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Nutrition Flashcards

1
Q

Fat soluble vitamins

A

A, D, E, K

  • Absorption - depends on gut/pancreas
  • Malabsorption syndrome (steatorrhea) = CF/sprue
  • More toxicity than water soluble, cause accumulate in fat
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2
Q

Water soluble vitamins

A

All B vitamins and C

  • B1 = thiamine
  • B2 = riboflavin
  • B3 = niacin
  • B5 = pantothenic acid
  • B6 = pyridoxine
  • B7 = biotin
  • B9 = folate
  • B12 = cobalamin
  • C = asorbic acid

“Tina Really Never Pooped Pink Before Fred Cut Ass”

B9/12 stored in liver; others wash out quickly; B-defic = glossitis, dermatitis, diarrhea

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3
Q

Vit A

A

Retinol - antioxidant, makes up retinal (visual pigment)

  • Need for differentiation of epithelial cells, prevents squamous metaplasia
  • Tx: measles, AML-M3
  • Found in leafy veggies + liver
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4
Q

VitA deficiency

A

Night blindness, dry/scaly skin, alopecia, corneal degeneration (keratomalacia), immune suppression

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5
Q

VitA excess

A
  • Arthralgia, skin changes (scaly), alopecia, cerebral edema, pseudotumor cerebri, osteoporosis, hepatic abn [chronic]
  • nausea/vom, vertigo, blurred vision [acute]
  • Teratogenic - dont get pregn w/ isotretinoin for acne
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6
Q

Vit B1

A

Thiamine - in thiamine pyrophosphate (TTP) = cofactor for dehydrogenase enzyme rxns

“ATP: a-ketoglutarate dehydrogenase, transketolase, pyruvate dehydrogenase”

  • TCA cycle: pyruvate dehydrogenase, a-ketoglutarate dehydrogenase
  • HMP shunt: transketolase
  • Branched-chain ketoacid dehydrogenase
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7
Q

Vit B1 deficiency

A

Impaired glucose breakdown –> ATP depletion worse w/ glucose infusion
- Affects aerobic tissues first (brain/heart)
- Deficiency w/ malnutrition/malabsorptio
*Wernicke-Korsakoff and beriberi syndrome
[Ber1Ber1 = Vit1 defic]

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8
Q

Wernicke-Korsakoff syndrome

A

Triad = confusion, opthalmoplegia, ataxia; confabulation, personality change, memory loss
- Damage to medial dorsal nucleus of thalamus + mammillary bodies

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9
Q

Dry beriberi

A

Polyneuritis, symmetric muscle wasting

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10
Q

Wet beriberi

A

High-output cardiac failure (dilated cardiomyopathy), edema

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11
Q

VitB2

A

Riboflavin
- FAD/FMN derived from riboflavin; used as cofactor in redox reactions (i.e. succinate dehydrogenase in TCA cycle)

“B2 = 2ATP”

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12
Q

VitB2 deficiency

A

Cheilosis (inflamm of lips, scaling/fissures of mouth), corneal vascularization

2 C’s of B2

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13
Q

VitB3

A

Niacin - part of NAD+

  • Comes from tryptophan
  • Need B2/B6 to synthesize B3 from tryptophan
  • Lowers VLDL, raises HDL*

NAD derived from Niacin (B3 = 3ATP)

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14
Q

Vit B3 deficiency

A

Glossitis
- Severe defic = pellegra
Causes: Hartnup (decr tryptophan absorp), malignant carcinoid syndr (incr tryptophan metabolism), isoniazid (B6 defic)

Pellegra sx (3Ds of B3): Diarrhea, Dementia, Dermatitis (causal necklace)

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15
Q

Vit B3 excess

A

Flushing (prostaglandin, not histamine), hyperglycemia, hyperuricemia

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16
Q

Vit B5

A

Panthothenate - component of enzyme CoA + fatty acid synthase

B5 = “pento”thenate

17
Q

VitB5 deficiency

A

Dermatitis, enteritis, alopecia, adrenal insufficiency

18
Q

Vit B6

A

Pyridoxine - converted to pyridoxal phosphate

  • Used as cofactor in transamination (AST/ALT), decarboxylation rxn, glycogen phosphorylase
  • *Needed to make heme, niacin, histamine, and NTs (5HT, DA, NE, Epi, GABA)
19
Q

VitB6 Deficiency

A

Convulsions, hyperirritability, periph neuropathy (OCPs/isoniazid induced), sideroblastic anemia from impaire heme synthesis/excess iron

20
Q

Vit B7

A

Biotin - cofactor for carboxylation enzymes (x carboxylase) –> which add 1-C group

  • Pyruvate carboxylase (pyruvate –> oxaloacetate)
  • Acetyl-CoA carboxylase (Acetyl-CoA –> malonyl-CoA)
  • Propionyl-CoA carboxylase (propionyl-CoA –> methylmalonyl-CoA)

Cofactor = avidin (lots in egg-whites, binds biotin)

21
Q

Vit B7 deficiency

A

Rare

  • Dermatitis, alopecia, enteritis
  • Antibiotic use or excessive raw egg white consumption
22
Q

Vit B9

A

Folic acid - converted to tetrahydrofolate (THF) = coenzyme for 1-C transfer/methylation rxns

  • Needed to make nitrogenase bases in DNA/RNA
  • Found in leafy veggies (Folate in Foliage)
  • Absorbed in jejunum
  • Liver has reserve
23
Q

Vit B9 deficiency

A

Macrocytic, megaloblastic anemia; Hypersegmented PMNs, glossitis
**No neuro deficits (unlike B12)
- Incr homocysteine, nl MMA
(Homocysteine –> methionine; not in methylmalonic CoA –> succinyl CoA)

Drug induced: phenytoin, sulfonamides, methotrexate (attacks folate)

  • Most common defic in US
  • Common in alcoholism + pregnancy
  • Give folate early pregn to prevent neural tube defects
24
Q

Vit B12

A

Cobalamin - cofactor for homocysteine methyltransferase (transfers CH3 groups) and methylmalonyl-CoA mutase

  • In animal products
  • Synthesized by microorganisms; large store in liver
25
Vit B12 Deficiency
Caused by: low intake, malabsorption, lack intrinsic factor, or lack of terminal ileum (Crohn's) - Macrocytic, megaloblastic anemia; hypersegmented PMNs * *Paresthesias + degeneration from abn myelin (unlike folate) --> if prolonged, irrever nerve damage - Incr homocysteine, incr MMA (homocystine --> methionine; methylmalonic CoA --> succinylCoA)
26
Vit C
Ascorbic Acid = anti-oxidant - Facilitates iron absorption ("absorbic acid"), reduces to Fe2+ - Need for hydroxylation of proline/lysine in collagen synthesis, and to convert DA --> NE In fruits/veggies, can treat methylmoglobinemia (too much Fe3; reduce Fe3 to Fe2)
27
Vit C deficiency
Scurvy! - Swollen gums, bruising, hemarthrosis, anemia, poor healing, perifollicular/subperiosteal hemorrhages, "corkscrew" hair - Weak immune response *vit C deficiency causes sCurvy from Collagen synthesis defect
28
Vit C excess
Nausea, vomiting, diarrhea, fatigue, calcium oxalate nephrolithiasis - Higher risk of iron toxicity in those predisposed (transfusions, hereditary hemochromatosis)
29
Vit E
Tocopherol/tocotrienol - Antioxidant - protects erythrocytes/membranes from free radical damage - Can enhance anticoag of warfarin "E for Erythrocytes"
30
Vit E deficiency
Hemolytic anemia, acanthocytosis, muscle weakness, posterior column/SCT demyelination (bc not protecting from free radical damage) *Neuro presentation like B12 defic; no megaloblastic anemia, hypersegmented PMNs or high MMA
31
Vit K
Cofactor for gamma-caroxylation of glutamic acid residues on proteins for blood clotting - Made by intestinal flora "K is for Koagulation" - **Clotting factors: II, VII, IX, X + Protein C/S <-- all need K - Warfarin = VitK antagonist
32
Vit K deficiency
- Neonatal hemorrhage w/ high PT/aPTT, but normal bleeding time t make VitK * Not in breast milk - give VitK injection after birth - Can also get after long abx use
33
Zinc
Needed for >100 enzyme activities | - Need to make zinc fingers (TF motif)
34
Zinc deficiency
Delayed wound healing, hypogonadism, decr hair, dysgeusia, anosmia, acrodermatitis enteropathica * Erythematous skin lesions around body orifices, vesicular/pustular w/o central clearing - Predispose to alcoholic cirrhosis
35
Ethanol metabolism reaction
ETHANOL --> alcohol dehydrogenase --> ADETALDEHYDE --> acetaldehyde dehydrogenase --> ACETATE *Uses NAD+ --> NADH
36
Ethanol and liver
* *Incr NADH/NAD+ ratio in liver: - Lactic acidosis, fasting hypoglycemia (prevents gluconeogenesis), hepatosteatosis (glycerol-3phos combines with FA --> TG) Incr NADH/NAD+ also disfavors TCA production of NADH, get incr acetyl-CoA for ketogenesis and lipogenesis (ketoacidosis and hepatosteatosis) * Fomepizole = inhibits alc dehydrogenase; antidote for methanol/ethylene glycol poisoning * Disulfiram = antibuse - inhibits acetylaldehyde dehydrogenase (more acetylaldehyde, worse hangover
37
Kwashiorkor
Protein malnutrition "MEAL = malnutrition, edema, anemia, liver (fatty)" - Skin lesions, edema, liver malfxn (fatty change bc decr apolipoprotein synthesis) - Small kid w/ swollen belly
38
Marasmus
Total calorie malnutrition --> tissue/muscle wasting, loss of subQ fat, variable edema "Marasmus = Muscle wasting"
39
Vit E excess
Adults: increased hemorrhagic stroke Infants: incr NEC

Biochemistry (6 decks)

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