Internal Medicine

0521779407-22 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:23

1538 Vitamin E Deficiency Vitamin K Deficiency

tests

Laboratory

■Basic blood studies:

➣tocopherol level <5 mcg/mL

differential diagnosis

n/a

management

n/a

specific therapy

■Vitamin E. No evidence Vitamin E prevents heart disease or cancers.

Side Effects & Contraindications

■None, perhaps increased tendency for bleeding

follow-up

n/a

complications and prognosis

■Completely reversible except in genetic defects

VITAMIN K DEFICIENCY

ELISABETH RYZEN, MD

history & physical

History

■newborns; marginal dietary intake, extensive surgery, trauma, pro-

longed TPN, biliary obstruction, malabsorption, liver disease; anti-

convulsant, anticoagulant use, cephalosporins, salicylates, mega-

doses vitamins A or E

Signs & Symptoms

■bleeding, easy bruising, epistaxis, hematuria, GI bleeding, signs of

anemia or menorrhagia, puncture site blood oozing