nutrition

Question 1

B vitamins?

Answer 1

Tigers Raid Nightly. Please Put Back Food Completely!

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

Question 2

which B vitamins are stored in the liver?

Answer 2

folate (B9)

B12

Question 3

vit A function?

Answer 3

visual pigment
epithelial cell differentiation –> specialized tissue
prevents squamous metaplasia

** tx: measles, AML-M3

Question 4

night blindness, dry scaly skin, corneal degeneration, Bitot spots on conjunctiva, immunosuppression?

Answer 4

vit A deficiency

Question 5

N/V/vertigo, blurred vision?

alopecia, dry skin, hepatic toxicity, pseudotumor?

Answer 5

vit A toxicity

** also a teratogen - cleft palate, cardiac; no isotretinoin for preggos!

Question 6

thiamine function?

Answer 6

in TPP: pyruvate DH, a-KG dH, transketolase, branched-chain ketoacid DH

Question 7

polyneuritis, symmetrical mm wasting?

Answer 7

dry beriberi (thiamine deficiency)

Question 8

high-output cardiac failure, edema?

Answer 8

wet beriberi (thiamine deficiency)

Question 9

how to dx thiamine deficiency?

Answer 9

administer B1, then measure RBC transketolase activity - if increases, B1 deficient

Question 10

riboflavin function?

Answer 10

component of FAD and FMN - used in redox reactions

** succ DH in TCA

Question 11

cheilosis and corneal vascularization?

Answer 11

riboflavin deficiency

Question 12

niacin synthesis?

Answer 12

derived from tryptophan

needs B2 and B6 for synthesis

Question 13

niacin function?

Answer 13

component of NAD and NADPH - redox reactions

** tx of dyslipidemia: increases HDL and lowers VLDL

Question 14

glossitis, diarrhea, dementia, dermatitis?

Answer 14

niacin deficiency!

** causes: Hartnup (decreased trp absorption), malignant carcinoid (increased trp metabolism), INH (decreased B6)

Question 15

facial flushing, hyperglycemia, hyperuricemia?

Answer 15

niacin excess

** prevent facial flushing with aspirin (caused by prostaglandin)

Question 16

pantothenic acid function?

Answer 16

component of CoA and FA synthase

Question 17

dermatitis, enteritis, alopecia, adrenal insufficiency?

Answer 17

pantothenic acid deficiency

Question 18

pyridoxine function?

Answer 18

converted to PLP - transamination, decarboxylation, glycogen phosphorylase
synthesis of neurotransmitters, heme, niacin, cystathionine, histamine

Question 19

convulsions, hyperirritability, peripheral neuropathy, sideroblastic anemia?

Answer 19

pyridoxine deficiency

Question 20

biotin function?

Answer 20

cofactor for carboxylation: pyr carboxylase, AcCoA carboxylase, propCoA carboxylase

Question 21

dermatitis, alopecia, enteritis caused by ABx or raw egg whites?

Answer 21

biotin deficiency (RARE)

Question 22

folate function?

Answer 22

converted to THF - 1-carbon transfer and methylation
synthesis of DNA/RNA bases
absorbed in jejunum
small reserve in liver

Question 23

macrocytic megaloblastic anemia, hypersegmented PMNs, glossitis, increased homocysteine with normal MMA?

Answer 23

folate deficiency

caused by phenytoin, sulfonamides, MTX

Question 24

cobalamin function?

Answer 24

cofactor for homocystein methyltransferase and methylmalonyl-CoA mutase
synthesized only by microorganisms
LARGE pool in liver

Question 25

macrocytic megaloblastic anemia, hypersegmented PMNs, glossitis, paresthesias/subacute combined degeneration, increased homocysteine and MMA?

Answer 25

cobalamin deficiency

** causes: veganism, malabsorption (sprue, tapeworm), lack of IF, absence of TI (Crohn’s)

Question 26

function of vit C?

Answer 26

facilitates iron absorption
needed to hydroxylate pro and lys in collagen synth
needed to convert dopa –> NE

Question 27

corkscrew hair, swollen/bleeding gums, hemarthrosis, perifollicular and subperiosteal hemorrhage?

Answer 27

scurvy = vit C deficiency

Question 28

N/V/D, fatigue, ca oxalate nephrolithiasis?

Answer 28

vit C toxicity

** can increase risk of iron toxicity in hemochromatosis, transfusions, etc

Question 29

vit D function?

Answer 29

increase intestinal absorption of Ca and P

increase bone mineralization

Question 30

bone pain and deformity/weakness, tetany?

Answer 30

Rickets/osteomalacia = vit D deficiency

exacerbated by low sun, pigmented skin, prematurity

Question 31

hypercalcemia, hypercalciuria, loss of appetite, stupor?

Answer 31

vit D toxicity

** seen in granulomatous dz: macrophages activate vit D

Question 32

vitamin E function?

Answer 32

antioxidant

can enhance warfarin anticoag

Question 33

hemolytic anemia, acanthocytosis, mm weakness, posterior column and spinocerebellar tract demyelination?

Answer 33

vitamin E deficiency

neurologic sx similar to B12

Question 34

vit K function?

Answer 34

cofactor for gamma-carboxylation of glutamate on clotting factors II, VII, IX, X, prot C, S

** synthesized by intestinal flora

Question 35

neonatal hemorrhage, increased PT and PTT with normal bleed time?

Answer 35

vit K deficiency

give injection at birth

Question 36

zinc function?

Answer 36

zinc fingers!

many enzymes

Question 37

delayed wound healing, hypogonadism, decreased adult hair, dysgeusia, anosmia, acrodermatitis enteropathica?

Answer 37

zinc deficiency

** may predispose to alcoholic cirrhosis

Question 38

skin lesions, edema, protruding belly?

Answer 38

Kwashiorkor

protein deficient diet –> decreased plasma oncotic pressure and liver malfunction (decrease apo synthesis)

Question 39

marasmus?

Answer 39

total calorie malnutrition –> tissue and mm wasting, loss of subQ fat