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Preventative Med. & Nutrition > Exam #1: Vitamins II > Flashcards

Exam #1: Vitamins II Flashcards

1
Q

What are the two types of reactive species? What are reactive species?

A

Oxygen
Nitrogen

*****Highly reactive free radicals that are formed in the process of radiation, exposure to chemicals, & normal physiologic processes

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2
Q

What are antioxidants?

A

Electron donors able to stabilize the free radical by “adding” an electron

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3
Q

What are the three major antioxidant enzymes?

A

1) Superoxide dismutase
2) Glutathione peroxidase
3) Catalases

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4
Q

What are the water soluble antioxidants?

A
  • Vitamin C
  • Urate
  • Glutathione
  • Bilirubin
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5
Q

What are the lipid soluble antioxidants?

A
  • Vitamin E
  • B-Carotene
  • A-Carotene
  • Lycopene
  • Lutein
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6
Q

Can vitamins prevent atherosclerosis?

A

Yes, Vitamin E & C have been shown to slow the development of atherosclerosis

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7
Q

Generally, which foods have higher antioxidant properties?

A

Red fruits and vegetables

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8
Q

How do the antioxidant properties of foods compare to supplements?

A

Higher antioxidant defense in food (or other properties in food) vs. antioxidant supplement

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9
Q

What is the relationship between AMD & antioxidants? What are the treatment implications?

A

AMD= Age Related Macular Degeneration

  • Caused by oxidative stress
  • Treatment with antioxidant supplementation slows progression
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10
Q

Describe how fat soluble vitamins enter and are stored in the body.

A

1) Require bile salts/ emulsification for absorption
2) Carrier protein for transport
3) Stored in body fat (to some extent)

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11
Q

What is the name for Vitamin A?

A

Retinol

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12
Q

What is the name for Vitamin D?

A

Cholecalciferol

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13
Q

What is the name for Vitamin E?

A

a-Tocopherol

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14
Q

What is the function of Vitamin E?

A

Generally, Vitamin E is an antioxidant. Specifically it functions to:

  • Maintain cell membrane integrity by preventing oxidation of unsaturated FAs
  • Works closely with glutathione peroxidase
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15
Q

What organs is Vitamin E especially important for?

A
  • Lungs
  • Brain
  • Erythrocytes
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16
Q

What are the negative interactions of Vitamin E with other fat soluble vitamins?

A

Vitamin K= antagonist (clotting factors)

Vitamin D= interfere with bone mineralization

Vitamin A= competition that may lead to deficiency

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17
Q

What is the relationship between PUFAs and Vitamin E?

A
  • Vitamin E stabilizes PUFAs

- Increased PUFA intake requires increased Vitamin E

18
Q

What are the causes of Vitamin E deficiency? What is Abetalipoproteinemia?

A

Abetalipoproteinemia= Rare genetic disease resulting in Vitamin E deficiency

Malabsoprtion syndromes e.g. celiac sprue and CF

19
Q

What are the manifestations of Vitamin E deficiency?

A

1) Hemolytic anemia
2) Retinal degeneration
3) Ceroid pigment accumulation
4) Neurologic deficits including damage to:
- Posterior columns
- Lateral corticospinal tracts
- Spinocerebellar tracts

20
Q

What are the signs of Vitamin E toxicity?

A
  • Fatigue
  • Diplopia
  • GI distress
  • Interference with other fat-soluble vitamins
21
Q

What are the major functions of Vitamin D?

A

1) Maintenance of adequate blood Ca++ and phosphorus
2) Cell differentiation
3) Immunity

22
Q

How is Vitamin D synthesized?

A

1) UV + 7-dehydrocholesterol forms D3
2) D3 from UV and dietary D3/D2 are transported to the liver
3) In the liver, Vitamin D is converted to 25-OH-D3, calcidiol*
4) This is transported to the kidneys, where it is further hydroxylated to 1, 25-OH D3 i.e. activated Calcitriol

*Measured in serum

23
Q

What is the active form of Vitamin D? What is the inactive form of Vitamin D? What is unique about the inactive form?

A 
Active= Calcitriol 
Inactive= Calcitroic acid

*****Inactive= water soluble for excretion from the body

24
Q

What is the role of macrophages in Vitmain D synthesis? What is the role of Vitamin D in immunity?

A

Macrophages release Vitamin D, which then turns T/B cells on or off

25
Q

What are the major factors that influence Vitamin D synthesis?

A
  • Time of day
  • Season
  • Latitude
  • Exposure to sunlight
  • Age
  • Skin pigmentation
26
Q

Above what latitude do individuals require Vitamin D supplementation in the winter months?

A

37 degrees i.e. us in Iowa

27
Q

What is the effect of low blood Ca++ on PTH and Vitamin D?

A
  • PTH and Vitamin D3 are produced when blood Ca++ is low
  • PTH
    1) stimulates Ca++ resorption from bone
    2) enhances renal tubular reabsorption to INCREASE blood Ca++
    3) stimulates renal production of Vitamin D3

*****PTH induced increased in D3 leads to increased intestinal absorption of Ca++ and phosphorus

28
Q

What is the effect of Vitamin D supplementation on hip and nonvertebral fracture?

A

Supplementation prevented fracture

29
Q

What is the connection between autoimmune disease and Vitamin D?

A

Patients with autoimmune disease have low Vitamin D levels or receptor polymmorphisms

30
Q

What happens with Vitamin D toxicity?

A

1) Kidney stones
2) Metaststaic calcifications of the kidney/ hypercalcemia
3) Anorexia
4) Abdominal pain

31
Q

What do you need to keep in mind with Vitamin D supplementation?

A

D2 vs. D3

32
Q

What are the major functions of Vitamin A?

A

1) Constituent of visual pigments
2) Cell differentiation i.e. epithelial cell to specialized cell (transcription factor)
3) Antioxidant
4) Skin health

33
Q

What are the major symptoms of Vitamin A deficiency?

A

1) Night blindness
2) Dry skin

Exacerbation of measles infection

34
Q

What is Vitamin A used as a therapy for? What form?

A
  • Acne
  • Psoriasis
  • Leukemia

Note that toxicity can happen with isotretinoin for acne

35
Q

What are the major manifestations of Vitamin A toxicity?

A

1) Alopecia
2) Visual changes
3) Headache
4) Skin changes
5) Hyperlipidemia
6) Hepatotoxicity
7) Arthralgia
8) Teratogen
- Cleft palate
- Cardiac abnormalities

36
Q

What are the three types of Vitamin K? Where do they come from?

A

1) Phylloquinone- Plants
2) Menaquinone- Animals & Bacteria
3) Menadione- Synthetic

37
Q

What are the functions of Vitamin K?

A

1) Carboxylation of glutamate, essential for production of blood clotting proteins
- II, VII, IX, X and proteins S and C

2) Post-translational modification of proteins
3) Synthesis of bone, skeletal tissue and kidney Gla proteins

38
Q

What is unique about the synthesis of Vitamin K? Why is this important?

A

Vitamin K is synthesized to an active form by the gut flora

1) Antibiotics can deplete the normal gut flora leading to Vitamin K deficiency
2) Newborns are born with a lack of gut flora and are deficient in Vitamin K
- Neonatal hemorrhage with increased PT and aPTT

39
Q

What are the symptoms of Vitamin K deficiency?

A

**Hemorrhage*

  • Recall, neonatal hemorrhage with increased PT and aPTT
40
Q

What form of Vitamin K can be toxic?

A
  • Synthetic, not natural

*****Note that it combines with sulfhydryl groups cause oxidation of phospholipids

41
Q

What are the manifestations of Vitamin K toxicity?

A

1) Hemolytic anemia

2) Hyperbilirubinemia

42
Q

What are the symptoms of Vitamin D deficiency?

A

1) Rickets in children
- Bending bones
- Rachitic bones
2) Osteomalacia
3) Tetany from hypocalcemia

**High risk in kids that are specifically breastfed*

Preventative Med. & Nutrition (30 decks)

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