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MIMS > Nutrition > Flashcards

Nutrition Flashcards

1
Q

what are the lipid soluble vitamins?

A

vitamins A, D, E, K

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2
Q

what are the water soluble vitamins?

A

B vitamins, vitamin C

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3
Q

what are the major minerals? (5)

A

calcium, phosphorus, potassium, sodium, magnesium

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4
Q

what are the trace minerals? (4)

A

iron, chloride, zinc, manganese

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5
Q

what are the ultra-trace minerals? (5)

A

cobalt, iodine, selenium, molybdenum, chromium

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6
Q

how are lipid soluble vitamins absorbed?

A

absorbed from gut and reach the circulation as dietary fats

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7
Q

where are lipid soluble vitamins mostly stored?

A

liver and adipose tissue- except vitamin K which has limited storage capacity

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8
Q

chemistry of vitamin A?

A

structurally related to retinol, carotenes and xanthophylls converted to vitamin by animal tissues

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9
Q

metabolic function of vitamin A?

A

antioxidant, nuclear transcription factor regulating gene expression, required for vision, growth, cell proliferation/differentiation, immune function

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10
Q

how are vitamin A levels assessed?

A

liver vitamin A levels, serum, relative dose response, retinol isotope dilution technique

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11
Q

what does vitamin A deficiency lead to?

A

birth defects, fetal mortality, de-differentiation, epithelial keratinisation, loss of appetite, xeropthalmia, blindness, impaired immune function

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12
Q

what causes vitamin A toxicity?

A

prolonged supplement use, excessive liver intake, skin preparations

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13
Q

what does vitamin A toxicity lead to?

A

birth defects, nausea, skin irritation, liver abnormalities, reduced bone mineral density

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14
Q

what is the alternative name for vitamin D?

A

calciferol

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15
Q

how is vitamin D activated?

A

photoactivation

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16
Q

what are factors affecting vitamin D synthesis?

A

ageing, skin pigmentation, clothing, season, latitude, time of day

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17
Q

what are the functions of vitamin D?

A

maintains serum [Ca] and [P] by enhancing intestinal absorption and mobilising Ca and P from bone; insulin secretion; production of renin; cell proliferation and differentiation; immune function

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18
Q

how are vitamin D levels assessed?

A

23-OH-D, 1,25(OH2D), erum alkaline phosphatase, bone collagen products in urine

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19
Q

what does vitamin D deficiency lead to?

A

rickets, decreased bone mineral density

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20
Q

what does vitamin D toxicity lead to?

A

calcification of bone and soft tissues

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21
Q

what are the naturally occurring forms of vitamin K?

A

phylloquinone (K1), menaquinones

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22
Q

what are good sources of vitamin K in the diet?

A

green leafy vegetables, some plant oils, synthesis by bacteria in large intestine

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23
Q

what is the function of vitamin K?

A

cofactor for carboxylation of glutamic acid residues in many proteins; blood coagulation; bone metabolism; prevention of vessel mineralisation; phagocytosis; cell adhesion and proliferation; protection against apoptosis

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24
Q

how are vitamin K levels assessed?

A

phylloquinone in serum, protein induced by vitamin K absence

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25
Q

what populations are at risk of vitamin K deficiency?

A

breast-fed infants, liver disease patients, people with fat malabsorption disorder

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26
Q

what can vitamin K deficiency lead to?

A

increased risk of haemorrhage

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27
Q

what does vitamin K toxicity cause?

A

liver damage, jaundice, haemolytic anaemia

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28
Q

what happens to water-soluble vitamins on entering the body?

A

dissolve in water

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29
Q

what happens to excess water-soluble vitamins?

A

can’t be stored, are excreted

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30
Q

what is the other name for vitamin B1?

A

thiamine

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31
Q

what is the active form of vitamin B1?

A

thiamine triphosphate

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32
Q

what is the function of thiamine?

A

co factor for multiple enzymes involved in metabolism of carbohydrate, branched chain amino acids and fatty acids

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33
Q

how are thiamine levels assessed?

A

TDP (diphosphate form) in whole blood or RBC, erythrocyte transkelotase activity coefficient (ETKAC)

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34
Q

what are high risk populations for thiamine deficiency?

A

patients with ETOH and/or malnutrition

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35
Q

what can thiamine deficiency cause?

A

beriberi (wet beriberi= heart failure, oedema, dyspnoea on exertion; dry beriberi= polyneuritis, symmetrical muscle wasting), can cause Wernicke encephalopathy (confusion, ophthalmoplegia, ataxia)

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36
Q

what does thiamine toxicity cause?

A

no toxic effects from oral overconsumption, anaphylactic responses with large IV doses

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37
Q

what is the other name for vitamin B3?

A

niacin

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38
Q

what is niacin/vitamin B3?

A

either NAD or NADP based on 1 group being H or PO3

39
Q

how is niacin synthesised in the body?

A

from tryptophan in the liver

40
Q

what are the functions of niacin?

A

redox reactions, substrate for enzymes in protein translation, immune function, DNA replication/repair, cell differentiation/apoptosis, cell signalling, genomic silencing (longevity)

41
Q

what can niacin be used to treat?

A

dyslipidaemia

42
Q

how are niacin levels assessed?

A

nicotinic acids and nicotinamide metabolites in urine, tissue and blood levels of NAD(H) or NADP(H), RBC [tryptophan and NAD/NADP]

43
Q

what populations are at risk of niacin deficiency?

A

alcoholics and those with malnutrition

44
Q

what does niacin deficiency lead to?

A

pellagra (diarrhoea, dermatitis, dementia)

45
Q

what can nicotinic acid toxicity lead to?

A

skin rashes, flushing, itching, increased LFT, transient hypotension, headache

46
Q

what is the function of folate?

A

needed for metabolism of nucleic acid precursors, several amino acids, methylation reactions

47
Q

what health conditions are associated with folate status?

A

cancer, CVD, psychiatric, neurodegenerative disorders

48
Q

how are folate levels assessed?

A

plasma folate, RBC folate, plasma homocysteine, macrocytic red cell, hypersegmented neutrophils, megaloblastic changes in bone marrow

49
Q

what can folate deficiency lead to?

A

fetal malformation, anaemia, diarrhoea, loss of appetites, weight loss, sore tongue, headaches, heart palpitations, irritability, behavioural disorders

50
Q

what are high risk populations for folate deficiency?

A

pregnant/lactating individuals, patients with alcoholism, malabsorption, liver disease, MTHFR polymorphisms, hemodialysis, chronic hemolytic anaemia

51
Q

what can folate toxicity cause?

A

insomnia, malaise, irritability, lower Zn status, GI distress

52
Q

what is the largest most complex vitamin?

A

vitamin B12

53
Q

what is the other name for vitamin B12?

A

cobalamin

54
Q

what are the richest dietary sources of cobalamin?

A

dairy products, meats, eggs, fish, shellfish

55
Q

what is the function of cobalamin?

A

folate metabolism, synthesis of succinyl-CoA, erythropoiesis, growth of nervous system

56
Q

what conditions is cobalamin thought to be involved in?

A

CVD, cancer, cognitive decline, depression

57
Q

how are cobalamin levels assessed?

A

total serum B12, plasma homocysteine, plasma/urinary methylmalonic acid, serum transcobalamin, macrocytic red cells, hypersegmented neutrophils

58
Q

what may cobalamin deficiency lead to?

A

megaloblastic anaemia, central/peripheral neuropathy, glossitis, increased risk of vascular disease, cancer, neural tube defects

59
Q

what are high risk populations for cobalamin deficiency?

A

individuals that exclude animal foods, food-bound vitamin B12 malabsorption, older adults

60
Q

what does intake of large amounts of cobalamin cause?

A

no adverse effects in healthy people

61
Q

what is vitamin B6?

A

pyridoxine

62
Q

what is the function of pyridoxine?

A

co-enzyme involved in function of more than 100 enzymes

63
Q

what conditions is pyridoxine involved in?

A

CVD, cancer, cognitive decline, depression, immune function

64
Q

what populations are at risk of pyridoxine deficiency?

A

alcoholics and those with malnutrition

65
Q

what can pyridoxine deficiency result in?

A

anaemia, hyperirritability, convulsions, peripheral neuropathy, mental confusion

66
Q

what can pyridoxine toxicity cause?

A

sensory neuropathy

67
Q

what is the other name for vitamin C?

A

ascorbic acid

68
Q

what is the function of vitamin C/ascorbic acid?

A

enhances Fe absorption, essential cofactor for reactions requiring a reduced metal ion, collagen production, wound healing, bone formation, enhancing the immune system, strengthening blood vessels

69
Q

how are ascorbic acid levels assessed?

A

plasma and leukocyte ascorbic acid levels

70
Q

what populations are at risk of ascorbic acid deficiency?

A

individuals with poor diets, alcoholics, drug users, elderly men

71
Q

what can ascorbic acid deficiency lead to?

A

scurvy

72
Q

what can ascorbic acid toxicity lead to?

A

nausea, diarrhoea

73
Q

what are the major minerals in the human body?

A

calcium, phosphorus, potassium, sodium, magnesium

74
Q

what are the trace minerals in the human body?

A

iron, chloride, zinc, manganese

75
Q

what are the ultra-trace minerals in the human body?

A

cobalt, iodine, selenium, molybdenum, chromium

76
Q

what % of total body Ca is structural (bones and teeth)?

A

more than 99%

77
Q

what is the functional calcium?

A

intracellular messenger and cofactor, activator/stabiliser of protein

78
Q

what is the function of calcium?

A

cell signalling, neural transmission, muscle function, membrane and cytoskeletal functions, enzymatic co-factor, blood coagulation, secretion, biomineralisation

79
Q

what does phytic acid do?

A

inhibits Ca absorption

80
Q

what do lactose and MCFAs do in infants for Ca absorption?

A

enhance it

81
Q

how are calcium levels assessed?

A

[Ca] in serum, dual x-ray absorptiometry to access bone mineral density and content

82
Q

what can Ca deficiency lead to?

A

osteoporosis, accelerated bone loss

83
Q

what are high risk populations for Ca deficiency?

A

individuals with chronic kidney failure, vitamin D deficiency, fat malabsorption, pregnancy, lactation

84
Q

what does hypercalcaemia cause?

A

lax muscle tone, constipation, large urine, volume, nausea, confusion, coma, death

85
Q

what are the primary oxidation states of iron in biology?

A

ferrous (+2), ferric (+3), ferryl (+4)

86
Q

what are the functions of iron?

A

oxygen transport and storage (haemoglobin and myoglobin), electron transport and energy metabolism, antioxidant and energy metabolism, antioxidant and beneficial pro-oxidant functions, DNA synthesis

87
Q

what is the function of hepcidin?

A

when body iron stores are sufficient to meet requirements hepcidin blocks dietary iron absorption, promotes cellular iron sequestration, reduces iron bioavailability

88
Q

what are inhibitors of non-haem iron absorption?

A

phytic acids, polyphenols, soy protein, coffee, calcium

89
Q

what are enhancers of non-haem iron absorption?

A

vitamin C, organic acids, meat, fish, poultry, ETOH

90
Q

what are high risk populations for iron deficiency?

A

preterm/low birth weight infants, infants/children 6mo-4y, adolescents, pregnant women, women of childbearing age, people with renal failure, GI disorders affecting FE absorption

91
Q

what is the single larges cause of poisoning fatalities in children under 6 years?

A

iron overdose

92
Q

what can long term iron toxicity cause (if not immediately lethal)?

A

damage to the CNS, liver, stomach

93
Q

what is hemochromatosis?

A

Fe accumulates in various tissues, typically leading to liver damage, diabetes mellitus, skin discolouration

MIMS (15 decks)

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