Nutritional Pathology

Question 1

What are the fat-soluble vitamins?

Answer 1

Vitamins A, K, D, E

Question 2

What is Vitamin B1?

Answer 2

Thiamine

Question 3

What are the most common disorders associated with Vitamin D deficiency in children and adults, respectively?

Answer 3

Children - Rickets
Adults - Osteomalacia

Question 4

True/False. Water-soluble vitamins are more toxic than fat-soluble vitamins at high doses.

Answer 4

False. Water-soluble vitamins are readily excretable in urine and toxicity is rare. Fat-soluble vitamins are more likely to be toxic.

Question 5

What drugs can impair the absorption of folic acid?

Answer 5

Sulfonamides

Question 6

What is Vitamin B12?

Answer 6

Cobalamin

Question 7

Isoniazid, goat milk, and chronic alcohol use are associated with deficiency of what vitamin?

Answer 7

Pyridoxine (B6)

Question 8

What factors are most associated with niacin deficiency?

Answer 8

Tryptophan deficiency, hartnup disease, chronic alcohol use, isoniazid

Question 9

A patient who recently immigrated to the USA presents with muscle emaciation, little subcutaneous fat, and diarrhea. What is their diagnosis?

Answer 9

Marasmus

Question 10

What hormone changes may be observed in a patient with anorexia nervosa?

Answer 10

Decreased LH, FSH, estrogen, & TH

Question 11

What is Vitamin B6?

Answer 11

Pyridoxine

Question 12

What is Vitamin C?

Answer 12

Ascorbic Acid

Question 13

What are the signs of Vitamin A toxicity?

Answer 13

Headache, dizziness, vision changes, weight change, bone and joint pain

Question 14

What vitamin is folic acid?

Answer 14

Vitamin B9

Question 15

A 5yo patient presents with tibial bowing, rachitic rosary, and pectus carinatium. What is the likely diagnosis?

Answer 15

Rickets due to Vitamin D deficiency

Question 16

True/False. Obesity is a form of malnutrition.

Answer 16

True

Question 17

What clinical diseases are associated with thiamine deficiency?

Answer 17

Beriberi, Wernicke Encephalopathy, Wernicke-Korsakoff

Question 18

Where is most Vitamin A stored in the body?

Answer 18

Liver

Question 19

What vitamin plays a role in collagen synthesis?

Answer 19

Vitamin C

Question 20

Kidney metabolism of Vitamin D is regulated by what three factors?

Answer 20

Hypocalcemia, hypophosphatemia, negative feedback

Question 21

What symptoms are associated with Vitamin D toxicity?

Answer 21

Hypercalcemia, calcification

Question 22

What vitamin deficiency is most common in the world?

Answer 22

Vitamin A

Question 23

A pregnant woman gives birth to a fetus with neural tube defects. What vitamin was likely deficient during pregnancy?

Answer 23

Vitamin B9 - Folic Acid

Question 24

What is the anti-obesity hormone produced by adipocytes?

Answer 24

Leptin

Question 25

What is the difference between dry & wet beriberi?

Answer 25

Dry beriberi - neuropathy, weakness, muscle atrophy Wet beriberi - edema, high cardiac output

Question 26

A patient who recently immigrated to the USA presents with edema, a distended abdomen, and diarrhea. They also seem apathetic and express little emotion. What is their diagnosis?

Answer 26

Kwashiorkor

Question 27

What is the function of retinol?

Answer 27

Vision, cell growth & differentiation, lipid metabolism

Question 28

What vitamin deficiency is most common in the USA?

Answer 28

Vitamins D & B12

Question 29

What distinguishes Wernicke-Korsakoff from Wernicke Encephalopathy?

Answer 29

Confusion and memory impairment in addition to neurological symptoms associated with Wernicke Encephalopathy

Question 30

What are the clinical features of vitamin B6 deficiency?

Answer 30

Sideroblastic (microcytic) anemia, convulsions (esp. infants), neuropathy

Question 31

Vitamin B3 is produced from what biological molecule?

Answer 31

Tryphtophan

Question 32

NAD+ & NADP+ are derived with assistance from what vitamin?

Answer 32

Niacin (B3)

Question 33

True/False. A patient with impaired renal function, but intact liver function will have no issues with Vitamin D absorption.

Answer 33

False. Vitamin D requires metabolism in both the liver and kidney. The kidney is responsible for producing the most active form of Vitamin D.

Question 34

What vitamins serve as anti-oxidants?

Answer 34

Vitamins C & E

Question 35

What is Vitamin A?

Answer 35

Retinol

Question 36

Squamous metaplasia is most common due to what Vitamin deficiency?

Answer 36

Vitamin A

Question 37

What vitamin is niacin?

Answer 37

Vitamin B3

Question 38

What are the clinical features of Vitamin E deficiency?

Answer 38

Hemolytic anemia, neuropathy, ataxia

Question 39

A malnourished patient presents with cheilosis and glossitis. What vitamin are they deficient in?

Answer 39

Riboflavin (B2)

Question 40

You suspect a patient has normal folate levels, but is deficient in Vitamin B12. How can you confirm this?

Answer 40

Test blood for methylmalonic acid - high levels indicate only a B12 deficiency

Question 41

FAD and FMN are generated from what vitamin?

Answer 41

Riboflavin (B2)

Question 42

A patient presents with diarrhea, dementia, and dermatitis. You know they have a vitamin deficiency. What is the diagnosis and associated vitamin deficiency?

Answer 42

Pellagra - Vitamin B3

Question 43

What is Vitamin B2?

Answer 43

Riboflavin

Question 44

What disease is associated with Vitamin C deficiency?

Answer 44

Scurvy

Question 45

Who is most at risk for Vitamin B12 deficiency?

Answer 45

Vegans & people with IF deficiencies

Question 46

What Vitamin functions to maintain plasma levels of calcium and phosphorous?

Answer 46

Vitamin D

Question 47

How do Marasmus and Kwashiorkor differ in terms of deficiency?

Answer 47

Marasmus is a caloric deficiency. Kwashiorkor is a protein deficiency, with appropriate caloric intake.

Question 48

What are three types of secondary malnutrition?

Answer 48

Cancer cachexia, anorexia nervosa, bulimia

Question 49

What is the clinical presentation of folic acid deficiency in adults?

Answer 49

Megaloblastic anemia - this is also a feature of B12 deficiency

Question 50

What coagulation factors are dependent upon Vitamin K?

Answer 50

Prothrombin (II), VII, IX, X, protein C, protein S

Question 51

A patient is found to have high homocysteine levels in the blood. What does this say about the patient's folate and B12 levels?

Answer 51

Both folate & B12 are deficient