Nutrition II

Question 1

vitamin B12

Answer 1

cobalamin

cofactor for homocysteine methyltransferase and methylmalonyl CoA mutase

Question 2

deficiency B12

Answer 2

macrocytic megaloblastic anemia

hypersegmented PMNs

paresthesias

degeneration dorsal columns, lateral corticospinal tracts, spinocerebellar tracts - abnormal myelin

increased serum homocysteine and methylmalonic acid levels

prolonged - irreversible

Question 3

intrinsic factor

Answer 3

for absorption of B12 - terminal ileum

Question 4

diagnosis of pernicious anemia

Answer 4

anti-IF Abs

Question 5

vitamin C

Answer 5

ascorbic acid
antioxidant
facilitate iron absorption - reduces Fe2+ state

also - hydroxylation of proline and lysine in collagen synthesis

and dopamine beta-hydroxylase - convert dopamine > NE

Question 6

tx methemoglobinemia

Answer 6

vit C

reduce Fe3 to Fe2

Question 7

deficiency vit C

Answer 7

scurvy
-swollen gum, bruising, petechiae, hemarthrosis, anemia, poor wound healing, corkscrew hair

collagen synthesis defect - no hydroxylation proline and lysine

Question 8

vit D2

Answer 8

ergocalciferol

-in plants

Question 9

vit D3

Answer 9

cholecalciferol

-in milk

Question 10

storage form vit D

Answer 10

25 OH D3

Question 11

active form vit D

Answer 11

calcitriol

1,25 OH D3

Question 12

function vit D

Answer 12

increased absorption Ca and P intestine

increased bone mineralization

Question 13

vit D deficiency

Answer 13

rickets - children

osteomalacia - adults

Question 14

rickets

Answer 14

vit D deficient children

Question 15

osteomalacia

Answer 15

vit D deficient adult

Question 16

breastfed infant

Answer 16

should get vit D supps

Question 17

excess vit D

Answer 17

with granulomatous disease
-vit D activated by epithelioid macros

hyperCa, hyperCa-uria, loss of appetite, stupor

Question 18

vitamin E

Answer 18

tocopherol
tocotrienol

antioxidant - protect RBC and membranes -from free rad damage

Question 19

tocopherol

Answer 19

vit E

Question 20

tocorienol

Answer 20

vit E

Question 21

vit E deficiency

Answer 21

hemolytic anemia
acanthocytosis
muscle weakness
posterior column and spinocerebellar tract demyelination

Question 22

phytomenadione

Answer 22

vit K

Question 23

phylloquinone

Answer 23

vit K

Question 24

phtonadione

Answer 24

vit K

Question 25

vitamin K

Answer 25

cofactor gamma-carboxylation of glutamic acid residues
-on colotting factors

synthesized by intestinal flora

Question 26

vit K factors

Answer 26

2, 7, 9, 10, protein C, protein S

Question 27

warfarin

Answer 27

vit K antagonist

Question 28

vit K deficiency

Answer 28

neonatal hemorrhage

increased PT and PTT
normal bleeding time

neonate - sterile intestine - cannot synthesize vit K

injection at birth - prevent hemorrhagic disease of newborn

Question 29

zinc

Answer 29

mineral - essential for activity of 100+ enzymes

formation of zinc fingers - transcription factor motif

Question 30

deficiency zinc

Answer 30

delayed wound healing
hypogonadism
decreased hair
dysgeusia
anosmia
acrodermatitis enteropathica - scaly plaque inguinal area

predispose alcoholic cirrhosis

Question 31

protein malnutrition

Answer 31

kwashiorkor

Question 32

kwashiorkor

Answer 32

protein malnutrition

skin lesion, edema, liver malfunciton - fatty change (decreased apolipoprotein synthesis)

small child - swollen abdomen

Question 33

marasmus

Answer 33

total calorie malnutrition

tissue and muscle wasting - loss subQ fat - variable edema

Question 34

fomepizole

Answer 34

inhibit alcohol DH

antidote methanol and ethylene glycol OD

Question 35

disulfiram

Answer 35

inhibit aldehyde DH

anabuse - acetaldehyde accumulate

Question 36

alcohol DH kinetics

Answer 36

zero order

Question 37

ethanol metabolism and NADH

Answer 37

increased NADH : NAD+ ratio

lactic acidosis
fasting hypoglycemia
hepatosteatosis

clinical picture of chronic alcoholic