Nutrients Flashcards

1
Q

Vitamin C function

A
  • antioxidant
  • protein/NT metabolism
  • absorption of non-iron heme

Post-translational stages of collagen synthesis

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2
Q

Vitamin C deficiency

A
Scurvy 
-poor wound healing
bleeding gums
perifollicular hyperkeratosis
petechial hemorrhage
coiled hair
Tooth loss
Impaired bone growth/bowing
Impaired bone healing
CNS
Infection
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3
Q

Risk fx vitamin C deficiency

A

intestinal disease
malabsorption
EtOH

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4
Q

Vitamin C toxicities

A

bloating
diarrhea
Enhanced iron absorption
inc risk of oxalate kidney stones

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5
Q

Risk fx vitamin C toxicity

A

supplement use

fortified diets

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6
Q

Thiamine B1 function

A

Cofactor for many enzymes:

  • transketolase (PPP)
  • pyruvate DH (lactate)
  • synthesis of Ach, GABA
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7
Q

Thiamine deficiency

A

Beriberi

  • peripheral neuropathy
  • HF/edema

Wernicke Korsakoff

  • progressive CNS disorder
  • ataxia
  • confusion
  • amnesia
  • confabulation
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8
Q

Risk fx for thiamine deficiency

A

alcohol use,

persistent vomiting, GI disease, HIV/AIDS, refeeding syndrome, hyperemesis gravidarum

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9
Q

Niacin (B3) function

A

Synthesis of NAD and NADP

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10
Q

Niacin (B3) deficiency

A

Pellagra (4 D’s)

  • dermatitis
  • diarrhea
  • dementia
  • death
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11
Q

Risk fx for Niacin deficiency

A

lower SES, primarily corn diet

  • malabsorption
  • Hartnup’s (AR, tryptophan transport)
  • carcinoid tumor
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12
Q

Niacin toxicity

A

flushing

high doses

  • GI symptoms heartburn, nausea, vomiting.
  • Hepatotoxicity.
  • Hyperuricemia and gout (niacin competes with uric acid for excretion).
  • Dec insulin sensitivity and glucose intolerance.
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13
Q

Folate function

A
  • nucleotide synthesis

- methylation

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14
Q

Folate deficiency

A

pregnancy: neural tube defects

- megaloblastic anemia, dec regen of tissue

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15
Q

Risk fx of Folate deficiency

A
  • generalized poor diet via illness/limited food ability
  • EtOH use
  • malabsorption disorders
  • anticonvulsant drugs
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16
Q

Risk fx of Folate toxicity

A

upper limit is based on amount of folic acid likely to mask macrocytic anemia occurring due to vitamin B12 defciency

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17
Q

Vitamin B12 function

A

Cofactor of

  • homocysteine –> methionine
  • methylmalonyl CoA –> sucCoA
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18
Q

B12 deficiency

A

Megaloblastic anemia, neuropathies, changed mental status, glossitis, diarrhea and malabsorption

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19
Q

Risk fx of B12 deficiency

A
  • vegans
  • decreased IF
  • bacterial overgrowth consuming B12
  • impaired ileal absorption
  • pernicious anemia
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20
Q

B12 toxicity

A

no upper limit/toxicity

21
Q

B6 function

A
  • enzyme cofactor (aa metabolism)
  • porphobilinogen synthesis
  • glycogenolysis
  • gene expression
  • supplemental tx for some sideroblastic anemias
22
Q

B6 deficiency

A
  • Seborrheic rash on face and extremities
  • Weakness and fatigue
  • Confusion
  • Glossitis and cheilitis/angular stomatitis
  • Peripheral neuropathy
  • Seizures in infants
  • Microcytic hypochromic anemia
23
Q

Risk fx B6 deficiency

A
  • poor intake
  • EtOH (impairs conversion to PLP)
  • malabsorption syndromes
  • theophylline, cycloserine, penicillamine, valproic acid, carbamezpine, phenytoin, corticosteroids steroids
24
Q

B6 toxicity

A

neurologic problems (peripheral nerves and dorsal columns (paresthesias and ataxia))

25
Q

Risk fx B6 toxicity

A

via diet supplements, not food

supplements for

  • hyperemesis gracidarum
  • carpal tunnel
  • premenstrual syndrome

*interactions w/ levodopa/phenytoin/phenobarbital/amiodarone/tetracyclines

26
Q

Risk fx Vitamin A deficiency

A
  • poor diet
  • malabsorption
  • liver disease
27
Q

Vitamin A deficiency

A
Night blindness
Abnormal epithelialization
E.g. Xeropthalmia
Impaired reproduction
Infection
E.g. respiratory, viral, diarrhea
Stunting
28
Q

Risk fx Vitamin A toxicity

A
  • supplements
  • renal disease
  • not carotenoids
29
Q

Vitamin A Toxicity

A
  • anorexia
  • HA
  • abd pain
  • liver disease
  • teratogenicity
  • osteoporosis
30
Q

Risk fx Vitamin D Deficiency

A
Dietary
-Exclusively breastfed infants
-Fat malabsorption
-Poor intake
Limited sun
Renal and liver disease
Obesity
31
Q

Vitamin D Deficiency

A

Children: Rickets
Adults: Osteomalacia
Myopathy and weakness
Long-term is contributor to osteoporosis risk

32
Q

Risk fx Vitamin D toxicity

A

Supplements and Rx
Not sun
Rarely food

33
Q

Vitamin D toxicity

A

Manifestations

  • Hypercalcemia
  • Nephrolithiasis
34
Q

Risk fx Vitamin E deficiency

A

Very low birth weight/preterm infants
Fat malabsorption
α-tocopherol transfer protein defects (rare)

35
Q

Vitamin E deficiency

A

Neuropathy
Myopathy
Retinopathy
RBC hemolysis

36
Q

Risk fx Vitamin E toxicity

A

supplement use

37
Q

Vitamin E toxicity

A

bleeding

mortality risk >400 IU/day

38
Q

inhibitors of gastric acid

A

impaired digestion of food-bound vitamin B12

39
Q

folic acid

A

masking of vitamin 12 deficiency

40
Q

metformin

A

vitamin B12 deficiency

41
Q

zinc supplements

A

copper deficiency

42
Q

isoniazid

A

B6 deficiency with neuropathy

43
Q

orlistat

A

fat soluble vitamin deficiency

44
Q

high dose loop diuretics

A

thiamine deficiency

45
Q

Risk fx Fe deficiency

A
Growth
Menstruation
Pregnancy
Dietary inhibitors
Malabsorption syndromes
Intestinal parasites
Vegetarians/vegans
Athletes
Blood loss
46
Q

Fe deficiency

A

-anemia
-fatigue and lethargy
-cold intolerance
↓ psychomotor development
↓ intellectual performance
Impaired immunity
↑ risk of lead poisoning

47
Q

Risk fx Zn deficiency

A

Acrodermatitis enteropathica
Malabsorption
Chronic diarrhea
Vegetarian diet

48
Q

Zn deficiency

A
Rash
Alopecia
Diarrhea
Infection
Hypogeusia
Hypogonadism
Mental slowing
Growth retardation