Met 2: Water Soluble Vitamins

Question 1

Does intake of water soluble vitamins alter tissue levels?

Answer 1

Acute intake doesn’t but chronic intake can alter tissue levels

Question 2

What 3 micronutrients are important for energy-releasing (catabolic) reactions?

Answer 2

Thiamin (B1) , riboflavin (B2), niacin (B3)

Question 3

What is one source of Thiamin/B1, Riboflavin/B2, Niacin/B3?

Answer 3

Whole and enriched grains

Question 4

What micronutrient is made from Tryptophan?

Answer 4

Niacin (B3)

Question 5

Name the 3 types of Thiamin (B1) deficiency and 1 feature of each

Answer 5

All B1 deficiency is considered “Beriberi”

• Dry Beriberi: peripheral neuropathy
• Wet: congestive heart failure
• Wernicke-Korsakoff: cerebral effects

Question 6

Name 4 symptoms of Wernicke-Korsakoff syndrome

Answer 6

• Ataxia
• Confusion
• Ophthalmoplegia
• Later, get memory loss

Question 7

4 groups of people who get thiamin deficiency

Answer 7

• Alcoholics
• Bariatric surgery pts
• Anorexia and re-feeding syndrome
• Southeast Asian immigrants

Question 8

2 symptoms of B2/Riboflavin Deficiency

Answer 8

Cheilosis and angular stomatitis

(both are lesions at corner of mouth)

Question 9

Patients who have a cornmeal based diet are at risk for….?

Answer 9

Pellagra (aka Niacin/B3 deficiency)

Question 10

Name the 4 D’s of Pellagra (Niacin/B3 deficiency)

Answer 10

• Diarrhea
• Dermatitis
  
  • Worse in sun exposed areas
  • Peeling with both hyper and hypopigmentation
• Dementia
• Death

Question 11

Functions of folate (4)

Answer 11

• Single carbon transfers
  
  • nucleic acid synthesis and amino acid metabolism
• DNA methylation

Question 12

Sources of folate (2)

Answer 12

foliage!

grains in USA are fortified

Question 13

Patients with autoimmune hemolytic anemia will need supplementation of _____

Answer 13

Folate

Question 14

4 Sx of folate deficiency

Answer 14

• Macrocytic anemia
• Hypersegmented neutrophils
• Glossitis
• Elevated homocysteine

Question 15

Why is folate fortified in our grains?

Answer 15

Prevent neural tube defects in infants

Neural tube closes before women even realize they are pregnant

Question 16

Functions of B12 (2)

Answer 16

• Helps folate do its job
  
  • B12 reforms tetrahydrofolate from methylfolate
• Lipid and fat metabolism

Question 17

Describe absorption and transport of B12 (4)

Answer 17

1. Vitamin 12 is cleaved from dietary protein in stomach
2. Binds Intrinsic Factor, which gets released in stomach
3. Cobalamin-IF absorbed in ileum
4. Transported in circulation as Transcobalamin II

Question 18

What one water soluble vitamin has large stores?

Where?

Answer 18

B12 has large stores in liver

Question 19

What is the source of B12?

What group is therefore at risk of deficiency?

Answer 19

• B12 found in animals products
  
  • synthesized by soil bacteria and then eaten by animals
• Vegans at risk of deficiency

Question 20

4 symptoms of B12 deficiency

Reversibility?

Answer 20

• Macrocytic anemia
• hypersegmented neutrophils
• Combined subacute neurologic degeneration
• Glossitis

Neurologic symptoms are EVENTUALLY IRREVERSIBLE

Question 21

5 Functions of Vitamin C

Answer 21

• Antioxidant
• Provides reducing equivalents (eg. reduces iron)
• WBC function
• Needed for hydroxylation reactions
• Converts dopamine into norepi

Question 22

Hydroxylation reactions are important in synthesizing… (2)

Answer 22

Collagen

Serotonin

Question 23

Sources of Vitamin C

Answer 23

Fresh fruits and vegetables

Question 24

4 classic symptoms of Vitamin C defiency (aka scurvy)?

2 Early symptoms

Answer 24

• Hemorrhage (bleeding gums, bruising)
• Hyperkeratosis of hair (kinky hair)
• Hematologic changes (anemia)
• Hypochondriasis (depression, weakness)

Early sx: weakness, achy joints

Question 25

Name 2 potential benefits of Vitamin C megadoses

How does the body handle excess Vitamin C?

Answer 25

Shortened length of common cold

Improved wound healing

Vitamin C is easily excreted by kidneys