Fat Soluble Vitamins

Question 1

Vit A sources

Answer 1

Retinyl palmitate

Livers, dair, egg yolk, fish oil

Question 2

Vit A is a precursor for what, and what are the dietary sources of that thing
Also, what does it do?

Answer 2

Beta carotene
carrot, pumpkin, spinach, broccoli
Retinalsignaling, maintenance of conjunctiva and cornea

Question 3

Vit A deficiency

Answer 3

Xeropthalmia
Bitot’s spots
night blindness –> total blindness
Immune impairment

Question 4

Risks of Vit A def

Answer 4

Diet poor in meat and veg
low intake of fat and protein
fat malabsorption (liver/panc/biliary insufficiency)

Question 5

Vit A toxicity

Answer 5

Only with preformed vit A (retinyl palmitate), as in cod liver oil or accutane
Not w/ B-carotene
Liver damage ->fibrosis ->failure

Question 6

Vit A tox test

Answer 6

Serum retinol–which remains normal until liver stores are exhausted.
Numbers also decreased w/ inflammation

Question 7

Dx/Tx Vit A deficiency

Answer 7

Serum Retinol test

High dose supplementation

Question 8

Vit D-what is it?

Answer 8

Hormone
plasma mmbr component and nuclear receptors
maintains intra/extra Ca2+ concentration via intestinal absorption, renal reabsorption, and mobilization from bone

roles in immune system- antimicrobial peptide generation in macrophages, modulation of cytomines

regulation of cell growth and differentiation

Question 9

Vit D sources

Answer 9

UVB –>dehydrocholesterol –>cholecalciferol D3 in skin
Fish liver oil, egg yolks, fortified milk
plant algae, yeast + UVB–>D2 ergocalciferol

Question 10

Vit D metabolism

Answer 10

Chylomicron absorption
hydroxylation of D2/D3 in liver
25-OH Vitamin D level reflects body stores of VD
25-OH hydroxylated in kidney to 1,25 OH (calcitriol)

Question 11

Vit D deficiency

Answer 11

25 OH 30 ng/mL

Question 12

Vit D deficiency syndrome

Answer 12

Childhood rickets–failed calcification, wite metaphyses, bony necklace, bone pain, bowed legs, fractures
Hypocalcemia: Trousseau’s sign curling of hand w/ BP cuff application

Question 13

Risks for Vit D deficiency

Answer 13

Low sun exposure
low dietary intake
breast feeding (none in breast milk)
obesity (sequestration in fat)
liver/renal dysfunction (cant hydroxylate to activate)

Question 14

Vit D Supplementation

Answer 14

breastfed infants : 400IU/day
Kids: 400
5-15 minutes sun exposure arms and legs
Adults: 600-1000 IU/day, possibly more in the elderly b/c of lower absorption and activation

Question 15

Vit D toxicity and risks for toxicity

Answer 15

hypercalcemia: vomiting, seizures, nephrocalcinosis
Sarcoidosis-granulomas activate vit D
Very high levels of supplementation

Question 16

Vit E–what is it

Answer 16

antioxidant, scavenges free radicals, stabilizes cell membranes

Question 17

Vit E sources

Answer 17

polyunsaturated fats: corn oil, nut oil, wheat germ

Question 18

Vit E deficiency

Answer 18

irreversible neurological degeneration
loss of reflexes, coordination, proprioception, spinocerebellar ataxia
Normocytic hemolytic anemia

Question 19

Vit E def. RF’s

Answer 19

malnourishment, prematurity, fat malabsorption

Question 20

Vit K role

Answer 20

carboxylation of clotting factors 1,7,9,10

Question 21

Vit K sources

Answer 21

Leafy greens, fruit, seeds, beef liver

synthesized by intestinal bacteria

Question 22

Vit K deficiency

Answer 22

Prolonged clotting time, hemorrhagic disease of the newborn

Question 23

Vit k deficiency prevention

Answer 23

IM injection for newborns