Micronutrients Flashcards
B1
water soluble
Thiamin - aerobic energy metabolism
Etiology: alcoholism, malabsorbtion, dialysis
Clin Findings: (early) anorexia, muscle cramps, irritibility; (late) beri beri, korsakoff syndrome
B2
water soluble
Riboflavin - energy metabolism
Etiology: occurs in combo w/other deficiencies; dietary inadequacy, med interactions, EtOH, undernutrition
Clin Findings: cheilosis/angular stomatitis; glossitis, seb dermatitis, weakess
B3
water soluble
Niacin (Nicotinic acid) - cofactor for energy metabolism
Etiology: diets based on corn, EtOH, nutrient drug interactions
Clin Findings: (nonspecific) anorexia, weakness, irritibility stomatitis, glossitis (severe) Triad of Pellagra
beriberi
Symptoms: weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate.
Dry beriberi affects the nervous system
Wet beriberi affects the cardiovascular system and other bodily systems
korsakoff syndrome
Thiamine (B1) deficiency
anterograde/retrograde amnesia; confabulation (invented memories); meager content in conversation; lack of insight; apathy - the patients lose interest in things quickly and generally appear indifferent to change.
cheilosis/angular stomatitis
inflammation/cracking of the corners of the mouth/lips
Triad of Pellagra
diarrhea, dementia, dermatitis
B5
water soluble
Pantothenic acid - fatty acid metabolism
etiology: only in experiments with low B5 diets
Clinical findings: GI, muscle cramps, depression, ataxia, paresthesia
B6
water soluble
Pyroxidine - protein synthesis, neurotransmitters
Etiology: medication interactions, BC pills, EtOH
Clin Findings: glossitis, cheilosis, weakness–severe cases peripheral neuropathy, anemia, seizures
B7
water soluble
Biotin - gene expression, gluconeogenesis
Etiology: inborn errors of metabolism (rare that diet causes this)
Clin Findings: mental changes, anorexia, paresthesia, scaling rash around eyes/nose/mouth/extremities
B9
water soluble
Folate - DNA/protein synthesis
Etiology: inadequate dietary intake, EtOH, decreased absorption (drug interactions), increased requirement (pregnancy, anemia), and loss (dialysis)
Clin findings: megaloblastic anemia (impairs DNA synthesis, causes continued RBC growth w/out division)
B12
water soluble
cyanocobalamin - oxidation of fatty acids, DNA synthesis, erythropoiesis
Etiology: decreased absorption (no production of factor needed to absorb, competition with bacteria, pancreatic insufficiency, crohns disease, meds etc)
Clin Findings: megaloblastic anemia (impairs DNA synthesis, causes continued RBC growth w/out division); glossitis, anorexia, diarrhea, neuro
Vitamin C
ascorbic acid - antioxidant, synth of peptide hormones, iron absorption, collagen synthesis
Etiology - dietary inadequacy, pt w/ chronic illness (cancer, kidney disease), smokers
Clin Findings
water soluble vitamins (9)
BC-FN-PP-RTV
biotin, cyanocobalamin, folate, niacin, pyroxidine, pantothenic acid, riboflavin, thiamin, vitamin C
fat soluble vitamins (4)
Vitamin A, D, E, K
Vitamin A
retinol normal function - vision, cell growth, immune function
Etiology: fat malabsorption, infection, measles, EtOH, protein-energy malnutrition
Clin Med: xeropthalma (not enough tears), night blindness, impaired embryonic development, immune dysfunction, follicular hyperkeratosis
Vitamin D
normal function - regulating blood Ca levels, bone health, immune function, inflammation
Etiology: aging, lack of sunlight exposure, fat malabsorption, very dark skin
Clin findings: Rickets in children (impaired mineralization in growing bones); osteomalacia in adults
Vitamin E
function - antioxidant, protects cell membranes from oxidative damage
Etiology: severe malnutrition, fat malabsorption, genetic abnormalities of vit E metabolism/transport
Clin Findings: peripheral neuropathy, skeletal muscle atrophy, spino cerebellar ataxia, retinopathy
Vitamin K
normal function - activates part of clotting cascade
Etiology: fat malabsorption, liver disease, antibiotic use
clinical findings: elevated prothrombin time, bleeding
Niacin toxicity
B3 - cutaneous flushing, gastric irritation, elevated liver enzymes, hyperglycemia, gout, itchy/dry skin
Pyroxidine toxicity
B6 - sensory neuropathy (sometimes irreversible), flushing, gout, maculopathy
Folate toxicity
B9 - hematologic responses
Vitamin C toxicity
gastric irritation, flatulence, diarrhea, false tests for urine glucose
Vitamin A toxicity
most toxic of all vitamins: teratogenic (accutane), nausea, headache, fatigue, appetite loss, increased ICP, cerebral edema, vertigo, diplopia, bulging fontanelles, dry skin
Vitamin D toxicity
not common; hypercalcemia, anorexia, N/V, hypertension, hypercalciuria, muscular weakness, joint pain, death
Vitamin E toxicity
least toxic of fat soluble vitamins; can impair function of vitamin K and interfere with normal clotting
Vitamin K toxicity
decreased effectiveness of anti coagulants (warfarin)
mineral micronutrients
calcium, sodium, chloride, phosphorous, potassium
calcium
function: bone mineralization, regulation of PTH, muscle function
etiology: absorption hindered by vit D deficiency, suppression of PTH, oxalic acid, hypoalbuminemia
clin findings: rickets in children, osteomalacia in adults
sodium
function: osmotic pressure, cell permeability, acid base balance, nervous syst stimulation, muscle contraction
etiology: excessive diaphoresis, overhydration, water retention
clin findings: n/v, dizziness, resp arrest, seizure, coma, brain damage, death
chloride
function: fluid/electrolyte balance
etiology: secondary to vomiting, diuretic therapy, kidney disease
clin findings: often asymtomatic, dehydration, fluid loss
phosphorous
function: maintains bones and teeth, transport of fats, nucleic acid/phospholipid synth
etiology: low vit D levels (deficiency is rare)
clin findings: rickets, muscle weakness, tissue hypoxia, rhabdo
potassium
function: regulation of osmotic pressure, protein/glycogen synthesis, cardiac nerve impulses/muscle contraction
etiology: secondary to illness, injury, diuretic therapy
clin findings: muscular weakness, paralysis, mental confusion, cardiac arrhythmia
