide comfort to patients with dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2033c461-957b-4b2b-961a-d3e57348b4d7
encoding: FLOAT32
metadata:
{"original_content": "Counseling may help family members who are dealing with anxieties about whether to use invasive\nnutritional support.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. How can counseling assist families in deciding whether to pursue invasive nutritional support for a loved one with a severe metabolic disorder?  \n2. What role does counseling play in addressing anxieties related to managing dietary deficiencies in patients requiring invasive nutritional interventions?  \n3. How can family counseling help alleviate concerns about the long-term effects of invasive nutritional support in individuals with chronic vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c10a6fc6-c429-45c8-8ebc-503d34fe9656
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 3.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated nutritionally?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 71b04542-9d0a-4070-8d28-a67bb32f7fda
encoding: FLOAT32
metadata:
{"original_content": "Nutritional Support\n75", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 22, "type": "text ", "chroma:document": "1. What are the recommended dietary interventions for managing vitamin and mineral imbalances?  \n2. How can nutritional support aid in the treatment of metabolic disorders?  \n3. What role does diet play in addressing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 67d44bf6-d4a0-474c-bd37-cbf371687a51
encoding: FLOAT32
metadata:
{"original_content": "Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the nutritional factors that can lead to obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1128a8fb-0e53-436a-977a-e0873c83b108
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency, and Toxicity\nIntroduction\nVitamins may be fat soluble (vitamins A, D, E, and K) or water soluble (B vitamins and vitamin C).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in fat-soluble vitamins like A, D, E, and K?  \n2. How does vitamin dependency differ from vitamin deficiency in terms of metabolic disorders?  \n3. What are the symptoms and risks associated with vitamin toxicity from excessive intake of water-soluble vitamins like B vitamins and vitamin C?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0de76c57-e1e7-4633-a9ce-2f229f257c58
encoding: FLOAT32
metadata:
{"original_content": "The B\nvitamins include biotin, folate, niacin, pantothenic acid, riboflavin (B\n2\n), thiamin (B\n1\n), B\n6\n (eg, pyridoxine),\nand B\n12\n (cobalamins).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health consequences of a deficiency in vitamin B12 (cobalamins)?  \n2. How does a lack of niacin contribute to the development of pellagra?  \n3. What role does thiamin (B1) play in preventing metabolic disorders like beriberi?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48055b3c-0102-46f4-b881-923e097e0033
encoding: FLOAT32
metadata:
{"original_content": "For dietary requirements, sources, functions, effects of deficiencies and toxicities,\nblood levels, and usual therapeutic dosages for vitamins, see\nTables 4-1\n and\n4-2\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the effects of vitamin deficiencies on metabolic disorders?  \n2. What are the usual therapeutic dosages for vitamins to address dietary deficiencies?  \n3. What are the potential toxicities associated with excessive intake of specific vitamins or minerals?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b085ad11-77db-46ee-8898-979c1573f3ff
encoding: FLOAT32
metadata:
{"original_content": "Dietary requirements for vitamins (and other nutrients) are expressed as daily recommended intake (DRI).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What is the recommended daily intake of specific vitamins to prevent deficiencies and associated nutritional disorders?  \n2. How can inadequate daily intake of certain nutrients contribute to metabolic disorders or vitamin imbalances?  \n3. What role does meeting the daily recommended intake of minerals play in managing obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ca630c1-9774-40f9-9e08-536739d28dbf
encoding: FLOAT32
metadata:
{"original_content": "There are 3 types of DRI:\n\u2022 \nRecommended daily allowance (RDA):\n RDAs are set to meet the needs of 97 to 98% of healthy\npeople.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How can the Recommended Daily Allowance (RDA) help prevent vitamin and mineral deficiencies in individuals with metabolic disorders?  \n2. What role does the RDA play in addressing dietary deficiencies linked to obesity-related health conditions?  \n3. How can the RDA be used to manage nutrient imbalances in individuals with specific nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 62d7db94-295b-486b-8c6c-4e6df6f1a6b3
encoding: FLOAT32
metadata:
{"original_content": "\u2022 \nAdequate intake (AI):\n When data to calculate an RDA are insufficient, AIs are based on observed or\nexperimentally determined estimates of nutrient intake by healthy people.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How is Adequate Intake (AI) determined for nutrients when Recommended Dietary Allowances (RDAs) cannot be established?  \n2. What role does Adequate Intake (AI) play in preventing dietary deficiencies and related health conditions?  \n3. How can Adequate Intake (AI) guidelines help address vitamin and mineral imbalances in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 891a1316-032d-451f-9688-b0c37ff57293
encoding: FLOAT32
metadata:
{"original_content": "\u2022 \nTolerable upper intake level (UL):\n ULs are the largest amount of a nutrient that most adults can\ningest daily without risk of adverse health effects.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health risks of exceeding the tolerable upper intake level (UL) for a specific vitamin or mineral?  \n2. How can exceeding the UL of a nutrient contribute to metabolic disorders or vitamin and mineral imbalances?  \n3. What role does the UL play in preventing dietary deficiencies and obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 67c93107-0af9-4732-8c3d-2064580aea18
encoding: FLOAT32
metadata:
{"original_content": "In developed countries, vitamin deficiencies result mainly from poverty, food faddism, drugs (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How do poverty and food faddism contribute to vitamin deficiencies in developed countries?  \n2. What role do certain drugs play in causing nutritional disorders or vitamin imbalances?  \n3. What are the primary causes of dietary deficiencies in developed nations?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 06f7964b-4c06-4894-ba8a-375e870f68ba
encoding: FLOAT32
metadata:
{"original_content": "7\n and\nTable 4-3\n), alcoholism, or prolonged and inadequately supplemented parenteral feeding. Mild vitamin\ndeficiency is common among frail and institutionalized elderly people who have protein-energy\nundernutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does prolonged and inadequately supplemented parenteral feeding contribute to vitamin deficiencies?  \n2. What are the nutritional challenges faced by frail and institutionalized elderly individuals with protein-energy undernutrition?  \n3. What is the relationship between alcoholism and the development of vitamin deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9a331555-44ef-4e6e-920f-581d781a3ff3
encoding: FLOAT32
metadata:
{"original_content": "In developing countries, deficiencies can result from lack of access to nutrients.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the common nutritional deficiencies observed in developing countries due to limited access to nutrients?  \n2. How does lack of access to essential vitamins and minerals contribute to metabolic disorders in developing regions?  \n3. What health conditions are linked to dietary deficiencies in populations with restricted nutrient availability?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a18f7d41-4f87-43f8-8d0b-a8109f67b7e2
encoding: FLOAT32
metadata:
{"original_content": "Deficiencies of water-soluble vitamins (except vitamin B\n12\n) may develop after weeks to months of\nundernutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How quickly can deficiencies of water-soluble vitamins (excluding vitamin B12) manifest due to undernutrition?  \n2. What are the potential health consequences of prolonged undernutrition leading to water-soluble vitamin deficiencies?  \n3. Why does vitamin B12 deficiency develop at a different rate compared to other water-soluble vitamins during undernutrition?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b6b6e9f5-ca7e-4a55-9d01-42fccea5f2a5
encoding: FLOAT32
metadata:
{"original_content": "Deficiencies of fat-soluble vitamins and of vitamin B\n12\n take > 1 yr to develop because the\nbody stores them in relatively large amounts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. Why do deficiencies of fat-soluble vitamins take longer to develop compared to water-soluble vitamins?  \n2. How does the body's storage capacity for vitamin B12 impact the timeline for deficiency symptoms to appear?  \n3. What factors contribute to the prolonged development of nutritional disorders related to fat-soluble vitamins and vitamin B12?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f0c310fe-e422-4464-a371-891de297e506
encoding: FLOAT32
metadata:
{"original_content": "Intake of vitamins sufficient to prevent classic vitamin\ndeficiencies (like scurvy or beriberi) may not be adequate for optimum health.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does the minimum intake of vitamins required to prevent classic deficiencies differ from the intake needed for optimal health?  \n2. Can insufficient vitamin intake, even if it prevents classic deficiencies, contribute to the development of other metabolic or nutritional disorders?  \n3. What are the potential health risks associated with consuming only the minimum amount of vitamins necessary to avoid conditions like scurvy or beriberi?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bd312e02-3e85-40b0-ae93-33e20bb67fa8
encoding: FLOAT32
metadata:
{"original_content": "This area remains one of\ncontroversy and active research.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the current controversies surrounding the role of specific nutrients in the development of metabolic disorders?  \n2. How do vitamin and mineral imbalances contribute to the progression of dietary deficiency-related health conditions?  \n3. What are the emerging areas of research in understanding the link between obesity and nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c32f9d13-7e7c-44a1-b17f-d8a10e32030b
encoding: FLOAT32
metadata:
{"original_content": "Vitamin dependency results from a genetic defect involving metabolism of a vitamin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does a genetic defect in vitamin metabolism lead to vitamin dependency?  \n2. What are the potential health consequences of untreated vitamin dependency caused by metabolic disorders?  \n3. Can dietary interventions help manage vitamin dependency resulting from genetic defects?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c050e77-dccd-4f3f-83a4-ee251905b850
encoding: FLOAT32
metadata:
{"original_content": "In some cases,\nvitamin doses as high as 1000 times the DRI improve function of the altered metabolic pathway.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How can extremely high doses of vitamins impact the function of altered metabolic pathways in certain nutritional disorders?  \n2. What are the potential benefits and risks of administering vitamin doses significantly exceeding the DRI for treating metabolic disorders?  \n3. In what specific cases might high-dose vitamin therapy be considered effective for correcting dietary deficiencies or metabolic imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9cbc199-c665-4ddc-a3a9-da946afb6959
encoding: FLOAT32
metadata:
{"original_content": "Vitamin\ntoxicity (hypervitaminosis) usually results from taking megadoses of vitamin A, D, C, B\n6\n, or niacin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health risks associated with megadoses of vitamin A, D, C, B6, or niacin?  \n2. How does hypervitaminosis differ between fat-soluble and water-soluble vitamins?  \n3. What symptoms might indicate vitamin toxicity from excessive intake of niacin or vitamin B6?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 70dd01da-633c-4854-8b75-c6b8d0d082e9
encoding: FLOAT32
metadata:
{"original_content": "Because many people eat irregularly, foods alone may provide suboptimal amounts of some vitamins.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How can irregular eating patterns contribute to vitamin deficiencies and related nutritional disorders?  \n2. What are the potential health risks of consuming suboptimal amounts of vitamins due to poor dietary habits?  \n3. Which vitamins are most commonly affected by irregular eating habits, and how can this lead to metabolic imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7c85bee2-7eed-4cba-95d4-02200c6b08f9
encoding: FLOAT32
metadata:
{"original_content": "In\nthese cases, the risk of certain cancers or other disorders may be increased.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to an increased risk of certain cancers?  \n2. What role do metabolic disorders play in the development of other health conditions?  \n3. How might vitamin and mineral imbalances influence the likelihood of developing chronic diseases?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 477bffcc-0c77-40af-b121-36b7b9299cd2
encoding: FLOAT32
metadata:
{"original_content": "Because of this risk, routine\ndaily multivitamin supplements are sometimes recommended.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. Why are routine daily multivitamin supplements recommended for individuals at risk of dietary deficiencies?  \n2. How can multivitamin supplements help prevent vitamin and mineral imbalances in people with metabolic disorders?  \n3. What role do multivitamin supplements play in managing nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bc242d1a-69f1-400e-a3ab-bd02fb45e69a
encoding: FLOAT32
metadata:
{"original_content": "Biotin and Pantothenic Acid\nBiotin acts as a coenzyme for carboxylation reactions essential to fat and carbohydrate metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does a deficiency in biotin affect carbohydrate metabolism and contribute to metabolic disorders?  \n2. What role does biotin play in preventing nutritional disorders related to fat metabolism?  \n3. Can a lack of pantothenic acid lead to specific vitamin imbalances or health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8af02d5b-429b-47af-b475-85b6d4483a07
encoding: FLOAT32
metadata:
{"original_content": "Adequate intake for adults is 30 \n\u03bc\ng/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health consequences of not meeting the adequate intake of 30 \u03bcg/day for adults?  \n2. How does a deficiency in this nutrient contribute to specific metabolic or dietary disorders?  \n3. What dietary sources can help adults meet the recommended intake of 30 \u03bcg/day to prevent related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 59f22411-728f-40d7-9d54-e5ee4845ca82
encoding: FLOAT32
metadata:
{"original_content": "Pantothenic acid is widely distributed in foods; it is an essential\ncomponent of coenzyme A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What role does pantothenic acid play in preventing metabolic disorders related to coenzyme A deficiency?  \n2. How can a deficiency in pantothenic acid contribute to nutritional disorders?  \n3. What dietary sources can help address pantothenic acid deficiency to prevent related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1bbeb9ae-8d08-4c33-b389-0ff9f4e37688
encoding: FLOAT32
metadata:
{"original_content": "Adults probably require about 5 mg/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the potential health consequences of consuming less than 5 mg/day of a specific nutrient in adults?  \n2. How does a deficiency of a nutrient requiring 5 mg/day contribute to the development of metabolic disorders?  \n3. What dietary adjustments can be made to meet the 5 mg/day requirement and prevent related nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f74ed73a-9ae2-4131-8c7c-776fac9a7e2f
encoding: FLOAT32
metadata:
{"original_content": "A beneficial role for pantothenic acid\nsupplementation in lipid metabolism, RA, or athletic performance remains unproved.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. Can pantothenic acid supplementation improve lipid metabolism in individuals with metabolic disorders?  \n2. Is there evidence supporting the use of pantothenic acid supplementation for managing rheumatoid arthritis (RA)?  \n3. Does pantothenic acid supplementation enhance athletic performance in individuals with dietary deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ba621b27-3c93-44b4-9d5d-b3e204f93d62
encoding: FLOAT32
metadata:
{"original_content": "Isolated deficiency of\nbiotin or pantothenic acid virtually never occurs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. Why is an isolated deficiency of biotin or pantothenic acid rare in humans?  \n2. What factors contribute to the low likelihood of developing a biotin or pantothenic acid deficiency?  \n3. How does the body's metabolism compensate to prevent isolated deficiencies of biotin or pantothenic acid?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 473eb15f-4589-4b84-90f8-6dbfad667af0
encoding: FLOAT32
metadata:
{"original_content": "Folate\nFolate (folic acid) is now added to enriched grain foods in the US.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does the addition of folic acid to enriched grain foods in the US help prevent folate deficiency?  \n2. What are the potential health consequences of a folate deficiency in the diet?  \n3. Can folic acid fortification in grain foods reduce the risk of certain metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9cb201c1-4402-41cf-a4c5-954670a18849
encoding: FLOAT32
metadata:
{"original_content": "Folate is also plentiful in various plant\nfoods and meats, but its bioavailability is greater when it is in supplements\n[\nTable 4-1.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. How does the bioavailability of folate in supplements compare to that in natural food sources, and what implications does this have for addressing folate deficiency?  \n2. What role does folate play in preventing nutritional disorders related to vitamin deficiencies?  \n3. Can the consumption of folate-rich plant foods and meats alone effectively prevent folate deficiency, or are supplements necessary?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3f523f8e-1562-4ed4-a2cc-2c3821ee7325
encoding: FLOAT32
metadata:
{"original_content": "Recommended Daily Intakes for Vitamins]\nor enriched foods than when it occurs naturally in food.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the recommended daily intakes of specific vitamins to prevent dietary deficiencies?  \n2. How do vitamin imbalances contribute to the development of metabolic disorders?  \n3. Can enriched foods help address vitamin deficiencies more effectively than natural food sources?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 08b1f086-047a-48db-a803-0296cbcb045d
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated nutritionally?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 520b5b6a-154a-4c93-8320-b9a40c7771f9
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n76", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 23, "type": "text ", "chroma:document": "1. What are the symptoms and health consequences of vitamin toxicity for specific vitamins like A, D, or E?  \n2. How can dependency on certain vitamins develop, and what are the potential risks associated with it?  \n3. What dietary strategies can be implemented to prevent vitamin deficiencies and maintain optimal nutrient balance?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3117b153-8259-40b6-a21e-5d99a3609277
encoding: FLOAT32
metadata:
{"original_content": "Folates are involved in RBC maturation and synthesis of purines and pyrimidines.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does a folate deficiency impact red blood cell maturation and lead to nutritional anemia?  \n2. What role do folates play in the synthesis of purines and pyrimidines, and how can their deficiency contribute to metabolic disorders?  \n3. What dietary sources can help prevent folate-related nutritional deficiencies and associated health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 09920dbf-a81a-456f-a9c5-429ed32d1436
encoding: FLOAT32
metadata:
{"original_content": "They are required for\ndevelopment of the fetal nervous system.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does a deficiency in specific nutrients affect the development of the fetal nervous system?  \n2. What dietary deficiencies are linked to impaired fetal nervous system development?  \n3. Which vitamins or minerals are critical for preventing nervous system-related disorders during fetal development?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 019be336-0183-495c-b48d-46e7927dc3b4
encoding: FLOAT32
metadata:
{"original_content": "Absorption occurs in the duodenum and upper jejunum.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does impaired absorption in the duodenum and upper jejunum contribute to vitamin and mineral deficiencies?  \n2. What nutritional disorders are associated with malabsorption in the duodenum and upper jejunum?  \n3. How does the absorption process in the duodenum and upper jejunum affect the management of metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d3b6eca6-8072-40bb-8512-d4023e572ef3
encoding: FLOAT32
metadata:
{"original_content": "Enterohepatic circulation of folate occurs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does impaired enterohepatic circulation of folate contribute to folate deficiency in individuals with liver disorders?  \n2. What role does enterohepatic circulation of folate play in maintaining adequate folate levels in patients with malabsorption syndromes?  \n3. Can disruptions in the enterohepatic circulation of folate lead to metabolic disorders related to one-carbon metabolism?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9747f720-c524-41fa-9239-3ed7923e52c7
encoding: FLOAT32
metadata:
{"original_content": "Folate supplements\n[\nTable 4-2.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How can folate supplementation help address dietary deficiencies related to folate?  \n2. What role does folate play in preventing metabolic disorders caused by vitamin imbalances?  \n3. Are folate supplements effective in managing health conditions linked to folate deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ee3707a1-7d01-461d-a04d-47c16b43f8aa
encoding: FLOAT32
metadata:
{"original_content": "Sources, Functions, and Effects of Vitamins]\ndo not protect against coronary artery disease or stroke (by lowering homocysteine levels); their role in\nreducing the risk of various cancers is unclear.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How do vitamin deficiencies contribute to the development of coronary artery disease or stroke?  \n2. What is the role of vitamins in potentially reducing the risk of various cancers?  \n3. Can lowering homocysteine levels through vitamin intake prevent metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c5e826a7-9416-402f-9d0e-13e261aa3b3f
encoding: FLOAT32
metadata:
{"original_content": "The upper limit for folate intake is 1000 \n\u03bc\ng; higher doses\n(up to 5 mg) are recommended for women who have had a baby with a neural tube defect.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What is the recommended folate intake for women who have previously had a baby with a neural tube defect?  \n2. What is the upper limit for folate intake in the general population?  \n3. How does exceeding the upper limit of folate intake relate to neural tube defect prevention?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 76798f6a-20fc-480b-9a6c-6fd2cc35ab31
encoding: FLOAT32
metadata:
{"original_content": "Folate is\nessentially nontoxic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the potential health implications of folate deficiency in the context of metabolic disorders?  \n2. How does the nontoxic nature of folate influence its use in treating dietary deficiencies?  \n3. Can excessive folate intake contribute to any imbalances or complications in individuals with pre-existing nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 12de236e-3e84-4f8e-ad8a-beed6ff0f75d
encoding: FLOAT32
metadata:
{"original_content": "Folate Deficiency\nFolate deficiency is common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the potential health consequences of folate deficiency?  \n2. How does folate deficiency relate to other nutritional or metabolic disorders?  \n3. What dietary sources can help prevent or address folate deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 83983430-1278-4c2a-8289-9d0a555714b1
encoding: FLOAT32
metadata:
{"original_content": "It may result from inadequate intake, malabsorption, or use of various drugs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the potential causes of nutritional deficiencies related to inadequate nutrient absorption?  \n2. How can the use of certain medications contribute to the development of vitamin or mineral imbalances?  \n3. What are the dietary factors that might lead to malabsorption-related metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6f108b89-005f-4af0-bd21-27f0880fc79b
encoding: FLOAT32
metadata:
{"original_content": "Deficiency causes megaloblastic anemia (indistinguishable from that due to vitamin B\n12\n deficiency).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the nutritional deficiencies that can lead to megaloblastic anemia?  \n2. How does a deficiency in certain vitamins, such as vitamin B12, contribute to the development of megaloblastic anemia?  \n3. What are the distinguishing factors between megaloblastic anemia caused by vitamin B12 deficiency and other nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6418a5e5-f4b6-4bee-bffa-2d9a8f26890e
encoding: FLOAT32
metadata:
{"original_content": "Maternal deficiency increases the risk of neural tube birth defects.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does maternal nutritional deficiency contribute to the development of neural tube defects in newborns?  \n2. What specific vitamins or minerals are critical to preventing neural tube defects during pregnancy?  \n3. What dietary interventions can reduce the risk of neural tube defects associated with maternal deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a2de5607-371c-4a43-b90e-6a6fa73bcc2c
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis requires laboratory testing\nto confirm.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What laboratory tests are commonly used to confirm a diagnosis of vitamin or mineral deficiencies?  \n2. How can metabolic disorders be identified through laboratory testing?  \n3. What role does laboratory testing play in diagnosing obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a22d42d-bbb0-4a38-8071-1cbc9dc1fa99
encoding: FLOAT32
metadata:
{"original_content": "Measurement of neutrophil hypersegmentation is sensitive and readily available.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How can neutrophil hypersegmentation be used to diagnose vitamin B12 or folate deficiencies?  \n2. What role does neutrophil hypersegmentation play in identifying nutritional anemia?  \n3. Is neutrophil hypersegmentation a reliable marker for detecting dietary-related metabolic disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d948a2a6-058f-42bd-86a6-f163647bbb6a
encoding: FLOAT32
metadata:
{"original_content": "Treatment\nwith oral folate is usually successful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How effective is oral folate treatment for nutritional deficiencies?  \n2. What role does folate play in addressing dietary deficiencies?  \n3. Can oral folate be used to treat specific vitamin imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 65825eb5-44f5-4add-8df7-cd57eaefe3ed
encoding: FLOAT32
metadata:
{"original_content": "Etiology and Pathophysiology\nThe most common causes are inadequate intake (usually in patients with undernutrition or alcoholism),\nincreased demand (eg, due to pregnancy or breastfeeding), and impaired absorption (eg, in tropical\nsprue, due to certain drugs).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the common causes of nutritional deficiencies in individuals with undernutrition or alcoholism?  \n2. How does pregnancy or breastfeeding increase the demand for specific nutrients, potentially leading to deficiencies?  \n3. What role do conditions like tropical sprue or certain drugs play in impairing nutrient absorption?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 50ed5e63-6725-4c18-ba0b-d5b5213dcf6f
encoding: FLOAT32
metadata:
{"original_content": "Deficiency can also result from inadequate bioavailability and increased\nexcretion (see\nTable 4-4\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does inadequate bioavailability contribute to nutritional deficiencies?  \n2. What role does increased excretion play in the development of vitamin and mineral imbalances?  \n3. What examples of nutritional disorders are associated with factors listed in Table 4-4?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5096213-24fa-42d4-a5a3-eb1d52ba9b59
encoding: FLOAT32
metadata:
{"original_content": "Prolonged cooking destroys folate, predisposing to inadequate intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does prolonged cooking contribute to folate deficiency and its associated health risks?  \n2. What are the potential nutritional disorders caused by inadequate folate intake due to cooking practices?  \n3. How can cooking methods be adjusted to preserve folate and prevent related dietary deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d0cb6ee5-23dd-4c97-9d40-42f1d7b734d8
encoding: FLOAT32
metadata:
{"original_content": "Intake is sometimes barely\nadequate (eg, in alcoholics).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does chronic alcohol consumption contribute to nutritional deficiencies?  \n2. What are the potential health consequences of barely adequate nutrient intake in individuals with alcohol use disorder?  \n3. Which specific vitamins or minerals are most commonly deficient in people with inadequate dietary intake due to alcoholism?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2d48a8cc-9ad4-401a-9aed-4b949c030a1c
encoding: FLOAT32
metadata:
{"original_content": "Liver stores provide only a several-month supply.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does the liver's limited storage capacity for nutrients impact the progression of dietary deficiencies?  \n2. What are the potential health consequences of depleting the liver's nutrient stores in individuals with metabolic disorders?  \n3. How does the liver's storage duration influence the management of vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9e5a2e9e-ccff-446d-8437-ff88887df168
encoding: FLOAT32
metadata:
{"original_content": "Alcohol interferes with folate absorption, metabolism, renal excretion, and enterohepatic reabsorption, as\nwell as intake.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does alcohol consumption contribute to folate deficiency in the body?  \n2. What are the metabolic pathways affected by alcohol that impair folate absorption and utilization?  \n3. How does alcohol-induced disruption of folate metabolism impact nutritional health and related disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18893c99-80c5-428a-9eef-9692d7e5b1df
encoding: FLOAT32
metadata:
{"original_content": "5-Fluorouracil, metformin, methotrexate, phenobarbital, phenytoin, sulfasalazine,\ntriamterene, and trimethoprim impair folate metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How do medications like methotrexate and phenytoin contribute to folate deficiency and related nutritional disorders?  \n2. What are the potential metabolic consequences of impaired folate metabolism caused by drugs such as metformin and sulfasalazine?  \n3. Which dietary interventions can help mitigate folate deficiency in patients taking medications like 5-Fluorouracil and trimethoprim?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bb0001d3-58a6-4307-8727-272553f25805
encoding: FLOAT32
metadata:
{"original_content": "In the US, many dietary staples (eg, cereals, grain products) are routinely enriched with folate, tending to\nreduce risk of deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does the enrichment of cereals and grain products with folate impact the prevalence of folate deficiency in the US?  \n2. What role does folate play in preventing nutritional disorders related to vitamin deficiencies?  \n3. Can the routine fortification of dietary staples with folate help mitigate health conditions caused by metabolic imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3bdda69e-e9b2-4c95-a469-378429b8c924
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 4-3. Potential Vitamin-Drug Interactions]\nSymptoms and Signs\nFolate deficiency may cause glossitis, diarrhea, depression, and confusion.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the symptoms and signs associated with folate deficiency?  \n2. How might vitamin deficiencies interact with certain medications?  \n3. What are the potential health effects of a folate deficiency on mental health?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d67a5c57-6a6e-4323-ba04-777c8250bf0b
encoding: FLOAT32
metadata:
{"original_content": "Anemia may develop\ninsidiously and, because of compensatory mechanisms, be more severe than symptoms suggest.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How do compensatory mechanisms affect the severity of symptoms in anemia caused by nutritional deficiencies?  \n2. What dietary deficiencies are most commonly associated with the development of anemia?  \n3. Can anemia progress without noticeable symptoms, and what role does nutrition play in its early detection?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5de38e1-9aaa-48eb-9914-e64b88af7033
encoding: FLOAT32
metadata:
{"original_content": "Folate deficiency during pregnancy increases the risk of fetal neural tube defects and perhaps other brain\ndefects (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does folate deficiency during pregnancy contribute to the development of fetal neural tube defects?  \n2. What are the potential brain defects associated with folate deficiency in pregnant individuals?  \n3. Why is adequate folate intake critical for fetal development during pregnancy?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18716921-944b-4457-9bad-f4b32fb624d5
encoding: FLOAT32
metadata:
{"original_content": "2992\n).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of vitamin and mineral imbalances in the body?  \n2. How do dietary deficiencies contribute to the development of metabolic disorders?  \n3. What are the potential health risks associated with obesity and its connection to nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fd3ec9fa-1b34-4ce8-9e51-0b137d26a569
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 CBC and serum vitamin B\n12\n and folate levels\nCBC may indicate megaloblastic anemia indistinguishable from that of vitamin B\n12\n deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How can a CBC and serum vitamin B12 test help differentiate between folate deficiency and vitamin B12 deficiency?  \n2. What are the nutritional implications of megaloblastic anemia in the context of vitamin B12 and folate levels?  \n3. What diagnostic markers are used to identify vitamin B12-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9abba333-424e-43bb-a9e5-383a16e05416
encoding: FLOAT32
metadata:
{"original_content": "If serum\nfolate is < 3 \n\u03bc\ng/L or ng/mL (< 7 nmol/L), deficiency is likely.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What serum folate level indicates a likely folate deficiency?  \n2. How can folate deficiency be identified through laboratory measurements?  \n3. What is the threshold for serum folate levels below which a nutritional disorder may be suspected?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 03794a80-85b0-4072-9f69-1bee0a36a93e
encoding: FLOAT32
metadata:
{"original_content": "Serum folate reflects folate status unless\nintake has recently increased or decreased.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does a recent change in dietary folate intake affect the accuracy of serum folate as an indicator of folate status?  \n2. What factors could lead to discrepancies between serum folate levels and actual folate status in the body?  \n3. In what scenarios might serum folate not reliably reflect a patient's folate deficiency or sufficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 29f0373b-dc1e-4382-9f16-341d5c9b7f51
encoding: FLOAT32
metadata:
{"original_content": "If intake has changed, erythrocyte (RBC) folate level better\nreflects tissue stores.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does erythrocyte folate level serve as an indicator of tissue folate stores in cases of dietary folate deficiency?  \n2. What is the relationship between changes in dietary folate intake and erythrocyte folate levels in individuals with metabolic disorders?  \n3. Why might erythrocyte folate levels be a more reliable marker than serum folate levels for assessing long-term folate status in patients with nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 955b1e85-f9ea-4fd8-8ca8-c36852fd6e7d
encoding: FLOAT32
metadata:
{"original_content": "A level of < 140 \n\u03bc\ng/L or ng/mL (< 305 nmol/L) indicates inadequate status.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the health implications of having a nutrient level below 140 \u03bcg/L or ng/mL?  \n2. How can inadequate nutrient status, as indicated by levels < 140 \u03bcg/L, contribute to dietary deficiencies or metabolic disorders?  \n3. What dietary or supplementation strategies can help address nutrient levels below 140 \u03bcg/L or ng/mL?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6378ac28-dd86-493d-8ec8-ee8550f8d9ec
encoding: FLOAT32
metadata:
{"original_content": "Also, an\nincrease in the homocysteine level suggests tissue folate deficiency (but the level is also affected by\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. How does an increase in homocysteine levels indicate tissue folate deficiency?  \n2. What factors, aside from folate deficiency, can influence homocysteine levels in the body?  \n3. What are the potential health implications of tissue folate deficiency as identified in nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 525c158a-dafe-4abc-8339-a5b3939f5d56
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n77", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 24, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and vitamin deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ea54ce6f-21c7-4b3e-82f6-96c3ff14638c
encoding: FLOAT32
metadata:
{"original_content": "vitamin B\n12\n and vitamin B\n6\n levels, renal insufficiency, and genetic factors).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How do deficiencies in vitamin B12 and vitamin B6 contribute to the development of metabolic disorders?  \n2. What role does renal insufficiency play in the imbalance of vitamin B12 and vitamin B6 levels?  \n3. How might genetic factors influence susceptibility to vitamin B12 and vitamin B6 deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f1cab9a7-c39a-4aed-8d7d-1068d5ca8e6b
encoding: FLOAT32
metadata:
{"original_content": "A normal methylmalonic acid\n(MMA) level may differentiate folate deficiency from vitamin B\n12\n deficiency because MMA levels rise in\nvitamin B\n12\n deficiency but not in folate deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How can methylmalonic acid (MMA) levels help distinguish between folate deficiency and vitamin B12 deficiency?  \n2. What metabolic marker is elevated in vitamin B12 deficiency but not in folate deficiency?  \n3. Why is a normal MMA level significant in diagnosing folate deficiency over vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0d1ed72a-656d-4ce1-821d-ebc3ef2d5ff8
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Supplemental oral folate\nFolate 400 to 1000 \n\u03bc\ng po once/day replenishes tissues and is usually successful even if deficiency has\nresulted from malabsorption.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What is the recommended daily dosage of oral folate supplementation for treating folate deficiency?  \n2. Can oral folate supplementation be effective in cases of malabsorption-related folate deficiency?  \n3. How does folate supplementation help replenish tissue stores in individuals with a nutritional deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 028af06d-301c-4ea4-a6ec-dbc6ed5a37d6
encoding: FLOAT32
metadata:
{"original_content": "The normal requirement is 400 \n\u03bc\ng/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the health consequences of not meeting the daily requirement of 400 \u03bcg/day for a specific nutrient?  \n2. How does a deficiency in a nutrient with a 400 \u03bcg/day requirement contribute to metabolic disorders?  \n3. What dietary adjustments can be made to meet the 400 \u03bcg/day requirement and prevent related nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 924eb517-95f2-4834-bfa4-6e379908eaa2
encoding: FLOAT32
metadata:
{"original_content": "[\nTable 4-4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the common symptoms and causes of specific vitamin and mineral deficiencies?  \n2. How do metabolic disorders impact nutrient absorption and overall health?  \n3. What dietary interventions are recommended for managing obesity and related health conditions?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c78ca4f-af9f-4788-bcb9-63631eaf7d14
encoding: FLOAT32
metadata:
{"original_content": "Causes of Folate Deficiency]\n(CAUTION: \nIn patients with megaloblastic anemia, vitamin B\n12\n deficiency must be ruled out before\ntreating with folate.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the potential causes of folate deficiency in individuals?  \n2. Why is it important to rule out vitamin B12 deficiency before treating megaloblastic anemia with folate?  \n3. How does folate deficiency relate to the development of megaloblastic anemia?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 568db78b-7474-40e5-bcc4-8714697981da
encoding: FLOAT32
metadata:
{"original_content": "If vitamin B\n12\n deficiency is present, folate supplementation can alleviate the\nanemia but does not reverse and may even worsen neurologic deficits\n.) For pregnant women, the\nrecommended daily allowance (RDA) is 600 \n\u03bc\ng/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does folate supplementation affect anemia and neurological deficits in individuals with vitamin B12 deficiency?  \n2. What is the recommended daily allowance (RDA) of folate for pregnant women?  \n3. Can folate supplementation worsen neurological symptoms in cases of vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 108e564e-a4ed-45e6-99dc-ebbb07d48c82
encoding: FLOAT32
metadata:
{"original_content": "For women who have had a fetus or infant with a\nneural tube defect, the recommended dose is 1000 to 5000 \n\u03bc\ng/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What is the recommended daily dose of folic acid for women who have previously had a fetus or infant with a neural tube defect?  \n2. How does folic acid supplementation help prevent neural tube defects in future pregnancies?  \n3. What are the potential risks of insufficient folic acid intake during pregnancy for women with a history of neural tube defects?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 16b20dde-2e2a-4f3b-9336-a19e5fcec184
encoding: FLOAT32
metadata:
{"original_content": "Niacin\nNiacin (nicotinic acid, nicotinamide) derivatives include nicotinamide adenine dinucleotide (NAD) and\nnicotinamide adenine dinucleotide phosphate (NADP), which are coenzymes in oxidation-reduction\nreactions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does a deficiency in niacin affect the body's ability to perform oxidation-reduction reactions?  \n2. What role do NAD and NADP play in metabolic disorders related to niacin deficiency?  \n3. Can niacin supplementation help address specific symptoms of dietary deficiencies or vitamin imbalances?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 603d4b06-4f0f-4e19-b675-2e246d521c1a
encoding: FLOAT32
metadata:
{"original_content": "They are vital in cell metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How do vitamin deficiencies impact cell metabolism in individuals with nutritional disorders?  \n2. What role do minerals play in maintaining proper cell metabolism in cases of dietary imbalances?  \n3. How can metabolic disorders disrupt the cellular processes vital for energy production?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e22f9e47-c85d-4b67-876a-4a0513a489a6
encoding: FLOAT32
metadata:
{"original_content": "Because dietary tryptophan can be metabolized to niacin,\nfoods rich in tryptophan (eg, dairy products) can compensate for inadequate dietary niacin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How can dietary tryptophan help prevent niacin deficiency in individuals with inadequate niacin intake?  \n2. What role do dairy products play in addressing nutritional disorders related to niacin deficiency?  \n3. Can tryptophan metabolism be utilized as a strategy to manage vitamin B3 (niacin) imbalances in the diet?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8eb78a11-ccc5-4ab9-bb97-14e0d8cb7521
encoding: FLOAT32
metadata:
{"original_content": "Niacin Deficiency\nDietary niacin deficiency (causing pellagra) is uncommon in developed countries.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the symptoms and health consequences of niacin deficiency in humans?  \n2. How does dietary niacin deficiency lead to the development of pellagra?  \n3. Why is niacin deficiency uncommon in developed countries?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0fa367ab-2ada-4d1a-9e7b-6e4316944f93
encoding: FLOAT32
metadata:
{"original_content": "Clinical\nmanifestations include the \"three Ds\": localized pigmented rash (dermatitis); gastroenteritis\n(diarrhea); and widespread neurologic deficits, including cognitive decline (dementia).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with the clinical manifestations of dermatitis, diarrhea, and dementia?  \n2. How does a deficiency in specific vitamins or nutrients lead to cognitive decline and neurologic deficits?  \n3. What dietary interventions can prevent or treat the \"three Ds\" symptoms in patients with this nutritional disorder?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a33f5e9-9ea5-4848-8be1-43b49eb33cbe
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical, and dietary supplementation (oral or, if needed, IM) is usually\nsuccessful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How is a nutritional disorder typically diagnosed?  \n2. What are the common methods of dietary supplementation for treating nutritional deficiencies?  \n3. When is intramuscular (IM) supplementation necessary for addressing dietary deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1a018588-58f9-45dd-a24d-e06756fea648
encoding: FLOAT32
metadata:
{"original_content": "Etiology\nPrimary deficiency results from extremely inadequate intake of both niacin and tryptophan, which usually\noccurs in areas where maize (Indian corn) constitutes a substantial part of the diet.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What dietary factors contribute to a primary deficiency of niacin and tryptophan?  \n2. How does a maize-based diet lead to nutritional deficiencies?  \n3. What are the nutritional implications of relying on a single staple food like maize?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 34cdb504-a44d-4f42-bfbc-db3a7b67f2be
encoding: FLOAT32
metadata:
{"original_content": "Bound niacin, found in\nmaize, is not assimilated in the GI tract unless it has been previously treated with alkali, as when tortillas\nare prepared.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does the preparation of maize with alkali impact the bioavailability of niacin and its role in preventing niacin deficiency?  \n2. What nutritional disorders can arise from consuming untreated maize as a staple food?  \n3. How does the inability to assimilate bound niacin in untreated maize contribute to the development of pellagra?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 78b7cf11-a057-46a6-85fa-80842982a886
encoding: FLOAT32
metadata:
{"original_content": "Corn protein is also deficient in tryptophan.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does a deficiency in tryptophan from corn protein contribute to nutritional disorders such as pellagra?  \n2. What are the potential health impacts of relying on corn as a primary protein source in the diet?  \n3. How can tryptophan deficiency from corn protein be mitigated through dietary supplementation or diversification?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2aea0982-dbce-47b3-a962-358a3739edd9
encoding: FLOAT32
metadata:
{"original_content": "The high incidence of pellagra in India among\npeople who eat millet with a high leucine content has led to the hypothesis that amino acid imbalance may\ncontribute to deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does a high leucine content in millet contribute to the development of pellagra?  \n2. Can amino acid imbalances in the diet exacerbate vitamin B3 (niacin) deficiency?  \n3. What dietary modifications can help prevent pellagra in populations consuming millet as a staple food?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e6187df4-77c0-417a-8a21-60a63418cf39
encoding: FLOAT32
metadata:
{"original_content": "Deficiencies of protein and many B vitamins commonly accompany primary niacin\ndeficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does a primary niacin deficiency contribute to deficiencies in protein and B vitamins?  \n2. What are the potential health consequences of simultaneous deficiencies in niacin, protein, and B vitamins?  \n3. What dietary interventions can address primary niacin deficiency and its associated nutrient deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a58e86a0-1e8f-4584-9104-5177282b6ca0
encoding: FLOAT32
metadata:
{"original_content": "Secondary deficiency may be due to diarrhea, cirrhosis, or alcoholism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How can chronic alcoholism contribute to secondary nutritional deficiencies?  \n2. What role does cirrhosis play in the development of secondary vitamin or mineral deficiencies?  \n3. In what ways can persistent diarrhea lead to secondary dietary deficiencies?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 735535e0-88b7-4f29-a9c8-25f0248dc554
encoding: FLOAT32
metadata:
{"original_content": "Pellagra also may occur in\ncarcinoid syndrome (tryptophan is diverted to form 5-hydroxytryptophan and serotonin) and in Hartnup\ndisease (absorption of tryptophan by the intestine and kidneys is defective).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. How does carcinoid syndrome contribute to the development of pellagra?  \n2. What role does defective tryptophan absorption in Hartnup disease play in causing pellagra?  \n3. How is tryptophan metabolism linked to nutritional deficiencies like pellagra?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 875eacb5-25aa-4791-9058-db5f0e30f551
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nPellagra is characterized by skin, mucous membrane, CNS, and GI symptoms.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the characteristic symptoms of pellagra related to the skin and mucous membranes?  \n2. How does pellagra affect the central nervous system (CNS)?  \n3. What gastrointestinal symptoms are associated with pellagra?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 98479744-ef19-4ee7-825f-c128b95b2ada
encoding: FLOAT32
metadata:
{"original_content": "Advanced pellagra can\ncause a symmetric photosensitive rash, stomatitis, glossitis, diarrhea, and mental aberrations.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the symptoms associated with advanced pellagra caused by nutritional deficiencies?  \n2. How does a deficiency in niacin or tryptophan contribute to the development of pellagra?  \n3. What are the characteristic skin and mental health manifestations of advanced pellagra?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 24cbc32c-2a67-4742-9cef-3d50ef71386b
encoding: FLOAT32
metadata:
{"original_content": "Symptoms\nmay appear alone or in combination.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the possible symptoms of a specific nutritional disorder, and can they occur simultaneously?  \n2. How can a combination of symptoms indicate a potential vitamin or mineral imbalance?  \n3. Are there specific dietary deficiencies that present with isolated symptoms versus combined symptoms?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4652023a-c106-46ae-9373-d6e4beb39b73
encoding: FLOAT32
metadata:
{"original_content": "Skin symptoms\n include several types of lesions, which are usually bilaterally symmetric. The distribution\nof lesions\u2014at pressure points or sun-exposed skin\u2014is more pathognomonic than the form of the lesions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What nutritional deficiencies are associated with bilaterally symmetric skin lesions?  \n2. How can sun exposure exacerbate skin symptoms related to dietary deficiencies?  \n3. Which metabolic disorders manifest as skin lesions at pressure points?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 60478e87-2535-4ef9-8af9-b714e4891cb2
encoding: FLOAT32
metadata:
{"original_content": "Lesions can develop in a glovelike distribution on the hands (pellagrous glove) or in a boot-shaped\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with the development of pellagrous glove or boot-shaped lesions?  \n2. How does niacin deficiency manifest in the skin and extremities?  \n3. What are the characteristic symptoms and physical signs of pellagra?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 913fc37a-8bec-4bec-a42d-9ccf7b3db81e
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n78", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 25, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and deficiency in terms of health outcomes?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 59170ba9-b067-49c4-8db3-9a64c1f910c3
encoding: FLOAT32
metadata:
{"original_content": "distribution on the feet and legs (pellagrous boot).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the symptoms and physical manifestations of pellagra, particularly in the lower extremities?  \n2. How does a deficiency in niacin or tryptophan contribute to the development of pellagrous boot?  \n3. What dietary interventions can prevent or treat the nutritional disorder associated with pellagrous boot?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4936bad7-866a-4321-a7ae-2cc0d21aa51f
encoding: FLOAT32
metadata:
{"original_content": "Sunlight causes Casal's necklace and butterfly-shaped\nlesions on the face.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with the development of Casal's necklace?  \n2. How does sunlight exposure exacerbate symptoms of certain vitamin deficiencies?  \n3. What role does diet play in preventing butterfly-shaped lesions on the face?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4ec95428-b0a1-4b8b-b6f3-3fcfda56e6e8
encoding: FLOAT32
metadata:
{"original_content": "Mucous membrane symptoms\n affect primarily the mouth but may also affect the vagina and urethra.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to mucous membrane symptoms in the mouth, vagina, or urethra?  \n2. Which vitamin or mineral imbalances are commonly associated with mucous membrane issues?  \n3. Are there specific dietary interventions that can alleviate mucous membrane symptoms caused by nutritional disorders?  "}


created_at: 2025-03-03 11:15:31
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a7005f96-ba00-42d9-80c0-f28e8079c27a
encoding: FLOAT32
metadata:
{"original_content": "Glossitis and stomatitis characterize acute deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional deficiencies are associated with glossitis and stomatitis?  \n2. How does an acute deficiency in specific nutrients manifest in oral health symptoms?  \n3. Which vitamins or minerals, when deficient, can lead to glossitis and stomatitis?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ddb7f7c3-7d7e-49fe-a9af-36513d2718cc
encoding: FLOAT32
metadata:
{"original_content": "As the deficiency progresses, the tongue and oral\nmucous membranes become reddened, followed by pain in the mouth, increased salivation, and edema of\nthe tongue.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the oral symptoms associated with a specific nutritional deficiency?  \n2. How does a deficiency impact the tongue and oral mucous membranes?  \n3. What are the progressive signs of a dietary deficiency affecting the mouth?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9cac244c-8929-4d01-a039-e8693eddaf5a
encoding: FLOAT32
metadata:
{"original_content": "Ulcerations may appear, especially under the tongue, on the mucosa of the lower lip, and\nopposite the molar teeth.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to ulcerations under the tongue and on the mucosa of the lower lip?  \n2. How might vitamin or mineral imbalances contribute to the development of oral ulcerations?  \n3. Are there specific dietary changes that can help prevent ulcerations opposite the molar teeth?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 57444890-ac90-45b6-b470-f25778000079
encoding: FLOAT32
metadata:
{"original_content": "GI symptoms\n early in the deficiency include burning in the pharynx and esophagus and abdominal\ndiscomfort and distention.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What gastrointestinal symptoms are associated with early stages of a nutritional deficiency?  \n2. How can a dietary deficiency lead to burning sensations in the pharynx and esophagus?  \n3. What are the abdominal symptoms that may indicate the onset of a metabolic or nutritional disorder?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 07cd28d3-b745-47d3-bfcf-d2841ac5cf02
encoding: FLOAT32
metadata:
{"original_content": "Constipation is common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can dietary fiber intake influence the occurrence of constipation?  \n2. What role do vitamin and mineral imbalances play in contributing to constipation?  \n3. Can metabolic disorders lead to chronic constipation, and if so, how?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d6e8137e-166e-4f23-bfe7-19b65d25efe2
encoding: FLOAT32
metadata:
{"original_content": "Later, nausea, vomiting, and diarrhea may occur. Diarrhea is often bloody because of bowel hyperemia and ulceration.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional disorders can cause bloody diarrhea due to bowel hyperemia and ulceration?  \n2. How do dietary deficiencies contribute to symptoms like nausea, vomiting, and diarrhea?  \n3. What metabolic imbalances are associated with gastrointestinal symptoms such as bloody diarrhea?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 808a9503-1098-402c-b510-ae502454aafd
encoding: FLOAT32
metadata:
{"original_content": "CNS symptoms\n include psychosis, encephalopathy (characterized by impaired consciousness), and\ncognitive decline (dementia).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to the development of psychosis or other CNS symptoms?  \n2. What specific vitamin or mineral imbalances are associated with encephalopathy and impaired consciousness?  \n3. Can dietary interventions help prevent or mitigate cognitive decline (dementia) caused by metabolic or nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bc02914c-0292-4d8b-940d-a1e3c86d7342
encoding: FLOAT32
metadata:
{"original_content": "Psychosis is characterized by memory impairment, disorientation, confusion,\nand confabulation; the predominant symptom may be excitement, depression, mania, delirium, or\nparanoia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to the development of psychosis-related symptoms such as memory impairment and disorientation?  \n2. What role do vitamin or mineral imbalances play in the onset of psychosis symptoms like mania or paranoia?  \n3. Could metabolic disorders linked to diet influence the severity of psychosis-related conditions such as delirium or depression?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c9d28e4e-6d11-45dc-9f3f-0e8bc9d34cb3
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Clinical evaluation\nDiagnosis is clinical and may be straightforward when skin and mouth lesions, diarrhea, delirium, and\ndementia occur simultaneously.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What clinical symptoms are indicative of a nutritional disorder involving skin and mouth lesions, diarrhea, delirium, and dementia?  \n2. How can a clinical evaluation assist in diagnosing a dietary deficiency-related condition?  \n3. What combination of symptoms might suggest a vitamin or mineral imbalance in a patient?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5821d8ec-d0b2-4cda-ac2b-55fa1c3eec94
encoding: FLOAT32
metadata:
{"original_content": "More often, the presentation is not so specific.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the potential causes of non-specific symptoms in nutritional disorders?  \n2. How can dietary deficiencies contribute to vague or non-specific health presentations?  \n3. What role do vitamin and mineral imbalances play in the development of metabolic disorders with unclear symptoms?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7d1431e9-bd5e-489b-8d39-8d38192888b5
encoding: FLOAT32
metadata:
{"original_content": "Differentiating the CNS\nchanges from those in thiamin deficiency is difficult.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can central nervous system changes caused by thiamin deficiency be identified and differentiated from other nutritional disorders?  \n2. What are the specific neurological symptoms associated with thiamin deficiency in comparison to other vitamin deficiencies?  \n3. What diagnostic approaches are used to distinguish thiamin deficiency-related CNS changes from similar symptoms caused by other dietary deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48bb001a-caad-4a1d-b978-a11e0ed481da
encoding: FLOAT32
metadata:
{"original_content": "A history of a diet lacking niacin and tryptophan may\nhelp establish the diagnosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional disorder is associated with a diet deficient in niacin and tryptophan?  \n2. How can dietary history aid in diagnosing niacin deficiency-related conditions?  \n3. What are the potential health consequences of prolonged niacin and tryptophan deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7ea58ed5-45ef-43f6-a459-3d0ebdabc2f1
encoding: FLOAT32
metadata:
{"original_content": "A favorable response to treatment with niacin can usually \nconfirm it.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can a favorable response to niacin treatment help confirm a specific nutritional disorder?  \n2. What role does niacin play in addressing vitamin deficiencies or metabolic disorders?  \n3. Which health conditions are typically treated or diagnosed using niacin supplementation?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c8635ef1-efdc-4377-93c0-f2978b741697
encoding: FLOAT32
metadata:
{"original_content": "If\navailable, laboratory testing can help confirm the diagnosis, particularly when the diagnosis is otherwise\nunclear.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can laboratory testing assist in diagnosing vitamin and mineral imbalances when symptoms are ambiguous?  \n2. What role does laboratory testing play in confirming metabolic disorders related to nutrition?  \n3. When is laboratory testing necessary to clarify the diagnosis of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d7961c5f-bc1c-4de0-b2f2-636d76015fe8
encoding: FLOAT32
metadata:
{"original_content": "Urinary excretion of N\n1\n-methylnicotinamide (NMN) is decreased; < 0.8 mg/day (< 5.8 \n\u03bc\nmol/day)\nsuggests a niacin deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can decreased urinary excretion of N-methylnicotinamide (NMN) be used to diagnose niacin deficiency?  \n2. What are the clinical implications of urinary NMN levels falling below 0.8 mg/day in relation to nutritional health?  \n3. How does niacin deficiency affect metabolic processes detectable through urinary biomarkers?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4541a2af-e01c-4f37-bffb-2bbb5b3e3866
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Nicotinamide and other nutrients\nBecause multiple deficiencies are common, a balanced diet, including other B vitamins (particularly\nriboflavin and pyridoxine), is needed.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can nicotinamide supplementation help address nutritional deficiencies?  \n2. Why is a balanced diet with riboflavin and pyridoxine important in treating multiple nutrient deficiencies?  \n3. What role do B vitamins play in managing metabolic disorders caused by dietary imbalances?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 60af8968-7360-4895-aab6-9fd256e302e1
encoding: FLOAT32
metadata:
{"original_content": "Nicotinamide is usually used to treat deficiency, because\nnicotinamide, unlike nicotinic acid (the most common form of niacin), does not cause flushing, itching,\nburning, or tingling sensations.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. Why is nicotinamide preferred over nicotinic acid for treating niacin deficiency?  \n2. What are the side effects associated with nicotinic acid that are avoided by using nicotinamide?  \n3. How does nicotinamide address symptoms of niacin deficiency without causing discomfort?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 033cc7c7-09e2-4426-b7bc-19351296713c
encoding: FLOAT32
metadata:
{"original_content": "Nicotinamide is given in doses ranging from 40 to 250 mg/day po in\ndivided doses 3 to 4 times a day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What is the recommended dosage range of nicotinamide for treating nutritional deficiencies?  \n2. How frequently should nicotinamide be administered daily for managing vitamin B3 deficiency?  \n3. Can nicotinamide supplementation be used to address metabolic disorders related to niacin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 958807b6-fe34-4f64-aa7b-826e0f84bf5c
encoding: FLOAT32
metadata:
{"original_content": "Niacin Toxicity\nNiacin (nicotinic acid) in large amounts is sometimes used to lower low-density lipoprotein\n(LDL) cholesterol and triglyceride levels and to increase high-density lipoprotein (HDL)\ncholesterol levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the potential health risks associated with excessive intake of niacin for managing cholesterol levels?  \n2. How does niacin toxicity affect lipid metabolism and cholesterol regulation in the body?  \n3. What are the symptoms and consequences of niacin overdose in the context of nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0d10e346-fd94-4fd0-8f97-600afb188624
encoding: FLOAT32
metadata:
{"original_content": "Symptoms may include flushing and, rarely, hepatotoxicity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What nutritional disorder is associated with symptoms like flushing and potential hepatotoxicity?  \n2. Could a vitamin or mineral imbalance cause flushing and hepatotoxicity?  \n3. What are the potential side effects of treatments for dietary deficiencies that might include flushing and hepatotoxicity?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b1ffac8e-7e3d-4a9b-9ebb-a87e1adc0795
encoding: FLOAT32
metadata:
{"original_content": "Immediate- and sustained-release preparations of niacin (but not nicotinamide) may improve lipid levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How does niacin supplementation affect lipid levels in individuals with metabolic disorders?  \n2. What is the difference in efficacy between immediate- and sustained-release niacin preparations for managing lipid imbalances?  \n3. Can niacin be used as a therapeutic option for addressing vitamin B3 deficiencies and associated lipid abnormalities?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: bf923106-bd69-425c-b9ab-5a1e10fc9af1
encoding: FLOAT32
metadata:
{"original_content": "Flushing, which is prostaglandin-mediated, is more common with immediate-release preparations.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How does the prostaglandin-mediated mechanism contribute to flushing in nutritional or metabolic disorders?  \n2. Are immediate-release preparations more likely to cause flushing in individuals with vitamin or mineral imbalances?  \n3. What role do prostaglandins play in the side effects of treatments for dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a67ad0bb-46b3-4197-9f1b-aa250cd044e2
encoding: FLOAT32
metadata:
{"original_content": "It may\nbe more intense after alcohol ingestion, aerobic activity, sun exposure, and consumption of spicy foods.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How does alcohol consumption exacerbate symptoms of certain nutritional or metabolic disorders?  \n2. What role does sun exposure play in the severity of symptoms related to vitamin or mineral imbalances?  \n3. Why might spicy foods trigger or worsen symptoms in individuals with specific dietary deficiencies or metabolic conditions?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6ee3ff63-b95b-45ee-927e-fa4c49a309f0
encoding: FLOAT32
metadata:
{"original_content": "Flushing is minimized if niacin is taken after meals or if aspirin (325 mg) is taken 30 to 45 min before\nniacin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can flushing caused by niacin supplementation be minimized in individuals with a nutritional deficiency?  \n2. What is the role of aspirin in managing side effects associated with niacin intake for metabolic disorders?  \n3. Why is it recommended to take niacin after meals to reduce adverse effects in patients with vitamin imbalances?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 59bc81b7-b45d-44cf-9b9c-53c485c5451b
encoding: FLOAT32
metadata:
{"original_content": "The chance of severe flushing can be reduced by starting immediate-release niacin at a low dose\n(eg, 50 mg tid) and increasing it very slowly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How can the risk of severe flushing be minimized when starting immediate-release niacin for a nutritional deficiency?  \n2. What is the recommended starting dose of immediate-release niacin to avoid adverse effects in treating metabolic disorders?  \n3. Why is it important to increase the dosage of immediate-release niacin slowly in managing vitamin imbalances?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b620f9ca-cdb0-4f1a-a402-90b3ecf766df
encoding: FLOAT32
metadata:
{"original_content": "At intermediate doses (1000 mg/day), triglyceride levels\ndecrease 15 to 20%, and HDL cholesterol levels increase 15 to 30%.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How does a 1000 mg/day dose impact triglyceride levels in individuals with metabolic disorders?  \n2. Can intermediate doses of 1000 mg/day improve HDL cholesterol levels in patients with dietary deficiencies?  \n3. What is the effect of 1000 mg/day on lipid profiles in individuals with obesity-related health conditions?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b7e164b7-2154-44eb-91d3-23ecad1508a2
encoding: FLOAT32
metadata:
{"original_content": "Reductions in LDL cholesterol are\nmodest (< 10%).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What dietary or lifestyle interventions can lead to modest reductions in LDL cholesterol levels?  \n2. How do modest reductions in LDL cholesterol impact the risk of developing cardiovascular diseases?  \n3. Are there specific nutritional disorders or deficiencies that contribute to less than 10% reductions in LDL cholesterol?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: df6508fe-d6e5-4b50-8670-ce5f6321fc07
encoding: FLOAT32
metadata:
{"original_content": "Higher doses of niacin (3000 mg/day) reduce LDL cholesterol 15 to 20% but may cause\njaundice, abdominal discomfort, blurred vision, worsening of hyperglycemia, and precipitation of\npreexisting gout.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the potential side effects of using high doses of niacin to lower LDL cholesterol?  \n2. How does niacin supplementation impact preexisting metabolic conditions like gout or hyperglycemia?  \n3. What is the effectiveness of niacin in reducing LDL cholesterol levels in individuals with nutritional or metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 180d6398-7b72-4768-99d7-ca964efed552
encoding: FLOAT32
metadata:
{"original_content": "People with a liver disorder probably should not take high-dose niacin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. Why might high-dose niacin be harmful to individuals with liver disorders?  \n2. What are the potential risks of using niacin supplements for managing cholesterol in people with metabolic disorders?  \n3. How do liver disorders affect the metabolism and safety of certain vitamins or supplements like niacin?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cabc0e87-48b7-4cba-b40c-416272d451e1
encoding: FLOAT32
metadata:
{"original_content": "Hepatotoxicity may be more common with some sustained-release preparations.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. How do sustained-release preparations contribute to hepatotoxicity in the context of metabolic disorders?  \n2. Are there specific dietary deficiencies or imbalances that increase the risk of hepatotoxicity with sustained-release formulations?  \n3. What role do vitamin or mineral imbalances play in the susceptibility to hepatotoxicity from sustained-release medications?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e8ae8e40-99ce-4ab5-94e0-d91bf7fe9605
encoding: FLOAT32
metadata:
{"original_content": "Some authorities\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the common symptoms and diagnostic criteria for vitamin and mineral deficiencies?  \n2. How are metabolic disorders such as phenylketonuria or galactosemia managed through dietary interventions?  \n3. What are the potential health risks and treatment options for obesity-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c4ccfd14-0a9e-4880-b6d1-25f517332aa7
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n79", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 26, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and vitamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c3862029-623e-4b8c-97a8-f81165a38d65
encoding: FLOAT32
metadata:
{"original_content": "recommend checking levels of uric acid, serum glucose, and plasma transaminases every 6 to 8 wk until\nthe dose of niacin has been stabilized.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How frequently should uric acid, serum glucose, and plasma transaminases be monitored when stabilizing a niacin dosage?  \n2. What metabolic markers are important to track during niacin therapy for managing nutritional or metabolic disorders?  \n3. Why is it necessary to monitor plasma transaminases during niacin supplementation?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 294ba336-ac15-4cfb-b0e5-4a3054bf666a
encoding: FLOAT32
metadata:
{"original_content": "Riboflavin\nRiboflavin (vitamin B\n2\n) is involved in carbohydrate metabolism as an essential coenzyme in many\noxidation-reduction reactions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How does a riboflavin deficiency impact carbohydrate metabolism and energy production?  \n2. What are the potential health consequences of impaired oxidation-reduction reactions due to insufficient riboflavin?  \n3. Which metabolic disorders are associated with a deficiency in riboflavin (vitamin B2)?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e25cc080-730f-4a09-8c75-b5cf8a23330d
encoding: FLOAT32
metadata:
{"original_content": "Riboflavin is essentially nontoxic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. Is riboflavin toxicity a concern in cases of excessive vitamin supplementation?  \n2. Can riboflavin supplementation be safely used to address dietary deficiencies without risk of overdose?  \n3. How does the nontoxic nature of riboflavin impact its role in managing metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5c071d2e-8ce9-4fbc-af8d-fecf1e1fca42
encoding: FLOAT32
metadata:
{"original_content": "Riboflavin Deficiency\nRiboflavin deficiency usually occurs with other B-vitamin deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the common co-occurring deficiencies associated with riboflavin deficiency?  \n2. How does riboflavin deficiency relate to other B-vitamin deficiencies?  \n3. What are the potential health impacts of a combined deficiency in riboflavin and other B vitamins?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 68204eba-0c36-47d4-93a3-bbb23990fad9
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and signs\ninclude sore throat, lesions of the lips and mucosa of the mouth, glossitis, conjunctivitis,\nseborrheic dermatitis, and normochromicnormocytic anemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause symptoms such as glossitis, seborrheic dermatitis, and normochromic normocytic anemia?  \n2. How might a deficiency in specific vitamins or minerals lead to lesions of the lips and mucosa of the mouth?  \n3. What dietary interventions could help alleviate conjunctivitis and sore throat associated with a nutritional disorder?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d182f3ef-40a2-43d3-9898-2657e8381cba
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How can a clinical diagnosis help identify a specific vitamin or mineral deficiency?  \n2. What clinical signs are typically used to diagnose metabolic disorders related to nutrition?  \n3. In what ways can clinical evaluation aid in distinguishing between dietary deficiencies and other health conditions?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2a7e404d-dd2a-407c-847c-77f42532efea
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of oral or, if needed, IM riboflavin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What is the recommended treatment for riboflavin deficiency?  \n2. In what forms can riboflavin be administered to address a nutritional disorder?  \n3. What role does riboflavin supplementation play in managing metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 38a1f23d-6077-4a76-8af5-b9ca43b19cd6
encoding: FLOAT32
metadata:
{"original_content": "Primary riboflavin deficiency results from inadequate intake of fortified cereals, milk, and other animal\nproducts.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What dietary sources are commonly associated with preventing primary riboflavin deficiency?  \n2. How does inadequate intake of fortified cereals and animal products contribute to riboflavin deficiency?  \n3. What are the nutritional implications of excluding milk and other animal products from the diet?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 36aa9ae9-d3f7-4fe1-a03a-2d6f856c4e0d
encoding: FLOAT32
metadata:
{"original_content": "The most common causes of secondary deficiency are chronic diarrhea, malabsorption\nsyndromes, liver disorders, hemodialysis, peritoneal dialysis, long-term use of barbiturates, and chronic\nalcoholism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the potential causes of secondary nutritional deficiencies related to chronic health conditions?  \n2. How can chronic alcoholism contribute to the development of vitamin and mineral imbalances?  \n3. What role do malabsorption syndromes play in the onset of dietary deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6d5ceb15-3b8a-42b0-8a0c-90a5932a077c
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nThe most common signs are pallor and maceration of the mucosa at the angles of the mouth (angular\nstomatitis) and vermilion surfaces of the lips (cheilosis), eventually replaced by superficial linear fissures.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies are associated with angular stomatitis and cheilosis?  \n2. How can dietary imbalances lead to pallor and maceration of the mucosa?  \n3. Which vitamins or minerals are commonly linked to the development of superficial linear fissures on the lips?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f7d1b175-bd9a-48ca-90d4-8032e9b106f4
encoding: FLOAT32
metadata:
{"original_content": "The fissures can become infected with \nCandida albicans\n, causing grayish white lesions (perleche).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies can lead to fissures that are susceptible to Candida albicans infections?  \n2. How does a deficiency in certain vitamins or minerals contribute to the development of perleche?  \n3. What dietary interventions can help prevent or manage Candida albicans infections in individuals with nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 386ee30e-74aa-41cf-9eca-a4604d3a01db
encoding: FLOAT32
metadata:
{"original_content": "The\ntongue may appear magenta.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies can cause a magenta-colored tongue?  \n2. How does a magenta tongue indicate potential vitamin or mineral imbalances?  \n3. Which metabolic disorders are associated with changes in tongue coloration?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 584e6c45-8276-4e91-acae-49f9fb8b5a63
encoding: FLOAT32
metadata:
{"original_content": "Seborrheic dermatitis develops, usually affecting the nasolabial folds, ears,\neyelids, and scrotum or labia majora.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. Can seborrheic dermatitis be linked to a deficiency in specific vitamins or minerals?  \n2. Are there dietary changes that can help manage or alleviate seborrheic dermatitis symptoms?  \n3. Is seborrheic dermatitis associated with any metabolic or nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab50b2de-7eb9-49db-acb3-0f6f2b962eaa
encoding: FLOAT32
metadata:
{"original_content": "These areas become red, scaly, and greasy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies could contribute to red, scaly, and greasy skin conditions?  \n2. Could a lack of essential fatty acids in the diet lead to skin issues like redness and scaliness?  \n3. How might vitamin or mineral imbalances manifest as greasy and inflamed skin?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d6986fb9-541d-403e-b1be-8592e86d00d6
encoding: FLOAT32
metadata:
{"original_content": "Rarely, neovascularization and keratitis of the cornea occur, causing lacrimation and photophobia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiencies can lead to neovascularization and keratitis of the cornea?  \n2. How does a lack of specific vitamins or minerals contribute to symptoms like lacrimation and photophobia?  \n3. What dietary interventions can prevent or manage corneal neovascularization associated with nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: def55685-d3ae-4ab5-a758-b008cd884822
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\nThe lesions characteristic of riboflavin deficiency are nonspecific.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms associated with riboflavin deficiency?  \n2. How can nonspecific lesions aid in the diagnosis of riboflavin deficiency?  \n3. What role does riboflavin play in preventing nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 517ca84f-2b40-40ec-9959-07fd38f5e78c
encoding: FLOAT32
metadata:
{"original_content": "Riboflavin deficiency should be\nsuspected if characteristic signs develop in a patient with other B vitamin deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the characteristic signs of riboflavin deficiency in patients with other B vitamin deficiencies?  \n2. How can riboflavin deficiency be identified in the context of broader B vitamin deficiencies?  \n3. What is the relationship between riboflavin deficiency and other B vitamin deficiencies in nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5bb35cda-cb30-4562-ae2b-0812e4145332
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis can be\nconfirmed by a therapeutic trial or laboratory testing, usually by measuring urinary excretion of riboflavin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How can a therapeutic trial be used to confirm a diagnosis of a nutritional disorder?  \n2. What role does urinary excretion of riboflavin play in diagnosing vitamin deficiencies?  \n3. Which laboratory tests are most effective for identifying riboflavin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a276cc75-1022-47d5-a0b4-66aaf99ebc9f
encoding: FLOAT32
metadata:
{"original_content": "Treatment\nRiboflavin 5 to 10 mg/day po is given until recovery.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What is the recommended daily dosage of riboflavin for treating a nutritional deficiency?  \n2. How is riboflavin administered to address a vitamin B2 deficiency?  \n3. What is the typical duration of riboflavin treatment for recovery from a nutritional disorder?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4c47315f-3be5-40a2-add3-fdd5dcfc67fa
encoding: FLOAT32
metadata:
{"original_content": "Other water-soluble vitamins should also be given.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. Why is it important to supplement with other water-soluble vitamins in cases of specific nutritional deficiencies?  \n2. How do deficiencies in water-soluble vitamins contribute to metabolic disorders?  \n3. What role do water-soluble vitamins play in preventing or managing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 07c51083-f194-4420-b548-cb366857928c
encoding: FLOAT32
metadata:
{"original_content": "Thiamin\nThiamin (vitamin B\n1\n) is widely available in the diet. Thiamin is involved in carbohydrate, fat, amino acid,\nglucose, and alcohol metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How does a deficiency in thiamin (vitamin B1) affect carbohydrate and glucose metabolism in the body?  \n2. What role does thiamin play in preventing metabolic disorders related to alcohol consumption?  \n3. Can a lack of thiamin contribute to amino acid metabolism imbalances and related health conditions?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d2e97c6e-4f12-43b2-90e2-8de05f7299ed
encoding: FLOAT32
metadata:
{"original_content": "Thiamin is essentially nontoxic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. Can excessive intake of thiamin lead to toxicity or adverse health effects?  \n2. How does the nontoxic nature of thiamin impact its use in treating thiamin deficiency disorders?  \n3. Are there any risks associated with high-dose thiamin supplementation in individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 82dbb7e0-b41a-40ec-ad91-64d973951458
encoding: FLOAT32
metadata:
{"original_content": "Thiamin Deficiency\nThiamin deficiency (causing beriberi) is most common among people subsisting on white rice\nor highly refined carbohydrates in developing countries and among alcoholics.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What dietary habits are associated with an increased risk of thiamin deficiency?  \n2. How does alcohol consumption contribute to the development of thiamin deficiency?  \n3. What populations are most at risk for developing beriberi due to thiamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 846e0e3e-b870-4c74-817e-be20ec4c904e
encoding: FLOAT32
metadata:
{"original_content": "Symptoms\ninclude diffuse polyneuropathy, high-output heart failure, and Wernicke-Korsakoff syndrome.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with symptoms like diffuse polyneuropathy and high-output heart failure?  \n2. How does a lack of specific vitamins contribute to the development of Wernicke-Korsakoff syndrome?  \n3. Which dietary deficiencies can lead to both neurological and cardiovascular complications?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8cad6c8d-def3-4685-b796-4efa31c86652
encoding: FLOAT32
metadata:
{"original_content": "Thiamin is given to help diagnose and treat the deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How is thiamin used in the diagnosis of thiamin deficiency?  \n2. What role does thiamin play in treating nutritional deficiencies?  \n3. What are the symptoms of a thiamin deficiency that might require supplementation?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: df7d01a8-b10c-49a2-94a0-d2e41c75cadd
encoding: FLOAT32
metadata:
{"original_content": "Etiology\nPrimary thiamin deficiency is caused by inadequate intake of thiamin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What is the primary cause of thiamin deficiency in individuals?  \n2. How does inadequate thiamin intake contribute to nutritional disorders?  \n3. What dietary factors might lead to a primary thiamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cee2bb51-c770-4458-9338-1a5e0215aedd
encoding: FLOAT32
metadata:
{"original_content": "It is commonly due to a diet of\nhighly refined carbohydrates (eg, polished rice, white flour, white sugar).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How can a diet high in refined carbohydrates contribute to nutritional deficiencies?  \n2. What are the potential health risks associated with consuming polished rice, white flour, and white sugar as dietary staples?  \n3. Which nutritional disorders are commonly linked to diets predominantly composed of highly refined carbohydrates?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dc6d3547-2afb-427b-bca0-67a4c8bb1c29
encoding: FLOAT32
metadata:
{"original_content": "It also develops when intake of\nother nutrients is inadequate; it often occurs with other B vitamin deficiencies.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. How does inadequate intake of other nutrients contribute to the development of B vitamin deficiencies?  \n2. What are the common nutritional disorders associated with multiple B vitamin deficiencies?  \n3. Why do B vitamin deficiencies often occur alongside deficiencies in other nutrients?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 127a603b-b836-4b91-ac7e-917482d49e62
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated nutritionally?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9ecddb6b-4167-4ed5-a23e-c5f188ebcc9f
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n80", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 27, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity for specific vitamins?  \n2. How can dietary deficiencies lead to metabolic disorders and related health conditions?  \n3. What are the differences between vitamin dependency and vitamin deficiency in terms of treatment and management?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fe60198f-6ae2-4ee1-94f6-0ab5a2ab8069
encoding: FLOAT32
metadata:
{"original_content": "Secondary thiamin deficiency is caused by increased demand (eg, due to hyperthyroidism, pregnancy,\nbreastfeeding, strenuous exercise, or fever), impaired absorption (eg, due to prolonged diarrhea), or\nimpaired metabolism (eg, due to hepatic insufficiency).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What factors can lead to secondary thiamin deficiency in individuals with increased metabolic demand?  \n2. How does prolonged diarrhea contribute to impaired thiamin absorption and deficiency?  \n3. In what ways can hepatic insufficiency affect thiamin metabolism and lead to nutritional disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a1b4d535-a2d0-4856-8a57-190267ce3ed4
encoding: FLOAT32
metadata:
{"original_content": "In alcoholics, many mechanisms contribute to\nthiamin deficiency; they include decreased intake, impaired absorption and use, increased demand, and\npossibly an apoenzyme defect.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the mechanisms by which alcohol consumption leads to thiamin deficiency?  \n2. How does impaired absorption contribute to thiamin deficiency in individuals with alcohol use disorder?  \n3. Could an apoenzyme defect play a role in the development of thiamin deficiency in alcoholics?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3cf242c1-7b0b-4aa7-a33c-ee4030ff6a0d
encoding: FLOAT32
metadata:
{"original_content": "Pathophysiology\nDeficiency causes degeneration of peripheral nerves, thalamus, mammillary bodies, and cerebellum.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiency leads to the degeneration of peripheral nerves, thalamus, mammillary bodies, and cerebellum?  \n2. How does a deficiency in specific nutrients contribute to damage in the mammillary bodies and thalamus?  \n3. What are the neurological consequences of a dietary deficiency that affects the cerebellum?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f46da341-e36c-43be-ade4-b18c399ff317
encoding: FLOAT32
metadata:
{"original_content": "Cerebral blood flow is markedly reduced, and vascular resistance is increased.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can specific dietary deficiencies contribute to reduced cerebral blood flow and increased vascular resistance?  \n2. What role do vitamin and mineral imbalances play in the regulation of cerebral blood flow?  \n3. Can metabolic disorders linked to obesity exacerbate vascular resistance in the brain?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 47448506-cfea-46ae-8a57-5930031e1210
encoding: FLOAT32
metadata:
{"original_content": "The heart may become dilated; muscle fibers become swollen, fragmented, and vacuolized, with\ninterstitial spaces dilated by fluid.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can nutritional deficiencies lead to structural changes in heart muscle fibers?  \n2. What dietary imbalances might contribute to fluid accumulation in interstitial spaces of the heart?  \n3. Which specific nutrients or vitamins are critical for preventing the dilation and fragmentation of heart muscle fibers?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a140cc1d-1a2b-4657-8cc2-bf0d1fd2c51b
encoding: FLOAT32
metadata:
{"original_content": "Vasodilation occurs and can result in edema in the feet and legs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to vasodilation and edema in the feet and legs?  \n2. What role do vitamin and mineral imbalances play in the development of edema associated with vasodilation?  \n3. Can obesity exacerbate vasodilation and lead to swelling in the lower extremities?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 461a5e0a-37e9-4ab6-bc11-be968a99766e
encoding: FLOAT32
metadata:
{"original_content": "Arteriovenous shunting of blood increases.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does arteriovenous shunting of blood impact nutrient delivery and absorption in individuals with metabolic disorders?  \n2. Can arteriovenous shunting of blood contribute to complications in obesity-related health conditions?  \n3. What role does arteriovenous shunting of blood play in the progression of vitamin and mineral deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 508ba363-dcd5-4bdd-b565-c779c112db44
encoding: FLOAT32
metadata:
{"original_content": "Eventually, high-output heart failure may occur.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to the development of high-output heart failure?  \n2. What role do vitamin and mineral imbalances play in the progression of high-output heart failure?  \n3. Are there specific metabolic disorders linked to the onset of high-output heart failure?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7d9b3e1b-fe13-47d8-90d9-4923a7c78e6d
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nEarly symptoms are nonspecific: fatigue, irritability, poor memory, sleep disturbances, precordial pain,\nanorexia, and abdominal discomfort.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause symptoms like fatigue, irritability, and poor memory?  \n2. How might dietary imbalances contribute to precordial pain and abdominal discomfort?  \n3. What are the early signs of a metabolic disorder linked to poor nutrition?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 48203d4a-d055-40ac-a430-922fe49f9e2d
encoding: FLOAT32
metadata:
{"original_content": "Dry beriberi\n refers to peripheral neurologic deficits due to thiamin deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the neurological effects of thiamin deficiency in the context of dry beriberi?  \n2. How does a lack of thiamin contribute to peripheral neurologic deficits?  \n3. What dietary deficiencies are associated with the development of dry beriberi?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c857f2a6-e9f5-4c53-a062-74f78e8d9138
encoding: FLOAT32
metadata:
{"original_content": "These deficits are bilateral\nand roughly symmetric, occurring in a stocking-glove distribution.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies are associated with bilateral and symmetric deficits in a stocking-glove distribution?  \n2. How can vitamin or mineral imbalances lead to peripheral neuropathy in a stocking-glove pattern?  \n3. Which metabolic disorders present with stocking-glove distribution symptoms and how are they linked to dietary factors?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dbc09b66-44fa-4b5b-b379-372872924d68
encoding: FLOAT32
metadata:
{"original_content": "They affect predominantly the lower\nextremities, beginning with paresthesias in the toes, burning in the feet (particularly severe at night),\nmuscle cramps in the calves, pains in the legs, and plantar dysesthesias.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause paresthesias and burning sensations in the lower extremities?  \n2. How might vitamin or mineral imbalances contribute to muscle cramps and leg pain?  \n3. What dietary interventions could alleviate plantar dysesthesias associated with metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0a844dc9-9964-42dd-a29d-072a0df2dc37
encoding: FLOAT32
metadata:
{"original_content": "Calf muscle tenderness,\ndifficulty rising from a squatting position, and decreased vibratory sensation in the toes are early signs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause calf muscle tenderness and difficulty rising from a squatting position?  \n2. How does decreased vibratory sensation in the toes relate to specific vitamin or mineral imbalances?  \n3. Which metabolic disorders are associated with early signs like muscle weakness and sensory changes?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d35073b6-f0c5-4e07-9d3f-a5c9d50015dc
encoding: FLOAT32
metadata:
{"original_content": "Muscle wasting occurs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies can contribute to muscle wasting?  \n2. How do metabolic disorders lead to muscle wasting in individuals?  \n3. What role do vitamin and mineral imbalances play in the development of muscle wasting?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f28593b4-67f8-4bb5-b9d7-dc37375cb099
encoding: FLOAT32
metadata:
{"original_content": "Continued deficiency worsens polyneuropathy, which can eventually affect the\narms.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does a nutritional deficiency contribute to the development of polyneuropathy?  \n2. What are the potential effects of prolonged dietary deficiencies on the arms?  \n3. Which specific nutrients, when deficient, are linked to worsening polyneuropathy?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 81116489-5cac-42a5-8ce1-a8c3afe4f89f
encoding: FLOAT32
metadata:
{"original_content": "Wernicke-Korsakoff syndrome,\n which combines Wernicke's encephalopathy (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What role does thiamine (vitamin B1) deficiency play in the development of Wernicke-Korsakoff syndrome?  \n2. How can dietary interventions help prevent or manage Wernicke-Korsakoff syndrome?  \n3. What are the metabolic consequences of chronic alcohol consumption in relation to Wernicke-Korsakoff syndrome?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5fdc304a-feeb-46c3-a658-163b861e29b4
encoding: FLOAT32
metadata:
{"original_content": "1522\n) and\nKorsakoff's psychosis (see p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the nutritional deficiencies associated with Korsakoff's psychosis?  \n2. How does a lack of specific vitamins contribute to the development of Korsakoff's psychosis?  \n3. What dietary interventions can help prevent or manage Korsakoff's psychosis?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: aab1502a-9275-4db9-bc99-a45d5692d3f5
encoding: FLOAT32
metadata:
{"original_content": "1523\n), occurs in some alcoholics who do not consume foods fortified with\nthiamin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies are associated with alcoholism?  \n2. How does a lack of thiamin in the diet affect metabolic health?  \n3. What are the potential health consequences of not consuming thiamin-fortified foods?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 971e3d95-caf2-4376-a4ea-826d059089dc
encoding: FLOAT32
metadata:
{"original_content": "Wernicke's encephalopathy consists of psychomotor slowing or apathy, nystagmus, ataxia,\nophthalmoplegia, impaired consciousness, and, if untreated, coma and death.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the neurological symptoms associated with thiamine (vitamin B1) deficiency in Wernicke's encephalopathy?  \n2. How can untreated nutritional deficiencies lead to severe outcomes like coma or death in Wernicke's encephalopathy?  \n3. What role does thiamine play in preventing psychomotor slowing and ataxia in metabolic disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4afa96b5-3657-40a2-bbf0-8af988edccf4
encoding: FLOAT32
metadata:
{"original_content": "It probably results from\nsevere acute deficiency superimposed on chronic deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the potential health consequences of a severe acute deficiency occurring alongside a chronic nutritional deficiency?  \n2. How might chronic dietary deficiencies exacerbate the effects of an acute nutritional deficiency?  \n3. What strategies can be implemented to prevent the compounding effects of chronic and acute nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fedbde25-f9d1-430b-8029-631da09fb10b
encoding: FLOAT32
metadata:
{"original_content": "Korsakoff's psychosis consists of mental\nconfusion, dysphonia, and confabulation with impaired memory of recent events.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does a deficiency in certain nutrients contribute to the development of Korsakoff's psychosis?  \n2. What role does thiamine (vitamin B1) deficiency play in the onset of mental confusion and memory impairment associated with Korsakoff's psychosis?  \n3. Can dietary interventions or supplementation help prevent or manage the symptoms of Korsakoff's psychosis?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 600cdf2e-289c-4712-bea7-26d95b0f8efe
encoding: FLOAT32
metadata:
{"original_content": "It probably results from\nchronic deficiency and may develop after repeated episodes of Wernicke's encephalopathy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the potential long-term effects of chronic nutritional deficiencies on brain health?  \n2. How does repeated Wernicke's encephalopathy contribute to the development of other nutritional disorders?  \n3. Which specific dietary deficiencies are associated with the progression of Wernicke's encephalopathy?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: db3481de-1560-4b37-8731-16a529bea32a
encoding: FLOAT32
metadata:
{"original_content": "Cardiovascular (wet) beriberi\n is myocardial disease due to thiamin deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does thiamin deficiency contribute to the development of cardiovascular (wet) beriberi?  \n2. What are the nutritional causes and consequences of myocardial disease in the context of thiamin deficiency?  \n3. What dietary interventions can prevent or treat cardiovascular (wet) beriberi caused by thiamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a2040f2d-3ee9-4efa-a01d-1a28bb9a0a93
encoding: FLOAT32
metadata:
{"original_content": "The first effects are\nvasodilation, tachycardia, a wide pulse pressure, sweating, warm skin, and lactic acidosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could lead to symptoms such as vasodilation, tachycardia, and lactic acidosis?  \n2. How might a metabolic disorder manifest with symptoms like a wide pulse pressure, sweating, and warm skin?  \n3. Could a vitamin or mineral imbalance be responsible for the combination of lactic acidosis and cardiovascular symptoms?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 87d4e42a-97b9-45ee-85f4-7bf30b43479c
encoding: FLOAT32
metadata:
{"original_content": "Later, heart\nfailure develops, causing orthopnea and pulmonary and peripheral edema. Vasodilation can continue,\nsometimes resulting in shock.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to the development of heart failure and associated symptoms like orthopnea and edema?  \n2. What role does vasodilation play in the progression of shock in the context of metabolic or dietary imbalances?  \n3. Which specific nutrient deficiencies or imbalances are linked to the onset of pulmonary and peripheral edema?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 507f08a5-fb46-4ac4-9ab0-a6dfe4b1fdd3
encoding: FLOAT32
metadata:
{"original_content": "Infantile beriberi\n occurs in infants (usually by age 3 to 4 wk) who are breastfed by thiamin-deficient\nmothers.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does maternal thiamin deficiency contribute to the development of infantile beriberi in breastfed infants?  \n2. What are the nutritional requirements for preventing thiamin deficiency in breastfeeding mothers?  \n3. What are the early signs and symptoms of thiamin deficiency in infants?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 696e690f-cdaa-429c-925d-f9b5b41798fb
encoding: FLOAT32
metadata:
{"original_content": "Heart failure (which may occur suddenly), aphonia, and absent deep tendon reflexes are\ncharacteristic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What nutritional deficiencies could lead to symptoms such as heart failure, aphonia, and absent deep tendon reflexes?  \n2. How might a deficiency in specific vitamins or minerals contribute to the sudden onset of heart failure?  \n3. What metabolic disorders are associated with the absence of deep tendon reflexes and aphonia?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4121e467-2d89-446e-ba92-b73d19e60957
encoding: FLOAT32
metadata:
{"original_content": "Because thiamin is necessary for glucose metabolism, glucose infusions may precipitate or worsen\nsymptoms of deficiency in thiamin-deficient people.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does thiamin deficiency impact glucose metabolism in the body?  \n2. Why might glucose infusions exacerbate symptoms in individuals with thiamin deficiency?  \n3. What are the potential risks of administering glucose to patients with undiagnosed nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f28d4c8f-62c1-455d-b460-56d4a1247f36
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Favorable response to thiamin\nDiagnosis is usually based on a favorable response to treatment with thiamin in a patient with symptoms\nor signs of deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How can a favorable response to thiamin treatment help diagnose a nutritional deficiency?  \n2. What symptoms or signs might indicate a thiamin deficiency in a patient?  \n3. In what scenarios is thiamin supplementation used as a diagnostic tool for metabolic or dietary disorders?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7248b968-29aa-4bd4-aac2-88af3793bf30
encoding: FLOAT32
metadata:
{"original_content": "Similar bilateral lower-extremity polyneuropathies due to other disorders (eg,\ndiabetes, alcoholism, vitamin B\n12\n deficiency, heavy metal poisoning) do not respond to thiamin.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. How does thiamin deficiency differ from vitamin B12 deficiency in causing bilateral lower-extremity polyneuropathies?  \n2. What are the nutritional causes of bilateral lower-extremity polyneuropathies that do not respond to thiamin supplementation?  \n3. How can heavy metal poisoning contribute to polyneuropathy, and how does it differ from dietary deficiencies like thiamin or vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dd84b94c-1278-412c-b733-b1cca5abe7b0
encoding: FLOAT32
metadata:
{"original_content": "Single-\nnerve neuritides (mononeuropathies\u2014eg, sciatica) and multiple mononeuropathies (mononeuritis\nmultiplex) are unlikely to result from thiamin deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. Can thiamin deficiency cause single-nerve neuritides such as sciatica?  \n2. Is multiple mononeuropathy (mononeuritis multiplex) associated with thiamin deficiency?  \n3. What neurological conditions are unlikely to result from a thiamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d97714db-a05f-4e9e-bcb2-f74b82bbac4b
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9eceeb24-db9d-4208-9dd8-9dfff549c464
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n81", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 28, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and vitamin deficiency?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2bb80d5c-181b-4d17-b208-61a1e31b8486
encoding: FLOAT32
metadata:
{"original_content": "Electrolytes, including Mg, should be measured to exclude other causes.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can measuring magnesium levels help identify the cause of a nutritional disorder?  \n2. What role do electrolytes play in diagnosing metabolic disorders?  \n3. Why is it important to exclude other causes when assessing vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8e2d27a5-f9b3-4f92-a9e3-43292afd0303
encoding: FLOAT32
metadata:
{"original_content": "For confirmation in equivocal\ncases, erythrocyte transketolase activity and 24-h urinary thiamin excretion may be measured.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can erythrocyte transketolase activity be used to confirm a thiamin deficiency?  \n2. What role does 24-hour urinary thiamin excretion play in diagnosing nutritional disorders?  \n3. In what situations might additional testing be required to confirm a suspected thiamin-related metabolic disorder?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c2c0aaba-9d8c-4e01-b10a-ffef7dec9e08
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis of cardiovascular beriberi can be difficult if other disorders that cause heart failure are present.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can a deficiency in thiamine (vitamin B1) lead to cardiovascular beriberi and heart failure?  \n2. What are the distinguishing nutritional or metabolic markers used to differentiate cardiovascular beriberi from other heart failure-causing disorders?  \n3. What dietary interventions can help prevent or manage cardiovascular beriberi in at-risk populations?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9707123c-2348-4843-9125-26de52d1d01e
encoding: FLOAT32
metadata:
{"original_content": "A therapeutic trial of thiamin can help.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can a therapeutic trial of thiamin be used to address symptoms of a thiamin deficiency?  \n2. What role does thiamin play in managing metabolic disorders?  \n3. In what nutritional disorders might a therapeutic trial of thiamin be considered a potential treatment?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: eb9d4d07-3963-4e88-a0ac-78470510ab1c
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Supplemental thiamin, with dose based on clinical manifestations\nEnsuring that dietary supplies of thiamin are adequate is important regardless of symptoms. Because IV\nglucose can worsen thiamin deficiency, alcoholics and others at risk of thiamin deficiency should receive\nIV thiamin 100 mg before receiving IV glucose solutions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. Why is it important to administer IV thiamin before IV glucose in individuals at risk of thiamin deficiency?  \n2. What is the recommended treatment approach for managing thiamin deficiency in patients with clinical symptoms?  \n3. How can dietary thiamin intake be optimized to prevent deficiency in at-risk populations?  "}


created_at: 2025-03-03 11:15:34
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cac9974f-ed08-431e-9341-4399db64fa6b
encoding: FLOAT32
metadata:
{"original_content": "For mild polyneuropathy, thiamin 10 to 20 mg po once/day is given for 2 wk.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What is the recommended dosage of thiamin for treating mild polyneuropathy?  \n2. How long should thiamin supplementation be administered for mild polyneuropathy?  \n3. Which vitamin deficiency is associated with the treatment of mild polyneuropathy?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ec32c368-5959-417a-bbb2-4c1069546595
encoding: FLOAT32
metadata:
{"original_content": "For moderate or advanced\nneuropathy, the dose is 20 to 30 mg/day; it should be continued for several weeks after symptoms\ndisappear.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What is the recommended daily dosage of a specific nutrient for managing moderate or advanced neuropathy?  \n2. How long should supplementation continue after neuropathy symptoms disappear?  \n3. What role does nutrient supplementation play in the treatment of neuropathy?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 16cd4f06-7c41-41cc-8cfb-1f95d90b2b10
encoding: FLOAT32
metadata:
{"original_content": "For edema and congestion due to cardiovascular beriberi, thiamin 100 mg IV once/day is given\nfor several days.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What is the recommended thiamin dosage for treating edema and congestion caused by cardiovascular beriberi?  \n2. How is intravenous thiamin used in the management of cardiovascular beriberi?  \n3. What are the nutritional interventions for addressing thiamin deficiency-related cardiovascular complications?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5a4e995c-ea06-49dc-abba-c054e384d7a3
encoding: FLOAT32
metadata:
{"original_content": "Heart failure is also treated.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to the development or progression of heart failure?  \n2. What role do vitamin and mineral imbalances play in managing heart failure symptoms?  \n3. Can obesity-related metabolic disorders increase the risk of heart failure, and how can nutrition address this?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d0705bf4-31db-491a-83f2-1f5586fbde07
encoding: FLOAT32
metadata:
{"original_content": "For Wernicke-Korsakoff syndrome, thiamin 50 to 100 mg IM or IV bid must usually be given for several\ndays, followed by 10 to 20 mg once/day until a therapeutic response is obtained.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What is the recommended dosage of thiamin for treating Wernicke-Korsakoff syndrome?  \n2. How is thiamin administered in cases of Wernicke-Korsakoff syndrome?  \n3. What is the duration of thiamin treatment required to achieve a therapeutic response in Wernicke-Korsakoff syndrome?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 05cb1b9d-c434-4e8b-a915-820e2b21f576
encoding: FLOAT32
metadata:
{"original_content": "Anaphylactic reactions\nto IV thiamin are rare.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the potential risks associated with intravenous thiamin administration in individuals with nutritional deficiencies?  \n2. How rare are anaphylactic reactions to IV thiamin in the treatment of thiamin deficiency?  \n3. What precautions should be taken when administering IV thiamin to patients with suspected vitamin B1 deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5da22bd-afd6-46f2-ab10-9c8c7cc7f0e6
encoding: FLOAT32
metadata:
{"original_content": "Symptoms of ophthalmoplegia may resolve in a day; improvement in patients with\nKorsakoff psychosis may take 1 to 3 mo.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How long does it typically take for symptoms of ophthalmoplegia to resolve in patients with nutritional deficiencies?  \n2. What is the expected recovery timeline for patients with Korsakoff psychosis caused by thiamine deficiency?  \n3. Are there differences in recovery times for neurological symptoms associated with vitamin deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7a404e88-28b5-49d4-80b0-7dd26233d2fe
encoding: FLOAT32
metadata:
{"original_content": "Recovery from neurologic deficits is often incomplete in\nWernicke-Korsakoff syndrome and in other forms of thiamin deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does thiamin deficiency contribute to the development of Wernicke-Korsakoff syndrome?  \n2. What are the long-term neurological effects of untreated thiamin deficiency?  \n3. Why is recovery from neurologic deficits often incomplete in cases of Wernicke-Korsakoff syndrome?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7abe5217-9cdb-47c6-b0ca-5dbe49caf2a5
encoding: FLOAT32
metadata:
{"original_content": "Because thiamin deficiency often occurs with other B vitamin deficiencies, multiple water-soluble vitamins\nare usually given for several weeks.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. Why is thiamin deficiency often associated with deficiencies in other B vitamins?  \n2. What is the recommended treatment duration for addressing thiamin and other B vitamin deficiencies?  \n3. How do water-soluble vitamins help in managing nutritional disorders related to thiamin deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7bdbbf68-ff75-49b6-82bc-bf58efa99fb5
encoding: FLOAT32
metadata:
{"original_content": "Patients should continue to consume a nutritious diet, supplying 1 to\n2 times the daily recommended intake of vitamins; all alcohol intake should stop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can a nutritious diet help address vitamin deficiencies in patients with metabolic disorders?  \n2. Why is it recommended to avoid alcohol intake when managing nutritional disorders?  \n3. What is the appropriate daily vitamin intake for patients recovering from dietary deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0135e776-34e7-41ae-b465-2cc5f73815d2
encoding: FLOAT32
metadata:
{"original_content": "Vitamin A\nVitamin A (retinol) is required for the formation of rhodopsin, a photoreceptor pigment in the retina.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does a deficiency in Vitamin A affect the formation of rhodopsin and vision?  \n2. What are the potential health consequences of a Vitamin A deficiency related to photoreceptor function?  \n3. Can Vitamin A supplementation help prevent or treat disorders associated with impaired rhodopsin production?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 026f2d65-88cc-4aca-be4a-55127c0c17da
encoding: FLOAT32
metadata:
{"original_content": "Vitamin\nA helps maintain epithelial tissues.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does a deficiency in Vitamin A contribute to disorders affecting epithelial tissues?  \n2. What are the potential health consequences of Vitamin A imbalance on epithelial tissue maintenance?  \n3. Can Vitamin A supplementation help prevent epithelial tissue-related disorders caused by dietary deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f93e644e-2cd6-443f-a385-e33750123048
encoding: FLOAT32
metadata:
{"original_content": "Normally, the liver stores 80 to 90% of the body's vitamin A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does impaired liver function affect the body's ability to store vitamin A?  \n2. What are the potential health consequences of the liver storing less than the normal 80 to 90% of the body's vitamin A?  \n3. Could a vitamin A deficiency be linked to metabolic disorders involving liver dysfunction?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7c93dbcd-ac19-4b7f-841c-549dcae06948
encoding: FLOAT32
metadata:
{"original_content": "To use\nvitamin A, the body releases it into the circulation bound to prealbumin (transthyretin) and retinol-binding\nprotein.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does a deficiency in retinol-binding protein affect the body's ability to utilize vitamin A?  \n2. What role does transthyretin play in the transport and metabolism of vitamin A in cases of malnutrition?  \n3. Can disruptions in the binding of vitamin A to prealbumin contribute to vitamin A deficiency disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 16dea8d7-7f14-4cee-a5e1-29a7f6bce6db
encoding: FLOAT32
metadata:
{"original_content": "\u03b2\n-Carotene and other provitamin carotenoids, contained in green leafy and yellow vegetables\nand deep- or bright-colored fruits, are converted to vitamin A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does a deficiency in \u03b2-carotene and provitamin carotenoids contribute to vitamin A deficiency-related disorders?  \n2. What role do green leafy and yellow vegetables play in preventing metabolic disorders linked to vitamin A deficiency?  \n3. Can a diet lacking deep- or bright-colored fruits lead to vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d076d30b-6432-4618-9c2a-1b08e819f8e3
encoding: FLOAT32
metadata:
{"original_content": "Carotenoids are absorbed better from\nvegetables when they are cooked or homogenized and served with some fats or oils.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can cooking and adding fats to vegetables improve carotenoid absorption in individuals with vitamin A deficiency?  \n2. What dietary modifications can help prevent carotenoid-related deficiencies in people with fat malabsorption disorders?  \n3. Could improper preparation of vegetables contribute to metabolic disorders linked to inadequate carotenoid intake?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab054665-0b9d-4d25-8d48-c92cca00d60c
encoding: FLOAT32
metadata:
{"original_content": "Retinol activity equivalents (RAE) were developed because provitamin A carotenoids have less vitamin A\nactivity than preformed vitamin A; 1 \n\u03bc\ng retinol = 3.33 IU.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does the conversion of provitamin A carotenoids to retinol activity equivalents (RAE) impact the assessment of vitamin A deficiency?  \n2. What role does the difference in vitamin A activity between preformed vitamin A and provitamin A carotenoids play in preventing nutritional disorders?  \n3. How can understanding the RAE conversion factor help in addressing vitamin A-related metabolic imbalances?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ed2f235-7629-4d15-bc36-7bd1ff1559f2
encoding: FLOAT32
metadata:
{"original_content": "Synthetic vitamin analogs (retinoids) are being used increasingly in dermatology.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How do synthetic vitamin analogs like retinoids impact vitamin A metabolism in individuals with dietary deficiencies?  \n2. Can the use of retinoids in dermatology lead to vitamin A toxicity or imbalance in patients with pre-existing nutritional disorders?  \n3. Are synthetic retinoids effective in addressing skin conditions caused by vitamin A deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: eee8f93d-7900-4f61-b03b-5b6e81820f13
encoding: FLOAT32
metadata:
{"original_content": "The possible protective\nrole of \n\u03b2\n-carotene, retinol, and retinoids against some epithelial cancers is under study.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How might \u03b2-carotene, retinol, and retinoids contribute to the prevention of epithelial cancers linked to dietary deficiencies?  \n2. What role do vitamin A derivatives play in addressing metabolic disorders associated with epithelial tissue health?  \n3. Can a deficiency in \u03b2-carotene or retinol increase the risk of developing epithelial cancers?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7f588df8-ff4c-4d09-b70f-3d0b75cfac70
encoding: FLOAT32
metadata:
{"original_content": "However, risk of\ncertain cancers may be increased after \n\u03b2\n-carotene supplementation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How does \u03b2-carotene supplementation influence the risk of developing certain cancers?  \n2. Are there specific nutritional disorders or deficiencies that might make \u03b2-carotene supplementation more harmful?  \n3. What are the potential metabolic implications of excessive \u03b2-carotene intake in relation to cancer risk?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 20adf30a-e3aa-4dbf-8943-6be490399f1c
encoding: FLOAT32
metadata:
{"original_content": "Vitamin A Deficiency\nVitamin A deficiency can result from inadequate intake, fat malabsorption, or liver disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the potential causes of Vitamin A deficiency in individuals?  \n2. How can fat malabsorption contribute to Vitamin A deficiency?  \n3. What role do liver disorders play in the development of Vitamin A deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3329ba78-7340-467f-ae99-87ec485dc441
encoding: FLOAT32
metadata:
{"original_content": "Deficiency impairs immunity and hematopoiesis and causes rashes and typical ocular effects\n(eg, xerophthalmia, night blindness).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the ocular effects associated with a deficiency that impairs immunity and hematopoiesis?  \n2. How does a nutritional deficiency contribute to the development of xerophthalmia and night blindness?  \n3. What are the dermatological symptoms caused by dietary deficiencies affecting immunity and hematopoiesis?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d061b723-d215-432e-8db7-43bfa8371107
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is based on typical ocular findings and low\nvitamin A levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. How can low vitamin A levels contribute to specific ocular findings in nutritional disorders?  \n2. What diagnostic methods are used to confirm vitamin A deficiency in patients with vision-related symptoms?  \n3. What are the ocular manifestations commonly associated with vitamin A deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 31b569a8-f393-4d73-a8f5-1fa972f997a8
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of vitamin A given orally or, if symptoms are severe or\nmalabsorption is the cause, parenterally.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the treatment options for vitamin A deficiency caused by malabsorption?  \n2. How is severe vitamin A deficiency managed in patients with nutritional disorders?  \n3. When is parenteral administration of vitamin A recommended over oral supplementation?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9098a4ef-af29-41be-b9fc-9d1657cbe609
encoding: FLOAT32
metadata:
{"original_content": "Etiology\nPrimary vitamin A deficiency is usually caused by prolonged dietary deprivation.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the primary dietary causes of vitamin A deficiency?  \n2. How does prolonged dietary deprivation lead to primary vitamin A deficiency?  \n3. What nutritional factors contribute to the development of vitamin A-related disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2291e6e2-634a-4585-b6c0-b9eadefb925a
encoding: FLOAT32
metadata:
{"original_content": "It is endemic in areas\nsuch as southern and eastern Asia, where rice, devoid of \n\u03b2\n-carotene, is the staple food.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What nutritional disorder is associated with a diet primarily based on rice lacking \u03b2-carotene?  \n2. How does a lack of \u03b2-carotene in staple foods contribute to vitamin A deficiency?  \n3. What are the health consequences of relying on a diet deficient in \u03b2-carotene in regions like southern and eastern Asia?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fda16c0d-c9b3-4c22-91e8-11c06a6926f2
encoding: FLOAT32
metadata:
{"original_content": "Xerophthalmia\ndue to primary deficiency is a common cause of blindness among young children in developing countries.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What is the primary nutritional deficiency responsible for xerophthalmia in young children?  \n2. How does xerophthalmia contribute to blindness in developing countries?  \n3. What populations are most at risk for developing xerophthalmia due to dietary deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0d409f53-d2fa-444b-bc1e-899d867306c8
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the clinical signs and symptoms of vitamin D deficiency and how is it diagnosed?  \n2. How can metabolic disorders like phenylketonuria (PKU) be managed through dietary interventions?  \n3. What are the potential health risks associated with long-term obesity and how can they be mitigated nutritionally?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 007433ce-659b-4dcf-b044-816da9a87920
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n82", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 29, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity in the human body?  \n2. How can dietary deficiencies lead to metabolic disorders and related health conditions?  \n3. What are the differences between vitamin dependency and vitamin deficiency in terms of nutritional needs?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 53730ed6-38c4-4c08-9255-1dd47a9adf38
encoding: FLOAT32
metadata:
{"original_content": "Secondary vitamin A deficiency may be due to decreased bioavailability of provitamin A carotenoids or to\ninterference with absorption, storage, or transport of vitamin A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What factors can decrease the bioavailability of provitamin A carotenoids in the diet?  \n2. How does interference with vitamin A absorption, storage, or transport contribute to secondary vitamin A deficiency?  \n3. What are the potential health consequences of secondary vitamin A deficiency caused by impaired nutrient metabolism?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4c21a00a-a341-45c4-a026-b96c26f48489
encoding: FLOAT32
metadata:
{"original_content": "Interference with absorption or storage is\nlikely in sprue, cystic fibrosis, pancreatic insufficiency, duodenal bypass, chronic diarrhea, bile duct\nobstruction, giardiasis, and cirrhosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How do conditions like cystic fibrosis and pancreatic insufficiency interfere with nutrient absorption and storage?  \n2. What role does bile duct obstruction play in the development of vitamin and mineral deficiencies?  \n3. How might chronic diarrhea contribute to nutritional imbalances or deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b3430ba4-4a25-49f3-b21b-489fff60421e
encoding: FLOAT32
metadata:
{"original_content": "Vitamin A deficiency is common in prolonged protein-energy\nundernutrition not only because the diet is deficient but also because vitamin A storage and transport is\ndefective.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does prolonged protein-energy undernutrition contribute to defective vitamin A storage and transport?  \n2. What are the dietary factors that lead to vitamin A deficiency in cases of protein-energy undernutrition?  \n3. What metabolic mechanisms are affected by vitamin A deficiency in individuals with prolonged undernutrition?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 802300ec-03e4-4026-ae9f-6c8495b36166
encoding: FLOAT32
metadata:
{"original_content": "In children with complicated measles, vitamin A can shorten the duration of the disorder and\nreduce the severity of symptoms and risk of death.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does vitamin A supplementation impact the severity of symptoms in children with complicated measles?  \n2. Can vitamin A reduce the risk of mortality in children suffering from measles-related complications?  \n3. What role does vitamin A play in managing nutritional deficiencies during infectious diseases like measles?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 055e4cc3-e027-4305-8a30-dce6766b804c
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nImpaired dark adaptation of the eyes, which can lead to night blindness, is an early symptom.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with impaired dark adaptation and night blindness?  \n2. How does a lack of specific vitamins or minerals affect vision and eye health?  \n3. What are the early symptoms of vitamin A deficiency in relation to eye function?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7a561adb-0018-406f-a6b6-e64557928c12
encoding: FLOAT32
metadata:
{"original_content": "Xerophthalmia (which is nearly pathognomonic) results from keratinization of the eyes. It involves drying\n(xerosis) and thickening of the conjunctivae and corneas.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with the development of xerophthalmia?  \n2. How does keratinization of the eyes relate to dietary deficiencies?  \n3. What are the ocular symptoms caused by vitamin A deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a5547e0b-37e3-4ee6-a3a5-68f0f2be01fa
encoding: FLOAT32
metadata:
{"original_content": "Superficial foamy patches composed of\nepithelial debris and secretions on the exposed bulbar conjunctiva (Bitot's spots) develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What nutritional deficiency is associated with the development of Bitot's spots on the conjunctiva?  \n2. How does a lack of specific vitamins contribute to the formation of epithelial debris in the eye?  \n3. What dietary interventions can prevent or treat the appearance of Bitot's spots?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c1be8456-3e50-4ff8-b02d-5d7806856fc5
encoding: FLOAT32
metadata:
{"original_content": "In advanced\ndeficiency, the cornea becomes hazy and can develop erosions, which can lead to its destruction\n(keratomalacia).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What are the ocular consequences of advanced vitamin A deficiency?  \n2. How does keratomalacia develop as a result of nutritional deficiencies?  \n3. What dietary interventions can prevent corneal damage associated with vitamin deficiencies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 253bf78d-ba34-41e1-aeef-4f296a5910c0
encoding: FLOAT32
metadata:
{"original_content": "Keratinization of the skin and of the mucous membranes in the respiratory, GI, and urinary tracts can\noccur.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does vitamin A deficiency contribute to keratinization of the skin and mucous membranes?  \n2. What are the nutritional interventions to prevent keratinization in the respiratory, GI, and urinary tracts?  \n3. Which metabolic disorders are associated with keratinization of mucous membranes?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7dfac328-f515-4afc-8939-e46826500906
encoding: FLOAT32
metadata:
{"original_content": "Drying, scaling, and follicular thickening of the skin and respiratory infections can result.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What nutritional deficiencies can cause drying, scaling, and follicular thickening of the skin?  \n2. How might a lack of specific vitamins or minerals contribute to an increased risk of respiratory infections?  \n3. Which dietary interventions can help prevent skin and respiratory issues associated with nutritional disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8e14da22-5aed-4de7-b69f-e22da417c57c
encoding: FLOAT32
metadata:
{"original_content": "Immunity\nis generally impaired.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How do specific nutritional deficiencies contribute to impaired immunity?  \n2. What role do vitamin and mineral imbalances play in weakening the immune system?  \n3. Can metabolic disorders linked to obesity affect immune function?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b2dac563-f092-4198-bbd0-943f44f4ce41
encoding: FLOAT32
metadata:
{"original_content": "The younger the patient, the more severe are the effects of vitamin A deficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does age influence the severity of symptoms in patients with vitamin A deficiency?  \n2. What are the potential health consequences of vitamin A deficiency in young children compared to adults?  \n3. Why might younger patients experience more severe effects of vitamin A deficiency than older individuals?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5eafb5cf-5253-4caf-92c9-78236c074c55
encoding: FLOAT32
metadata:
{"original_content": "Growth retardation and\ninfections are common among children.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How can nutritional deficiencies contribute to growth retardation in children?  \n2. What role do vitamin and mineral imbalances play in increasing susceptibility to infections in children?  \n3. Which dietary interventions can help address growth retardation caused by metabolic or nutritional disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 67c1e71b-65eb-4c80-8877-5cb83cce6e5e
encoding: FLOAT32
metadata:
{"original_content": "Mortality rate can exceed 50% in children with severe vitamin A\ndeficiency.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What is the mortality rate associated with severe vitamin A deficiency in children?  \n2. How does severe vitamin A deficiency impact child health outcomes?  \n3. What are the potential risks of untreated vitamin A deficiency in pediatric populations?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab1e5862-7105-46c4-a36f-dd1d9b890a84
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Serum retinol levels, clinical evaluation, and response to vitamin A\nOcular findings suggest the diagnosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How can serum retinol levels be used to diagnose a vitamin A deficiency?  \n2. What ocular findings are indicative of a nutritional disorder related to vitamin A deficiency?  \n3. How does a patient's response to vitamin A supplementation confirm a diagnosis of a dietary deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b81b43e6-49c5-4050-8ee3-6b54f78cf441
encoding: FLOAT32
metadata:
{"original_content": "Dark adaptation can be impaired in other disorders (eg, zinc\ndeficiency, retinitis pigmentosa, severe refractive errors, cataracts, diabetic retinopathy).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does zinc deficiency contribute to impaired dark adaptation?  \n2. What role do dietary deficiencies play in the progression of retinitis pigmentosa?  \n3. Can addressing nutritional imbalances improve dark adaptation in individuals with diabetic retinopathy?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b6955416-073a-4df5-8046-b5a7b9a290ae
encoding: FLOAT32
metadata:
{"original_content": "If dark\nadaptation is impaired, rod scotometry and electroretinography are done to determine whether vitamin A\ndeficiency is the cause.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How can vitamin A deficiency be diagnosed in cases of impaired dark adaptation?  \n2. What diagnostic tests are used to assess the impact of nutritional deficiencies on vision?  \n3. What role does rod scotometry play in identifying vitamin-related metabolic disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1dd094d6-f338-47f7-b334-8c8c936fec82
encoding: FLOAT32
metadata:
{"original_content": "Serum levels of retinol are measured.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How can serum retinol levels indicate a deficiency in vitamin A?  \n2. What role do serum retinol levels play in diagnosing malnutrition-related disorders?  \n3. Can low serum retinol levels be linked to impaired immune function or vision problems?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ba7edc55-1ccf-48cc-9250-8d7c841784a8
encoding: FLOAT32
metadata:
{"original_content": "Normal range is 28 to 86 \n\u03bc\ng/dL (1 to 3 \n\u03bc\nmol/L).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What are the potential health implications of having a value outside the normal range of 28 to 86 \u03bcg/dL (1 to 3 \u03bcmol/L) for a specific nutrient or mineral?  \n2. How does a deficiency or excess of this nutrient or mineral contribute to the development of metabolic disorders?  \n3. What dietary adjustments can help maintain levels within the normal range of 28 to 86 \u03bcg/dL (1 to 3 \u03bcmol/L)?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 80b3fba0-c4c1-4320-b2b5-57f8ec291638
encoding: FLOAT32
metadata:
{"original_content": "However, levels\ndecrease only after the deficiency is advanced because the liver contains large stores of vitamin A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. Why do vitamin A levels in the body remain stable until a deficiency becomes advanced?  \n2. How does the liver's storage capacity for vitamin A impact the progression of deficiency symptoms?  \n3. What role does the liver play in maintaining vitamin A levels during periods of dietary insufficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 887cf219-45c3-4f59-a5f8-db93aa0e0c25
encoding: FLOAT32
metadata:
{"original_content": "Also,\ndecreased levels may result from acute infection, which causes retinol-binding protein and transthyretin\n(also called prealbumin) levels to decrease transiently.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does an acute infection impact retinol-binding protein and transthyretin levels in the context of nutritional disorders?  \n2. What is the relationship between decreased prealbumin levels and vitamin A transport in the body?  \n3. Can transient decreases in retinol-binding protein indicate a potential vitamin deficiency during an acute infection?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6dabea57-305b-48cf-bdf7-56895a7182c6
encoding: FLOAT32
metadata:
{"original_content": "A therapeutic trial of vitamin A may help confirm\nthe diagnosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How can a therapeutic trial of vitamin A assist in diagnosing specific nutritional disorders?  \n2. What role does vitamin A play in addressing dietary deficiencies or imbalances?  \n3. Are there specific symptoms or conditions that improve with vitamin A supplementation, confirming a metabolic disorder?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ca5ed7b9-f047-420d-b932-2f8379472311
encoding: FLOAT32
metadata:
{"original_content": "Prevention\nThe diet should include dark green leafy vegetables, deep- or bright-colored fruits (eg, papayas,\noranges), carrots, and yellow vegetables (eg, squash, pumpkin).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What types of fruits and vegetables can help prevent vitamin A deficiency?  \n2. How can a diet rich in bright-colored fruits and vegetables support metabolic health?  \n3. Which dietary choices are recommended to prevent nutritional disorders related to vitamin imbalances?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9bf8ca2f-a1eb-42ab-9d85-f561f392113f
encoding: FLOAT32
metadata:
{"original_content": "Vitamin A-fortified milk and cereals, liver,\negg yolks, and fish liver oils are helpful.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What dietary sources can help address a vitamin A deficiency?  \n2. How can fortified foods contribute to preventing vitamin A-related nutritional disorders?  \n3. What are the benefits of consuming fish liver oils for vitamin A metabolism?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5b5ceb5c-d4ca-44b2-a679-b8829af2008a
encoding: FLOAT32
metadata:
{"original_content": "Carotenoids are absorbed better when consumed with some\ndietary fat.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. How does the absence of dietary fat impact the absorption of carotenoids in individuals with fat malabsorption disorders?  \n2. Could a deficiency in dietary fat contribute to vitamin A deficiency in populations reliant on carotenoid-rich foods?  \n3. What role does impaired fat metabolism play in the bioavailability of carotenoids for individuals with metabolic disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab14b387-d04f-431f-af09-a1dfc1a9ef93
encoding: FLOAT32
metadata:
{"original_content": "If milk allergy is suspected in infants, they should be given adequate vitamin A in formula\nfeedings.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What are the nutritional considerations for infants with a milk allergy to ensure adequate vitamin A intake?  \n2. How can formula feedings be adjusted to address vitamin deficiencies in infants with milk allergies?  \n3. What are the potential health risks of vitamin A deficiency in infants with milk allergies?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: acc560da-6c1b-4b67-9b31-e02fd22a6ea1
encoding: FLOAT32
metadata:
{"original_content": "In developing countries, prophylactic supplements of vitamin A palmitate in oil 60,000 RAE\n(200,000 IU) po every 6 mo are advised for all children between 1 and 5 yr of age; infants < 6 mo can be\ngiven a one-time dose of 15,000 RAE (50,000 IU), and those aged 6 to 12 mo can be given a one-time\ndose of 30,000 RAE (100,000 IU).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What is the recommended prophylactic vitamin A dosage for children aged 1 to 5 years in developing countries to prevent vitamin A deficiency?  \n2. At what age and dosage should infants under 6 months receive vitamin A supplementation to address potential deficiencies?  \n3. How does the recommended vitamin A supplementation dosage differ for infants aged 6 to 12 months compared to younger or older children?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 06e7cb9f-ee7b-41e3-935e-94c40ccfeadd
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Vitamin A palmitate\nDietary deficiency is traditionally treated with vitamin A palmitate in oil 60,000 IU po once/day for 2 days,\nfollowed by 4500 IU po once/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What is the recommended treatment protocol for a dietary deficiency of vitamin A?  \n2. How is vitamin A palmitate administered to address a nutritional disorder?  \n3. What is the initial and maintenance dosage of vitamin A palmitate for treating vitamin A deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 152f74a3-6ff3-4992-b1fb-060b8162d1f7
encoding: FLOAT32
metadata:
{"original_content": "If vomiting or malabsorption is present or xerophthalmia is probable, a\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What are the potential nutritional deficiencies associated with vomiting or malabsorption?  \n2. How does xerophthalmia relate to vitamin A deficiency and its diagnosis?  \n3. What diagnostic approaches are recommended for identifying malabsorption-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ad45e845-6f36-4c38-a5c2-4d4f0e7beac0
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n83", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 30, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and vitamin deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4c06c9ec-ebca-450f-82ba-7c8356e37887
encoding: FLOAT32
metadata:
{"original_content": "dose of 50,000 IU for infants < 6 mo, 100,000 IU for infants 6 to 12 mo, or 200,000 IU for children > 12 mo\nand adults should be given for 2 days, with a third dose at least 2 wk later.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What is the recommended vitamin dosage for treating deficiencies in infants and children of different age groups?  \n2. How should vitamin supplementation be scheduled for adults with nutritional deficiencies?  \n3. What is the appropriate interval for administering a third dose of supplementation in cases of vitamin deficiency?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 64794369-ce68-443f-8ef3-1d20486f7627
encoding: FLOAT32
metadata:
{"original_content": "The same doses are\nrecommended for infants and children with complicated measles.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional interventions are recommended for infants and children with complicated measles?  \n2. How do vitamin or mineral deficiencies impact the recovery process in children with measles?  \n3. Are there specific dietary guidelines for managing measles-related complications in pediatric patients?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2dae789f-9d41-44f2-bdf6-0752104f32e5
encoding: FLOAT32
metadata:
{"original_content": "Infants born of HIV-positive mothers\nshould receive 50,000 IU (15,000 RAE) within 48 h of birth.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What is the recommended vitamin A dosage for infants born to HIV-positive mothers to prevent potential nutritional deficiencies?  \n2. How does early administration of vitamin A impact the health outcomes of infants born to HIV-positive mothers?  \n3. What role does vitamin A play in addressing potential metabolic or immune-related disorders in newborns of HIV-positive mothers?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4497f016-2eb6-46d8-b9af-506188047c24
encoding: FLOAT32
metadata:
{"original_content": "Prolonged daily administration of large doses,\nespecially to infants, must be avoided because toxicity may result.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the potential toxic effects of prolonged high-dose administration of certain nutrients in infants?  \n2. How can excessive intake of vitamins or minerals lead to nutritional disorders?  \n3. What guidelines should be followed to prevent toxicity from daily supplementation in vulnerable populations like infants?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7694e886-3bd3-4906-bdb9-787f6c780ad0
encoding: FLOAT32
metadata:
{"original_content": "For pregnant or breastfeeding women, prophylactic or therapeutic doses should not exceed 10,000 IU\n(3000 RAE)/day to avoid possible damage to the fetus or infant.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What is the maximum safe dosage of vitamin A for pregnant or breastfeeding women to prevent potential harm to the fetus or infant?  \n2. How can excessive intake of vitamin A during pregnancy or breastfeeding lead to nutritional or metabolic disorders in infants?  \n3. What are the potential health risks associated with exceeding 10,000 IU of vitamin A per day for pregnant or breastfeeding women?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 373dffa3-549b-44ff-839a-613721842080
encoding: FLOAT32
metadata:
{"original_content": "Vitamin A Toxicity\nVitamin A toxicity can be acute (usually due to accidental ingestion by children) or chronic.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the differences between acute and chronic vitamin A toxicity?  \n2. What are the potential causes of acute vitamin A toxicity in children?  \n3. How does excessive vitamin A intake lead to health complications?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8e1f42e8-d7f1-4bca-a966-b60a107c79a9
encoding: FLOAT32
metadata:
{"original_content": "Both\ntypes usually cause headache and increased intracranial pressure.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How do nutritional disorders contribute to increased intracranial pressure?  \n2. What dietary deficiencies are associated with headaches and intracranial pressure?  \n3. Can vitamin or mineral imbalances lead to symptoms like headaches and increased intracranial pressure?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 41fd415e-2c03-44a8-8ab8-4d81233ac4a7
encoding: FLOAT32
metadata:
{"original_content": "Acute toxicity also causes\nnausea and vomiting.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the symptoms of acute toxicity in the context of nutritional disorders?  \n2. How does acute toxicity manifest in cases of vitamin or mineral imbalances?  \n3. Can acute toxicity from dietary deficiencies lead to nausea and vomiting?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 13bfffe9-fc59-48c4-9182-32e7134add87
encoding: FLOAT32
metadata:
{"original_content": "Chronic toxicity also causes changes in skin, hair, and nails; abnormal\nliver test results; and, in a fetus, birth defects.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How does chronic toxicity affect the appearance and health of skin, hair, and nails?  \n2. What are the potential impacts of chronic toxicity on liver function as indicated by abnormal test results?  \n3. Can chronic toxicity during pregnancy lead to birth defects in a fetus?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6181016e-c53e-4dc3-ba81-dc027bd11bd4
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How can a clinical diagnosis help identify a specific vitamin or mineral deficiency?  \n2. What clinical signs are typically used to diagnose metabolic disorders related to nutrition?  \n3. Can obesity-related health conditions be diagnosed solely through clinical evaluation?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6987bc03-b026-4666-91b6-c3e32aa10a03
encoding: FLOAT32
metadata:
{"original_content": "Unless birth defects\nare present, adjusting the dose almost always leads to complete recovery.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How can adjusting nutrient intake doses lead to recovery from dietary deficiencies?  \n2. What role does dose adjustment play in managing metabolic disorders?  \n3. Can vitamin and mineral imbalances be corrected through tailored dosage adjustments?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 12a3b8fd-8a55-4dd2-8865-8e60b18bd9fd
encoding: FLOAT32
metadata:
{"original_content": "Acute vitamin A toxicity in children may result from taking large doses (> 100,000 RAE [> 300,000 IU]),\nusually accidentally.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the potential health risks of acute vitamin A toxicity in children?  \n2. What dosage of vitamin A is considered toxic for children?  \n3. How can accidental overdoses of vitamin A in children be prevented?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6ea9ddc3-541d-406f-8126-df6d6b15121a
encoding: FLOAT32
metadata:
{"original_content": "In adults, acute toxicity has occurred when arctic explorers ingested polar bear or\nseal livers, which contain several million units of vitamin A.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the health risks associated with consuming animal livers that contain extremely high levels of vitamin A?  \n2. How does acute vitamin A toxicity manifest in adults, and what are its potential consequences?  \n3. What dietary precautions should be taken to avoid vitamin A toxicity in extreme environments like the Arctic?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ff44a4b2-6daf-4f46-956c-702c551a24a1
encoding: FLOAT32
metadata:
{"original_content": "Chronic toxicity in older children and adults usually develops after doses of > 30,000 RAE (> 100,000\nIU)/day have been taken for months.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the potential health risks associated with chronic vitamin A toxicity in older children and adults?  \n2. At what dosage does chronic vitamin A toxicity typically develop in older children and adults?  \n3. How long does it take for chronic vitamin A toxicity to manifest when consuming excessive doses of vitamin A?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e2943946-c5f1-4d47-a34f-e9adf40a2bb1
encoding: FLOAT32
metadata:
{"original_content": "Megavitamin therapy is a possible cause, as are massive daily\ndoses (50,000 to 120,000 RAE [150,000 to 350,000 IU]) of vitamin A \nor its metabolites, which are\nsometimes given for nodular acne or other skin disorders.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the potential health risks associated with megavitamin therapy involving high doses of vitamin A?  \n2. How can excessive intake of vitamin A contribute to nutritional or metabolic disorders?  \n3. What are the implications of using high-dose vitamin A treatments for skin conditions like nodular acne?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 282974a5-6fc6-4d43-bd7f-d2882da154c1
encoding: FLOAT32
metadata:
{"original_content": "Adults who consume > 1500 RAE (> 4500\nIU)/day of vitamin A may develop osteoporosis.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How does excessive vitamin A intake contribute to the development of osteoporosis in adults?  \n2. What is the recommended safe upper limit of vitamin A consumption to prevent bone health issues?  \n3. Are there specific populations at higher risk of osteoporosis due to high vitamin A intake?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: fc8b6ab6-df56-4620-86a5-9816ea878be4
encoding: FLOAT32
metadata:
{"original_content": "Infants who are given excessive doses (6,000 to 20,000\nRAE [18,000 to 60,000 IU]/day) of water-miscible vitamin A may develop toxicity within a few weeks.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the potential health risks of excessive vitamin A intake in infants?  \n2. How quickly can vitamin A toxicity develop in infants given high doses?  \n3. What is the safe upper limit of vitamin A intake for infants to avoid toxicity?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ebe66af0-1781-4e1e-9cde-7c2229c75e19
encoding: FLOAT32
metadata:
{"original_content": "Birth\ndefects occur in children of women receiving isotretinoin (which is related to vitamin A) for acne treatment\nduring pregnancy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How does isotretinoin, a compound related to vitamin A, contribute to birth defects during pregnancy?  \n2. What role does vitamin A imbalance play in the development of nutritional disorders during pregnancy?  \n3. Are there dietary or nutritional guidelines to mitigate the risks of birth defects associated with isotretinoin use?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0db917ef-dd50-4505-a2c8-d97d8e5ba322
encoding: FLOAT32
metadata:
{"original_content": "Although carotene is converted to vitamin A in the body, excessive ingestion of carotene causes\ncarotenemia, not vitamin A toxicity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What is the difference between carotenemia and vitamin A toxicity in terms of their causes and effects on the body?  \n2. How does the body metabolize carotene into vitamin A, and why does excessive carotene intake lead to carotenemia instead of vitamin A toxicity?  \n3. What are the potential health implications of carotenemia, and how can it be managed through dietary adjustments?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1e0ce91d-ceff-45cb-9e06-a24975a11004
encoding: FLOAT32
metadata:
{"original_content": "Carotenemia is usually asymptomatic but may lead to carotenodermia,\nin which the skin becomes yellow.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the visible symptoms of carotenemia caused by excessive dietary intake of carotenoids?  \n2. How does carotenemia differ from jaundice in terms of skin discoloration?  \n3. Can excessive consumption of carotenoid-rich foods lead to any health complications beyond skin discoloration?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 324eea47-6354-45c7-ac47-e342e1b69d6e
encoding: FLOAT32
metadata:
{"original_content": "When taken as a supplement, \n\u03b2\n-carotene has been associated with\nincreased cancer risk; risk does not seem to increase when carotenoids are consumed in fruits and\nvegetables.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. Why does \u03b2-carotene supplementation increase cancer risk, but consumption through fruits and vegetables does not?  \n2. How do dietary sources of carotenoids differ from supplements in their impact on cancer risk?  \n3. What role do carotenoids play in the prevention or exacerbation of nutrition-related disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 780d0ac7-504a-4c2a-b42c-0ec9eddb2529
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nAlthough symptoms may vary, headache and rash usually develop during acute or chronic toxicity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the common symptoms of acute or chronic toxicity related to vitamin or mineral imbalances?  \n2. How can headaches and rashes indicate a potential nutritional disorder?  \n3. What dietary factors might contribute to the development of toxicity symptoms like headaches and rashes?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0bd3c573-5343-424b-a73c-ee0931bbad9c
encoding: FLOAT32
metadata:
{"original_content": "Acute\ntoxicity causes increased intracranial pressure.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How does acute toxicity contribute to increased intracranial pressure in the context of nutritional disorders?  \n2. What specific dietary imbalances or deficiencies could lead to acute toxicity and subsequent intracranial pressure elevation?  \n3. Are there particular vitamins or minerals that, when consumed in toxic amounts, are associated with increased intracranial pressure?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4bdc734d-9380-496f-abc7-93d47052e2d0
encoding: FLOAT32
metadata:
{"original_content": "Drowsiness, irritability, abdominal pain, nausea, and\nvomiting are common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional deficiencies could cause symptoms like drowsiness, irritability, abdominal pain, nausea, and vomiting?  \n2. How might a vitamin or mineral imbalance contribute to persistent abdominal pain and nausea?  \n3. Could these symptoms indicate a metabolic disorder related to improper nutrient absorption?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a7199982-3877-4107-8f61-e5537ba32513
encoding: FLOAT32
metadata:
{"original_content": "Sometimes the skin subsequently peels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances can cause skin peeling as a symptom?  \n2. Could a lack of specific vitamins or minerals lead to skin peeling in individuals with metabolic disorders?  \n3. How does a dietary deficiency contribute to skin conditions like peeling in the context of nutritional disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1ac6c0e5-566b-499e-9899-70f3f55c9f9d
encoding: FLOAT32
metadata:
{"original_content": "Early symptoms of chronic toxicity are sparsely distributed, coarse hair; alopecia of the eyebrows; dry,\nrough skin; dry eyes; and cracked lips.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the early symptoms of chronic toxicity related to nutritional imbalances?  \n2. How can chronic toxicity affect the condition of hair, skin, and lips?  \n3. What physical signs might indicate a potential vitamin or mineral imbalance?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 561ba92f-db98-480e-8e23-1434b479a1c6
encoding: FLOAT32
metadata:
{"original_content": "Later, severe headache, pseudotumor cerebri, and generalized\nweakness develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could lead to the development of pseudotumor cerebri?  \n2. How might excessive intake of certain vitamins or minerals contribute to severe headaches and generalized weakness?  \n3. What metabolic disorders are associated with symptoms like severe headache, pseudotumor cerebri, and generalized weakness?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1f4fdfb1-2d6b-4980-b0fe-c7165672aae3
encoding: FLOAT32
metadata:
{"original_content": "Cortical hyperostosis of bone and arthralgia may occur, especially in children.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could contribute to cortical hyperostosis of bone in children?  \n2. How might dietary factors influence the development of arthralgia in pediatric patients?  \n3. Are there specific vitamins or minerals associated with the prevention or exacerbation of cortical hyperostosis and arthralgia in children?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 760b18a3-149e-4dd4-8fb3-26197ac4cebd
encoding: FLOAT32
metadata:
{"original_content": "Fractures may occur easily, especially in the elderly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How can dietary deficiencies contribute to an increased risk of fractures in the elderly?  \n2. What role do vitamin and mineral imbalances, such as calcium or vitamin D deficiency, play in bone health and fracture susceptibility?  \n3. Are metabolic disorders linked to poor bone density and a higher likelihood of fractures in older adults?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 952900f1-0df8-4fb7-b0e5-31ea3daf52be
encoding: FLOAT32
metadata:
{"original_content": "In children, toxicity can cause pruritus, anorexia, and\nfailure to thrive.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How does toxicity in children contribute to symptoms like pruritus and anorexia?  \n2. What nutritional imbalances or toxicities can lead to failure to thrive in children?  \n3. What are the potential dietary or metabolic causes of pruritus in pediatric patients?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d5b748f4-d2d0-4130-9540-2cf25714859b
encoding: FLOAT32
metadata:
{"original_content": "Hepatomegaly and splenomegaly may occur.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What nutritional deficiencies or metabolic disorders can lead to hepatomegaly and splenomegaly?  \n2. How do vitamin or mineral imbalances contribute to the development of hepatomegaly and splenomegaly?  \n3. Can obesity or related dietary health conditions cause hepatomegaly and splenomegaly?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: df330d98-a46e-4d3d-a328-3118624ac3ac
encoding: FLOAT32
metadata:
{"original_content": "In carotenodermia, the skin (but not the sclera) becomes deep yellow, especially on the palms and soles.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What dietary factors can lead to the development of carotenodermia?  \n2. How can carotenodermia be differentiated from jaundice based on physical symptoms?  \n3. Which parts of the body are most affected by carotenodermia, and why?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 66ff8d37-0e1f-43d4-ae41-0ce366f70ced
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Clinical evaluation\nDiagnosis is clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How is a nutritional disorder diagnosed through clinical evaluation?  \n2. What clinical signs are typically assessed to diagnose dietary deficiencies?  \n3. Can metabolic disorders be identified solely through clinical evaluation?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6a4fc450-8988-47bb-bf1c-f4004a42a609
encoding: FLOAT32
metadata:
{"original_content": "Blood vitamin levels correlate poorly with toxicity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How can poor correlation between blood vitamin levels and toxicity impact the diagnosis of vitamin-related nutritional disorders?  \n2. What are the potential risks of relying solely on blood vitamin levels to assess vitamin toxicity in cases of metabolic disorders?  \n3. How might the poor correlation between blood vitamin levels and toxicity influence treatment strategies for vitamin and mineral imbalances?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6552fba6-f54d-4064-8815-2ea71429434e
encoding: FLOAT32
metadata:
{"original_content": "However, if clinical diagnosis is\nequivocal, laboratory testing may help.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. How can laboratory testing assist in confirming a diagnosis of a nutritional disorder when clinical symptoms are unclear?  \n2. What role does laboratory testing play in identifying vitamin and mineral imbalances?  \n3. In cases of suspected metabolic disorders, how can lab results complement clinical evaluations?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e30ce1c5-b211-4c89-91c8-d442e30561a9
encoding: FLOAT32
metadata:
{"original_content": "In vitamin A toxicity, fasting serum retinol levels may increase from\nnormal (28 to 86 \n\u03bc\ng/dL [1 to 3 \n\u03bc\nmol/L]) to > 100 \n\u03bc\ng/dL (> 3.49 \n\u03bc\nmol/L), sometimes to > 2000 \n\u03bc\ng/dL (> 69.8\n\u03bc\nmol/L).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the normal and toxic serum retinol levels associated with vitamin A in the context of nutritional disorders?  \n2. How does vitamin A toxicity affect fasting serum retinol concentrations?  \n3. What are the upper thresholds of serum retinol levels observed in severe cases of vitamin A toxicity?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c09d0ec3-defe-4dc2-96f4-1c605f05f653
encoding: FLOAT32
metadata:
{"original_content": "Hypercalcemia is common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What dietary factors or nutritional imbalances contribute to the development of hypercalcemia?  \n2. How does hypercalcemia affect the metabolism of other essential nutrients in the body?  \n3. What are the potential health risks associated with prolonged hypercalcemia due to excessive calcium intake?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4cc5e6a4-58da-432f-820b-6c0a851af9ed
encoding: FLOAT32
metadata:
{"original_content": "The Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4. Vitamin Deficiency, Dependency & Toxicity\n84", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 31, "type": "text ", "chroma:document": "1. What are the clinical symptoms and diagnostic criteria for vitamin D deficiency?  \n2. How can excessive intake of vitamin A lead to toxicity, and what are its health implications?  \n3. What dietary interventions are recommended for managing iron deficiency anemia?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 87587218-0e5a-4815-b600-5651f9e943c1
encoding: FLOAT32
metadata:
{"original_content": "Differentiating vitamin A toxicity from other disorders may be difficult.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How can vitamin A toxicity be distinguished from other nutritional or metabolic disorders?  \n2. What symptoms overlap between vitamin A toxicity and other vitamin or mineral imbalances?  \n3. What diagnostic approaches are used to confirm vitamin A toxicity in the context of similar dietary deficiencies or excesses?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 940a3bfa-06eb-42ad-9093-031db0af8d93
encoding: FLOAT32
metadata:
{"original_content": "Carotenodermia may also occur in\nsevere hypothyroidism and anorexia nervosa, possibly because carotene is converted to vitamin A more\nslowly.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does severe hypothyroidism contribute to the development of carotenodermia?  \n2. What is the relationship between anorexia nervosa and the slowed conversion of carotene to vitamin A?  \n3. Why does impaired carotene metabolism lead to visible skin discoloration in certain nutritional disorders?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 8ced8cee-09bb-415b-b909-065ad4fbc5f4
encoding: FLOAT32
metadata:
{"original_content": "Prognosis\nComplete recovery usually occurs if vitamin A ingestion stops.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What is the expected recovery outcome for individuals who stop excessive vitamin A intake?  \n2. How does halting vitamin A consumption impact the prognosis of related nutritional disorders?  \n3. Can complete recovery from vitamin A toxicity occur without medical intervention if intake is discontinued?  "}


created_at: 2025-03-03 11:15:36
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 4680b00d-31c6-4507-a19f-d82768e5db76
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and signs of chronic toxicity\nusually disappear within 1 to 4 wk.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How long does it typically take for symptoms of chronic toxicity to resolve after addressing the underlying nutritional imbalance?  \n2. What are the common signs and symptoms associated with chronic toxicity due to dietary deficiencies or excesses?  \n3. Can chronic toxicity symptoms caused by vitamin or mineral imbalances improve within a specific timeframe?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 17a01877-2527-4c9d-bea0-dd44202989ec
encoding: FLOAT32
metadata:
{"original_content": "However, birth defects in the fetus of a mother who has taken\nmegadoses of vitamin A are not reversible.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the potential risks of taking megadoses of vitamin A during pregnancy?  \n2. How can excessive vitamin A intake affect fetal development?  \n3. Are birth defects caused by vitamin A megadoses reversible?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ab36e100-9dd7-462f-a5fc-c13beab83da0
encoding: FLOAT32
metadata:
{"original_content": "Treatment\nVitamin A is stopped.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the potential health consequences of discontinuing Vitamin A supplementation in individuals with a Vitamin A deficiency?  \n2. How does stopping Vitamin A intake affect the management of hypervitaminosis A?  \n3. What dietary adjustments are recommended when Vitamin A supplementation is discontinued in patients with a nutritional disorder?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 896b6733-3259-4be9-90a5-2c11ba3f7939
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n6\nVitamin B\n6\n includes a group of closely related compounds: pyridoxine, pyridoxal, and pyridoxamine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the specific compounds included in the Vitamin B6 group, and how might their deficiency contribute to nutritional disorders?  \n2. How does a deficiency in Vitamin B6 compounds like pyridoxine, pyridoxal, and pyridoxamine affect metabolic processes?  \n3. What health conditions can arise from an imbalance or deficiency of Vitamin B6-related compounds?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b3d5cb4a-2ae4-484c-ad38-6d5701b2d8f9
encoding: FLOAT32
metadata:
{"original_content": "They\nare metabolized in the body to pyridoxal phosphate, which acts as a coenzyme in many important\nreactions in blood, CNS, and skin metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does pyridoxal phosphate deficiency affect central nervous system metabolism?  \n2. What role does pyridoxal phosphate play in skin-related metabolic disorders?  \n3. Can a deficiency in the precursors of pyridoxal phosphate lead to blood-related nutritional disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2c09d40c-9cf6-4cfb-a7e8-eb83ae217c4a
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n6\n is important in heme and nucleic acid\nbiosynthesis and in lipid, carbohydrate, and amino acid metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does a deficiency in Vitamin B6 affect amino acid metabolism and contribute to metabolic disorders?  \n2. What role does Vitamin B6 play in preventing nutritional disorders related to heme biosynthesis?  \n3. Can a lack of Vitamin B6 lead to imbalances in carbohydrate and lipid metabolism, and how might this impact overall health?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b0a70349-76f8-46c3-a21b-e34ee17f5406
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n6\n Deficiency and Dependency\nBecause vitamin B\n6\n is present in most foods, dietary deficiency is rare.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the potential health consequences of a dietary deficiency of vitamin B6?  \n2. How does the rarity of dietary vitamin B6 deficiency impact the prevalence of related nutritional disorders?  \n3. What foods are typically rich in vitamin B6, and how can they prevent deficiency-related health issues?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5313305a-0497-454a-a5ed-8e62d677d37c
encoding: FLOAT32
metadata:
{"original_content": "Secondary deficiency\nmay result from various conditions.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the potential conditions that can lead to a secondary nutritional deficiency?  \n2. How do secondary deficiencies differ from primary deficiencies in terms of their causes?  \n3. What role do metabolic disorders play in the development of secondary nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 64fd10f6-e6cc-4e5a-b773-3753e965cb99
encoding: FLOAT32
metadata:
{"original_content": "Symptoms can include peripheral neuropathy, a pellagra-\nlike syndrome, anemia, and seizures, which, particularly in infants, may not resolve when\ntreated with anticonvulsants.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What nutritional deficiencies can lead to symptoms such as peripheral neuropathy and a pellagra-like syndrome?  \n2. How can anemia and seizures in infants be linked to dietary or metabolic disorders?  \n3. Why might seizures in infants not resolve with anticonvulsant treatment in cases of nutritional imbalance?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0d68f7c2-fc2d-4ba3-9108-ee339eadb399
encoding: FLOAT32
metadata:
{"original_content": "Impaired metabolism (dependency) is rare; it causes various\nsymptoms, including seizures, intellectual disability, and anemia.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the symptoms associated with impaired metabolism in rare nutritional disorders?  \n2. How can impaired metabolism lead to intellectual disability and anemia?  \n3. What role does impaired metabolism play in causing seizures related to nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 46010baf-ae1d-4981-90fd-7a9ad9a22120
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical;\nno laboratory test readily assesses vitamin B\n6\n status.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How is a clinical diagnosis made for vitamin B6 deficiency in the absence of specific laboratory tests?  \n2. What are the challenges in assessing vitamin B6 status in patients with suspected nutritional deficiencies?  \n3. What clinical signs or symptoms might indicate a vitamin B6 deficiency in the context of metabolic disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 55cdc20f-d719-43c1-b01e-e58966c05a7f
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of giving oral vitamin\nB\n6\n and, when possible, treating the cause.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What is the recommended treatment for a nutritional disorder caused by vitamin B6 deficiency?  \n2. How can the underlying cause of a vitamin B6 deficiency be addressed in conjunction with supplementation?  \n3. What role does oral vitamin B6 play in managing metabolic disorders related to dietary deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5ef0876f-99d9-4b17-8f09-6b3530519440
encoding: FLOAT32
metadata:
{"original_content": "Dietary deficiency, though rare, can develop because extensive processing can deplete foods of vitamin\nB\n6\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does extensive food processing contribute to vitamin B6 deficiency?  \n2. What are the potential health consequences of a dietary deficiency in vitamin B6?  \n3. Which foods are most likely to lose vitamin B6 content due to processing?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9e1e1951-559b-4b67-9984-adf9eb769b32
encoding: FLOAT32
metadata:
{"original_content": "Secondary deficiency most often results from protein-energy undernutrition, malabsorption,\nalcoholism, use of pyridoxine-inactivating drugs (eg, anticonvulsants, isoniazid, cycloserine, hydralazine,\ncorticosteroids, penicillamine), or excessive loss.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the potential causes of secondary nutritional deficiencies related to protein-energy undernutrition?  \n2. How do pyridoxine-inactivating drugs contribute to secondary vitamin deficiencies?  \n3. What role does malabsorption play in the development of secondary nutritional disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: da4b143f-a2e5-4f4f-a16c-24d7033046fd
encoding: FLOAT32
metadata:
{"original_content": "Rarely, it results from increased metabolic demand (eg,\nin hyperthyroidism).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does hyperthyroidism contribute to increased metabolic demand and its impact on nutritional disorders?  \n2. What are the potential nutritional deficiencies that can arise due to increased metabolic demand in hyperthyroidism?  \n3. Can hyperthyroidism-induced metabolic changes lead to vitamin or mineral imbalances?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b0948057-932a-4f46-8024-7cf2792da25e
encoding: FLOAT32
metadata:
{"original_content": "Rare inborn errors of metabolism can affect pyridoxine metabolism.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How do rare inborn errors of metabolism impact the body's ability to process pyridoxine (vitamin B6)?  \n2. What are the potential nutritional deficiencies associated with impaired pyridoxine metabolism?  \n3. Are there specific dietary interventions to manage metabolic disorders affecting pyridoxine utilization?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d099efb4-807e-4dc6-8ebf-4a9fc8bbc7ca
encoding: FLOAT32
metadata:
{"original_content": "The role of vitamin B\n6\n deficiency in increasing plasma homocysteine levels and in contributing to vascular\ndisorders is under study.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How does vitamin B6 deficiency influence plasma homocysteine levels in the body?  \n2. What is the potential link between vitamin B6 deficiency and the development of vascular disorders?  \n3. Can addressing vitamin B6 deficiency help mitigate the risk of homocysteine-related metabolic disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 222f25eb-e749-4585-87ec-76e5debff2cc
encoding: FLOAT32
metadata:
{"original_content": "Symptoms and Signs\nDeficiency causes a pellagra-like syndrome, with seborrheic dermatitis, glossitis, and cheilosis, and, in\nadults, can cause depression, confusion, EEG abnormalities, and seizures.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the symptoms of a nutritional deficiency that leads to a pellagra-like syndrome?  \n2. How does a deficiency manifest in adults in terms of neurological and psychological symptoms?  \n3. What are the dermatological signs associated with this specific nutritional disorder?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: af2d76bb-f3a4-4708-83db-1ed359e02ced
encoding: FLOAT32
metadata:
{"original_content": "Rarely, deficiency or\ndependency causes seizures in infants.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What specific nutritional deficiencies or dependencies can lead to seizures in infants?  \n2. How do dietary imbalances contribute to neurological symptoms like seizures in early childhood?  \n3. What are the potential metabolic disorders associated with seizures caused by nutrient deficiencies in infants?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 275e8f74-63e9-47aa-aed7-4f1b2303e8b8
encoding: FLOAT32
metadata:
{"original_content": "Seizures, particularly in infants, may be refractory to treatment\nwith anticonvulsants. Normocytic, microcytic, or sideroblastic anemia can also develop.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What nutritional deficiencies or imbalances could contribute to refractory seizures in infants?  \n2. How might dietary factors lead to the development of normocytic, microcytic, or sideroblastic anemia?  \n3. What role do vitamin or mineral deficiencies play in the management of seizures unresponsive to anticonvulsants?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: cbac3836-a9fc-4238-85e2-a6bccc765bc6
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis\n\u2022 Clinical evaluation\nVitamin B\n6\n deficiency should be considered in any infant who has seizures, any patient who has seizures\nrefractory to treatment with anticonvulsants, and any patient with deficiencies of other B vitamins,\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. How can Vitamin B6 deficiency be identified in patients with treatment-resistant seizures?  \n2. What clinical signs suggest a potential deficiency in multiple B vitamins?  \n3. In what scenarios should Vitamin B6 deficiency be considered during a clinical evaluation?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1fa50300-2227-4aeb-a181-cad42826e7e0
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n85", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 32, "type": "text ", "chroma:document": "1. What are the symptoms and health effects of vitamin deficiency in the human body?  \n2. How can excessive intake of vitamins lead to toxicity and related health complications?  \n3. What are the differences between vitamin dependency and deficiency in terms of metabolic impact?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e7673dd0-d57b-4345-9b5f-501d035b9f91
encoding: FLOAT32
metadata:
{"original_content": "particularly in patients with alcoholism or protein-energy undernutrition.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the common nutritional deficiencies observed in patients with alcoholism?  \n2. How does protein-energy undernutrition contribute to metabolic disorders?  \n3. What are the potential health impacts of vitamin and mineral imbalances in individuals with chronic undernutrition?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 429dcf9a-c49c-483b-987d-95d27716216f
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How can a clinical diagnosis help identify a specific vitamin or mineral deficiency?  \n2. What clinical signs are typically used to diagnose metabolic disorders related to nutrition?  \n3. Can obesity-related health conditions be diagnosed solely through clinical evaluation?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 55bad564-bfb9-4b42-ba1f-37babf4d18ea
encoding: FLOAT32
metadata:
{"original_content": "There is no single accepted laboratory test of vitamin B\n6\n status; measurement of serum pyridoxal\nphosphate is most common.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What is the most commonly used laboratory test to assess vitamin B6 status?  \n2. How is serum pyridoxal phosphate relevant to diagnosing vitamin B6 deficiency?  \n3. Why might there be no single accepted laboratory test for vitamin B6 status?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6c3d2da6-6cb8-410a-8224-48bf2e58f6ab
encoding: FLOAT32
metadata:
{"original_content": "Treatment\n\u2022 Pyridoxine\n\u2022 Elimination of risk factors when possible\nFor secondary deficiency, causes (eg, use of pyridoxine-inactivating drugs, malabsorption) should be\ncorrected if possible.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How is pyridoxine used in the treatment of nutritional deficiencies?  \n2. What are the potential causes of secondary pyridoxine deficiency that should be addressed?  \n3. What steps can be taken to eliminate risk factors contributing to pyridoxine deficiency?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 86d330ef-aa1d-4410-b119-053e70b64e69
encoding: FLOAT32
metadata:
{"original_content": "Usually, pyridoxine 50 to 100 mg po once/day corrects the deficiency in adults.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What is the recommended daily dosage of pyridoxine to correct a deficiency in adults?  \n2. How is pyridoxine deficiency typically treated in adults?  \n3. What role does pyridoxine play in addressing nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3b7e7b84-f443-450d-8d46-6f6697e9a0d4
encoding: FLOAT32
metadata:
{"original_content": "Most\npeople taking isoniazid should also be given pyridoxine 30 to 50 mg/day.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. Why is pyridoxine supplementation recommended for individuals taking isoniazid?  \n2. What nutritional deficiencies can arise from isoniazid treatment without pyridoxine supplementation?  \n3. How does pyridoxine help prevent metabolic disorders associated with isoniazid use?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: a0d70bb4-720c-45c2-9be0-df142c657b33
encoding: FLOAT32
metadata:
{"original_content": "For deficiency due to increased\nmetabolic demand, amounts larger than the daily recommended intake may be required.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the recommended dietary adjustments for individuals with increased metabolic demand due to a nutritional disorder?  \n2. How can vitamin or mineral deficiencies be addressed when daily recommended intake levels are insufficient?  \n3. In what scenarios might increased metabolic demand lead to the need for higher nutrient intake to prevent or manage dietary deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 9c7b0f21-d8b3-4cab-bd17-16e7f946bb8c
encoding: FLOAT32
metadata:
{"original_content": "For most cases\nof inborn errors of metabolism, high doses of pyridoxine may be effective.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How can high doses of pyridoxine be used to manage inborn errors of metabolism?  \n2. What role does pyridoxine play in addressing metabolic disorders?  \n3. Are there specific inborn errors of metabolism that respond particularly well to pyridoxine supplementation?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 145e6f65-b30d-4843-a0ff-4ea1f25407ad
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n6\n Toxicity\nThe ingestion of megadoses (> 500 mg/day) of pyridoxine (eg, taken to treat carpal tunnel syndrome or\npremenstrual syndrome although efficacy is unproved) may cause peripheral neuropathy with deficits in a\nstocking-glove distribution, including progressive sensory ataxia and severe impairment of position and\nvibration senses.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the potential neurological effects of consuming excessive amounts of vitamin B6?  \n2. How does vitamin B6 toxicity manifest in terms of sensory and motor impairments?  \n3. What are the risks associated with using high doses of vitamin B6 to treat conditions like carpal tunnel syndrome or premenstrual syndrome?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 42952d41-8887-425f-a009-a55048358ead
encoding: FLOAT32
metadata:
{"original_content": "Senses of touch, temperature, and pain are less affected.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How do nutritional deficiencies impact the sensory systems, particularly touch, temperature, and pain perception?  \n2. Are there specific dietary imbalances that minimally affect the senses of touch, temperature, and pain?  \n3. What role do vitamins and minerals play in preserving sensory functions related to touch, temperature, and pain?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 092c62c0-1b19-49d2-8570-f61c2c7d7950
encoding: FLOAT32
metadata:
{"original_content": "Motor and central nervous\nsystems are usually intact. Diagnosis is clinical.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How can a clinical diagnosis help identify nutritional disorders when the motor and central nervous systems are unaffected?  \n2. What dietary deficiencies might present without impairing the motor and central nervous systems?  \n3. Are there specific metabolic disorders that leave the motor and central nervous systems intact but still require clinical diagnosis?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f22c4cb5-b144-444e-867c-68e83cb08171
encoding: FLOAT32
metadata:
{"original_content": "Treatment is to stop taking vitamin B\n6\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the potential health effects of excessive vitamin B6 intake?  \n2. How is vitamin B6 toxicity diagnosed and managed?  \n3. What dietary adjustments are recommended for someone experiencing vitamin B6-related health issues?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0519d80c-5da5-4c47-b0ed-2d8189eb31c0
encoding: FLOAT32
metadata:
{"original_content": "Recovery is slow and, for some patients,\nincomplete.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. Why might recovery from certain nutritional disorders be slow or incomplete?  \n2. What factors contribute to incomplete recovery in patients with dietary deficiencies or metabolic disorders?  \n3. How do vitamin and mineral imbalances impact the recovery process in nutrition-related health conditions?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 54d6c712-3d39-44b9-96ab-f6fb3fc37918
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n12\nCobalamin is a general term for compounds with biologic vitamin B\n12\n activity.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the health consequences of a vitamin B12 (cobalamin) deficiency?  \n2. How does a lack of vitamin B12 contribute to metabolic disorders?  \n3. What dietary sources can help prevent vitamin B12-related nutritional deficiencies?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 241a70cc-ca10-444b-847a-576865bbf1ef
encoding: FLOAT32
metadata:
{"original_content": "These compounds are\ninvolved in nucleic acid metabolism, methyl transfer, and myelin synthesis and repair.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How do deficiencies in compounds involved in nucleic acid metabolism affect myelin synthesis and repair in metabolic disorders?  \n2. What role do methyl transfer processes play in the development of nutritional deficiencies or imbalances?  \n3. Can disruptions in nucleic acid metabolism contribute to dietary-related neurological disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 49671c3c-4c45-49d0-a85f-81fdcd0c3e4b
encoding: FLOAT32
metadata:
{"original_content": "They are necessary\nfor the formation of normal RBCs.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in essential nutrients affect the formation of normal red blood cells?  \n2. What nutritional disorders are associated with impaired red blood cell production?  \n3. Which vitamins or minerals are critical for maintaining healthy red blood cell formation?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 18765188-ca4d-4609-96cf-22f1da24acc6
encoding: FLOAT32
metadata:
{"original_content": "Food-bound vitamin B\n12\n is released in the stomach's acid environment and is bound to R protein\n(haptocorrin).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in stomach acid impact the release of food-bound vitamin B12 and its subsequent absorption?  \n2. What role does R protein (haptocorrin) play in the metabolism of vitamin B12, and how might its dysfunction contribute to nutritional disorders?  \n3. Could impaired release of vitamin B12 in the stomach lead to specific dietary deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: ef0b8e79-26f1-4d76-b957-f211c3b4f327
encoding: FLOAT32
metadata:
{"original_content": "Pancreatic enzymes cleave this B\n12\n complex (B\n12\n-R protein) in the small intestine.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in pancreatic enzymes affect the absorption of vitamin B12 in the small intestine?  \n2. What role does the cleavage of the B12-R protein complex play in preventing vitamin B12 deficiency?  \n3. Could impaired pancreatic enzyme function contribute to metabolic disorders related to vitamin B12 malabsorption?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: dbab871b-3970-4f5d-a31f-9cec6249370e
encoding: FLOAT32
metadata:
{"original_content": "After\ncleavage, intrinsic factor, secreted by parietal cells in the gastric mucosa, binds with vitamin B\n12\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in intrinsic factor lead to vitamin B12 deficiency and related nutritional disorders?  \n2. What role does the gastric mucosa play in preventing vitamin B12-related metabolic disorders?  \n3. How can impaired secretion of intrinsic factor contribute to dietary deficiencies and anemia?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1932bd22-8522-4e2e-a537-6cbc75bc8d25
encoding: FLOAT32
metadata:
{"original_content": "Intrinsic\nfactor is required for absorption of vitamin B\n12\n, which takes place in the terminal ileum.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in intrinsic factor lead to vitamin B12 malabsorption?  \n2. What are the potential health consequences of impaired vitamin B12 absorption in the terminal ileum?  \n3. Which nutritional disorders are associated with a lack of intrinsic factor?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: f104e02a-246c-4209-a60d-98a69f677722
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n12\n in plasma is bound to transcobalamins I and II.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does the binding of Vitamin B12 to transcobalamins I and II affect its absorption and utilization in cases of dietary deficiency?  \n2. What role do transcobalamins play in the development of metabolic disorders related to Vitamin B12 deficiency?  \n3. Can abnormalities in transcobalamin function contribute to vitamin and mineral imbalances in the body?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1ecb5492-09b9-45c8-a6f0-f77c04d5ef75
encoding: FLOAT32
metadata:
{"original_content": "Transcobalamin II is responsible for delivering\nvitamin B\n12\n to tissues.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in Transcobalamin II affect the delivery of vitamin B12 to tissues and contribute to nutritional disorders?  \n2. What are the potential health consequences of impaired vitamin B12 transport due to Transcobalamin II dysfunction?  \n3. Could a mutation in the Transcobalamin II gene lead to metabolic disorders related to vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 108bbbce-4e6b-4c28-90c1-14ce73b9a838
encoding: FLOAT32
metadata:
{"original_content": "The liver stores large amounts of vitamin B\n12\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does a deficiency in vitamin B12 storage in the liver contribute to metabolic disorders?  \n2. What are the potential health consequences of impaired liver function on vitamin B12 levels in the body?  \n3. Can vitamin B12 imbalances due to liver dysfunction lead to specific nutritional deficiencies or related health conditions?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 3c5207db-e77f-4820-bca7-8f0ab439da43
encoding: FLOAT32
metadata:
{"original_content": "Enterohepatic reabsorption helps\nretain vitamin B\n12\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How does enterohepatic reabsorption contribute to the retention of vitamin B12 in the body?  \n2. What role does vitamin B12 play in preventing nutritional deficiencies and metabolic disorders?  \n3. Could impairments in enterohepatic reabsorption lead to vitamin B12 deficiency and related health conditions?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 0b6c6ba2-94cb-4745-8173-d748460bf500
encoding: FLOAT32
metadata:
{"original_content": "Liver vitamin B\n12\n stores can normally sustain physiologic needs for 3 to 5 yr if B\n12\nintake stops (eg, in people who become vegans) and for months to 1 yr if enterohepatic reabsorption\ncapacity is absent.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How long can the liver's vitamin B12 stores sustain physiological needs in individuals who stop consuming B12, such as vegans?  \n2. What is the impact of impaired enterohepatic reabsorption on the duration of vitamin B12 stores in the liver?  \n3. How does the body's ability to store and recycle vitamin B12 relate to dietary deficiencies in vegans?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 2069cf22-2ca0-4162-a717-4e07787945a5
encoding: FLOAT32
metadata:
{"original_content": "Large amounts of vitamin B\n12\n seem to be nontoxic but are not recommended for regular use (ie, as a\ngeneral tonic).", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the potential risks of using large amounts of vitamin B12 as a general tonic?  \n2. Can excessive intake of vitamin B12 contribute to any metabolic imbalances or nutritional disorders?  \n3. Why is regular use of high doses of vitamin B12 not recommended despite its nontoxicity?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d4cdb8c4-c4c7-4a4b-87a2-ccd8ec73f342
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n12\n Deficiency\nDietary vitamin B\n12\n deficiency usually results from inadequate absorption, but deficiency can\ndevelop in vegans who do not take vitamin supplements.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the dietary causes of vitamin B12 deficiency in vegans?  \n2. How does inadequate absorption contribute to vitamin B12 deficiency?  \n3. What are the potential health risks associated with a dietary vitamin B12 deficiency?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 6113d5dd-8436-4b43-a109-8b963878d362
encoding: FLOAT32
metadata:
{"original_content": "Deficiency causes megaloblastic\nanemia, damage to the white matter of the spinal cord and brain, and peripheral neuropathy.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the neurological consequences of a deficiency that leads to megaloblastic anemia?  \n2. How does a nutritional deficiency contribute to damage in the white matter of the spinal cord and brain?  \n3. What dietary deficiencies are associated with peripheral neuropathy?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5ca281a1-3767-480c-ab13-178856bc3a79
encoding: FLOAT32
metadata:
{"original_content": "Diagnosis is usually made by measuring serum vitamin B\n12\n levels.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. How is a deficiency in vitamin B12 diagnosed in patients with suspected nutritional disorders?  \n2. What role does serum vitamin B12 measurement play in identifying dietary deficiencies?  \n3. Can metabolic disorders be linked to abnormal serum vitamin B12 levels?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7df3b2c3-fb18-4b98-998b-1d0faaf2d784
encoding: FLOAT32
metadata:
{"original_content": "The Schilling test helps\ndetermine etiology.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What is the role of the Schilling test in diagnosing vitamin B12 deficiency?  \n2. How can the Schilling test help identify the cause of a nutritional absorption disorder?  \n3. In what ways does the Schilling test differentiate between dietary deficiency and malabsorption in cases of anemia?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: c589b970-678f-4c37-877f-4678b301d7e0
encoding: FLOAT32
metadata:
{"original_content": "Treatment consists of oral or parenteral vitamin B\n12\n.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What is the recommended treatment for a vitamin B12 deficiency?  \n2. How is vitamin B12 administered in cases of severe nutritional deficiency?  \n3. What are the therapeutic options for addressing metabolic disorders related to vitamin B12 imbalance?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d326a6d0-29d8-4580-ba8e-b44c637463c1
encoding: FLOAT32
metadata:
{"original_content": "Folate (folic acid)\nshould not be used instead of vitamin B\n12\n because folate may alleviate the anemia but allow\nThe Merck Manual of Diagnosis & Therapy, 19th Edition Chapter 4.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. Why is folate supplementation insufficient for treating anemia caused by vitamin B12 deficiency?  \n2. What are the potential risks of using folate to address anemia without addressing an underlying vitamin B12 deficiency?  \n3. How does the relationship between folate and vitamin B12 impact the diagnosis and treatment of nutritional anemia?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 65064bd5-e360-464e-9743-ece60544dad9
encoding: FLOAT32
metadata:
{"original_content": "Vitamin Deficiency, Dependency & Toxicity\n86", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 33, "type": "text ", "chroma:document": "1. What are the symptoms and health risks associated with vitamin toxicity?  \n2. How can dietary deficiencies lead to metabolic disorders?  \n3. What are the differences between vitamin dependency and vitamin deficiency?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: d16e63ea-b0ca-4c4d-ab31-0fda4045a62d
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{"original_content": "neurologic deficits to progress.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. What specific dietary deficiencies can lead to neurologic deficits?  \n2. How do vitamin and mineral imbalances contribute to the progression of neurologic disorders?  \n3. What metabolic disorders are commonly associated with neurologic deficits?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 7d9a975c-6aee-4c1e-ad20-c99402a266a9
encoding: FLOAT32
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{"original_content": "Etiology\nInadequate vitamin B\n12\n intake is possible in vegans but is otherwise unlikely.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. Why are vegans at a higher risk of developing a vitamin B12 deficiency?  \n2. What dietary habits could lead to inadequate vitamin B12 intake?  \n3. How does insufficient vitamin B12 intake contribute to nutritional disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 5a4e8b66-fa11-4806-9eb5-de8218131866
encoding: FLOAT32
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{"original_content": "Breastfed babies of vegan\nmothers may develop vitamin B\n12\n deficiency by age 4 to 6 mo because their\n[\nTable 4-5.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. What are the potential risks of vitamin B12 deficiency in breastfed infants of vegan mothers?  \n2. At what age might breastfed infants of vegan mothers begin to show signs of vitamin B12 deficiency?  \n3. How does a vegan mother's diet impact the vitamin B12 levels in her breastfed baby?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: b8c4d481-2380-4885-ab08-585df299f095
encoding: FLOAT32
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{"original_content": "Causes of Vitamin B\n12\n Deficiency]\nliver stores (which are normally extensive) are limited and their rapid growth rate results in high demand.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. What factors contribute to the depletion of liver stores of Vitamin B12 in individuals with high growth rates?  \n2. How does rapid growth impact the demand for Vitamin B12 in the body?  \n3. What are the nutritional implications of limited liver stores of Vitamin B12 in relation to deficiency disorders?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 1a761748-45ce-49b3-be27-182808bf862c
encoding: FLOAT32
metadata:
{"original_content": "Vitamin B\n12\n deficiency usually results from inadequate absorption (see \nTable 4-5\n and p.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. What are the potential health consequences of inadequate absorption of Vitamin B12?  \n2. How does Vitamin B12 deficiency relate to other nutritional or metabolic disorders?  \n3. What dietary or medical interventions can address Vitamin B12 absorption issues?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: 15488ab7-0915-4674-baed-070638f2bf6c
encoding: FLOAT32
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{"original_content": "153\n), which, in\nthe elderly, most commonly results from decreased acid secretion.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. How does decreased acid secretion in the elderly contribute to nutritional disorders?  \n2. What are the potential health impacts of reduced stomach acid on vitamin and mineral absorption?  \n3. Which dietary adjustments can help mitigate the effects of decreased acid secretion in older adults?  "}


created_at: 2025-03-03 11:15:40
topic: persistent://default/default/c12e1df1-2824-43db-a4f8-b8dd71fff39c
id: e95a0510-0e02-4e7f-8886-1ef66b89c72d
encoding: FLOAT32
metadata:
{"original_content": "In such cases, crystalline vitamin B\n12\n(such as that available in vitamin supplements) can be absorbed, but food-bound vitamin B\n12\n is not\nliberated and absorbed normally.", "source": "Nutritional Medical Reference/Nutritional Disorders.pdf", "page": 34, "type": "text ", "chroma:document": "1. Why might individuals with certain nutritional disorders require crystalline vitamin B12 supplements instead of obtaining it from food sources?  \n2. What factors prevent the normal liberation and absorption of food-bound vitamin B12 in some metabolic disorders?  \n3. How does the absorption mechanism of crystalline vitamin B12 differ from that of food-bound vitamin B12 in cases of dietary deficiencies?  "}


