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BIOCHEMISTRY > BIOCHEMISTRY- Nutrition > Flashcards

BIOCHEMISTRY- Nutrition Flashcards

1
Q

Which vitamins are fat soluble?

A

A, D, E, K

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2
Q

Which organs carry the absoption of fat soluble vitamins?

A

Gut and pancreas

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3
Q

Which vitamins have more toxicity?

A

Fat vitamins

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4
Q

Why do vitamin A, D, E and K are more toxic?

A

Because they accumulate in fat

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5
Q

This diseases can cause fat soluble vitamin deficiencies because if a malabsoption syndrome

A

Cystic fibrosis and sprue

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6
Q

This are examples of watter soluble vitamins

A

B1, B2, B3, B5, B6, B7, B9, B12 and C

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7
Q

All watter soluble vitamins are easily wash out from the body except for…

A

Vitamin B12 and folate (B9)

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8
Q

Where do cobalamin and folate are stored?

A

In the liver

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9
Q

Which are the three characteristics of the B- complex deficiencies?

A

Dermatitis, glositis and diarrhea

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10
Q

Antoxidant, constituent of of visual pigments

A

Vitamin A

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11
Q

What other names does Vitamin A receives?

A

Retinol

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12
Q

What effect does Retinol has on epithelial cells?

A

Essential dor normal differentiation of ephitelial cells into specialized tissue

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13
Q

What kind of cancer does Vitamin A prevents?

A

prevents squamos metaplasia

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14
Q

What diseases are treated with vitamin A?

A

measles and AML, subtype M3

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15
Q

Vitamin A as Retin-A, topically which kind of use does it has?

A

For wrinkles and acne

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16
Q

Where can we find Vitamin A?

A

In liver and leafy vegetables

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17
Q

This are the consequences for Vitamin A deficiency

A

Night blindness (nyctalopia), dry, scaly skin (xerosis cutis); alopecia, cerebral edema, pseudotumor cerebri, corneal degeneration (keratomalacia); immune suppression

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18
Q

Arthralgia, skin changes (scalines), alopecia, cerebral edema, pseudotomor cerebri, osteoporosis hepatic abnormalities… are signs of which vitamin excess?

A

Vitamin A or Retinol

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19
Q

Before indicating Isotretinoin for treatment in severe acne, for what do we need to have special precautions?

A

Negative pregnancy test and reliable contraception because is very Teratogenic

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20
Q

What kind of Teratogenic abnormalities can be present with the excess of vitamin A?

A

Cleft palate, cardiac abnormalities

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21
Q

Which vitamin is the thiamine?

A

Vitamine B1

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22
Q

In vitamin B1, Which is the cofactor for several dehydrogenase enzyme reaction?

A

Thiamine pyrophosphate

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23
Q

Which are the enzyme reactions caused by Thiamine pyrophosphate?

A

Pyruvate deshydrogenase (links glycolysis to TCA cycle)
α ketoglutarate dehydrogenase (TCA cycle)
Transketolase (HMP shunt)
Branched-chain ketoacid dehydrogenase

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24
Q

If there is a vitamin B1 deficiency what happens to the glucose?

A

Impaired glucose breakdown

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25
Q

What happens to the ATP in Vitamin B1 deficiency? and what will happen if we give a glucose infusion?

A

ATP depletion worsened by glucose infusion

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26
Q

Which tissue are first affected by thiamine depletion?

A

Highly aerobic tissues (Brain and Heart)

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27
Q

Weinicke-Korsakoff syndrome and Beriberi are diseases for which vitamin deficiency?

A

Vitamin B1

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28
Q

Name two kind of patients that can present Thiamine deficiency

A

Seen in malnutrition and alcoholism

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29
Q

Which laboratory test helps in the diagnosis of Vitamin B1 deficiency?

A

Increase RBC transketolase activity following vitamin B1 administration

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30
Q

Which is the classic triad in Wernicke Korsakoff syndrome?

A

Confussion
Ophtalmoplegia
Ataxia

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31
Q

This are other symptoms that can be seen in Wernicke Korsakoff syndrome

A

confabulation personality change, memory loss (permanent)

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32
Q

Anatomically, where is the site of damage in the brain in Wernicke Korsakoff syndrome

A

Damage to medial dorsal nucleus of thalamus, mamilary bodies

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33
Q

Dry or Wet beriberi… polyneuritis, symmetrical muscle wasting

A

Dry beriberi

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34
Q

Dry or Wet beriberi… high output cardiac failure (dilated cardiomyopathy), edema

A

Wet beriberi

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35
Q

This vitamin is a component of flavins FAD and FMN

A

Vitamin B2 Riboflavin

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36
Q

What is the use of FAD and FMN?

A

Cofactors in redox reactions

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37
Q

This is an example of the FMN and FAD used as cofactors

A

The succinate dehydrogenase reaction in the TCA cycle

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38
Q

Which are the two manifestation If there is a Vitamin B2 deficiency?

A

Cheilosis and Corneal vascularization

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39
Q

Which is the alternative name of vitamin B3

A

Niacin

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40
Q

What importance does the Niacin has in redox reactions?

A

Constituent of NAD+, NADP+

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41
Q

This vitamin is derived from tryptophan

A

Vitamin B3 (Niacin)

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42
Q

Which vitamins does Niacin requires for its synthesis

A

Vitamin B2 and Vitamin B6

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43
Q

Which disease is treated with vitamin B3?

A

Dyslipidemia

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44
Q

How does Niacin helps in the treatment of Dyslipidemia?

A

Lowers levels of VLDL and raises levels of HDL

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45
Q

Severe deficiency of Niacin, What disease does it causes?

A

Pellagra

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46
Q

Which is the disease that has a decrease in tryptophan absorption? and which disease can be the consequence?

A

Hartnup disease, which can cause Pellagra due to decrease in tryptophan absorption

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47
Q

What kind of disease has an increase trypthophan metabolism that leads to Pellagra?

A

Malignant carcinoid

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48
Q

This first-line medication in prevention and treatment of tuberculosis decreases vitamin B6 which can lead to vitamin B3 deficiency

A

Isoniazid

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49
Q

This are 3 main causes of Pellagra

A

Hartnup disease
Malignant carcinoid syndrome
Use of Isoniazid

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50
Q

Which is one of the main findings in Vitamin B3 deficiency?

A

Glossitis

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51
Q

Which are the three symptoms found in pellagra?

A

Diarrhea, Dementia and Dermatitis

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52
Q

How does the Dermatitis is manifested in Pellagra?

A

Casal necklace or hyperpigmentation of sun exposed limbs

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53
Q

Facial flushing induced by prostanglandin, hyperglicemia, hyperuricemia… this are findings of which vitamin excess?

A

Niacin

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54
Q

This vitamin is essential component of coenzyme A and fatty acid synthase

A

Vitamin B5

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55
Q

Which is the importance of CoA?

A

Is a cofactor for acyl transfers

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56
Q

Which is the other name for vitamin B5?

A

pantothenate

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57
Q

This are the findings in vitamin B5 deficiency

A

Dermatitis, enteritis, alopecia, adrenal insufficiency

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58
Q

Better known as pyridoxine

A

Vitamin B6

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59
Q

Vitamin B6 is converted to which cofactor, in order to be used in transamination, decarboxylation reactions and glycogen phosphorylase?

A

pyridoxal phosphate

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60
Q

In which synthesis process is necessary the pyridoxine?

A

Cystathionine, heme, niacin, histaminem and neurotransmitters including serotonin, epinephrine, norepinephrine, dopamine, and GABA

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61
Q

Convulsions, hyperirritability, peripheral neuropathy and anemia… this findings correspond to which vitamin deficiency?

A

Vitamin B6

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62
Q

What kind of anemia is caused by pyridoxine deficiency? What is the explanation for this anemia?

A

Sideroblastic anemias due to impaired hemoglobin synthesis and iron excess

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63
Q

This vitamin is a cofactor for carboxylation enzymes (which add a 1 carbon group)

A

Vitamin B7

64
Q

This is the alternative name for Vitamin B7

A

Biotin

65
Q

This are the sites where the Vitamin B7 works as a cofactor and adds 1 Carbon group

A

Pyruvate carboxylase: pyruvate to oxaloacetate
Acetyl-CoA carboxylase: acetyk CoA to malonyl-CoA
Propionyl-CoA carboxylase: propionyk-CoA to methylmalonyl-CoA

66
Q

Which is the cause of biotin deficiency?

A

Caused by antibiotic use or excessive ingestion of raw egg whites

67
Q

It´s relatively rare to see a Vitamin B7 deficiency, but when this happens which kind of findings are common?

A

Dermatitis, alopecia, enteritis

68
Q

Which vitamin is Folic Acid?

A

Vitamin B9

69
Q

Folic Acid is converted to…

A

Tetrahydrofolate (THF)

70
Q

What is it for THF?

A

A coenzyme for 1’carbon transfer/methylation reactions

71
Q

What importance does the THF and folic acid have in DNA and RNA?

A

Important for the synthesis of nitrogenous bases in DNA and RNA

72
Q

Where do we find Vitamin B9

A

Found in leafy green vegetables

73
Q

Where does the folic acid is absorbed?

A

In jejunum

74
Q

Where is the small reserved of folic acid?

A

Primarily in the liver

75
Q

If there is a deficiency in folic acid, how are the blood cell affected?

A

Macrocytic, megaloblastic anemia

hypersegmented PMN

76
Q

What is the difference between vitamin B9 and B12 symptoms?

A

There is no neurologic symptoms in folic acid deficiency

77
Q

Which labs alterations do we see in acid folic deficiency?

A

Increase homcystein, normal methylmalonic acid

78
Q

Most common vitamin deficiency

A

Folic Acid deficiency

79
Q

Which kind of patients present vitamin B9 deficiency

A

Alcoholism and pregnant patients

80
Q

Which kind of drugs can cause acid folic deficiency?

A

Phenytoin, Sulfonamides, Methotrexate

81
Q

The suplementation of this vitamin can decrease the risk of neural tube defects in the early pregnancy

A

Vitamin B9 or folic Acid

82
Q

Cofactor for homocysteine methyltransferase and methylmalonyl CoA mutase

A

Vitamin B12

83
Q

In which form does Cobalamin transfers CH3 groups

A

As Methylcobalamin

84
Q

Which kind of food is high in vitamin B12?

A

Animal products

85
Q

Who synthesized cobalamin?

A

Only by microorganisms

86
Q

How much time can Vitamin B12 be reserved in the liver?

A

Several years

87
Q

Which are the reasons for cobalamin deficiency?

A

Insuficient intake (Veganism)
Malabsoption (Sprue, enteritis)
Lack of intrinsic factor (pernicious anemia, gastric bypass surgery)
Absence of terminal ileum (Chron disease)

88
Q

Which bacteria is the cause of malabsorption of Vitamin B12?

A

Diphyllobotrium lactum

89
Q

What do we need to make the diagnosis of Pernicious anemia?

A

Anti-intrinsic factor antibodies

90
Q

In blood studies this are the main findings in Cobalamin deficiency…

A

Macrocytic, megaloblastic anemia; hypersegmented PMN

91
Q

Which kind of neurologic findings are seen in cobalamin deficiency?

A

paresthesias and subacute combined degeneration

92
Q

Anatomically where are the degenerations of Vitamin B12 deficiency?

A

Degeneration of dorsal columns, lateral corticospinal tracts and spinocerebellar tracts

93
Q

Why does subacute combined degeneration happens in patients with cobalamin deficiency?

A

Due to abnormal myelin

94
Q

This laboratories are altered in patients with cobalamin deficiency

A

Increase serum homocysteine and methylmalonic acid levels

95
Q

Neurologically, what happens if there is a prolonged deficiency of Vitamin B12 deficiency?

A

Irreversible nerve damage

96
Q

This antioxidant is found in fruits and vegetables

A

Vitamin C

97
Q

How does Vitamin C facilitates iron absorption?

A

By reducing it to Fe2+ state

98
Q

Why does Ascorbic Acid is required for collagen synthesis?

A

Because is necessary for hydroxylation of proline and lysine in collagen synthesis

99
Q

How does Vitamin C is related to dopamine?

A

Because it is necessary for dopamine β-hydroxylase, which converts dopamine to NE

100
Q

This vitamin is tha ancillary treatment for methemoglobinemia by reducing Fe3+ to Fe2+

A

Vitamin C

101
Q

This disease is caused by ascorbic acid deficiency

A

Scurvy

102
Q

How does vitamin C deficiency causes Scurvy?

A

Due to a collagen synthesis defect

103
Q

This are the characteristics of a patient with Scurvy

A

Swollen gums, bruising, hemarthrosis, anemia, poor wound healingm perifollicular, and subperiosteal hemorrhages, corkscrew hair

104
Q

How is the immune response in the scury patients?

A

Weakened immune response

105
Q

Nausea, vomiting, diarrhea, fatigue, nephrolithiasis are findings related to which vitamin excess?

A

Vitamin C

106
Q

Which kind of kidney stones are form with ascorbic acid excess?

A

Calcium oxalate nephrolithiasis

107
Q

Better known as ergocalciferol

A

Vitamin D2

108
Q

This kind of vitamin D is ingested from plants

A

Ergocalciferol (Vitamin D2)

109
Q

What is the other name for Vitamin D3?

A

Cholecalciferol

110
Q

From where do we get Vitamin D3?

A

Consumed in milk, formed in sun exposed skin

111
Q

In which stratum of the skin, does cholecalciferol is formed after the sun exposure?

A

Stratum basale

112
Q

Which is the storage form of vitamin D3?

A

25-OH D3

113
Q

This is the active form of Vitamin D3

A

1,25 (OH)2 D3 (calcitriol)

114
Q

What kind of function does Vitamin D has?

A

Increases intestinal absoption of calcium and phosphate

Increases bone mineralization

115
Q

Rickets in children is the manifestation of this vitamin deficiency

A

Vitamin D deficiency

116
Q

In adults what is the name of the disease caused by Vitamin D deficiency?

A

Osteomalacia

117
Q

Aside of rickets and osteomalacia, which other disease can happen with Vitamin D deficiency?

A

hypocalcemic tetany

118
Q

In breastfed infants, which vitamin should receive orally?

A

Vitamin D

119
Q

This are other risk factors that exacerbates the disease

A

By low sun exposure, pigmented skin, prematurity

120
Q

This are the after effects that can be seen in Vitamin D excess?

A

Hypercalcemia, hypercalciuria, loss of apetite, stupor

121
Q

Which vitamin is altered in Sarcoidosis?

A

Increase activation of vitamin D by epithelioid macrophages

122
Q

What is the function of Vitamin E?

A

Antioxidant (protects erythrocytes and membranes from free radicals damage)

123
Q

What effect does Vitamin E can have in conjuction with Warfarin?

A

Can enhance anticoagulant effects of Warfarin

124
Q

Which findings are common on tocopherol deficiency?

A

Hemolytic anemia, achanthocytosis, muscle weakness, posterior column and spniocerebellar tract demyelination

125
Q

The neurological presentation of Vitamin E is similar from which other vitamin?

A

Vitamin B12

126
Q

Tocopherol/tocotrienol are other names for this vitamin

A

Vitamin E

127
Q

Cofactor for the γ- carboxylation of glutamic acid residues on various proteins required for blood clotting

A

Vitamin K

128
Q

Who synthesizes Vitamin K?

A

Intestinal Flora

129
Q

Which Clotting factors require vitamin K for their activitation?

A

II, VII, IX, X, and protein C and S

130
Q

Which medicine is Vitamin K antagonist?

A

Warfarin

131
Q

When do we suspect of neonatal deficiency vitamin K?

A

Neonatal hemorrhage with ↑ PT and ↑ aPTT but normal bleeding time

132
Q

Can neonates synthesize vitamin K?

A

No, neonates have sterile intestines and are unable to synthesize vitamin K

133
Q

When is another situation of Vitamin K deficiency?

A

After prolonged use of broad spectrum antibiotics

134
Q

In order to prevent bleeding diathesis in neonates, what do we do?

A

Neonates are given vitamin K injection at birth

135
Q

Is Vitamin K in breast milk?

A

No

136
Q

This suplementation is essential for the activity if 100+ enzymes

A

Zinc

137
Q

This is a transcription factor motif

A

Zinc fingers

138
Q

Which findings are common in Zinc deficiency?

A

Delayed wound healing, hypogonadism, decrease adult hair, dysgeusia, anosmia, acrodermatitis enteropathica. May predispose to alcoholic cirrhosis

139
Q

Which is the product of alcohol dehydrogenase in ethanol? where does it takes place?

A

Convertion to Acetaldehyde in cytosol

140
Q

From Acetaldehyde to Acetate which enzyme it´s the responsable to act? and where does this takes place?

A

Acetaldehyde dehydrogenase working in the mitochondria

141
Q

In the ethanol metabolism, who is the limiting reagent?

A

NAD+

142
Q

How does Alcohol dehydrogenase operates?

A

via zero order kinetics

143
Q

What does the ↑ NADH/ NAD+ ratio in ethanol metabolism in the liver causes?

A

Pyruvate → Lactate (Lactic Acidosis)
Oxaloacetate→ Malate (prevents gluconeogenesis → fasting hypoglicemia)
Glyceraldehyde 3 phosphate →glycerol 3 phosphate (combines with fatty acids to make triglycerides→hepatosteatosis)

144
Q

How does the ↑ NADH/ NAD+ ratio is related to Acetyl CoA?

A

↑ NADH/ NAD+ ratio disfavors TCA production of NADH so it leads to ↑ utilization of acetyl CoA for Ketogenesis

145
Q

If there is ↑ utilization of acetyl CoA for ketogenesis, which would be the repercussions?

A

Ketoacidosis and lipogenesis (leads to more hepatosteatosis)

146
Q

This medicine is the antidote for methanol or ethylene glycol poisoning

A

Fomepizole

147
Q

Where does Fomepizole works?

A

Inhibits alcohol dehydrogenase

148
Q

This medicine inhibits acetaldehyde dehydrogenase

A

Disulfiram

149
Q

Which metabolit accumulates and causes hangover symptoms?

A

Acetaldehyde

150
Q

With Disulfiram use, this are common symptoms

A

Hangover symptoms becuase of Acetaldehyde accumulation

151
Q

This disease is the result of protein malnutrition

A

Kwashiorkor

152
Q

Which are the results of protein malnutrition?

A

Skin lesions, edema, liver malfunction

153
Q

Why is liver malfunction present in Kwashiorkor child?

A

Fatty change due to ↓ apolipoprotein synthesis

154
Q

Which is the clinical picture of Kwashiorkor child?

A

Small child with swollen belly

155
Q

What is the difference between marasmus and kwashiorkor?

A

Marasmus has a total calorie malnutrition

156
Q

Which are the results of Marasmus?

A

Resulting in tissue and muscle wasting, loss of subcutaneous fat and variable edeme

BIOCHEMISTRY (12 decks)

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