Basic Science

Question 1

What is the role of vitamin A in skin?

Answer 1

vital for epithelial proliferation, keratinisation and development

Question 2

how does vitamin A deficiency present?

Answer 2

keratotic follicular (in hair follicles) papules on the thighs and upper arms and dry skin

Question 3

How do you diagnose vitamin A deficiency?

Answer 3

measure serum vitamin A

Question 4

what role does vitamin K have?

Answer 4

essential for several blood coagulation factors

Question 5

how does vitamin K deficiency present?

Answer 5

bleeding tendency

seen in skin as purpura and easy bruising

Question 6

How is vit K deficiency diagnosed?

Answer 6

measure coagulation and serum vit K

Question 7

what is the role of vit B2 (riboflavin)?

Answer 7

essential co-factor in numerous metabolic reactions

Question 8

how does vit B2 deficiency present?

Answer 8

lesions of the margins of the lips- cheilosis and the corners of the mouth - angular stomatitis
painful, red, dry tongue

Question 9

how is vit B2 deficiency diagnosed?

Answer 9

measure the activity of the erythrocyte glutathione reductase (EGR)

Question 10

what is the role of vit B3 (niacin)?

Answer 10

essential co-factor n numerous metabolic reactions

Question 11

what is vit B3 found in?

Answer 11

meat, fish, nuts, coffee, also converted from dietary tryptophan (essential amino acids) in the body
deficiency common in countries high grain/ low meat diet e.g. indo-china

Question 12

How does vit B3 deficiency present?

Answer 12

Pellagra (high grain/low meat)
Dermatitis (bilateral, symmetrical, itchy red rash, worse in areas of sun exposure)
Delirium (headaches, irritability and anxiety)
Diarrhoea (abdo pain, nausea and vomiting)
Death (4-5 years if not treated)

Question 13

how is vit B3 deficiency diagnosed?

Answer 13

it’s a clinical diagnosis because niacin is so difficult to measure
nicotinamide supplementation brings rapid improvement

Question 14

what is the role of vit B6?

Answer 14

co-enzyme for many processes

Question 15

what is the presentation of vitamin B6 deficiency?

Answer 15

dermatitis of face, scalp, neck, shoulders, buttocks and perineum
tongue inflammation

Question 16

how is vit B6 deficiency diagnosed?

Answer 16

measure serum or urinary B6

trial of supplementation

Question 17

what is the role of folate and vit B12?

Answer 17

they are both critical co-enzymes in many processes with similar deficiency states

Question 18

what is folate found in?

Answer 18

liver, green leafy veg, beans , nuts and milk

Question 19

what is vit B12 found in?

Answer 19

foods of animal origin

Question 20

how does folate and vit B12 deficiency present?

Answer 20

anaemia 
angular stomatitis 
glossitis 
hair depigmentation 
skin and mucous membrane pigmentation 
vit B12 deficiency has neurological symptoms

Question 21

how do you diagnose folate and B12 deficiency?

Answer 21

measure serum folate and B12

Question 22

What is the role of Biotin?

Answer 22

essential co-factor for carboxylase enzymes

Question 23

how does biotin deficiency present?

Answer 23

Very rare- usually only malabsorptive states or inadequate parentral nutrition
facial dermatitis
glossitis
alopecia

Question 24

how is biotin deficiency diagnosed?

Answer 24

measure serum biotin

Question 25

what is the role of zinc?

Answer 25

required for many metabolic pathways

required for structure and function of skin and so vital in wound healing

Question 26

how does genetic zinc deficiency present?

Answer 26

acrodermatitis enteropathica [lack of zinc absorption] 
infants develop diarrhoea 
alopecia
dry/brittle hair 
perioral
facial and acral dermatitis

Question 27

how does acquired zinc deficiency present?

Answer 27

more common - due to increased elimination of zinc secondary to burns and infection
dermatitic rash mainly on hands and feet
growth retardation in children