Vitamins and Minerals Flashcards
Iron
Hemoglobin, myoglobin
Storage of excess: liver, spleen, bone marrow
Deficiency -> microcytic anemia
Iron poisoning
Kids – prenatal vitamins or iron supplements
GI: gastric bleeding, hematemesis, abd pain
-> hypovolemic shock -> death if bleeding severe
6-72 hours -> metabolic acidosis
2-8 wks -> scarring of GI tract damaged by free radicals -> obstruction
Zinc
Zinc-finger motif
-unable to transcribe DNA
healing
immune system
carbonic anhydrase – req Zn
Lactate dehydrogenase req Zn
Zinc deficiency
Delayed wound healing Decreased body and facial hair Hypogonadism Anosmia Dysgensia – decreased taste Decreased immune response
Rash around mouth, nose, anus
-acrodermatitis enteropathica
anorexia, D growth retardation depressed mental function impaired night vision infertility
Lead poisoning
Decreased in IQ Hearing problems Growth impairment Peripheral neuropathy -wrist/foot drop
interferes w/ remodeling cartilage -> lead lines in bones
-teeth, gum junction
“Burton’s lines”
Decreased hemoglobin synthesis -> anemia Abd pain Nephropathy Encephalopathy -> death
Peripheral blood smear:
Basophilic stippling – inhibits rRNA -> retained segments of rRNA
BM bx: ringed sideroblasts
-red cell precursor containing mt filled w/ iron
Tx: mild – remove source
Mod-high w/ sx: succimer or EDTA
Peds w/ severe tox: dimercaprol +/- succimer
Ferritin
Iron-protein complex – ferric acid and apoferriton
Cellular storage protein for iron, increased in hepatocytes
Acute phase reactant – bind iron so bacteria can’t utilize it
Transferrin
Protein that binds ferric molecules and transports them through plasma
Synthesized in liver
T1/2 8 days
Increased in iron deficiency – cells hungry for iron -> increased binding capacity
Mercury poisoning
Accumulates in kidney and brain -> peripheral neuropathy, neuropsych problems
Acrodynia – peeling of fingertips
(also seen in Kawasaki dz)
abd pain
Common sources:
Fish: shark, swordfish, tile fish, king mackerel
-avoid in pregnancy -> fetal brain damage
old thermometers, batteries
*organic mercury more likely to enter and stay in body than inorganic mercury
B1 – thiamine
Active: thiamine pyrophosphate
Cofactor for:
pyruvate dehydrogenase – pyruvate to acetyl CoA
alpha ketoglutarate dehydrogenase – a-ketoglutarate -> succinyl CoA
Phosphopentose isomerase, transketolase – ribulose 5-Pi -> Ribose 5-pi, G3P, F6P
-pentose phosphate pathway
Thiamine deficiency
Poor nutrition (alcoholism)
Malabsorption
Increased loss of water soluble vit – dialysis
Damage to medial thalamus and mammillary bodies of posterior hypothalamus
Generalized cerebral atrophy
Wernicke-Korsakoff Sn
Wernicke encephalopathy – acute: encephalopathy
CN3 dysfunction
Ataxic gait
Korsakoff Sn: chronic form
Tx: thiamine supplement
ALWAYS thiamine before glucose
Wet vs Dry Beriberi
Thiamine defiency
Dry: Nerves peripheral neuropathy -toe drop, wrist drop, foot drop -muscle weakness -hypo-/a-reflexia
Wet: heart Peripheral vasodilation High output HF Peripheral edema Cardiomegaly
Tx: thiamine supplement
Always Thiamine before glucose
B2 Riboflavin
Cofactor for dehydrogenase enzymes
Cofactors for redox reactions: Flavin mononucleotide (FMN) Flavin adenine dinucleotide (FAD)
Deficiency:
Dermatitis
Angular stomatitis
Glossitis
Vit B 3 – niacin
Nicotinamide adenine dinucleotide (NAD)
Nicotinamide adenine dinucleotide phosphate (NADP)
Redox reaction
Derived from tryptophan
Niacin deficiency
Pellagra : Dermatitis, diarrhea, dementia
Hartnup dz – decreased Trp absorption
Maligant carcinoid sn: increased Trp metabolism
INH –inhibits B6 and B3
