BIOCHEMISTRY - NUTRITION Flashcards

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1
Q

Toxicity of what kind of vitamins are common

A

Fat soluble vitamin toxicity (due to its accumulation in fat)

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2
Q

Common causes of fat soluble vitamin deficiency

A

Malabsorption syndromes with steatorrhoea
Cystic fibrosis
Celiac diseases
Mineral oil intake

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3
Q

Which water soluble vitamins do not get washed off easily and where are they stored

A

B12 (stored in liver for 3 to 4 years)

B9 (stored in liver for 3 to 4 months)

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4
Q

Vitamin B complex deficiency result in?

A

Dermatitis
Glossitis
Diarrhoea

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5
Q

Vitamin A is also known as?

A

Retinol

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6
Q

Functions of Vitamin A

A

Constituent of visual pigments
Differentiation of epithelial cells to specialised tissues
Prevents squamous metaplasia
Treats - mealses and acute promyelocytic leukemia

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7
Q

Topical form of vitamin A used to treat wrinkles and acne

A

RETIN A

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8
Q

Treatment of cystic acne

A

ISORETINOIN

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9
Q
Night blindness
Dry scalp
Dry skin
Bitot's spot
Keratomalacia
Immunosuppression occur in?
A

Vitamin A deficiency

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10
Q

Side effects of excess Vitamin A

A
Teratogenic (cleft lip and palate)
Acute toxicity (nausea, blurred vision, vertigo)
Chronic toxicity (alopecia, dry skin, hepatic toxicity and enlargement)
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11
Q

Vitamin B is also known as

A

THIAMINE

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12
Q

Vit B1 is a co-factor for what enzymes?

A

Branched chain ketoacid reductase
Alpha ketoglutarate dehydrogenase
pyruvate dehydrogenase
Transketolase

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13
Q

Vitamin B1 deficiency cause

A

Wernicke Korsakoff encephalopathy
Wet beriberi
Dry beriberi

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14
Q

Damage to medial dorsal nucleus and mamillary bodies occur in

A

WERNICKE KORSAKOFF ENCEPHALOPATHY

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15
Q

Confusion
Ophthalmoplegia
Ataxia triad occurs in?

A

WERNICKE KORSAKOFF ENCEPHALOPATHY

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16
Q

What reduces risk of developing Wernicke Korsakoff encephalopathy in alcoholics?

A

Administration of Thiamine (B1)

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17
Q

Polyneuropathy
Symmetrical muscle wasting
Identify the type of B1 deficiency

A

Dry beriberi

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18
Q

Complication of wet beriberi

A

High output cardiac failure (dilated cardiomyopathy)

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19
Q

Bilateral pedal edema
Enlarged heart (CXR)
Fatigue
Identify the type of B1 deficiency

A

Wet beriberi

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20
Q

Vitamin B2 is also known as

A

RIBOFLAVIN

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21
Q

Riboflavin is a component of ___ and ___

A

FAD & FMN

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22
Q

Inflammation of lips, scaling and fissures at corners of lips - known as?

A

Cheilosis (occurs in B2 deficiency)

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23
Q

Cheilosis

Corneal vascularization occurs in which deficiency?

A

B2 (Riboflavin) Deficiency

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24
Q

Vitamin B3 is also known as

A

Niacin

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25
Q

B3 is derived from

A

Tryptophan

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26
Q

Synthesis of B3 requires?

A

B2 and B6

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27
Q

Functions of B3 include

A

Treatment of dyslipidemia

Lowers levels of LDL and VLDL

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28
Q

Diarrhoea
Dementia
Dermatitis (hyper-pigmentation of sun exposed limbs) seen in?

A

Pellagra (B3 deficiency)

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29
Q

Glossitis occurs as a consequence of

A

B3 (Niacin) deficiency

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30
Q

Why patients with DM are discouraged from taking Niacin supplements

A

Since the side effect of Niacin is Hyperglycemia

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31
Q

Patients with active TB and begins treatment soon develops pellagra like symptoms, why?

A

Isoniacid - decreases B6 levels

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32
Q

Patient with dyslipedemia on taking meds increases facial flushing. How to manage this case?

A

Aspirin (reduces flushing) + Niacin

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33
Q

Facial flushing
Hyperglycema
Hyperurecemia seen in?

A

B3 (Niacin) toxicity

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34
Q

Vitamin B5 is also known as

A

Pantothenic acid

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35
Q

B5 is an essential component of

A

Coenzyme A

Fatty acid synthase

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36
Q

Dermatitis
Enteritis
Alopecia
Adrenal insufficiency seen in?

A

B5 (Pantothenic acid) deficiency

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37
Q

30 year old woman with critical malnutrition. Presents with Hypotension, Hypoglycemia, hair loss, rash, malnutrition and reduced adrenal gland function. Diagnosis?

A

B5 (Pantothenic acid) deficiency

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38
Q

Vitamin B6 is known as

A

Pyridoxine

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39
Q

B6 - pyridoxal phosphate, is a co-factor for the following reactions?

A

Transamination

Decarboxylation reaction

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40
Q

B6 (Pyridoxine) required for synthesis of the following

A

Heme
Niacin
Histamine
Neurotransmitters (serotonin, epinephrine, NE, Dopamine and GABA)

41
Q

Convulsions
Sideroblastic anemia
Hyperirritability
Peripheral neuropathy seen in?

A

Pyridoxine (B6) deficiency

42
Q

Vitamin B7 is also known as

A

Biotin

43
Q

B7 acts as co-factor for

A

Pyruate carboxylase
Acetyl Co-A carboxylase
Propionyl Co-A carboxylase

44
Q

Dermatitis
Enteritis
Alopecia seen in?

A

B7 (Biotin) deficiency

45
Q

Causes of B7 deficiency

A

Long tern antibiotic use

Excessive ingestion of raw egg whites

46
Q

Vitamin B9 is known as

A

Folate

47
Q

Folate is found in

A

Green leafy vegetables

48
Q

Functions of B9 (folate)

A

Synthesis of nitrogenous bases for DNA and RNA

49
Q

Folate is stored in?

A

Liver

50
Q

Macrocytic megaloblastic anemia - seen in?

A

B9 (Folate) deficiency

51
Q

Causes of B9 deficiency

A

Jejunal resection

Drugs (phenytoin, sulfonamides and methotrexate)

52
Q

Folate is absorbed in?

A

Jejunum

53
Q

Findings of megaloblastic anemia

A

Hypersegmented neutrophils
Glossitis
No neurological symptoms
Macrocytic RBCs

54
Q

Vitamin B12 is known as

A

Cobalamine

55
Q

Function of Vitamin B12

A

DNA synthesis

Cofactor for Methionine synthase

56
Q

Macrocytic, megaloblastic anemia
Paresthesias
Subacute combined degeneration seen in?

A

B12 (cobalamine) deficiency

57
Q

Prolonged deficiency of B12 results in

A

Irreversible nerve damage

58
Q

Causes of B12 (cobalamine) deficiency?

A
Malabsorption
Lack of interinsic factor
Absence of terminal ileum (surgical resection)
Drugs (metformin)
Insufficient intake (veganism)
59
Q

The difference between B12 and Folate deficiency?

A

B12 deficiency results in neurological manifestation

B9 deficiency doesn’t

60
Q

Folate supplementation can mask the ________ symptoms of B12 deficiency but not the _______ symptoms

A

1 - Hematological

2 - Neurological

61
Q

What helps in transportation of B12 in circulation

A

Intrinsic factor

62
Q

Vitamin C is also known as

A

Ascorbic acid

63
Q

Source of Vit C

A

Fruits (oranges) and vegetables

64
Q

Functions of Vitamin C

A
Facilitates Iron absorption (by conerting from ferric to ferrous state)
Collagen synthesis (hydroxylation of proline and leucine)
65
Q

Which type of Vitamin is used for treatment of Methemoglobinemia?

A

Vitamin C

66
Q

Vitamin C is known as

A

Ascorbic acid

67
Q

Vitamin C deficiency is known as

A

Scurvy

68
Q
Swollen gums
Easy bruising
Petechiae
Hemarthrosis
Anemia
Poor wound healing
Perifollicular and subperiosteal haemorrhages 
Corkscrew hair
Weakened immune response seen in?
A

Scurvy (Vitamin C deficiency)

69
Q

Ascorbic acid (Vit C) toxicity features?

A
Nausea
Vomitting
Diarrhoea
Fatigue
Calcium oxalate nephrolithiasis
Increased iron toxicity
70
Q

Increased iron toxicity due to Vit C deficiency can cause?

A

Worsening of hemochromatosis

Transfusion related iron overload

71
Q

Vitamin D3 - _____

Vitamin D2 - _____

A

1 - Cholecalciferol

2 - Ergocalciferol

72
Q

Source of Vitamin D

A

Exposure of skin to the sun
Ingestion of fish
Milk
Plants

73
Q

Functions of Vitamin D3

A

Increases absorption of Calcium and Phospate
At low levels - increases bone mineralisation
At high levels - increases bone resorption

74
Q

Regulation of Vitamin D levels are done by

A

Increase PTH

Decrease - calcium, phosphate and 1,25(OH)2D3

75
Q

Deficiency of Vitamin D causes

A

Rickets (children)
Osteomalacia (adults)
hypocalcemic tetany

76
Q

Causes of Vit D deficiency

A
Malabsorption
Reduced sun exposure
Poor diet
CKD
Advanced liver disease
77
Q

Hypercalcemia
Hypercalciuria
Loss of appetite
Stupor seen in?

A

Vitamin D toxicity

78
Q

Vit D excess is seen in?

A

Granulomatous diseases

79
Q

Vitamin E is also known as

A

Tocopherol

Tocotrienol

80
Q

Function of Vit E

A

Protects RBCs from free radical damage

81
Q
Hemolytic anemia
Acanthocytosis
Muscle weakness
Demyelination of posterior column (reduced position and vibration sense)
Spinocerebellar tract ataxia seen in?
A

Vitamin E deficiency

82
Q

Enterocolitis (children)

Enhanced anticoagulant effects of Warfarin seen in?

A

Vitamin B6 Toxicity

83
Q

Warfarin is a _____

A

Vitamin K antagonist

84
Q

Function of Vitamin K

A

Maturation of clotting factors II, VII, IX, X and protein C and S

85
Q

Vitamin K is synthesised by

A

Intestinal flora

86
Q

Vitamin K is activated by

A

Epoxide reductase

87
Q

Reduced form of Vitamin K is a co-factor of

A

Gamma carboxylation of glutamic acid residues (req for clotting)

88
Q

Neonatal hemorrhage is seen in

A

Vitamin K deficiency

89
Q

Lab findings

A

Increased- PT, aPTT

Normal bleeding time

90
Q

Since Vitamin K is not available in breast milk, another way to administer Vit K?

A

Vit K injection immediately after birth

91
Q

Main source of Vitamin K

A

Intestinal Bacteria

92
Q

Function of zinc

A

Activity of 100+ enzymes

formation of Zinc fingers (req for protein synhesis)

93
Q
Delayed wound healing
Suppressed immunity
Male hypogonadism
Reduced adult hair
Dysgeusia
Anosmia seen in?
A

Zinc deficiency

94
Q

Zinc deficiency can pre-dispose to

A

Alcoholic cirrhosis

95
Q

Zinc deficiency is associated with

A

Accrodermatitis enteropathica

96
Q

Types of protein energy malnutrition

A

Marasmus

Kwashiokar

97
Q

Causes of Marasmus

A
Malnutrition
Edema
Anemia
Liver (fatty)
Skin lesions
98
Q

Manifestations of Kwashiokar

A

Skin lesions
Edema
Liver malfunction

99
Q

Manifestation of Marasmus

A

Muscle wasting