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DEMS > FAT SOLUBLE VITAMINS > Flashcards

FAT SOLUBLE VITAMINS Flashcards

1
Q

which water soluble vitamin is stored

A

B12

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2
Q

Fat soluble vitamins

- require what for absorption?

A

dietary fat

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3
Q

Do fat soluble vitamins require blood transport?

A

yes and no

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4
Q

Function of vitamin A

A

photochemical for vision
- retinal signaling
maintenance of conjunctiva and cornea

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5
Q

Vitamin A - 2 types of food sources

A
  1. preformed retinyl palmitate from animal sources (liver, dairy, egg yolk, fish oil)
  2. Precursor beta-carotene (deep yellow and green veggies)
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6
Q

Vit A deficiency

A

Eyes: xerophthalmia - corneal dryness ; Bitot’s Spots ; Night Blindness ; total blindness

Epithelium: linings flat, dry, and keratinized

Immune Impairment - dysregulation ; effect depends on infectious agent ;

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7
Q

VitA immune impairment treatment?

A

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

VitA treatment with measles reduces morbidity and mortality

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8
Q

VitA risk of deficiency

A

low vitA intake - poor diet (e.g. autistic with restricted diet)
PEM
Low fat intake (<5%kcal)
Fat malabsorption - liver disease / pancreatic insufficiency

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9
Q

VitA toxicity from?

A

Not precursor beta carotene

ONLY preformed retinyl palmitate (e.g. cod liver oil)

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10
Q

VitA toxicity symptoms

A 
Vomiting
Increased ICP
Bone pain / osteopenia
liver damage 
death 
birth defects
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11
Q

VitA - labs

A

serum retinol level - remains normal until liver store exhausted
decreased with inflammation - negative acute phase reactant

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12
Q

Vit D function

A

Hormone

  • plasma membrane and nuclear receptors in range of tissues
  • maintains IC and EC calcium
  • -> via intestinal absorption of Ca and P, renal reabsorption, and mobilization from bone
  • Immune function
  • innate -> antimicrobial peptide generation in macrophages
  • adaptive -> modulation of cytokines

Regulates cell growth and differentiation

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13
Q

Sources of vitD

A

conversion in skin
UVB light
Dehydrocholesterol –> cholecalciferol D3

dietary
- fish liver oil, fatty fish, egg yolk, fortified milk and formula

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14
Q

VitD metabolism

Absorption?

A

absorption via chylomicrons - requires fat

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15
Q

VitD metabolism

Hydroxylation?

A

D2 or D3 + OH in liver

25 OH VitD - level reflects body stores

25 OH VitD hyroxylated in Kidney to active form 1,25 OH VitD (Calcitriol)

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16
Q

VitD deficiency

definition

A

Deficiency 25OH VitD <20ng/mL

17
Q

VitD Deficiency

syndrome

A 
Childhood rickets (<11ng/mL)
Failure of calcification 
wide metaphyses: wrists
bone pain 
bowed legs 
fractures

adult osteoporosis

18
Q

VitD risk for deficiency

A 
low sun exposure
- dark pigment 
low intake
fat malabsorption 
breastfed infant --> supplement 
obesity (fat sequestration)
liver / renal disease (X-OH)
- need calcitriol Rx supplement
19
Q

Vit D supplementation

A

Breastfed (400 IU D3)

Children (EAR 400; RDA 600)

Adults (600 IU ; 800 IU>70 yr)

20
Q

VitD tox

A

hypercalcemia

vomiting / seizures / nephrocalcinosis / vascular and soft tissue calcinosis

21
Q

risk for VitD tox?

A

sarcoidosis (granulomas activate D)
>10,000 iu/d in child or preg
>50-100,000iu in adult >3wk

22
Q

VitE function

A

antioxidant
scavenge free radicals
stabilize membranes

23
Q

VitE source

A

polyunsaturated fat rich veggie oils (sunflower) corn, nuts, wheat germ

24
Q

VitE deficiency

A

neurologic degeneration that is IRREVERSIBLE
Loss of DTRs and coordination

hemolytic anemia

25
Q

VitE deficiency risk

A

malnourished
premature
fat malabsorption
short gut

26
Q

VitE tox

A

relatively low

coagulopathy - very large doses inhibit vitK dependent clotting factors

27
Q

VitK

function

A

carboxylation of clotting factors (e.g. prothrombin gamma carboxyglutamate)

28
Q

VitK source

A

leafy greens, broccoli, fruits, seeds, beef liver

synthesis by intestinal bacteria

29
Q

VitK deficiency

A

prolonged coagulation time

Hemorrhagic disease of newborn (purpura / gi bleed / cns bleed)

30
Q

Risk for VitK deficiency

A

newborn
fat malabsorption
chronic antibiotics

31
Q

VitK deficiency prevention

A

newborns all 0.5-1.0mg IM once

32
Q

VitA deficiency finding

A

eyes
epithelium
infections

33
Q

VitaminA deficiency risk

A

poor or extreme low fat diet

34
Q

Vitamin D deficiency finding

A

rickes
osteopenia
malacia

35
Q

Vitamin D deficiency risk

A 
low sun
dark pigment 
obesity 
breast feeding 
liver/kidney disease (calcitriol supplement)
36
Q

Vitamin E deficiency finding

A

neurologic

anemia

37
Q

VitE deficiency risk

A

prematurity

38
Q

VitK deficiency finding

A

impaired clotting

39
Q

VitK deficiency risk

A

newborn
antibiotics
poor diet

DEMS (21 decks)

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