CPR APPLICATIONS FOUNDATION · CHAPTER 14 · ABNORMAL
Abnormal Foundations of Nutrition & Bioenergetics
Organize the chapter before drilling into individual CPR concepts.
Supplemental foundation map: this page orients the detailed CPR Applications for Chapter 14. It is not part of the canonical CPR object inventory.
Move through Chapter 14
Normal Foundations
Abnormal Foundations · You are here
Treatment Foundations
14.6 · SOURCE CPR FOUNDATION
Concept
Most nutrition and bioenergetics pathology is failure of intake, absorption, storage, or fuel use under stress. Step 1 does not usually ask “what nutrient is low” directly. It gives anemia, neuropathy, rash, edema, hypoglycemia, bleeding, or mental-status change and asks you to trace backward.
Pattern
The exam groups disorders by output failure. Macrocytosis suggests DNA-synthesis cofactor deficiency, bleeding with normal platelets suggests vitamin-dependent clotting or collagen failure, fasting intolerance suggests fuel mobilization failure, and decline after refeeding suggests intracellular electrolyte shifts.
Rule
- Use the symptom cluster before the nutrient list. Anemia, neuro signs, bleeding, skin changes, and bone symptoms are pattern clues.
- Use timing for metabolic disease. Fasting, feeding, protein load, or carbohydrate load can reveal the pathway.
- Use treatment timing for iatrogenic complications. Refeeding and glucose can worsen unstable physiology.
Applications
- Macrocytic anemia neurologic findings → B12 deficiency
- Macrocytic anemia without neurologic symptoms → folate deficiency is possible, but vitamin B12 deficiency may also lack neurologic findings; test appropriately
- Bleeding gums poor healing → vitamin C deficiency
- Elevated PT/INR normal platelets → vitamin K deficiency
- Night blindness xerosis → vitamin A deficiency
- Bone pain with low calcium and elevated PTH → consider vitamin D deficiency among other causes of secondary hyperparathyroidism
- Fasting hypoketotic hypoglycemia → consider fatty acid oxidation deficiency, hyperinsulinism, and other relevant metabolic causes
- Protein load vomiting lethargy hyperammonemia → urea-cycle failure
- Post-refeeding confusion arrhythmia weakness → refeeding syndrome
- Tip: Output pattern comes before deficiency name
CPR APPLICATIONS · ACTIVE REASONING
Interpret biochemical deficiency patterns
Make a prediction first. Each worked answer is available without JavaScript. These exercises do not save or send responses.
Worked reasoning and transfer
Best answer: B12 and folate deficiency remain possibilities. Absence of neurologic symptoms does not exclude B12 deficiency.
Transfer: Which tests separate them?
Worked reasoning and transfer
Best answer: Phosphate, potassium and magnesium shifts. Refeeding can induce insulin-mediated intracellular electrolyte shifts.
Transfer: What monitoring prevents deterioration?
Worked reasoning and transfer
Best answer: Evaluate fatty acid oxidation and other causes. Hypoketotic hypoglycemia can occur with fatty acid oxidation defects or hyperinsulinism.
Transfer: What measurements during a supervised evaluation help?
Explain it back: Write a causal chain for one decision, then identify which piece of evidence would change the answer.
Unscored teaching examples; not validated assessment items or patient-specific advice.
How to use this foundation map
- Identify the organizing mechanism.
- Recognize the pattern.
- Restate the rule without looking.
- Test transfer with applications and question practice.
Pair CPR with the 5P Approach™ when solving cases and questions.