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Pharm exam 5 chapters > ch 67 highlights > Flashcards

ch 67 highlights Flashcards

1
Q

recommended dietary allowance

A

requirements of nearly all healthy individuals
differ for males and females
increase for women who are pregnant or breastfeeding
Change as people grow older

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2
Q

estimate of the average daily intake required to meet nutritional needs

A

AI - adequate intake

only estimates

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3
Q

You need a EAR to make a

A

RDA

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4
Q

If you cannot make an RDA, you get a

A

AI

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5
Q

fat soluble vitamins

A

A, D, E, K

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6
Q

water soluble vitamins

A

C and B

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7
Q

the level of intake that will meet nutritional requirements for 50% of healthy individuals

A

Estimated Average Requirement

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8
Q

too much vitamin A causes

A

increases r/o osteoporosis in postmenopausal women and an cause birth defects when the vitamin is taken early in pregnancy

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9
Q

too much vit E in older people with chronic health problems

A

increases r/o death

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10
Q

Nutrition experts recommend vit B12 (cyanocobalamin) for all

A

people over 50 years

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11
Q

Nutrition experts recommend folic acid for all

A

women of childbearing age

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12
Q

Nutrition experts recommend vit d (plus calcium)

A

for postmenopausal women and others at risk for fractures

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13
Q

smoking increases risk of what vit def

A

vit c

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14
Q

vegan diets need what supplements

A

A
B2
B12
D

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15
Q

Breastfeeding infants need what supplement

A

Vit D

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16
Q

vitamin a use

A 
adaptation to dim light
embryogenesis
spermatogenesis
immunity
growth
skin and mucous membranes
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17
Q

Vit A food sources

A 
dairy products
meat
fish
oil
carrots
cantaloupe
mangoes
spinach
tomatoes
pumpkin
sweet potato
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18
Q

what is the first indication of a vit a def

A

night blindness

can lead to blindness

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19
Q

increased levels of vit A will block what vit

A

vit D

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20
Q

excess vit A can lead to

A

birth defects
liver injury
bone-related disorders

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21
Q

tox Vit a symptoms

A 
vomiting
jaundice
hepatosplenomegaly
skin changes
hypomenorrhea
elevation of Intracranial pressure

disappear after vit A withdrawal

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22
Q

Vit D plays a critical role in

A

calcium metabolism and maintenance of bone health

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23
Q

Vid d def in children

A

rickets

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24
Q

Vit d def in adults

A

osteomalacia

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25
Q

Vit E uses

A

antioxidant

role in protecting blood cells from homolysis

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26
Q

Vit E sources

A 
vegetable oils 
nuts
wheat germ
whole grain products
mustard greens
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27
Q

Vit E def

A

ataxia
sensory neuropathy
areflexia
muscle hypertrophy

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28
Q

high dose vit E does what

A

increases risk for hemorrhagic stroke by inhibiting platelet aggregation

increased cancer risk
high doses of antioxidants may cause cancer or accelerate cancer progression

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29
Q

High dose vit E in combination with vit C has what effects on the benefits of exercise on insulin sensitivity

A

can blunt the beneficial effects of exercise on insulin sensitivity

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30
Q

Vitamin K actions

A

needed to coagulate blood

1) correction or prevention of hypoprothrombinemia and bleeding caused by vit k deficiency
2) control of hemorrhage caused by warfarin

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31
Q

sources of Vit K

A

met through dietary sources, synthesized by intestinal flora

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32
Q

vit K may be low in who

A

newborns due to the intestinal colonization of the gut is not complete until several days after birth

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33
Q

vit K def causes

A

produces bleeding tendencies

if severe, spontaneous hemorrhage may occur

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34
Q

what disease processes can decrease vit k uptake

A

obstructive jaundice

malabsorption syndromes - sprue, celiac disease, cystic fibrosis of the pancreas

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35
Q

newborns receive what injection after delivery

A

Vit K1 (phytonadione)

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36
Q

Vit k tox can cause

A

hyperbilirubinemia, hemolytic anemia and jaundice in newborn

oral form of vit k is not toxic in adults

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37
Q

ascorbic acid (Vit C)

A

synthesis of adrenal steroids
conversion of folic acid to folinic acid
regulation of the resp cycle in mitochondria
facilitates absorption of dietary iron

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38
Q

the only established indication for Vit C is

A

prevention and treatment of scurvy

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39
Q

for severe, acute def of vit c what route of administration is recommended

A

Vit C

40
Q

studies have shown that large doses of Vit C do/do not reduce the incidence of colds

A

do not, although the intensity or duration may be decreased slightly

41
Q

sources for vit c (ascorbic acid)

A 
citrus fruits and juices
tomatoes
potatoes
strawberries
melons
spinach
broccoli

OJ and lemon juice are especially rich sources

42
Q

symptoms of scurvy

A 
faulty bone and tooth development
loosening of teeth
gingivitis
bleeding gums
poor wound healing
hemorrhage into muscles and joints
ecchymoses
43
Q

though not a common cause of deficiency, smoking creates an increased need for

A

vit c

44
Q

symptoms
nausea
abd cramps
diarrhea

what vit tox causes these symptoms

A

Vit C tox

45
Q

Vit B3 (Niacin) roles or nicotinic acid

A

plays a role in cellular respiration

46
Q

sources of niacin (nicotinic acid) aka vit B3

A 
liver
poultry
fish
potatoes
peanuts
cereal bran
cereal germ
47
Q 
Pellagra - rough skin
     - dermatitis-scaling, cracking of skin
abd pain
diarrhea
soreness of tongue and mouth
irritability
insomnia
memory loss
anxiety
dementia
A

Niacin def symptoms

all symptoms can be reversed with niacin replacement therapy

48
Q

Niacin/Vit B3 (nicotinic acid) tox

A

vasodilation
flushing
dizziness
nausea

49
Q

Vit B12 (riboflavin) uses

A

acts as a coenzyme for multiple oxidative reactions

50
Q 
sore throat
angular stomatitis (cracks in the skin at the corners of the mouth)
A

Vit B12 (riboflavin) def

51
Q

later symptoms of Vit B12 (riboflavin) def

A

cheilosis (painful cracks in the lips)
glossitis (inflammation of the tongue)
vascularization of the cornea
itchy dermatitis of the scrotum or vulva

52
Q

Vit B12 (riboflavin) tox

A

excess is excreted in the urine

53
Q

Vit B12 (riboflavin) can help prevent

A

migraine headaches - prophylactic effects do not develop until after 3 months of treatment

54
Q

Vit B1 (Thiamine) actions

A

coenzyme for carbohydrate metabolism

55
Q

Vit B1 (Thiamine) sources

A

enriched fortified or whole grain products esp breads and ready to eat cereals
fish (esp tuna, salmon and anchovies)
liver

chicken
pork
beef
lamb

56
Q

Vit B1 (Thiamine) def produces

A

wet beriberi

dry beriberi

57
Q

primary symptom is fluid accumulation in the legs
cardiovascular complications
rapidly progress to circulatory collapse and death

A

wet beriberi (easier to fix)

58
Q

neurologic and motor deficits (anesthesia of the feet, ataxic gait, footdrop, wristdrop)

A

dry beriberi (harder to fix)

59
Q

Wernicke-Korsakoff syndrome

A

Thiamine deficiency (B1) in people with chronic alcohol consumption

60
Q 
neurologic and psychologic manifestations
nystagmus
diplopia
ataxia
inability to remember the recent past
A

Wernicke-Korsakoff syndrome

61
Q

tox for Vit B1 (Thiamine)

A

devoid of tox symptoms

62
Q

Vit B6 (Pyridoxine) action

A

coenzyme in the metabolism of amino acids and proteins

63
Q

Vit B6 (Pyridoxine) sources

A 
fortified, ready to eat cereals
meat
fish
poultry
white potatoes and other starchy vegetables
non-citrus fruits
beef liver
soy based products
64
Q 
seborrheic dermatitis 
anemia
peripheral neuritis
convulsions
depression 
confusion
A

Vit B6 (Pyridoxine) def

65
Q

dietary def of Vit B6 (Pyridoxine) is rare except among people

A

who abuse alcohol on a long term basis

66
Q

People who are predisposed to neuropathy like people with diabetes or alcoholism should receive daily

A

Vit B6 (Pyridoxine) supplements

67
Q

infants with irritability
convulsions
anemia
might be deficient in

A

Vit B6 (Pyridoxine)

permanent cognitive deficits unless treated early

68
Q

ataxia

numbness to hands and feet

A

Vit B6 (Pyridoxine) tox from high doses

in low doses no tox

69
Q

Vit B12 (Cyanocobalamin) action

A

carb and fat metabolism
protein synthesis
synthesis of DNA
formation of blood cells

70
Q

sources of Vit B12 (Cyanocobalamin)

A 
clams 
liver
meat
fish
poutry
eggs
milk
fortified processed cereals
71
Q

Vit B12 (Cyanocobalamin) def results in

A

megoblastic anemia (ie: pernicious)
macrocytic anemia
neurologic damage

72
Q

what populations are at high risk for Vit B12 (Cyanocobalamin)

A

bariatric surgery
strict vegan diet
age associated gastric atrophy

73
Q

Most common presenting symptom of Vit B12 (Cyanocobalamin) def

A

Glossitis

74
Q

Vit B12 (Cyanocobalamin) def symptoms

A

-impaired cognition
-mood alterations
-psychosis
peripheral sensory deficits with weakness
ataxia
extrapyramidal symptoms
GI effects
Glossitis

75
Q

Vitamin B9 occurs in 2 forms

A

folic acid

folate

76
Q

Which B9 form is the naturally occurring form of the vit

A

Folate

77
Q

Which B9 form is the synthetic form

A

Folic acid which is more stable than folate

78
Q

Folate functions as a

A

coenzyme in the synthesis of nucleic acids (DNA and RNA). Has a role in the metabolism of amino acids

79
Q

Folic acid supplements are used to prevent

A

neural tube defects

80
Q

Sources of folate

A

Beef liver is the highest

spinach
black eyed peas
asparagus
green leafy vegetables

all enriched grain products must be fortified with folic acid

81
Q

pregnancy recommendation for folic acid intake

A

all women who are capable of becoming pregnant consume 400-800 ug of supplemental folic acid each day in addition to the folate they get from food

82
Q

def in folic acid or vit B12 can result in megaloblastic anemia and neurologic damage. Deficiency in B9(folic acid) occur in concert. In instances were both are responsible what can be done?

A

high doses of folate can reverse the anemia but they cannot reverse the neurological damage that occurs secondary to vit B12 def

83
Q

Vit B5 (Pantothenic acid) and supplemental use

A

OTC is available but there is no therapeutic use for this supplement bc def does not occur, no supplement is needed

84
Q

Vit B5 (Pantothenic acid) sources

A

is present in virtually all foods

85
Q

Vit B5 (Pantothenic acid) tox

A

no tox

86
Q

Vit B7(Biotin) actions

A

involved in metabolism of carbs and fats

87
Q

Primary reason people take Vit B7 (Biotin)

A

treat hair loss and improve skin conditions

88
Q

Vit B7 Biotin sources

A

wide variety of foods

synthesized in intestinal bacteria

89
Q 
dermatitis
conjunctivitis
hair loss
muscle pain
peripheral paresthesias
lethargy
hallucinations
depression
A

Vit B7 Biotin def

90
Q

Vit B7 tox

A

no tox

91
Q

what will increase absorption of iron

A

Vit C (OJ)

92
Q

What supplement is given in high doses to treat hyperlipidemia

A

Nicotinic acid - causes vasodilation

93
Q

What supplement is used to reduce cholesterol

A

Niacin

94
Q

nicotinamide

A

no vasodilation but does not help with cholesterol

95
Q

B6 interferes with

A

levodopa (Parkinson med)

Pharm exam 5 chapters (15 decks)

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