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Flashcards in Skildum: Vitamins Deck (82):
1

Which cofactor is not required by the pyruvate dehydrogenase complex?

Biotin (carboxylation cofactor)

2

What are the fat soluble vitamins?

A, D, E, K

3

What is the biologically active form of vitamin A?

all trans retiniol

4

What are the structural elements of Vit A?

B-Ionine ring
branched polyunsaturated chain
alcohol

5

What can the alcohol of trans-retinol be converted to in the body?

aldehyde
carboxylic acid
ester w/ FA (palmitate)

6

What are the dietary forms of Vit A?

retinyl-acyl esters
carotenes (two molecules of retinol)

BOTH can be converted to all trans retinol

7

What is vit A found in?

Red, yellow, orange fruits and vegetables

*carrotts

8

What are lycopene, lutein, canthaxanthin?

Other forms of Vit A

9

What are the circulating forms of vit A?

carboxylic acid
retinoic acid

these are exported into the blood

10

What happens to the esterified retinoic acid esters?

Transfered into chylomicrons> enter the lymph system

11

What happens to retinoic acid that enters the blood?

Majority enters the liver (first organ that gets a crack at vits and nutrients)

12

What stores Vit A?

Vit A>
taken up by hepatocytes>
esterified to fat>
stored in stellate cells (enlarged stellate cells> vit A toxicity)

13

What mediates retiniol homeostasis in the body?

hepatocytes

14

What are the sources of retinyl to the hepatocytes?

dietary: chylomicrons
stored: stellate cells

15

Retinyl esters g out to...

Stellate cells (storage)
VLDL (to tissues)

16

Retinol goes out to the serum in complex w/..

transthyretin
RBP

17

Retinoic acid goes out to the serum complexed to..

albumin

18

What are the functions of Vit A in the body?

Vision

19

Vit A def?

night blindness

20

Vit A toxicity?

blurred vision

21

How does light signaling through the eye reach neurons in the brain?

Rhodopsin (Opsin-cis-retinal)>
Light>
conversion to trans-retinal>
activates heterotrimeric G protein>
closure of Na channel>
hyperpolarization of rod cell>
signaling to neuron

22

Retinoic acid acts as a ligand for RAR, RXR and PPAR which act as...

activated TFs

23

What does retinoic acid as a transcription activator stimulate?

1. differentiation of goblet cells (gut)--> affect absorption
2. apoptosis of cancer cells (anti-cancer properities)
3. maturation of dendritic cells
4. recruitment of Ab secreting cells to small intestine

24

What does retinoic acid TFs inhibit?

keratinization

25

Carotenes can be cut by monooxygenase to form...

molecules of retinal

26

W/out being cut, carotenes act as ....

antioxidants b/c their double bonds can neutralize singlet oxygen and free radicals

27

What are the clinical sxs of Vit A def?

anorexia
retarded growth
increased susceptibility to infections
alopecia
keratinization of epithelial cells

eyes: NIGHT BLINDNESS, xeropthalmia, bitot's spots

28

How do you diagnose Vit A def?

look at the relative dose response:

Measure plasma retinol conc>
give oral bolus of retinyl>
measure plasma retinol conc after 5 hrs

The HIGHER the RDR (liver and stellate cells aren't maintaining homeostasis) the more the body is relying on short term dietary vit K, rather than liver and adipose stores.

RDRs> 20% indicate the liver is NOT maintaining serum vit K

29

What is the tolerable upper limit for Vit A? And what SE are associated w/ large doses?

3000 RAE/day

nausea, vomiting, blurred vision, HA, desquamation of skin, alopecia, ataxia, liver damage, conjunctivitis, eye pain

30

What vitamin and common acne medicine is a teratogen in high doses?

Vit A

Acutane

31

What are the two types of Vit E?

1. tocopherols (saturate 16 C acyl chains)

2. Tocotrienols (polyunsaturated 16 C acyl chains)

32

Where is Vit E found?

plant oils (PALM OIL, sunflower oil, canola oil, wheat germ)

33

Describe Vit E digestion/absorption (parallels fat digestion and absorption!)

Tocopherols, tocotreinol-acyl esters>
pancreatic lipase>
tocopherols, tocotrienols>
intestinal epithelial cell>
chylomicrons>
tissues>
chylomicron remnants>
liver>
VLDL>
tissues

34

What type of vit E sterioisomers are exported in VLDL?

RRR

35

Where does vit E function?

Lipid bilayers in intracellular and plasma membranes.

The phenolic hydroxyl can distribute and stabilize singlet oxygen and free radicals as part of cellular oxidative stress defense

36

What can regenerate Vit E when oxidized?

ascorbate (vit C)

37

What does vit E inhibit?

Vit K absorption and metabolism

38

What people have Vit E def?

Absorption problems:
premature infants
chrons
short bowel syndrome
inherites lipoprotein disorders

39

A pt presents w/ myopathy, hemolytic anemia, peripheral neuropathy, ataxia, and loss of vibratory sense. Dx?

vit E def

40

What is the TUL of Vit E?

1000 mg/day

(not very toxic)

41

What is the main form of Vit K in the diet?

phylloquinone from leafy green vegatbles

42

What produces menaquinones?

fermentation (in gut, cheese)

Have variable numbers of isoprenoid subunits on the acyl chain

43

What is a synthetic vit K used in animal feed?

menadione

44

Describe vit K digestion/absorption.

phylloquinone, menaquinone>
intestinal epithelial cell>
chylomicrons>
tissues>
chylomicron remnants>
liver>
VLDL>
tissues

45

Where is Vit K stored?

cell membranes, especially the lung, kidney, bone marrow, adrenal glands

46

What does Vit K do in target cells?

Acts as a cofactor for glutamyl carboxylase

47

What does glutamyl carboxylase do?

coarboxylates gluatmic side chains on blood clotting proteins

48

What inhibits vit K epoxide reductase?

coumadin

49

What cofactors are dependent on Vit K dependent carboxylation?

Factor IX (Christmas factor), Factor VIIa, Factor X (Stuart factor), and prothrombin

50

Vit K def can affect what populations?

Infants (milk is low in vit K)
People w/ absorption disorders

51

A severe Vit K def can manifest as what type of disorder?

coagulation disorder--> increased PTT and increased bleeding

52

Is there a TUL for vit K?

no but Menadione causes liver toxicity at high doses

53

Where is vit D found?

animal origin: liver, eggs, fatty fish

shitake mushrooms

fortified dairy products

54

Vitamin D can be synthesized de nove from ....

cholesterol

55

What is required to make active vit D3?

metabolism of skin, liver, kidney

56

What is the most important fxn of Vit D?

Ca homeostasis

57

How is Ca homeostasis maintained in the kidney?

When the serum Ca is below a set point>
parathyroid>
PTH>
kidney> 1 alpha hydroxylase>
1,25-OH D2>
bone and gut

58

What does low serum Ca conc trigger in the bone and gut?

bone- mobilization of bone Ca

gut- increased Ca uptake

59

What is the dietary form of Vit D and how is it abosrbed?

cholecalciferol

passive diffusion w/ fat into intestinal epithelial cells>
transported to tissue in chylomicrons>
taken up by liver in chylomicron remnants

60

What is the main form of Vit D circulating in the blood and the form measured to assess vit D status?

25-hydroxycholecalciferol

61

What is considered a healthy amt of vit D?

30-40 ng/mL

62

Where makes the biologically active 1,25-OHD3?

Acyl hydroxylation in the kidney in response to PTH (produced in response to low Ca)

63

What is VDR?

ligand activated TF

64

What genes are regulated by vit D (VDRE)?

calcium transport proteins: calbindin, TRPV6, PMCA1b

65

Activated VDR increases expression of...

1. Ca channel TRPV6 at the brush border

2. Calbindin in the cytoplasm (chaperones Ca from luminal to basolateral side)

3. Ca ATPase pumps at the basolateral membrane

66

How does VDR affect tight junction permeability to Ca?

Low Ca conc--> high vit D conc--> claudin is disrupted--> tight junctions are not so tight--> paracellular transport of Ca and other substances

67

Rickets is associated w/ what def? What is rickets?

Vit D

seizures, growth retardation, failure of bone mineralization (osteomalacia)

68

What can cause vit D def?

dietary
genetic
secondary to absorption problem like Chrons

69

What vitamin is most likely to have toxic effects?

Vit D

70

What is hte TUL of vit D?

4000 IU for age 9+

71

What are the toxic affects of Vit D?

When serum 25-OHD3> 500 ng/mL calcification of soft tissues (kidneys, heart, lungs, blood vessels), hyperphosphatemia, HTN

(too much Ca uptake from the gut--> Ca going to where you don't want it to be)

72

s

Stem cells secrete Wnt--> maintains stem cells in a dedifferentiated state

B-cat is in association w/ actin cytoskeleton or free in cytoplasm. In an unstimulated cell it binds with the APC protein--> phosphorylation--> ubiquitination and degradation of beta catenin. Normally Beta cateninin is sequestered on teh cytoskeleton or ubiquinated and deegraded.

Wnt binds frizzle and it blocks the GSK3B that phosphorylates B catenein and signals disuprtion through the proteasome. Wnt stabalizes b catenin some enters the nuculeus and becomes a TF.

73

What happens in the absence of Wnt?

B catenin is phosphorylated by the APC/axin/GSK3/CK1 complex.

Phosphorylation of b-catenin results in ubiquination and degradation in the proteasome.

74

What happens when Wnt is present?

Wnt binds frizzled receptor>
inactivation of the APC/axin/GSK3/CK1 complex>
B catenin remains unphosphorylated>
unphosphorylated b catenin accumulates>
translocates to the nucleus>
binds Lef1/TCF>
activates trxn of target genes (cyclin D1 and myc)

75

What promotes differentiation of intestinal epithelial cells?

Gradient of APC and Beta catenin

crypt--de differentiated and have more replication potential (beta catenin)

villus- terminally differentiated, more APC present

76

What occurs early in the development of colorectal cancer?

loss of fxn mutations in APC

77

APCmin mice develop...

multiple spontaneous tumors

78

VDR null mice recapitulate the phenotype of...

rickets (vit d def)

79

VDR null mice have elevated...

cylcin D expression

80

VDR null mice have decreased expression of...

p21 and p27 expression

81

DHFR is an E2F regulated gene. What level of DHFR expression would you predict in tumor cells from VDR knockout mice relative to tumor cells from wild type mice?

DHFR expression is HIGHER in tumors from VDR knockout animals

Tumors WANT to express DHFR

In mice w/out vit D receptor, their tumors have more D1 (oncogene driving cell growth)--> RB--> E2F--> TF for DHFR and many other things.

Vit D receptor is beneficial in keeping colorectal cells in a less dividing phenotype.

82

How does high conc of Vit D relate to the incidence of colorectal adenoma?

High conc of Vit D REDUCES the incidence of colorectal adenoma