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Metabolism > Micronutrients > Flashcards

Micronutrients Flashcards

1
Q

what are micronutrients made out of

A
  • vitamins (organic)

- trace elements (inorganic)

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2
Q

what are micronutrients

A

these are essential compounds that are required in the diet at very small amounts

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3
Q

Role of micronutrients

A 
Cofactor 
coenzymes
Antioxidant
genetic control 
structural components
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4
Q

what does a cofactor do

A
  • non-protein chemical compound or metallic ion required for a protein’s biological activity to happen.
  • Iron / Zinc
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5
Q

what does coenzymes do

A
  • Small non-protein organic molecule
  • Cannot catalyze a reaction by themselves but they help enzymes to do so.
  • example includes Thiamine pyrophosphate (TPP)
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6
Q

what do antioxidants do

A
  • they inhibit the oxidation of other molecules

- examples include beta-carotene and vitamin C

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7
Q

what does genetic control do

A

substances such as vitamin A and D control gene expression

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8
Q

what do they do as a structural component

A
  • Phospholipids form complexes with both Mg2+ and Ca2+.

- These complexes are parts of membranes in the cell

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9
Q

what do micronutrients do in adults

A
  • maintain homeostasis
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10
Q

what do micronutrients do in children

A
  • they are more important in children
  • they are used as an energy supply
  • they are used as body growth and development
  • this is because they have a higher metabolism than adult
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11
Q

Supply of micronutrients has

A

short and long term health implications

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12
Q

what food can you get in vitamin D

A

oily fish
diary products
orange juice

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13
Q

where can you get B12

A

meet and dairy food

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14
Q

if you are vegan what vitamins will you be lacking

A
  • Vitamin D
  • vitamin B12
  • therefore you need to take supplements
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15
Q

what gives us the amount of vitamins that we should have

A
  • recommended dietary allowance

- limits are defined for deficiency or toxicity

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16
Q

name some fat soluble vitamins

A

A D E K

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17
Q

name some water soluble vitamins

A

B, Folate (B9),Biotin (B7), C

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18
Q

what is the difference between fat soluble vitamins and water soluble vitamins

A

Fat soluble

  • these can be stored in the body
  • they are toxic when they are in excess

water soluble

  • they are not stored in the body
  • they often act as coenzymes
  • No toxicity as it is excreted in the urine
  • excess is excreted in the urine
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19
Q

where do fat soluble and water soluble vitamins go

A

fat soluble - lymph fluid

water soluble - portal vein

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20
Q

if you have alcohol dependency what vitamin do you have deficiency in

A

Chiefly B vitamins (Vit B1)

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21
Q

if you have small bowel disease what vitamin do you have deficiency in

A

Chiefly Folate (Vit B9)

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22
Q

if you are elderly with a poor diet what vitamin do you have deficiency in

A

Chiefly Vit D (if no sunshine); Folate

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23
Q

if you have anorexia what vitamin do you have deficiency in

A

chiefly folate

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24
Q

what are the causes of vitamin deficiency in developed countries

A
  • decreased intake
  • decreased absorption
  • long term enteral or paranteral nutrition
  • drugs antagonists (methotrexate interfering with folate metabolism)
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25
Q

if you have Ileal disease what vitamin are you lacking

A

only vitamin B12

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26
Q

if you have liver and billiary tract disease what vitamin are you lacking

A

Fat soluble vitamins

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27
Q

if you have Intestinal bacterial overgrowth what vitamin are you lacking

A

vitamin B12

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28
Q

if you have oral antibiotics what vitamin are you lacking

A

vitamin K

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29
Q

if you have renal disease what vitamin defincey to you have

A
  • vitamin D
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30
Q

vitamin A

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors to defienciy:
- Infection, measles, protein-energy malnutrition

clinical features:
Xerophthalmia,

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31
Q

vitamin D

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
- Aging, lack of sunlight exposure

Clinical features:
- Rickets; osteomalacia

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32
Q

Vitamin E

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Antibiotic use

Clinical features:
Peripheral neuropathy, spinocerebellar ataxia, skeletal
muscle atrophy, retinopathy

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33
Q

Vitamin K

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Antibiotic use

Clinical features:
Coagulopathy

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34
Q

Vitamin C

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
smoking

Clinical features:
scurvy

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35
Q

B1

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Concommittant Vitamin B6, B12 & folate deficiency

Clinical features:
Beri beri

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36
Q

B2

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Malabsorption

Clinical features:
Magenta tongue, angular stomatitis, seborrhea,cheilosis

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37
Q

B3

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Vitamin B6 deficiency, riboflavin deficiency

Clinical features:
Pellagra

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38
Q

B6

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Isoniazid use

Clinical features:
- neuropathy and anaemia

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39
Q

B12

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Gastric atrophy (pernicious anemia),
terminal ileal disease, strict
vegetarianism

Clinical features:
Anaemia,

40
Q

Folate

  • Contributing factors to deficiency
  • Clinical features
A

Contributing factors in deficiency:
Sulfasalazine, pyrimethamine, triamterene

Clinical features:
Anaemia

41
Q

Calcium

  • Function
  • deficiency
A

Function:
Mechanical stability of the skeleton, neuromuscular activity, signal transduction

Deficiency:

  • osteoporosis
  • parenthesis
  • muscle spams
42
Q

Phosphorus

  • Function
  • deficiency
A

Function:
Component of structural proteins, enzymes, transcription factors, ATP and nucleic acids

Deficiency:
Bone pain, pseudofractures, and proximal muscle weakness or, rickets and short stature in children neurological manifestations

43
Q

Iron

  • Function
  • deficiency
A

Function:
Part of the heme protein and enzymes

Deficiency:
Anemia

44
Q

selenium

  • Function
  • deficiency
A

Function:
Component of glutathione peroxidase and deiodinase enzymes

Deficiency:
cardiomyopathy

45
Q

zinc

  • Function
  • deficiency
A

Function:
Synthesis and stabilization of proteins, DNA, and RNA ; normal spermatogenesis, fetal growth, and embryonic development

Deficiency:
Growth retardation, alopecia, dermatitis, diarrhoea, congenital malformations

46
Q

copper

  • Function
  • deficiency
A

Function:
Part of numerous enzymes for iron metabolism; melanin, elastin and collagen synthesis; and central nervous system function

Deficiency:
growth retardation

47
Q

how many deaths does malnutrition cause

A

1/3 of child deaths worldwide

48
Q

what is kwashiorkor

A
  • effects babies and toddlers
  • caused by a lack of protein
  • involved micronutiernta and antioxidant deficiencies
49
Q

what happens in marasmus

A
  • servere malnutrition

- muscle wasting/protein loss

50
Q

why is nutrient important

A
  • Impaired wound healing
  • Impaired immune response, predisposing to infection
  • Reduced muscle strength – delayed recovery from chest infection or weaning off ventilator, impaired cardiac function, reduced mobility
  • Inactivity – pressure sores, thromboembolism
  • Increased risk of postoperative complications
  • Depression and self-neglect
51
Q

what does iron defiency lead to

A

Anaemia- ability to effect oxygen delivery to the body, lethargy & constitutional disturbance

52
Q

why is Iron important

A
  • Oxygen transport within haemoglobin

- Myoglobin function in skeletal muscle

53
Q

where is iron absorbed

A
  • in the upper small bowel
54
Q

how is iron transported in serum

A
  • with transferrin
55
Q

how is iron stored

A

Iron is stored in liver and bone marrow as ferritin

56
Q

what prevents too much iron

A

Be aware of haem chelaters (used to prevent Iron overload / and prevent oxidative damage in patients)

57
Q

what happens if you have a deficiency in iron

A 
Microcytic anaemia
Lethargy & fatigue
Adults
Cognitive impairment
Children
Exacerbation of inflammatory states
58
Q

what happens if you have excess in iron

A 
Haemochromatosis
Lethargy & fatigue
Abdominal & joint pain
Reduced libido
Bronzing of skin
Diabetes
Cirrhosis
Cardiomyopathy
59
Q

what disorders does vitamin D cause

A

osteomalacia and rickets

60
Q

what is D3 and why it is special

A

Cholecalciferol (D3)

- special as we can make it artificially by adding UV light to D2

61
Q

How can you make vitamin D

A

sunlight
Caucasians
20-30 minutes of sunlight ≈ 2,000 iU Vitamin D
Two or three exposures a week during summer
Non-causcasian
Require 2-10 times the exposure- melanin acts as a barrier

62
Q

what lifestyle factors contribute to vitamin D deficiency

A 
Obesity
Smoking (and Betel)
Alcohol
Exercise
Exclusive breast feeding >6/12
63
Q

what disease factors lead to vitamin D deficiency

A 
Reduced skin synthesis
Decreased bioavailability
Drug-related
Increased excretion
Impaired hydroxylation
Acquired
64
Q

what is rickets

A
  • this is when you have growth retardation
  • this causes the expansion of the growth plate
  • it happens in children prior to epiphyseal fusion
65
Q

what is osteomalacia

A
  • this is when you have reduced bone strength
66
Q

what are symptoms of osteomalacia

A 
Increase in bone fracture
Bone pain 
Bending of bones
Muscle weakness
Waddling gait
67
Q

what does B1 (thiamine) deficiency lead to

A

Wernicke’s Encephalopathy &

Korsakoff’s Psychosis

68
Q

Where is B1 absorbed

A

jejunum

69
Q

what is B1 involved in

A

Involved in glycolysis and Krebs cycle - cannot be able to generate energy and ATP, start producing lactic acid and anaerobic respiration instead
Involved in BCAA metabolism
Involved in pentose phosphate cycle metabolism

70
Q

where is vitamin B1 seen

A

Most commonly seen in malignancy and alcoholism

Anorexia & weight loss

71
Q

what are the symptoms of vitamin B1

A

Cognitive impairment

Muscle weakness

72
Q

What are the two types of BeriBeri

A

dry and wet and shoshin

73
Q

describe dry beri beri

A
  • effects peripheral neuropathy

- effects motor and sensory

74
Q

describe what happens in wet beri beri

A 
Cardiac
- Enlarged heart
- Tachycardia 
- High-output CCF 
- Peripheral oedema 
Neurological
- Peripheral neuritis
75
Q

describes what happens in shoshin Beriberi

A

Fulminant cardiac failure

Lactic acidosis

76
Q

what are the symptoms of Wernicke’s encephalopathy

A 
Horizontal nystagmus (involuntary, rapid and repetitive movement of the eyes)
Ophthalmoplegia (paralysis or weakness of the eye)
Cerebellar  ataxia (inflamed cerebellum)
77
Q

what are the symptoms of Korsakoff syndrome

A
  • Korsakoff syndrome
    Mental impairment (additional loss of memory and a confabulatory psychosis).
  • It is irreversible!
78
Q

what does vitamin B3 definitely lead to

A

pellagra

79
Q

where is vitamin B3 absorbed

A

jejunum

80
Q

what happens to excess B3

A

It is excreted in the urine

81
Q

what are the 2 chemical forms of vitamin B3

A

nicotinic acid

nicotinamide

82
Q

describe the structure of vitamin B3

A
  • Form two pyridine nucleotides (NAD and NADP) which act as hydrogen acceptors in many oxidative reactions
  • their reduced forms (NADH and NADPH) act as hydrogen donors in reductive reactions.
83
Q

when would you get vitamin B3 deficiency

A

Vegetarian diets (corn based), alcoholism, other vitamin deficiency states

84
Q

what diseases does vitamin B3 lead to

A
  • Hartnups diseae
  • carcinoid syndrome
  • isoniazid use - for TB treatment
85
Q

what is hartnups disease

A

Congenital defects of intestinal and kidney absorption of tryptophan

86
Q

what is carcinoid syndrome

A

Increased conversion of tryptophan to Serotonin

87
Q

what happens if the diet is deficient in niacin

A

If the diet is deficient in niacin, your body can manufacture it from tryptophan

88
Q

what are early symptoms of pellagra

A 
Loss of appetite
Generalized weakness
Irritability
Abdominal pain
Vomiting
Bright-red glossitis
89
Q

what are late symptoms of pellagra

A 
“Casal’s necklace”
Vaginitis
Oesophagitis
Diarrhoea
Depression
Seizures 
The four D’s: dermatitis, diarrhoea, dementia , death
90
Q

what happens with niacin toxicity

A

Flushing has been observed at therapeutic dose of niacin (hypertrigliceridemia)

Glucose intolerance, macular oedema, and macular cysts

91
Q

what happens in vitamin B9 folate deficiency

A

Neural tube defects in fetus

92
Q

what happens in vitamin B12 deficiency

A

Anaemia, GI & neurological disturbance

93
Q

how much of vitamin B12 is absorbed or excreted

A

40% absorbed, 60% excreted in urine or bile

94
Q

what is vitamin B12 used for

A

Cofactor for methionine synthase and methylmalonyl–coenzyme A (CoA) synthase

Available in many forms
Cyanocobalamin used therapeutically

95
Q

what causes vitamin B12 deficiency

A 
Disorders of terminal ileum
Defective release of cobalamin from food
Inadequate production of IF
Transcobalamin II deficiency (rare)
Congenital enzyme defects (rare)

Metabolism (26 decks)

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