Medicine

Question 1

Which vitamins are deplete within year?

Answer 1

B12 and A

Question 2

Which vitamins deplete after weeks?

Answer 2

Folates and B1

Question 3

What is thiamine pyrophosphate responsible for?

Answer 3

Carbohydrates metabolism.

• decarboxylation of acetyl coA in mitichodria
• decarb of alpha ketoacids in kerbs cycle

Has a role in peripheral nervous conduction.

Question 4

B1 sources

Answer 4

Cereal and legumes.

Pork and beef meat.

Question 5

Deficiency B1 leads to?

Answer 5

• inability to metabolize glucose for nerves conduction.

- increase lactic and pyruvic acids which lead to vasodilation and increase cardiac output.

Question 6

Causes of deficiency?

Answer 6

Poor intake
Hyperemesis gravidarum
Chronic illnesses as Cancer
Alcoholism

Question 7

B1 clinical features (disease)?

Answer 7

Dry beriberi
1. peripheral neuropathy:
Sensory and motor pain and parasthesia

	2.Cerebral involvement :
        	Wernicke-encephalopathy   
		mental impairment 
		cerebellar  ataxia  	
		ophthalmoplegia   
		 Korsakoff  syndrome : 
		loss of new memory 
		confabulation
Wet beriberi 
    high output failure

Question 8

Treatment or diagnosis of b1 deficiency?

Answer 8

Levels of thiamine in blood

100mg/d parentral for 7 days then orally till improved

Question 9

Clinical manifestations of B2 deficiency?

Answer 9

1. Mucocutaneous lesion
   angular stomatitis
   cheilosis.
   red inflamed tongue
   2. Seborrhoeic dermatitis
      (face around the nose)

Question 10

Diagnoses and treatment of b2 deficiency?

Answer 10

Diagnosis
serum or urinary level

 	Treatment
Riboflavin 10 mg daily

Question 11

Forms of Vitamin B three?

Answer 11

nicotinic acid

nicotinamide

Question 12

Functions b3?

Answer 12

Oxidative functions in production of energy and DNA repair

Question 13

How can it be synthesized?

Answer 13

From tryptophan

Question 14

Clinical manifestation of B3 deficiency?

Answer 14

Pellagra: dermatitis dementia diarrhea

Question 15

Diagnosis and treatment of B3 deficiency?

Answer 15

Diagnosis
Urinary 2 pyridone and 2 methyl nicotinamide

Treatment Nicotinamide 300 mg daily by mouth

Question 16

Forms of B6?

Answer 16

Pyridoxine
Pyridoxal
Pyridoxamine

Question 17

Functions of B6?

Answer 17

cofactor of many enzymes involved in the metabolism of many amino acids.

neurotransmitters synthesis

Vitamine metabolism as niacin

Question 18

Which drugs cause B6 deficiency?

Answer 18

Isoniazid
Hydralazine
Penicillamine

Question 19

Clinical manifestations of B6 deficiency?

Answer 19

1. mucosal changes

2. The peripheral neuropathy

Question 20

Treatment of B6 deficiency?

Answer 20

100 mg daily should not be exceeded.

Question 21

What is the function of B 12?

Answer 21

Cofactor for activation of folate

Question 22

What causes B12 deficiency?

Answer 22

Deficiency
1. Low dietary intake, Vegans
2. Impaired absorption
Stomach : Pernicious anaemia Gastrectomy
Congenital deficiency of intrinsic factor
Small bowel: ileal disease or resection Bacterial overgrowth
Diphyllobothrium latum

Question 23

Clinical features of b12 deficiency?

Answer 23

megaloblastic anemia

glossitis and angular stomatitis.

The neurological changes 
 polyneuropathy 
subacute combined degeneration of the     	spinal cord
psychiatric problems depression 
Dementia
optic atrophy

 polyneuropathy 
symmetrical paraesthesiae in the fingers and toes

subacute combined degeneration
( posterior, lateral columns of the spinal cord)

loss of vibration sense and proprioception
sensory ataxia
progressive weakness
Paraplegia may result.

Question 24

Diagnosis and treatment of B12 deficiency?

Answer 24

Investigations 
Hematological findings  
	features of a megaloblastic anemia 
2. Bone marrow  
	features of megaloblastic erythropoiesis (
3. Serum vitamin B12  

			Treatment     Hydroxocobalamin 1000 μg can be given intramuscularly.