Feb7 M3-Vitamins and Minerals

Question 1

vitamins def

Answer 1

13 organic molecules that must be consumed in mg doses throughout life

Question 2

water-soluble and fat-soluble vitamins and how many of each

Answer 2

9 water soluble (vit C and B)

4 fat soluble (A,D,E,K)

Question 3

nutritionally essential minerals

Answer 3

Fe, Mg, Ca, PO4, zinc, Na, K, Cl

Question 4

trace elements + examples

Answer 4

less than few mg required for life

iodine, copper, selenium

Question 5

main cause of vitamin deficiency and other causes

Answer 5

• inadequate consumption

- other: malasoprtion, increased excretion, abnormal loss, catabolism

Question 6

3 stages of vitamin deficiency diseases

Answer 6

1. tissue depletion
2. sublinical vitamin deficiency
3. specific vitamin deficiency disease

Question 7

tissue depletion stage def

Answer 7

vitamin levels (tissue stores) are subnormal for metabolic needs

Question 8

sublinical vitamin deficiency def

Answer 8

• metab functions requiring vitamin are impaired but body adapts and compensate.
• feel fatigue, decreased endurance. increased long-term risk of certain disease

Question 9

specific vitamin deficency disease def

Answer 9

important metab impairment, non specific and specific symptoms with clinical picture of a specific vitamin deficiency disease

Question 10

what predisposes people to vitamin deficiency disease

Answer 10

malnutrition, malabsorption or metab disease, anorexia, advanced disease

Question 11

sources of vitA

Answer 11

certain parts of animals, certain vegetables and fruits (those with carotenoids, especially beta-carotene)

Question 12

what happens with beta carotene in the body

Answer 12

converted to retinol, one of the 3 forms of vitamin A

Question 13

what’s retinol

Answer 13

a form of vitamin A essential for vision (bc light sensitive pigments of the retina contain a retinol derivative)

Question 14

symptom of severe vit A deficiency

Answer 14

night blindness (impaired dark adaptation)

Question 15

consequences of vitA deficiency

Answer 15

• immunodeficiency, resp disease, diarrhea, infection

- in pregnancy, severefetal malformation

Question 16

what patients have vit A deficiency most commonly

Answer 16

pts with fat malabsorption (pancreatic insufficiency, chronic biliary obstruction, CF, celiac disease)

Question 17

what’s unique with vitA

Answer 17

only vitamin that is toxic when consumed in excess

Question 18

who is given vitA supplements typically

Answer 18

pregnant women

Question 19

thiamine (vit B1) function

Answer 19

coenzyme function for decarboxylation reactions. + cofactor in pyruvate dehydrogenase

Question 20

wet vs dry beriberi

Answer 20

wet beriberi = B1 deficiency shows heart failure and edema

dry beriberi= B1 deficiency gives skm atrophy and nerve dysfct

Question 21

niacin (B3) function

Answer 21

required to synthesize NAD and NADP

Question 22

end stage disease of niacin deficiency and manifestation

Answer 22

pellagra. rashes, diarrhea, inflammed tongue, mood disturbances

Question 23

pyridoxine (B6) function

Answer 23

(converted to pyridoxal phosphate) cofactor of many enzymes, including CBS, involved in homocysteine metabolism

Question 24

pyridoxine deficiency appears how

Answer 24

peripheral neuropathy, psychiatric depression,

Question 25

when to strongly consider and treat (preventively) B1, B3 and B6 deficiency

Answer 25

• alcoholism
• poor food intake
• chronic starvation
• malabsorption
• chronic vomiting

Question 26

folate function

Answer 26

folate = family of molecules use to direct methyl (one carbon) groups in the cell to specific metab pathways (including homocysteine remethylation and DNA synthesis)

Question 27

folate deficiency symptoms (severe)

Answer 27

poor cell turnover (bc of DNA synth fct): GI epithelium BM.

anemia, diarrhea, fetal malformations

Question 28

sublinical folate deficiency consequence

Answer 28

hyperhomocystinemia, homocystinuria

Question 29

folic acid in what food and systematically give supplement to who

Answer 29

coloured fruits and vegetables

given to pregnant women

Question 30

who’s at greater risk of folate deficiency and some people supplemented

Answer 30

alcoholism, poor diet, starvation

supp in hemolytic anemia (poor tunrover)

Question 31

cobalamin (B12) fct

Answer 31

coenzyme for methionine synthase (makes homocysteine back into met) and another enzyme

Question 32

2 consequences of B12 deficiency

Answer 32

• hyperhomocystinuria and GI symptoms like folate deficiency

- peripheral neuropathy

Question 33

how cobalamin (B12) is absorbed

Answer 33

Intrinsic factor produced by parietal cells in the stomach. IF-B12 complex absorbed in ileum

Question 34

pernicious anemia def

Answer 34

auto-immune destruction of parietal cells (no more IF)

Question 35

when to consider B12 supp by injection

Answer 35

stomach removed or diseased or absent ileum

Question 36

mistake to avoid in treating macrocytic anemia (of folate or cobalamin deficiency)

Answer 36

give folate only. MUST give folate AND cobalamin if cobalamin deficiency is present bc otherwise peripheral neuropathy

Question 37

ascorbic acid (vit C) fct

Answer 37

1. reducing agent in hydroxylation rxs

2. required for collagen, NE and E synthesis

Question 38

end stage disease of vit C deficiency and symptoms

Answer 38

scurvy: fatigue, skin lesions, mood disturbances, gingivitis, joint hemorrhage

Question 39

people who are commonly vitamin C deficient

Answer 39

alcoholism, poor diet, starvation, malabsorption

Question 40

cholecalciferol (vit D) active molecule and fct

Answer 40

1,25 dihydroxy vitD (calcitriol). calcium homeostasis, SI, kidney, parathyroid

Question 41

vit D deficiency in adults vs children

Answer 41

children: rickets (undermineralized bones)
adults: osteomalacia

Question 42

why vit D deficiency affects brain, muscles and immune cells (risk of prob in all these + possible autoimmune disease)

Answer 42

bc these cells take up 25-OH vit D and make it calcitriol for internal use

Question 43

who’s at risk for vitD deficiency

Answer 43

not exposed to sunlight, dark skin, fat malabsorption, liver disease, renal disease

Question 44

essential FAs def and 2 essential

Answer 44

polyunsaturated FAs for PGs and thromboxane synthesis

1. omega 6 EFAs needed for arachidonic acid synthesis
2. omega 3 EFAs for synth of FAs needed in growth

Question 45

iron function

Answer 45

binds O2 in Hb. essential in activity of many enzymes too

Question 46

where’s Fe in the body

Answer 46

two thirds in the blood

one third in bone marrow, spleen, muscles (myoglobin) and liver (ferritin stores it)

Question 47

most common Fe deficiency disease

Answer 47

iron deficiency anemia

Question 48

iron deficiency (and iron deficiency anemia) common in what patients + misleading lab test

Answer 48

systemic inflamm. acute phase response causes anemia + hard to see anemia bc plasma ferritin increases

Question 49

zinc fct and food source

Answer 49

component of many enzymes. meat and flesh are main sources of zinc.

Question 50

who is more likely to develop zinc deficiency

Answer 50

chronically starving patients, chronic inflammatory diarrhea (inflammatory diarrhea is rich in zinc)

Question 51

zinc deficiency in adults consequence

Answer 51

ageusia (taste impairment), skin rash, impaired wound healing, immune deficiency