GI Malapsorption - Vitamins

Question 1

What kind of anaemia occurs in iron deficiency?

Answer 1

Microcytic (smaller and paler red cells)

Question 2

What are the 3 possible reasons for iron deficiency to occur?

Answer 2

1) Not enough dietary iron intake
2) Decreased iron absorption
3) Increased iron loss (sloughed mucosal cell, bleeding)

Question 3

What is osteoporosis, ricketts and osteomalacia and what vitamin deficiency are they associated with?

Answer 3

All associated with Vitamin D deficiency
Osteoporosis - reduced bone density
Osteomalacia - normal amount of bone but mineral content low
Ricketts - occurs if low amount on minerals when bones are growing

Question 4

What are the possible causes of Vitamin D deficiency?

Answer 4

1) Inadequate sunlight
2) CKD
3) Malabsorption - coeliac, intestinal resection, cholestasis (Vit D is fat soluble)

Question 5

Other than Vitamin D deficiency what are the other causes of osteoporosis? 4

Answer 5

1) Anorexia
2) Smoking
3) Alcoholism
4) Steroid therapy

Question 6

Where is Intrinsic factor formed and where is Vit B12 absorbed?

Answer 6

B12/IF complex formed in stomach and absorbed in the terminal ileum therefore gastric mucosal atrophy and terminal ileum disease can lead to B12 deficiency

Question 7

What is B12 required for and what kind of deficiency does B12/folate (Vit B9) deficiency lead to?

Answer 7

Normal proliferation of cells is dependent on adequate vitamin B1 and B9 (folate) - necessary for production of DNA
Leads to macrocytic anaemia (pernicious anaemia)

Question 8

Xerophthalmia is caused by a deficiency in which vitamin?

Answer 8

A

Question 9

Beri Beri is caused by a deficiency in what vitamin?

Answer 9

B1 (Thiamine)

Question 10

Angular stomatis and cholitis are caused by deficiencies in what vitamin?

Answer 10

B2

Question 11

Polyneuropathy is caused by a deficiency in what vitamin?

Answer 11

B6

Question 12

Pernicious anaemia is caused by a deficiency in which vitamin?

Answer 12

B12

Question 13

Scurvy is caused by a deficiency in what vitamin?

Answer 13

C

Question 14

Osteomalacia is caused by a deficiency in what vitamin?

Answer 14

D

Question 15

Bleeding disorders are caused by deficiencies in which vitamins?

Answer 15

E and K

Question 16

Most vitamins are absorbed in the small intestine, specifically what part of the small intestine is vitamin C and B12 absorbed in?

Answer 16

B12 = terminal ileum
C = proximal ileum

Question 17

What 6 minerals are needed as part of the diet which are all absorbed in the SI?

Answer 17

1) Calcium
2) Zinc
3) Iron
4) Copper
5) Magnesium
6) Selenium

Question 18

What is the role of thiamin (B1) and what does deficiency result in?

Answer 18

Co factor in decarboxylation reactions - CO2 released (Krebs cycle, link reaction)
Beri beri - muscle weakness, nerve damage

Question 19

What is the role of riboflavin (B2) and can you become deficient in it?

Answer 19

FAD

Very rare

Question 20

Role of niacin and deficiency (B3)?

Answer 20

NADH

Pellagra - depression, dermatitis, diarrhoea, death

Question 21

Role of pantothenic acid (B5)?

Answer 21

Co A

Question 22

Role of biotin (B7)?

Answer 22

Prosthetic group, carries CO2 in carboxylation reactions

Question 23

What is the role of pyridoxal phosphate (B6) and what does deficiency result in?

Answer 23

Co factor for enzymes involved in protein metabolism, haem synthesis, neurotransmitter synthesis, modulates steroid hormone action
Deficiency = irritability, depression, confusion, inflammation of tongue or mouth

Question 24

Role of folic acid (B9) and what does deficiency result in?

Answer 24

DNA synthesis, 1C transfers

Neural tube defects - spina bifida, anencephaly, macrocytic anaemia