DIT Vitamins

Question 1

Follow vitamin D metabolism

Answer 1

7 dehydrocholesterol with sunlight goes to cholecaferol (D3)

Liver makes 25-hydroxychoelcalferol (WHAT IS MEASURED IN BLOOD)

Kidney makes 1,25 OH (Calcitriol) which is active

Question 2

What disease might make you hypercalcemic that is kind of surprising?

Answer 2

Sarcoid b/c macrophage activation causes 25-OH to be made into 1,25 OH (calcitriol) active

Question 3

Vitamins supplemented for babies and why?

Answer 3

Breastmilk doesn’t have enough Vit D

No intestinal flora to make Vit K, so supplemented at birth

Question 4

What is Vit A used for medically?

Answer 4

Acne
Measles
AML (M3)

Question 5

What is one thing that can cause corneal ulceration?

Answer 5

Vitamin A deficiency.

Question 6

Vitamin E deficiency can cause what? (tocopherol)

Answer 6

Hemolytic anemia
Spinocerebellar degeneration so Ataxia
Peripheral neuropathy and proximal muscle weakness

Question 7

What does Vit c do?

Answer 7

Antixidant
Keeps iron reduced for absorption (ABSORBic acid)
Hydroxylation of PROLINE and LYSINE in collagen synthesis
Dopamine hydroxylase to make NE from dopamine

Question 8

Thiamine does what? (B1)

Answer 8

Dehydrogenase reactions. think ATP

Alphaketoglutarate (TLC For Nobody)
Transketolase (HMP shunt)
Pyruvate Dehydrogenase (TLC For Nobody

Question 9

What is affected in thiamine deficiency?

Answer 9

Needed for glucose breakdown, so ATP depletion in aerobic tissues (BRAIN AND HEART)

Wernicke Korsakoff and BerIBerI

Wernicke: ataxia, opthalomplegia, confusion. CONFABULATION and memory loss can be permanent with damage to dorsal nucleus of thalamus and mamilary bodies.

Dry beriberi: muscle wasting
Wet beriberi: dilated cardiomyopathy and edema (heart failure)

Question 10

Wernicke vs korsakoff? And beriberi?

Answer 10

Wernicke is acute: triad: confusion, ataxia, occulomotor dysfunciton (stupor, coma, hypotension possible)

Korsakoff: Memoryloss RETROGRADE and ANTEROGRADE, confabulation to fill in gaps, apathy, personality change

Beriberi: Dry (nerves): neuropathy with myelin degeneration: wrist drop and stuff

Wet beriberi: peripheral vasodilation and high output heart failure (dilated cardiomyopathy)

Question 11

Riboflavin deficiency?

Answer 11

B2: FADI is fiboFlavin

Chelosis (lip inflammation), corneal vascularization…

Question 12

What can cause niacin deficiency? What are symptoms?

Answer 12

Hartnup disease: less tryptophan absorption.

Pellagra. 3 D’s:
Dermatitis
Dementia
Diarrhea

Question 13

What does pyridoxine do?

Answer 13

B6 is for transamination: ALT and AST.

Also converts AA precursors into things like cystathionine, heme, niacin, neurotransmitters…

Question 14

B6 deficiency is what?

Answer 14

looks like B2 deficiency:

Angular cheilosis, glossitis

But unique: CONVULSIONS (not enough GABA to inhibit) and peripheral neuropathy (neurotransmitters)

Question 15

What does INH cause deficiency of?

Answer 15

B6 and B3, so add them

Question 16

What is biotin needed for? (mnemonic)

Answer 16

Buy-a-tin of CO2 is mnemonic
Adding a carboxyl group (CO2)

If you see an enzyme with carboxylase in it, it uses biotin

Question 17

What can cause a B7 deficiency?

Answer 17

AVIDin in egg whites AVIDly BInds BIotin

(b7)

Can’t carboxylate

Question 18

What does B9 do?

Answer 18

Folic acid is to be made to tetrahydrofolate to make DNA and repair DNA

1 carbon transfers.

Question 19

What does cobalamin do?

Answer 19

B12 is needed to make homocystein to methionine WHICH ALSO reloads THF so you can use that for DNA synthesis and shit.

Question 20

B12 vs B9 megaloblastic anemia differentiation is figured out how?

Answer 20

Check serum levels of the vitamin or serum levels of:

Homocysteine (cobalamin is cofactor to make it into methionine)

Methylmalonyl-CoA (MMA) is converted to succinyl CoA to make myelin, so that is the other thing you can check

Question 21

Other than megaloblastic anemia and hyper segmented neutrophils, B12 deficiency symptoms:

Answer 21

Neuro issues: Ataxia, memoryloss, dementia, severe weakness:

B/c myelin deficiency: can’t make MMA into succinylCoA which would then make myelin