B Vitamins and Iron

Question 1

What is another name for Vit B1?

Answer 1

thiamine

Question 2

What is another name for Vit B2?

Answer 2

riboflavin

Question 3

What is another name for Vit B3?

Answer 3

niacin

Question 4

What is another name for Vit B6?

Answer 4

pyridoxine

Question 5

What is another name for Vit B12?

Answer 5

cobalamin

Question 6

Indications for B1

Answer 6

1. Prophylaxis for deficiency
2. Alcoholics
3. Beriberi Syndrome
4. Wernicke-Korsakoff Syndrome

Question 7

Indications for B2

Answer 7

1. deficiency

2. migraine prophylaxis

Question 8

S/E for B2

Answer 8

yellow body fluids

Question 9

Indications for B3

Answer 9

hypercholesterolemia

Question 10

B3 MOA

Answer 10

increases HDL, decreases LDL and VLDL

Question 11

B3 S/E

Answer 11

flushing, nausea

can take aspirin to prevent flushing

Question 12

Indications for B6

Answer 12

1. morning sickness/nausea

2. Isoniazid antidote (TB medication)

Question 13

Indications for B12

Answer 13

1. pernicious anemia
2. intrinsic factor deficiency
3. gastric bypass
4. vegetarian/vegan

Question 14

B12 Route of Administration

Answer 14

1. IM for gastric bypass, pernicious anemia, intrinsic factor deficiency
2. PO for vegetarian/vegan

Question 15

Indications for folic acid

Answer 15

prenatal vitamin, megaloblastic macrocytic anemia

Question 16

Folic Acid Function

Answer 16

prevent neural tube defects in fetuses ie. spina bifida, reduces side effects of methotrexate

Question 17

What do you have to monitor in RA patients taking methotrexate?

Answer 17

serum transaminase levels for hepatic dysfunction –> folic acid reduces levels

Question 18

Indication for iron

Answer 18

iron deficiency anemia

Question 19

Causes of iron deficiency anemia

Answer 19

chronic blood loss, malnutrition, pregnancy, renal failure

Question 20

What labs do you order to screen for iron deficiency?

Answer 20

TIBC (total iron binding capacity), ferritin, total iron, transferrin

Question 21

S/E of iron

Answer 21

nausea, abdominal pain, black stool, constipation

Question 22

What should the patient take with their iron supplement? With food or empty stomach?

Answer 22

Vit C - it enhances absorption

empty stomach

Question 23

What inhibits iron absorption?

Answer 23

Antacids, PPIs, H2 antagonists, Calcium

Question 24

Route of administration of iron

Answer 24

PO (ferrous sulfate) or IV (iron dextran)

*anaphylaxis w/ IV form

Question 25

What foods have Vit B1 in them?

Answer 25

enriched flour and cereal

Question 26

What can B1 deficiency lead to?

Answer 26

brain damage which manifests as Wernicke-Korsakoff Syndrome

Question 27

Why are alcoholics at higher risk for B1 deficiency?

Answer 27

absorption is markedly decreased in alcoholics

Question 28

Function of B2

Answer 28

plays a role in ATP production through metabolism of carbs, fats, and proteins

Question 29

Function of B3

Answer 29

plays role in lipid and protein metabolism

Question 30

Function of B6

Answer 30

essential for production of Vit B12 and folate, necessary for absorption and metabolism of amino acids

Question 31

Function of B12

Answer 31

key role in DNA synthesis

Question 32

Effects of Vit B12 deficiency

Answer 32

1. large, dysfunctional RBC precursors

2. affect on nervous system - inflammation, demyelination, neuronal cell death

Question 33

What secretes intrinsic factor?

Answer 33

parietal cells in stomach

Question 34

Which is absorbed better: ferrous iron or ferric iron?

Answer 34

ferrous iron (from animal)

Question 35

Who should be given IV iron instead of PO iron?

Answer 35

patients who are unable to take or tolerate oral iron

Question 36

Patients which what symptoms should be tested from iron deficiency anemia?

Answer 36

restless leg symptoms

Question 37

When is iron toxicity likely?

Answer 37

in patients with iron storage disease ie. hemochromatosis

and iron loading anemias ie. thalassemia