Micronutrients and Trace Elements Flashcards

1
Q

function of iron

A
  • oxygen transport in blood/ muscle

- electron transport

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2
Q

function of iodine

A

thyroxine (T4)
triiodothyronine (T3)

ability of thyroid gland to concentrate iodine

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3
Q

function of zinc

A
  • gene expression
  • zinc metalloenzymes
  • cell membrane structure/ fxn
  • induce metallothionein synthesis
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4
Q

function of copper

A

oxidative enzymes

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5
Q

function of selenium

A
  • important antioxidant
  • glutathione peroxidase
  • thyroid function ( interaction with I)
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6
Q

function of molybdenum

A

xanthine oxidase

sulfite oxidase

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7
Q

function of manganese

A
  • mitochondrial SOD
  • CHO metabolism
  • mucopolysaccharide synthesis
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8
Q

function of chromium

A

-facilitates binding of insulin to receptors

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9
Q

function of fluoride

A

integrity of teeth/ skeleton

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10
Q

function of cobalt

A

structure of cobalamin b12

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11
Q

heart failure, anorexia, slow growth

A

severe iron deficiency

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12
Q

anemia, impaired cognitive development, decreased exercise tolerance

A

mild iron deficiency

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13
Q

hypothyroidism

A

severe iodide deficiency

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14
Q

goiter

A

mild iodide deficiency

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15
Q

spontaneous abortion, cretinism, deafness, mental retardation

A

fetus iodide deficiency

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16
Q

acro-orficial dermatitis, diarrhea, increased infections, poor wound healing, delayed sexual maturations, personality changes

A

severe zinc deficiencies

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17
Q

growth retardation, anorexia, increased infections

A

mild zinc deficiency

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18
Q

intra-uterine growth retardation, congenital malformations

A

fetus zinc deficiency

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19
Q

mental retardation, seizures, connective tissue defects, fractures

A

severe copper deficiency

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20
Q

anemia, neutropenia, osteoporosis, seborrheic skin lesions

A

mild copper deficiency

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21
Q

connective tissue defects baby

A

fetus copper deficiency

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22
Q

cardiomyopathy, skeletal myopathy

A

severe selenium deficiency

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23
Q

macrocytosis, loss of hair pigment, hypothyroidism

A

mild selenium deficiency

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24
Q

sources of iron

A

Heme Iron:
-Cellular animal protein
Non-heme Iron:
-legumes, nuts, whole grains

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25
Q

Iron Absorption:
Dietary Factors:
insoluble complexes

A

phytate, tanins

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26
Q

Iron Absorption:

Oxidation state

A
  • ascorbic acid: Fe3+ –> Fe2+

- absorption enhanced for reduced state

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27
Q

Iron Absorption:

Mineral Mineral Interactions

A

-excessive Zn or Cu decreases Fe absorption

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28
Q

Iron Absorption:

Host Factors 2

A
  1. Fe deficiency –> increased absorption

2. inflammation–> increased hepcidin from liver –> decreased absorption at enterocyte

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29
Q

Iron Absorption:

Quantity in Gut lumen

A

inverse relationship

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30
Q

main site of iron regulation

A

intestinal absorption

31
Q

major route of iron loss

A

bleeding

32
Q

major iron stores

A

liver, bone marrow, spleen

33
Q

Iron transport and storage form

A

transport: transferrin
Storage: ferritin/ hemosiderin

34
Q

most common nutritional deficiency in the world

A

iron

35
Q

iron deficiency in men or post-menopausal women

A

merits investigation for source of bleeding

36
Q

iron deficiency manifestation

A
  • Anemia: microcytic, hypochromic

- W.o anemia: impaired cognitive function, growth

37
Q

iron deficiency diagnosis

A

Severe Deficiency:
-low Hb/Hct & microcytic/ hypo chromic rbc

Mild, moderate/ Severe Defic:
-low ferritin

Low % Sat:
-low serum Fe with high TIBC

38
Q

labs to check with ferritin

A
  • ferritin is an acute phase protein elevated with inflammation
  • need to also check ESR or CRP for accurate interpretation
39
Q

Iron is a potent pro-

A

oxidant

40
Q

large doses of supplemental iron interfere with absorption of

A

zinc and copper

41
Q

hereditary hemochromatosis

A
  • defect in hepcidin
  • excessive Fe absorption
  • accumulated Fe damages liver and increases risk of HCC
42
Q

medicinal FE overdose

A

-hemorrhagic gastroenteritis
-shock and acidosis
coag defects
-hepatic failure

43
Q

lethal Fe dose in children

A

1-2grams

44
Q

especially critical during periods of growth and cellular/ tissue proliferation & immune function

A

zinc

45
Q

sources of zinc

A
animal products (oysters)
beef> poultry> fish/milk/ eggs
46
Q

zinc absorption is impaired by

A

phytate, a dietary complex involved in iron absorption

found only in plants,~corn, legumes, nuts

47
Q

Zinc Absorption:

Systemic levels

A

unlike iron absorption, since absorption is not increased with deficiency

48
Q

zinc homeostasis maintained by what paired processes

A

absorption and excretion

  • zinc secreted into go tract with digestion as part of pancreatic-biliary secretions
  • some is reabsorbed and some is excreted
49
Q

how is zinc homeostasis different from iron

A

there is a route to excrete zinc, whereas with iron the body has to be careful how much iron to take in because it can be toxic and is difficult to get rid of

50
Q

7 populations at risk for iron deficiency

A
  • infants > 6 mths: low stores & high requirement
  • premature infants: low stores & high requirement
  • adolescents: high requirement & poor intake
  • pregnant women: increased requirement (27mg/day)
  • chronic infestations
  • bariatric surgery
  • elderly
51
Q

9 populations at risk for zinc deficiency

A
  • infants
  • young children
  • breastfed infants >6mths
  • pregnant women
  • monotonous plant diets: esp high in phytate
  • bariatric surgery
  • elderly
  • GI illness/ injury: diarrhea
  • Wounds, burns
52
Q

why are breastfed infants > 6mths at risk for zinc deficiency?

A

after 6mths because human milk has low Zn levels after 6mths

53
Q

contrast risk populations iron (2) deficiency vs zinc deficiency (4)

A

Iron:

  • adolescents
  • Chronic infestations

Zinc:

  • breastfed infants >6mths
  • monotonous plant diets: esp high in phyla
  • Diarrhea
  • Wounds/ burns
54
Q

poor zinc status in the elderly is associated with a higher risk of what?

A

pneuonia

55
Q

Copper ot zinc ratio (CuZ)

A

increased ratio in the elderly associated with higher mortality, may be a biomarker of aging

56
Q

Zinc deficiency and death

A

worldwide
-estimated to account for 0.4 million deaths/ year in children younger than 5

(second only to vitamin A which is estimated to be responsible for 0.6 million deaths/ year)

57
Q

acrodermatitis enteropathica

A
  • mutation in zinc transporter ZIP4
  • fatal if not treated
  • responds to high doses of Zn supplements (lifetime)
58
Q

acrodermatitis enteropathica presentation

A

severe dermatitis, growth failure, diarrhea

59
Q

zinc toxicity

A
  • relatively low

- >50mg/d can decrease HDL, impair absorption of Fe and Cu, cause nausea, diarrhea

60
Q

zinc within first 24hours of symptoms of a cold

A
  • decrease duration of illness by 1-4 days
  • reduce severity of symptoms
  • may prevent viral replication or attachment to nasal membranes
61
Q

iodine sources

A
  • seafood
  • grown things: depends on content of soil- especially low in mountainous areas
  • Today: iodized salt
62
Q

cassava

A
  • goitrogen
  • contains ions that compete with iodide (like SCN-)
  • associated with widespread goiter and hypothyroidism
63
Q

Absorption process iodine

A

Iodide Uptake –> binding to T3, T4 –> Circulation

64
Q

iodine worldwide deficiency

A

common–> endemic goiter and cretinism in children (5.7 million cretins exist; 1 billion persons at risk for I deficiency disorders)

65
Q

Cretin child: deaf mutism

A
  • dwarfed, mentally retarded, dull facies, large tongue

- I deficiency during pregnancy

66
Q

I deficiency on fetus

A

-increased abortions, stillbirths, congenital abnormalities

67
Q

goiter

A

-enlarged thyroid gland to compensate for decreased I for thyroid hormone synthesis

68
Q

populations with endemic iodine deficiency

A

mean IQ loss: 13.5 points

69
Q

Copper food source

A

shellfish, meats, nuts

low in milk

70
Q

Copper absorption and metabolism

A

30-40% absorption from mixed diet, stored in liver, excreted in bile

71
Q

Selenium

A

foods associated with with amino acids

72
Q

keshan disease

A

-cardiomyopathy in china prevented with Se supplementation

Cause:
-interaction with other nutritional deficits or viral infection

*Viral mutation increases virulence in Se deficient host

73
Q

selenium absorption and metabolism

A
  • 60-80% absorbed from diet
  • Kidneys main site of homeostasis
  • urine excretion