03 Vitamin E & K

Question 1

What is vitamin E ?

Answer 1

Describes a group of fat-soluble compounds that contains antioxidant activities.

Question 2

What are the 8 forms of vitamin E ?

Answer 2

Alpha-tocopherol
Beta-tocopherol
Gamma-tocopherol
Delta-tocopherol

Alpha-tocotrienol
Beta-tocotrienol
Gamma-tocotrienol
Delta-tocotrienol

Question 3

What is vitamin E describe as?

Answer 3

Fertility vitamin and anti-aging vitamin

Question 4

What is toco? And phero ?

Answer 4

Tocos=child birth

Pheros=to bear

Question 5

What is the differance between Tocotrienol(T3) and Tocopherol(Toc) ?

Answer 5

T3 has unsaturated isoprenoid tail.

Toc has saturated phytyl side-chain

Question 6

Antioxidants in Vitamin E protects the cell from…….

Answer 6

Free radicals ( also called reactive oxygen species , ROS )

Question 7

What are free radicals/ROS?

Answer 7

Highly reactive and unstable molecules which are forms of molecular oxygen and they contain unpaired electron

Question 8

Examples of free radicals/ROS ?

Answer 8

Oxygen O2
Superoxide anion O2(-)
Peroxide O2(-2)
Hydrogen peroxide H2O2
Hydroxyl radical OH
Hydroxyl ion OH(-)

Question 9

What does ROS/free radicals do?

Answer 9

They will do anything to be stable. Like stealing electrons from cellular molecules which might damage the DNA and protiens(enzymes) and cell membrane.

Question 10

Diseases ROS cause?

Answer 10

Cancer, cadiovascular disease, accelerated aging .

Question 11

How does a human body get ROS ?

Answer 11

Formed endogenously (inside the body) during metabolism. 
Exogenously ( environmental exposures) such as cigarette smoke , air pollution and ultraviolet radiation

Question 12

is ROS produced in the body?

Answer 12

Yes. During metabolism.

Question 13

To make a cell with free radicals a healthy cell we need ……

Answer 13

Antioxidants

Question 14

Vitamin E functions?

Answer 14

Regulating immune function
Maintaining endothelial cell inegrity 
Cell signaling
Regulation of gene expression 
Balancing normal coagulation ( blood going to solid)

Question 15

What does alpha-tocopherol inhibit?

Answer 15

Alpha-tocopherol inhibits protien kinase C .

Protien kinase C is involved in proliferation and differentiation of smooth muscle cells, platlets and monocytes.

So it helps in diabetes mellitus , atheroscelerosis, inflamation and cancer

Question 16

Normal leveles of vitamin E ……… arachiodonic acid release. Which ……….. prostacyclins which then ……….. blood vessles and ………. Platlet aggregation.

Answer 16

Increase
Increases
Dialates
Inhibit

Question 17

High dose of vitamin E inhibits ……

Answer 17

Thromboxanes release

Question 18

Vitamin Edeficoncy is rare and a little amount is needed in the diet. True or false?

Answer 18

True

Question 19

High consumption of vitamin E in food doesnt cause damage. But, high does of alpha-tocopherol supplements can cause …………..

Answer 19

Hemorrhage.

So it interrupts blood coagulation

Question 20

What is vitamin k?

Answer 20

Group of naturaly occuring and synthetic vitamins that have coagulant properties.

Question 21

How many k vitamins?

Answer 21

4k vitamins

K1 (Phylloquinone), the plant form, and the only form available for
therapeutic use

Intestinal flora can also convert K1 into
vitamin K2 (Menaquinone), the animal form

Vitamin K3 (Menadione), artificially produced from K1, no longer used as it interferes with the function of glutathione.

Vitamin K4 (Menadiol).

Both k3 and k4 can be metabolized to K1

Question 22

Vitamin k works as a coenzyme for what enzyme?

Answer 22

For gamma glutamate carboxylase enzyme which is required for gamma-carboxylation of glutamate residues of certain calcium- binding proteins

Question 23

Gamma carboxylation is essential for what ?

Answer 23

Gamma carboxylation is essential for the effective calcium binding and thus functioning of these proteins( calcium binding proteins)

Question 24

Vitamin K is reduced to what?

Answer 24

Vitamin k is reduced to KH2 by the enzyme reductase

Question 25

What enzyme is used to reduce vitamin k to KH2 ?

Answer 25

Enzyme reductase using NADH.

Question 26

KH2 is converted back to VITAMIN K after ……….

Answer 26

Carboxylation which again generates KH2

Question 27

Vitamin K is ..………….. into vitamin KH2 by the enzyme ………….. by using / converting NADH into NAD.

Answer 27

Oxidized | reductase

Question 28

Vitamin KH2 is ………….. into vitamin K by using …………………….. . Where an inactive protein like glutamate turns into an active protein like carboxyglutamate. CO2 is added

Answer 28

Reduced | Gamma glutamyl carboxylasr

Question 29

There are several vitamin K-dependent | proteins acting as anticoagulants, including ?

Answer 29

clotting factors II (prothrombin), VII, IX, X, as well as proteins C, S and Z.

Question 30

Examples of major vitamin K dependent_protiens

Answer 30

Cogulation factors and anti-cogulation factors, both are in liver, their function is to contribute to normal coagulation. Osteocalcin(OC) ,in bones, function is to contribute to bne health Matrix Gla protein(MGP), in Aorta and heart valves, function is to inhibit calcification in arteries GAS6 , in aorta and brain, function is to modulate cell growth

Question 31

GAS6 ?

Answer 31

It is a vitamin k dependent protien It is in aorta and brain It modulates cell growth

Question 32

Matrix gla protien (MGP) ?

Answer 32

It is a vitamin k dependent protien It is in aorta and heart valves It inhibits calcification in arteries

Question 33

Osteocalcin ( OC)

Answer 33

It is a vitamin k dependent protien It is in bone It contributes to bone growth

Question 34

Coagulation factors and anti-coagulation factors

Answer 34

It is a vitamin k dependent protien It is in liver It contributes to normal coagulation

Question 35

How does clotting factors work?

Answer 35

Any injury to vessels triggers the release of clotting factors which activate prothrombin into thrombin, then thrombin activates fibrinogen which is soluble into an insoluble fibrin, these fibrin strands stick to platelets that gathered before because of vaso constriction, so when fibrin sticks to it, an insoluble clot will be formed

Question 36

What is Vitamin K Deficiency Bleeding (VKDB) ?

Answer 36

The deficiency syndrome is traditionally known as Hemorrhagic Disease of the Newborn. It has 3 types

Question 37

What are the 3 types of Vitamin K Deficiency Bleeding (VKDB)?

Answer 37

``` Early VKDB (0-24 hours after delivery). Classic VKDB (1-7 days after delivery). Late VKDB (1-12 weeks after delivery). ```

Question 38

VKDB affects who more?

Answer 38

``` ▪ Preterm babies. ▪ Exclusive breastfeeding. ▪ Broad spectrum antibiotics?! ▪ Liver disease (alcoholism). ▪ Malabsorption ```

Question 39

Prophylaxis/prevention of Vitamin K Deficiency Bleeding (VKDB) ?

Answer 39

Because no screening test is available, it is now common pediatric practice to protect all infants by giving vitamin K ORALLY (rather than intramuscularly) in the immediate perinatal period

Question 40

Is vitamin k toxic?

Answer 40

When taken orally, natural K vitamins seem free of toxic side effects. The synthetic vitamin K, menadione, has been associated with neonatal hemolysis and liver damage

Question 41

Clotting factors numbers?

Answer 41

2 7 9 10