Nutrition Flashcards

1
Q

What is vitamin B6

A

Vitamin B6 is a water soluble vitamin of the B complex group.

It is converted to pyridoxal phosphate (PLP) which is a cofactor for many reactions including transamination, deamination and decarboxylation.

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2
Q

Causes of vitamin B6 deficiency

A

isoniazid therapy

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3
Q

Consequences of vitamin B6 deficiency

A

peripheral neuropathy

sideroblastic anemia

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4
Q

vitamin B6 is also known as

A

pyridoxine

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5
Q

Vitamin C is also known as

A

ascorbic acid

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6
Q

Vitamin C Functions

A

antioxidant
collagen synthesis
facilitates iron absorption
cofactor for norepinephrine synthesis

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7
Q

Vitamin C deficiency (scurvy) leads to

A

defective synthesis of collagen resulting in capillary fragility (bleeding tendency) and poor wound healing

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8
Q

Features vitamin C deficiency

A

gingivitis, loose teeth
poor wound healing
bleeding from gums, haematuria, epistaxis
general malaise

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9
Q

Vitamin A is water solubke

A

false

fat soluble

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10
Q

Vitamin A/retinol Functions

A

converted into retinal, an important visual pigment
important in epithelial cell differentiation
antioxidant

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11
Q

Consequences of vitamin A deficiency

A

night blindness

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12
Q

Name all the Vitamin B types

A
B3 Niacin
B6 Pyroxidine
B7 Biotin
B9 Folic Acid
B12 Cyanocobalamin
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13
Q

Deficiency of Thiamine leads to?

A

Beriberi
polyneuropathy, Wernicke-Korsakoff syndrome
heart failure

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14
Q

Deficiency of Niacin leads to?

A

Pellagra
dermatitis
diarrhoea
dementia

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15
Q

Deficiency of Pyridoxine leads to?

A

Anaemia, irritability, seizures

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16
Q

Deficiency of Biotin leads to?

A

Dermatitis, seborrhoea

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17
Q

Deficiency of Vitamin D leads to?

A

Rickets, osteomalacia

18
Q

Deficiency of Vitamin E leads to?

A

Mild haemolytic anaemia in newborn infants, ataxia, peripheral neuropathy

19
Q

Deficiency of Vitamin K leads to?

A

Haemorrhagic disease of the newborn, bleeding diathesis

20
Q

NICE define malnutrition as the following:

A

a Body Mass Index (BMI) of less than 18.5; or
unintentional weight loss greater than 10% within the last 3-6 months; or
a BMI of less than 20 and unintentional weight loss greater than 5% within the last 3-6 months

21
Q

MUST (Malnutrition Universal Screen Tool) takes into account?

A

BMI, recent weight change and the presence of acute disease

22
Q

Management of malnutrition is difficult. NICE recommend the following points:

A

dietician support if the patient is high-risk
a ‘food-first’ approach with clear instructions (e.g. ‘add full-fat cream to mashed potato’), rather than just prescribing oral nutritional supplements (ONS) such as Ensure
if ONS are used they should be taken between meals, rather than instead of meals

23
Q

Niacin is a water soluble vitamin of the B complex group. It is a precursor to

A

NAD+ and NADP+ and hence plays an essential metabolic role in cells.

24
Q

Hartnup’s disease:

A

hereditary disorder which reduces absorption of tryptophan

25
Q

carcinoid syndrome:

A

ncreased tryptophan metabolism to serotonin

26
Q

Thiamine is therefore important in

A

catabolism of sugars and aminoacids

27
Q

clinical consequences of thiamine deficiency are therefore seen first in which type of tissues

A

clinical consequences of thiamine deficiency are therefore seen first in highly aerobic tissues such as the brain (Wenicke-Korsakoff syndrome) and the heart (wet beriberi).

28
Q

Causes of thiamine deficiency:

A

alcohol excess. Thiamine supplements are the only routinely recommend supplement in patients with alcoholism
malnutrition

29
Q

Wernicke’s encephalopathy features?

A

nystagmus, ophthalmoplegia and ataxia

30
Q

Korsakoff’s syndrome features?

A

amnesia, confabulation

31
Q

dry beriberi is what secondary to thiamine defiency?

A

peripheral neuropathy

32
Q

wet beriberi is what secondary to thiamine defiency?

A

dilated cardiomyopathy

33
Q

Symptoms and signs include of scurvy

A

Follicular hyperkeratosis and perifollicular haemorrhage
Ecchymosis, easy bruising
Poor wound healing
Gingivitis with bleeding and receding gums
Sjogren’s syndrome
Arthralgia
Oedema
Impaired wound healing
Generalised symptoms such as weakness, malaise, anorexia and depression

34
Q

Total iron binding capacity (TIBC) raised in?

A

raised in iron deficiency anaemia (IDA)

raised in pregnancy and by oestrogen

35
Q

Ferritin raised/ low in?

A

raised in inflammatory disorders

low in IDA

36
Q

Anaemia of chronic disease bloods?

A

normochromic/hypochromic, normocytic anaemia
reduced serum and TIBC
normal or raised ferritin

37
Q

Ferritin is an acute phase protein

A

true
may be synthesised in increased quantities in situations where inflammatory activity is ongoing. Falsely elevated results may therefore be encountered clinically and need to be taken in the context of the clinical picture and blood results.

38
Q

We can split the causes of increased ferritin levels into 2 distinct categories based on?

A

Without iron overload (around 90% of patients) With iron overload (around 10% of patients)

39
Q

increased ferritin levels
Without iron overload (around 90% of patients)
causes?

A
Inflammation (due to ferritin being an acute phase reactant)
Alcohol excess
Liver disease
Chronic kidney disease
Malignancy
40
Q

increased ferritin levels
With iron overload (around 90% of patients)
causes?

A

Primary iron overload (hereditary haemochromatosis)

Secondary iron overload (e.g. following repeated transfusions)

41
Q

The best test to see whether iron overload is present is transferrin saturation.

A

true

42
Q

Ferritin levels may be decreased in

A

Because iron and ferritin are bound the total body ferritin levels may be decreased in cases of iron deficiency anaemia.