BIOCHEMISTRY - NUTRITION Flashcards by Shriya Dev

Toxicity of what kind of vitamins are common

Fat soluble vitamin toxicity (due to its accumulation in fat)

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Common causes of fat soluble vitamin deficiency

Malabsorption syndromes with steatorrhoea
Cystic fibrosis
Celiac diseases
Mineral oil intake

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Which water soluble vitamins do not get washed off easily and where are they stored

B12 (stored in liver for 3 to 4 years)

B9 (stored in liver for 3 to 4 months)

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Vitamin B complex deficiency result in?

Dermatitis
Glossitis
Diarrhoea

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Vitamin A is also known as?

Retinol

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Functions of Vitamin A

Constituent of visual pigments
Differentiation of epithelial cells to specialised tissues
Prevents squamous metaplasia
Treats - mealses and acute promyelocytic leukemia

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Topical form of vitamin A used to treat wrinkles and acne

RETIN A

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Treatment of cystic acne

ISORETINOIN

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Night blindness
Dry scalp
Dry skin
Bitot's spot
Keratomalacia
Immunosuppression occur in?

Vitamin A deficiency

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Side effects of excess Vitamin A

Teratogenic (cleft lip and palate)
Acute toxicity (nausea, blurred vision, vertigo)
Chronic toxicity (alopecia, dry skin, hepatic toxicity and enlargement)

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Vitamin B is also known as

THIAMINE

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Vit B1 is a co-factor for what enzymes?

Branched chain ketoacid reductase
Alpha ketoglutarate dehydrogenase
pyruvate dehydrogenase
Transketolase

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Vitamin B1 deficiency cause

Wernicke Korsakoff encephalopathy
Wet beriberi
Dry beriberi

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Damage to medial dorsal nucleus and mamillary bodies occur in

WERNICKE KORSAKOFF ENCEPHALOPATHY

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Confusion
Ophthalmoplegia
Ataxia triad occurs in?

WERNICKE KORSAKOFF ENCEPHALOPATHY

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What reduces risk of developing Wernicke Korsakoff encephalopathy in alcoholics?

Administration of Thiamine (B1)

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Polyneuropathy
Symmetrical muscle wasting
Identify the type of B1 deficiency

Dry beriberi

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Complication of wet beriberi

High output cardiac failure (dilated cardiomyopathy)

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Bilateral pedal edema
Enlarged heart (CXR)
Fatigue
Identify the type of B1 deficiency

Wet beriberi

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Vitamin B2 is also known as

RIBOFLAVIN

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Riboflavin is a component of ___ and ___

FAD & FMN

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Inflammation of lips, scaling and fissures at corners of lips - known as?

Cheilosis (occurs in B2 deficiency)

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Cheilosis

Corneal vascularization occurs in which deficiency?

B2 (Riboflavin) Deficiency

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Vitamin B3 is also known as

Niacin

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B3 is derived from

Tryptophan

Synthesis of B3 requires?

B2 and B6

Functions of B3 include

Treatment of dyslipidemia | Lowers levels of LDL and VLDL

Diarrhoea Dementia Dermatitis (hyper-pigmentation of sun exposed limbs) seen in?

Pellagra (B3 deficiency)

Glossitis occurs as a consequence of

B3 (Niacin) deficiency

Why patients with DM are discouraged from taking Niacin supplements

Since the side effect of Niacin is Hyperglycemia

Patients with active TB and begins treatment soon develops pellagra like symptoms, why?

Isoniacid - decreases B6 levels

Patient with dyslipedemia on taking meds increases facial flushing. How to manage this case?

Aspirin (reduces flushing) + Niacin

Facial flushing Hyperglycema Hyperurecemia seen in?

B3 (Niacin) toxicity

Vitamin B5 is also known as

Pantothenic acid

B5 is an essential component of

Coenzyme A | Fatty acid synthase

Dermatitis Enteritis Alopecia Adrenal insufficiency seen in?

B5 (Pantothenic acid) deficiency

30 year old woman with critical malnutrition. Presents with Hypotension, Hypoglycemia, hair loss, rash, malnutrition and reduced adrenal gland function. Diagnosis?

B5 (Pantothenic acid) deficiency

Vitamin B6 is known as

Pyridoxine

B6 - pyridoxal phosphate, is a co-factor for the following reactions?

Transamination | Decarboxylation reaction

B6 (Pyridoxine) required for synthesis of the following

Heme Niacin Histamine Neurotransmitters (serotonin, epinephrine, NE, Dopamine and GABA)

Convulsions Sideroblastic anemia Hyperirritability Peripheral neuropathy seen in?

Pyridoxine (B6) deficiency

Vitamin B7 is also known as

Biotin

B7 acts as co-factor for

Pyruate carboxylase Acetyl Co-A carboxylase Propionyl Co-A carboxylase

Dermatitis Enteritis Alopecia seen in?

B7 (Biotin) deficiency

Causes of B7 deficiency

Long tern antibiotic use | Excessive ingestion of raw egg whites

Vitamin B9 is known as

Folate

Folate is found in

Green leafy vegetables

Functions of B9 (folate)

Synthesis of nitrogenous bases for DNA and RNA

Folate is stored in?

Liver

Macrocytic megaloblastic anemia - seen in?

B9 (Folate) deficiency

Causes of B9 deficiency

Jejunal resection | Drugs (phenytoin, sulfonamides and methotrexate)

Folate is absorbed in?

Jejunum

Findings of megaloblastic anemia

Hypersegmented neutrophils Glossitis No neurological symptoms Macrocytic RBCs

Vitamin B12 is known as

Cobalamine

Function of Vitamin B12

DNA synthesis | Cofactor for Methionine synthase

Macrocytic, megaloblastic anemia Paresthesias Subacute combined degeneration seen in?

B12 (cobalamine) deficiency

Prolonged deficiency of B12 results in

Irreversible nerve damage

Causes of B12 (cobalamine) deficiency?

``` Malabsorption Lack of interinsic factor Absence of terminal ileum (surgical resection) Drugs (metformin) Insufficient intake (veganism) ```

The difference between B12 and Folate deficiency?

B12 deficiency results in neurological manifestation | B9 deficiency doesn't

Folate supplementation can mask the ________ symptoms of B12 deficiency but not the _______ symptoms

1 - Hematological | 2 - Neurological

What helps in transportation of B12 in circulation

Intrinsic factor

Vitamin C is also known as

Ascorbic acid

Source of Vit C

Fruits (oranges) and vegetables

Functions of Vitamin C

``` Facilitates Iron absorption (by conerting from ferric to ferrous state) Collagen synthesis (hydroxylation of proline and leucine) ```

Which type of Vitamin is used for treatment of Methemoglobinemia?

Vitamin C

Vitamin C is known as

Ascorbic acid

Vitamin C deficiency is known as

Scurvy

``` Swollen gums Easy bruising Petechiae Hemarthrosis Anemia Poor wound healing Perifollicular and subperiosteal haemorrhages Corkscrew hair Weakened immune response seen in? ```

Scurvy (Vitamin C deficiency)

Ascorbic acid (Vit C) toxicity features?

``` Nausea Vomitting Diarrhoea Fatigue Calcium oxalate nephrolithiasis Increased iron toxicity ```

Increased iron toxicity due to Vit C deficiency can cause?

Worsening of hemochromatosis | Transfusion related iron overload

Vitamin D3 - _____ | Vitamin D2 - _____

1 - Cholecalciferol | 2 - Ergocalciferol

Source of Vitamin D

Exposure of skin to the sun Ingestion of fish Milk Plants

Functions of Vitamin D3

Increases absorption of Calcium and Phospate At low levels - increases bone mineralisation At high levels - increases bone resorption

Regulation of Vitamin D levels are done by

Increase PTH | Decrease - calcium, phosphate and 1,25(OH)2D3

Deficiency of Vitamin D causes

Rickets (children) Osteomalacia (adults) hypocalcemic tetany

Causes of Vit D deficiency

``` Malabsorption Reduced sun exposure Poor diet CKD Advanced liver disease ```

Hypercalcemia Hypercalciuria Loss of appetite Stupor seen in?

Vitamin D toxicity

Vit D excess is seen in?

Granulomatous diseases

Vitamin E is also known as

Tocopherol | Tocotrienol

Function of Vit E

Protects RBCs from free radical damage

``` Hemolytic anemia Acanthocytosis Muscle weakness Demyelination of posterior column (reduced position and vibration sense) Spinocerebellar tract ataxia seen in? ```

Vitamin E deficiency

Enterocolitis (children) | Enhanced anticoagulant effects of Warfarin seen in?

Vitamin B6 Toxicity

Warfarin is a _____

Vitamin K antagonist

Function of Vitamin K

Maturation of clotting factors II, VII, IX, X and protein C and S

Vitamin K is synthesised by

Intestinal flora

Vitamin K is activated by

Epoxide reductase

Reduced form of Vitamin K is a co-factor of

Gamma carboxylation of glutamic acid residues (req for clotting)

Neonatal hemorrhage is seen in

Vitamin K deficiency

Lab findings

Increased- PT, aPTT | Normal bleeding time

Since Vitamin K is not available in breast milk, another way to administer Vit K?

Vit K injection immediately after birth

Main source of Vitamin K

Intestinal Bacteria

Function of zinc

Activity of 100+ enzymes | formation of Zinc fingers (req for protein synhesis)

``` Delayed wound healing Suppressed immunity Male hypogonadism Reduced adult hair Dysgeusia Anosmia seen in? ```

Zinc deficiency

Zinc deficiency can pre-dispose to

Alcoholic cirrhosis

Zinc deficiency is associated with

Accrodermatitis enteropathica

Types of protein energy malnutrition

Marasmus | Kwashiokar

Causes of Marasmus

``` Malnutrition Edema Anemia Liver (fatty) Skin lesions ```

Manifestations of Kwashiokar

Skin lesions Edema Liver malfunction

Manifestation of Marasmus

Muscle wasting

BIOCHEMISTRY - NUTRITION Flashcards

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