Vitamin & Mineral-Related Pathologies Flashcards
(26 cards)
Vitamin A Deficiency OR Excess
Common Pres (2)?
PRES:
- Alopecia
- Scaly skin
Fat-Soluble Vitamin Deficiency
Causes (2)?
CAUSES:
- Malabsorption Sx (ie Cystic Fibrosis, Sprue)
- Mineral oil intake
Vitamin A Deficiency
Mech, Pres (7)?
Vit A = necessary for differentiation of epithelial cells -> specialized tis (ie mucus-secreting cells, pancreatic cells).
Deficiency -> Metaplasia.
PRES:
- Immune suppression
- Alopecia
- Xerosis Cutis (dry scaly skin)
- Keratomalacia (Corneal degen / softening)
- Nyctalopia (night blindness)
- Xerophthalmia
- Periductal Mastitis (squamous metaplasia of lactiferous ducts ->
duct infl + blockage)
Vitamin A Excess
Pres (7), CI?
PRES:
- Alopecia
- Scaly skin
- Arthralgias
- Osteoporosis
- Cerebral Edema
- Pseudotumor Cerebri
- Hepatic abnormalities
CI: ** Teratogenic **
Vitamin B Deficiencies
Pres (3 KEYS)?
PRES:
- Dermatitis
- Glossitis
- Diarrhea
Vitamin B1 (Thiamine) Deficiency
Causes (2), Mech (2), Pres (2 Conditions), DX?
CAUSES: malnutrition + malabsorption
- Malnutrition
- Alcoholism
MECH:
- Impaired glucose B/D -> ATP depletion
(worsened by glucose infusion)
** Highly aerobic tis (ie brain, heart) affected first **
- Def of dehydrogenase enz for which Vit B1 is a cofactor: “ATP”
- a-ketoglutarate dehydrogenase (Maple Syrup Urine Dz)
- Transketolase
- Pyruvate dehydrogenase
PRES:
- Beriberi (Wet + Dry)
- Wernicke-Korsakoff Sx
DX:
-↑RBC Transketolase activity (following B1 admin)
Wernicke-Korsakoff Sx
Locations (2), Pres (TRIAD + 3)?
- MD nucleus (Thalamus)
- Mamillary Bodies (Hypothalamus)
PRES:
- “Ataxia + Confusion + Opthalmoplegia”
- Confabulation
- Personality change
- Memory loss (permanent)
Dry Beriberi
Pres (2)?
PRES:
- Symmetrical muscle wasting
- Polyneuritis
Wet Beriberi
Pres (2)?
PRES:
- Edema
- Dilated Cardiomyopathy (high-output HF)
Vitamin B2 (Riboflavin) Deficiency
Pres (2)?
THINK: 2 Cs of B2
PRES:
- Cheilosis
- Corneal vascularization
Vitamin B3 (Niacin) Deficiency
Pres?
THINK: 3 Ds of B3
PRES: Pellagra
- “Dementia”, “Dermatitis”, “Diarrhea”
Vitamin B3 (Niacin) Excess
Pres, Labs (2)?
PRES:
- Facial flushing (induced by Prostaglandin)
LABS:
- HYPERglycemia
- HYPERuricemia
Pellagra
Causes (3), Pres (3)?
CAUSES:
- Hartnup dz (↓Tryptophan abs)
- Malignant Carcinoid Sx (↑Tryptophan metab)
- Isoniazid (↓Vitamin B6)
PRES:
- Dementia (incl hallucinations)
- Diarrhea
- Dermatitis (“casal necklace” or hyperpigmentation of sun-exposed limbs)
Vitamin B5 (Pantothenate) Deficiency
Adrenal Insufficiency
Vitamin B6 (Pyridoxine) Deficiency
Mech,↓By, Pres (4: 1 Heme + 3 Neuro)?
Vit B6 = cofactor for δ-ALA Synthase.
↓BY:
- Isoniazid
PRES:
- Sideroblastic Anemia (due to Fe excess + impaired Hb syn)
- Peripheral Neuropathy
- Convulsions
- Hyperirritability
Vitamin B7 (Biotin) Deficiency RARE
Causes (2)?
CAUSES:
- Ingestion of raw egg whites
- Antibiotic use
Vitamin B9 (Folate) Deficiency
Causes / Seen In (3), Pres (2), Micro Finding, Labs?
- Folate involved in nucleic acid / DNA synthesis and is needed in rapidly-dividing cells. *
CAUSES:
- Malnutrition (eg alcoholics) / malabsorption
- Impaired metab (drug-induced: MTX, Phenytoin, Sulfonamides)
- ↑requirement (eg pregnancy, hemolytic anemia)
PRES: ** NO NEURO s + s = distinguishing factor from B12 def **
- Glossitis
- Megaloblastic Anemia (Macrocytic)
FINDING:
- Hypersegmented Neutrophils
LABS:
- Homocysteine↑(however normal methylmalonic acid)
Vitamin B12 (Cobalamin) Deficiency
Causes (4), Pres (2 + 5 Neuro), Micro Finding, Labs (2), DX?
CAUSES:
- Malnutrition (insufficient intake eg strict vegans) /
Malabsorption (ie Enteritis, Sprue)
- Diphyllobothrium latum (fish tapeworm)
- Absence of Terminal Ileum (ie Crohn’s)
- Lack of Intrinsic Factor (ie Pernicious Anemia, Gastric Bypass surgery)
- PPIs
PRES:
- Glossitis
- Megaloblastic Anemia (Macrocytic)
- Neuro s + s (due to involvement of B12 in
F.A pathways and Myelin synthesis):
- Dementia
- Peripheral Neuropathy
- Dorsal Column tract (proprioception problems)
- Lateral Corticospinal tract (spasticity)
- Spinocerebellar tract
FINDING:
- Hypersegmented Neutrophils
LABS:
- Homocysteine↑
- Methylmalonic acid ↑
DX: Schilling Test (etiology of def)
Vitamin C Deficiency
Pres (Name of Condition + 6)?
PRES: Scurvy (Collagen syn defect)
- “Corkscrew hair”
- Swollen gums
- Poor wound healing
- Anemia
- Mucosal bleeding / Bruising / Hemarthrosis
- Perifollicular + Subperiosteal Hemorrhages
Vitamin C Excess
Pres (3), Comp?
PRES:
- Nausea / Vomiting / Diarrhea
- Fatigue
- Ca Oxalate Nephrolithiasis
COMP:
- Fe toxicity (in predisposed ppl)
Vitamin D Deficiency
Name of Conditions (Children vs Adults),
Exacerbations (3),
Pres (common to both), Labs (4: 2 and 2)?
- Rickets (Children: bone pain + DEFORMITY)
- Osteomalacia (Adults: bone pain + MUSCLE WEAKNESS)
EXACERBATIONS:
- Prematurity
- Pigmented skin
- Low sun exposure
PRES:
- Increased risk for bone fractures
LABS:
- ↓serum Ca + P
- ↑serum PTH + Alkaline Phosphatase
Vitamin D- Resistant / Hypophosphatemic Rickets
Inher, Mech, Causes / Assoc, Pres (3)?
XD.
MECH = Phosphate wasting at proximal tubule
CAUSES / ASSOC:
- Fanconi Sx (PCT reabs defect ->↓P reabs)
PRES:
- Bowing of legs
- Enlarged forehead (osteoid deposition on skull)
- “Pigeon breast” deformity: Ant protrusion of sternum + inward bending of ribs
Vitamin D Excess
Causes (3), Pres (2), Labs (2), Urine?
CAUSES:
- Over-supplementation
- Granulomatous disease
- Sarcoidosis (↑ACTIVATION of Vit D by epithelioid macrophages)
PRES:
- Loss of appetite
- Stupor
LABS:
- ↑Ca + P
- ↓PTH
URINE:
-↑Ca
Vitamin K Deficiency
Causes (2)?
CAUSES:
- Neonates (sterile intestines that are unable to syn Vit K)
- Prolonged use of broad-spectrum Antibiotics
