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5 star topic: couple questions > vitamins > Flashcards

vitamins Flashcards

(66 cards)

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1
Q

fat-soluble vitamins

A

ADEK

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2
Q

fat malabsorption diseases = diseases with ADEK deficiency

A

cystic fibrosis
pancreatic insufficiency
ILEUM pathology (absorption of ADEK)

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3
Q

roles of vitamin D (calcitriol)

A

intestine: ↑Ca absorption - ↑ expression of Ca binding protein, ↑PO4 + Mg absorption
kidney: ↑ PTH-dependent Ca reabsorption
bone: ↑Ca reabsorption

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4
Q

types of vitamin D deficiency

A

1) inadequate dietary vitamin D
2) impaired hydroxylation to make 25-OH vitamin D (liver)
3) impaired hydroxylation to make 1,25-(OH)2 vitamin D (kidney)
4) end-organ insensitivity to vitamin D

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5
Q

complications of vitamin D deficiency

A

demineralization of bone: low vitamin D → no absorption of Ca, PO4 from intestine →↓ serum Ca →↑ PTH → PTH mediated ↑ serum Ca via bone resorption, PTH mediated ↓ PO4 secretion in kidney → no source of Ca or PO4 for strong bones in future

symptoms: bone tenderness, muscle weakness, skeletal deformities - bowing, pathologic fractures, dental problems
children: rickets
adults: osteomalacia

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6
Q

does breast milk have adequate amounts of vit. D

A

NO. need to supplement

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7
Q

vitamin D toxicity

A

1) too much vit. D supplementation
2) sarcoidosis: macrophages in granulomas ↑conversion of 25-OH vit. D3 → 1,25-OH2 vit. D3
hypercalcemia: STONES, BONES, GROANS, pyschiatric OVERTONES

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8
Q

role of vitamin K

A

post-translational modification of various clotting factors (co-factor for gamma-carboxylation of glutamic acid residues in clotting factors)

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9
Q

source of vitamin D

A

plants (D2)

milk + sunexposed skin (D3)

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10
Q

source of vitamin K

A

intestinal flora

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11
Q

clotting factors that require vitamin K for activation

A

CF: 2,7,9,10
protein C + S
prothrombin

CF decreased if take: warfarin (vit. K antagonist)

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12
Q

complications with vitamin D in newborns

A

newborn has sterile gut - can’t make vitamin K → no clotting factors → hemorrhage

newborns receive single IM dose of vitamin K at birth

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13
Q

vitamin K deficiency

A

drug-induced: warfarin (coumadin), anticonvulsants (phenytoin), antibiotics (no flora)

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14
Q

types of vitamin A

A

retinol: eye, immune system, maintenance of epithelial cells + mucous secreting cells
retinal
B-carotene: cleaved in intestine to 2 molecules of retinol
retinoic acid: unusable by body, but can treat some diseases

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15
Q

vitamin A treatment

A 
↓size + secretion of sebaceous glands:
mild-mod acne: tretinoin (topical)
mild severe acne: isotretinoin (oral)
measles
AML (M3 type)
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16
Q

vitamin A deficiency

A

night blindness
xerophthalmia (dry conjunctiva →corneal ulceration)
keratomalacia: wrinkle, clouded cornea
bitot spots: dry silver plaques on bulbar conjunctiva

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17
Q

corneal ulceration

A

vitamin A deficiency

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18
Q

vitamin A toxicity

A 
headache
N/V
stupor
↑ ICP: psuedotumor cerebri
dry and pruritic
hyperlipidemia
hepatomegaly +/- cirrhosis
bone + joint pain
alopecia
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19
Q

contraindication for vitamin A supplementation

A

pregnancy: teratogen

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20
Q

role of vitamin E (α-tocopherol)

A

antioxidant: prevent non-enzymatic oxidation of cell components by O2 free radicals (esp RBCs)

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21
Q

vitamin E deficiency

A

hemolytic anemia: RBC not protected
spinocerebellar degeneration → ataxia
peripheral neuropathy
proximal muscle weakness

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22
Q

antioxidants

A

vitamin E

vitamin C

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23
Q

water-soluble vitamins

A

B vitamins

vitamin C

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24
Q

B1 name

A

thiamine

active form: thiamine pyrophosphate (TPP)

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25
B2 name
riboflavin active forms: flavin adenine dinucleotdie: FAD flavin mononucleotide: FMN
26
B3 name
niacin active form: NAD+ NADP+
27
B5 name
pantothenic acid | componenent of coenzyme A (coA) which transfers acyl groups
28
B6 name
pyridoxine active form: pyridoxal phosphate: PLP
29
B7 name
biotin: apoenzymes for carboxylation reactions | "carboxylase" require B7
30
B9 name
folate/folic acid synthesis (purine + pyrimidines) + repair of DNA rapid cell division + growth biologically active form = tetrahydrofolate (THF): coenzyme for 1 C transfer/methylation
31
B12 name
cobalamin co-factor for homocysteine methyltransferase: homocysteine → methionine + THF (active form of folate) need for DNA synthesis
32
role of vitamin C (ascorbic acid)
hydroxylation of prolyl + lysyl residues of collagen dopamine ßhydroxylase needs Ca: dopamine → NE antioxidant: protect RBCs facilitates IRON absorption in gut: vitamin C keeps iron in reduced state = easier to absorb (take iron with OJ)
33
vitamin C deficiency
``` scurvy: collagen synthesis defect sore, spongy gums loose teeth fragile blood vessels swollen joints hemarthrosis impaired wound healing anemia ```
34
role of TPP (thiamine pyrophosphate): active form of B1
1) pyruvate dehydrogenase (TLC for Nobody = cofactors): pyruvate → acetyl CoA (link glycolysis to TCA) 2) α ketoglutarate dehydrogenase: α ketoglutarate → succinyl coA (TCA) 3) transketolase (HMP shunt = pentose phosphate pathway)
35
thiamine deficiency (B1)
poor nutrition: alcoholism malabsorption ↑ loss of water-soluble vitamins: dialysis brain affected first damage to medial thalamus + mammillary bodies of posterior hypothalamus + general cerebral atrophy Wernicke-Korsakoff syndrome Beriberi: dry or wet
36
role of thiamine
co-factor for oxidative metabolism: need to breakdown glucose → ATP BRAIN is affected first
37
Wernicke-Korsakoff syndrome
``` Wernicke encephalopathy: acute triad: encephalopathy, oculomotor dysfunction, gait ataxia stupor, coma, hypotension, hypothermia Korsakoff syndrome: chronic, consequence of WE memory loss: anterograde + retrograde confabulation: invent memories personality changes apathy ```
38
primary food is polished/dehusked rice
beriberi (thiamine deficiency)
39
dry beriberi
NERVES peripheral neuropathy with myelin degeneration: toe drop, wrist drop, foot drop muscle weakness hyporeflexia or areflexia
40
wet beriberi
HEART peripheral vasodilation → high output heart failure peripheral edema dilated cardiomyopathy
41
treatment of thiamine deficiency (B1)
``` thiamine supplementation (ALWAYS give BEFORE glucose) *giving glucose to thiamine deficient or near-deficient pt → worsen WE ```
42
vitamin B2 (riboflavin) deficiency
dermatitis cheiolosis (scaling and fissures at corners of mouth) angular stomatitis (mouth) glossitis
43
role of FMN/FAD
co-factors for redox reactions | any "dehydrogenase" enzyme requires B2 as cofactor
44
role of NAD+/NADP+
used in redox reactions
45
source of B3 (niacin)
tryptophan in diet: NAD+/NADP+
46
B3 (niacin) deficiency
pellagra: 3 D's dermatitis diarrhea dementia
47
causes of B3 (niacin) deficiency
1) Hartnup disease: ↓ tryptophan absorption 2) malignant carcinoid syndrome: ↑ tryptophan metabolism 3) INH (isoniazid): Inhibit B6 + B3
48
niacin is used for the treatment of
dyslipidemia: ↑ HDL, ↓LDL SE: flushing reaction: take aspirin 30 min before taking niacin
49
vitamin B5 deficiency (pantothenate)
dermatitis enteritis alopecia adrenal insufficiency
50
role of pyridoxal phosphate (PLP)
coenzyme for many enzymes: esp amino acid metabolism (transaminations + deaminations) conversion of amino acid precursors into: heme, niacin, histamine, GABA, dopa, NE, epi
51
B6 (pyridoxine) deficiency
``` similar to riboflavin (B2): angular cheilosis glossitis CONVULSIONS: need B6 to make GABA (main inhibitor NT) PERIPHERAL NEUROPATHY ```
52
cause of B6 deficiency
INH for TB inhibits B6 + B3 | add B6 to prevent
53
cause of B7 (biotin) deficiency
avidin (egg whites) prevents absorption of biotin | antibiotics
54
source of B9 (folic acid)
diet
55
vitamin B9 (folic acid) deficiency
``` meds (tx: give folic acid to counteract): phenytoin sulfonamide TMP MTX malnutrition pregnancy: rapid growth of fetus ```
56
complications of B9 (folic acid) deficiency
``` in utero: neural tube defect (most common cause) growth stage: growth failure child/adult: megaloblastic anemia (need folate for rapidly dividing RBCs) glossitis diarrhea depression confusion megaloblastic anemia ```
57
vitamin B12 (cobalamin) deficiency
``` NEURO sx: parasthesia ataxia (no vibration/position sense) memory loss dementia severe weakness megaloblastic anemia ↓B12 level ↑methylmalonic acid (MMA): needs B12 for metabolism ↑ homocysteine: need B12 for homocysteine → methionine ```
58
cause of cavitamin B12 (cobalamin) deficiency
malabsorption of B12 in terminal ileum: #1) pernicious anemia (autoimmune destruction of gastric parietal cells + IF) 2) gastric bypass (remove part of stomach) only found in animal 3) chron's, celiac, enteritis 4) found only in animal products: VEGETARIANS OR VEGANS if no supplementation
59
absorption of B12 in GI gut occurs
B12-IF in duodenum → absorbed in terminal ileum
60
treatment of B12 deficiency
oral or IM supplementation if can absorb B12
61
determining cause of vitamin B12 (cobalamin) deficiency
check for Abs to IF schilling test: radiolabeled B12 → see how much in urine later on low: absorption problem
62
vitamin deficiency with neuro symptoms
vitamin B1: WE vitamin B6: seizure vitamin B12: parasthesia, ataxia
63
used in redox reactions
``` vitamin B2 (riboflavin) vitamin B3 (niacin) ```
64
used in carboxylation reaction
``` vitamin B7 (biotin) vitamin K ```
65
need for DNA synthesis
B9 | B12
66
vegetarians should supplement in diet
B12

5 star topic: couple questions (13 decks)

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