DIT Vitamins Flashcards
Follow vitamin D metabolism
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
What disease might make you hypercalcemic that is kind of surprising?
Sarcoid b/c macrophage activation causes 25-OH to be made into 1,25 OH (calcitriol) active
Vitamins supplemented for babies and why?
Breastmilk doesn’t have enough Vit D
No intestinal flora to make Vit K, so supplemented at birth
What is Vit A used for medically?
Acne
Measles
AML (M3)
What is one thing that can cause corneal ulceration?
Vitamin A deficiency.
Vitamin E deficiency can cause what? (tocopherol)
Hemolytic anemia
Spinocerebellar degeneration so Ataxia
Peripheral neuropathy and proximal muscle weakness
What does Vit c do?
Antixidant
Keeps iron reduced for absorption (ABSORBic acid)
Hydroxylation of PROLINE and LYSINE in collagen synthesis
Dopamine hydroxylase to make NE from dopamine
Thiamine does what? (B1)
Dehydrogenase reactions. think ATP
Alphaketoglutarate (TLC For Nobody)
Transketolase (HMP shunt)
Pyruvate Dehydrogenase (TLC For Nobody
What is affected in thiamine deficiency?
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)
Wernicke vs korsakoff? And beriberi?
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)
Riboflavin deficiency?
B2: FADI is fiboFlavin
Chelosis (lip inflammation), corneal vascularization…
What can cause niacin deficiency? What are symptoms?
Hartnup disease: less tryptophan absorption.
Pellagra. 3 D’s:
Dermatitis
Dementia
Diarrhea
What does pyridoxine do?
B6 is for transamination: ALT and AST.
Also converts AA precursors into things like cystathionine, heme, niacin, neurotransmitters…
B6 deficiency is what?
looks like B2 deficiency:
Angular cheilosis, glossitis
But unique: CONVULSIONS (not enough GABA to inhibit) and peripheral neuropathy (neurotransmitters)
What does INH cause deficiency of?
B6 and B3, so add them
What is biotin needed for? (mnemonic)
Buy-a-tin of CO2 is mnemonic
Adding a carboxyl group (CO2)
If you see an enzyme with carboxylase in it, it uses biotin
What can cause a B7 deficiency?
AVIDin in egg whites AVIDly BInds BIotin
(b7)
Can’t carboxylate
What does B9 do?
Folic acid is to be made to tetrahydrofolate to make DNA and repair DNA
1 carbon transfers.
What does cobalamin do?
B12 is needed to make homocystein to methionine WHICH ALSO reloads THF so you can use that for DNA synthesis and shit.
B12 vs B9 megaloblastic anemia differentiation is figured out how?
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
Other than megaloblastic anemia and hyper segmented neutrophils, B12 deficiency symptoms:
Neuro issues: Ataxia, memoryloss, dementia, severe weakness:
B/c myelin deficiency: can’t make MMA into succinylCoA which would then make myelin
