Vitamins

Question 1

Vitamin A used to treat?

Answer 1

AML 3, Auer rods, translocation of RARA in front of PML, high dose retinoids lead to maturation.
Also used to treat measles

Question 2

Vitamin A not given to

Answer 2

Pregnant mothers teratogenic effects, mainly cleft palates, but can also be cardiac anomalies

Question 3

Test thiamine deficency

Answer 3

-Test transketolase, a member of HMP shunt, thiamine is only cofactor required for this enzyme

Question 4

Dry Beri Beri

Answer 4

Polyneuritis and muscle weakness (different from wernicke encephalopathy)

Question 5

Wet Beri Beri

Answer 5

Dilated cardiomyopathy and high output cardiac failure (edema)

Question 6

Riboflavin Deficency

Answer 6

Cheliosis (inflammation and scaling of lips)

Corneal vascularization

Question 7

B Complex deficencies

Answer 7

Diahrrea, glositis, dermatitis

Question 8

B3 de novo synthesis

Answer 8

From tryptophan (hartnup) requires B6 (INH)

Question 9

B3 clinical uses

Answer 9

-Increase HDL and treat dyslipidemia, may cause facial flushing (co administer COX inhibitors)

Question 10

B6 normal function

Answer 10

cofactor in tranaminase reactions

Question 11

What requires B6 for production

Answer 11

-Heme, histamine, neurotransmitters

Question 12

B6 deficency

Answer 12

• Sideroblastic anemia because of decreased heme

- convulsions from decreased NT (GABA, caetacholamines)

Question 13

B7 (Biotin) function

Answer 13

-Carboxylation reactions

Question 14

Cause of biotin deficency

Answer 14

-consumption of raw eggs, Avdin-biotin interaction

Question 15

Active form of folate

Answer 15

tetrahydrofoloate

Question 16

Folate normal physiology

Answer 16

Used to transfer one carbon bases in pyrimidine synthesis makes dTMP

Question 17

Buildup with deficency

Answer 17

-Homocysteine is reduced to methionine. Loss of folate leads to increased homocysteine and decreased methionine

Question 18

Manifestations of folate deficency

Answer 18

macrocytic anemia and hypersegmented neutrophils

-Neural tube defects in pregnancy

Question 19

Clinical manifestations of biotin deficency

Answer 19

-necessary for carboxylation reactions of gluconeogenesis. Deficency leads to fasting hypoglycemia

Question 20

Folate can be deceased by which drugs

Answer 20

-Phenytoin, sulfonamides, MTX

Question 21

B12 Function

Answer 21

-Transfer carbon from methylmalnyl coA to make succinyl CoA

Question 22

B12 deficency

Answer 22

• Macrocytic anemia and hypersegmented neutrophils

- Neurologic symptoms because of damage to myelin

Question 23

B12 metabolism

Answer 23

• Binds R binder in salivary glands
• Picks up intrinsic factor from the stomach (Secreted by parietal cells)
• Binds receptor in gut

Question 24

Cause of B12 deficency

Answer 24

• Pernicous anemia (atrophic gastritis prevents secretion of intrinsic factor)
• Surgery to decrease absorption in gut
• Diphyllobothrium latum (fish tape worm)

Question 25

Other enzyme with 1 carbon transfers

Answer 25

• SAM, transfers methyl units from methionine to anoabolic pathways
• Needs to be regenerated from homcysteine by B12 and folate
• Requires ATP
• Most notably necessary for conversion of NE to Epi

Question 26

Vitamin C function

Answer 26

• Proline and lysine hydroxylation
• Increases absorption of Fe in gut by keeping in +2 state
• Necessary for conversion of dopamine to NE

Question 27

Vitamin E deficency

Answer 27

• Lipid membrane damage - acanthocytosis RBC

- Posterior column and spinocerebellar degeneration

Question 28

Vitamin K function

Answer 28

-gamma carboxylation, generates Ca binding site for clotting factors

Question 29

Factors dependent on Vitamin K

Answer 29

• 2, 7, 9, 10
• Also C and S
• Warfarin induced necrosis if not given with heparin (C has short half life)