Fat Soluble Vitamins

Question 1

What are 2 types of water vitamins

Answer 1

• Non B complex- only Vit C

- B complex

Question 2

Water Soluble vitamin

Answer 2

not stored (only b12 is)
HIghly absorbed
excreted in ua
low tox level

Question 3

Fat Soluble Vitamins

Answer 3

Accumulate in “stores”
Require dietary fat absorption
+/- blood transport system
Potential toxicity with excess intake

Question 4

Vitamin A Function

Answer 4

Photochemical for vision
retinal signaling

Maintenance of conjunctiva and cornea

Question 5

xerophthalmia (corneal dryness)–> Bitot’s Spots, night blindness –> total blindness

Answer 5

Vitamin A deficiency

Question 6

Food sources for Vitamin A

Answer 6

Animal sources

Precursor beta carotene- dark vegetable

Question 7

Vitamin A - Deficiency Immune Impairment

Answer 7

Dysregulation

Treatment of Deficiency decreases all cause child mortality 23-34% in developing world

Vit A treatment with measles reduces morbidity and mortality including in US when retinol level is low

Question 8

Vitamin A deficiency eyes

Answer 8

xerophthalmia (corneal dryness)–> Bitot’s Spots, night blindness –> total blindness

Question 9

Vit A - Toxicity

Answer 9

not seen with precursor

s/s:
NV, ↑ ICP, HA
Bone pain

• Birth defects
• liver damage hepatitis–> fibrosis–> failure–> Death

Question 10

Vit A – Risk of Deficiency

Answer 10

Low Vit A intake
Diet poor in colored veggies, meat/dairy
Protein Energy Malnutrition
Very Low fat intake (

Question 11

Serum Retinol level
Remains normal until liver stores exhausted

Decreased with inflammation
Negative Acute Phase Reactant

Answer 11

Vit A – Laboratory Testing

Question 12

Vit A – Laboratory Testing

Answer 12

Serum Retinol level
Remains normal until liver stores exhausted

Decreased with inflammation
Negative Acute Phase Reactant

Question 13

Hormone- Plasma membrane and nuclear receptors in a range of tissues

Answer 13

Vit D

Also Ca regulation and immune system

Question 14

Vitamin D sources

Answer 14

Conversion in skin

Diet (fish, fat, egg)

Question 15

UVB light–> Dehydrocholesterol–> Cholecalciferol D3 in skin

Answer 15

Conversion in skin Vit D

Question 16

Vit D - Metabolism

Answer 16

Absorption – chylomicrons

Requires fat absorption

Question 17

D2 or D3 +OH in ______

25 OH Vit D –level reflects body stores

Answer 17

liver

Deficiency 25OH Vit D

Question 18

25 OH Vit D hydroxylated in _____ to active form 1,25 OH Vit D (Calcitriol)

Answer 18

kidney

If kidneys dont work, may have vit d def

Question 19

Deficiency 25 OH Vit D

Answer 19

Childhood rickets -

Question 20

Vit D – Risk for Deficiency

Answer 20

Low Sun exposure 
Dark skin
Low dietary intake
Fat Malabsorption
Breastfed Infant
Obesity -- Fat sequestration, sedentary
Liver or Renal Disease (X-OH)-- Need Calcitriol Rx supplementation

Question 21

How much to use vit d

Answer 21

Breastfed Infants - 400IU D3 per day by 2 months

600 IU/d for children

Adults- variable

Question 22

Sun exposure and Vit D

Answer 22

5-15 min of arm and leg in sun will get correct amount

derms recommend do supplement instead

Question 23

Vit D - Toxicity

Answer 23

Hypercalcemia==> Vomiting, seizures, nephrocalcinosis, vascular and soft tissue calcinosis

Sarcoidosis

Question 24

Function: antioxidant, scavenges free radicals, stabilizes cell membranes

Answer 24

Vitamin E – Function

Question 25

Vitamin E sources

Answer 25

polyunsat fat veggie oil
corn
nuts

Question 26

Vitamin E – Function

Answer 26

antioxidant, scavenges free radicals, stabilizes cell membranes

Question 27

Neurologic Degeneration IRREVERSIBLE
Loss of reflexes (DTRs)
Loss of coordination
Loss of vibration and position sense
Spinocerebellar ataxia
Neuropathy
Ophthalmoplegia

Answer 27

Vit E – Deficiency

Question 28

Vit E – Deficiency

Answer 28

Neurologic Degeneration IRREVERSIBLE:
Loss of reflexes (DTRs)
Loss of coordination
Loss of vibration and position sense
Spinocerebellar ataxia
Neuropathy
Ophthalmoplegia

hemolytic anemia

Question 29

Vit E – Toxicity

Answer 29

Relatively Low
Coagulopathy
Very large doses inhibit Vit K dependent clotting factors

Question 30

Vit K – Function

Answer 30

Function – carboxylation of clotting factor proteins (II prothrombin, VII, IX, X)

Question 31

Vit K Source

Answer 31

leafy green 
broccoli 
fruit 
seeds
beef liver

Question 32

Vitamin K - Deficiency

Answer 32

prolonged coagulation time
Hemorrhagic disease of the newborn
Purpura, GI bleeds, CNS bleeds