nutrition Flashcards
vit K fnx
cofactor for y-carboxylation of glutamic acid residues on factors II, VII, IX, X, proteins C and S
synthesized by gut flora
vit K deficiency
neonatal hemorrhage w/increased PT and aPTT, normal BT
not in breast milk given to neonates
zinc fnx
mineral essential for activity of 100+ enzymes
zinc deficiency
delayed wound healing hypogonadism decreased adult hair dysgeusia anosmia acrodermatitis enteropathica
vit A fnx
antioxidant retinal normal differentiation of epi -> specialized tissue prevents squamous metaplasia Tx measles and AML subtype M3
vit A deficiency
night blindness (nyctalopia) dry, scaley skin corneal degeneration bitot spots immunosuppression
acute vit A toxicity
nausea
vomiting
vertigo
blurred vision
chronic vit A toxicity
alopecia dry skin hepatic toxicity and enlargemnt arthralgia psudotumor cerebri
vit A teratogen
cleft palate and cardiac abnormalities
cannot Tx acne w/isotretinoin w/o neg prego test
Vit B1 fnx
thiamine thiamine pyrophosphate (TPP)-cofactor fo dehydrogenase enzyme rxns in TCA cycle and HMP shunt
Vit B1 is a cofactor for what enzymes
ATP
alpha-ketoglutarate dehydrogenase
Transketolase
pyruvate dehydrogenase
vit B1 deficiency
impaired glucose meta -> ATP depletion worsened by glucose infusion
Wernicke-Korsakoff
Ber1Ber1
increased RBC transketolase actictiy after B1 administration
Dry Ber1Ber1
polyneuritis
symmetrical mm wasting
wet Ber1Ber1
high-output cardiac failure (dilated cardiomyopathy)
edema
vit B2 fnx
riboflavin
component of flavins FAD and FMN used in redox rxns
vit B2 deficiency
riboflavin
2 C’s of B2
Cheilosis (inflammation of lips, scaling and fissures)
Corneal vascularization
vit B3 fnx
niacin
NAD and NADP used in redox rxns
used to TX dyslipedmia
vit B3 deficiency
niacin glossitits pellagra: 3 D's of B3 diarrhea dementia (and hallucinations) dermatitis (C3/4 dermatome - broad collar rash and hyperpigmentation of sun-exposed areas) can be d/t hartnup disease
excess vit B3
niacin facial flushing d/t prostaglandins, not histamine coadmin aspirn hyperglycemia hyperuricemia
vit B5 fnx
pantothenic acid
essential component of CoA and fatty synthase
vit B5 deficiency
pentothenic acid dermatitis enteritis alopecia adrenal insufficency
vit B6 fnx
pyroxidine converted to pyrdioxal phospate (PLP)- cofactor for transamination, decarboxylation, glycogen phosphorylase needed for synthesis of: -cystathionine -heme -niacin -histamine -NTs
vit B6 deficeincy
pyroxidine convulsions hyperirritability peripheral neuropathy sideroblastic anemias can be d/t isonizid and OCPs
vit B7 fnx
biotin
cofactor for carboxylation enzymes
vit B7 deficiency
biotin rare dermatitis alopecia enteritis can be d/t abx or excessive ingestion of raw egg whites
vitB9 fnx
folate
converted to THF needed for pyrimadine synthesis
small reserve in liver
vitB9deficiency
folate macrolytic, megaloblastic anemia hypersegmented neutros glosstits no neuro symptoms usually in alcoholics and prego supplement in prego to prevent neural tube defects
vitB9 deficiency labs
increased homocysteine
normal methylmalonic acid levels
increased MCV
drugs that cause vit B9 deficiency
phenytoin
sulfonamides
methotrexate
vit 12 fnx
cobalamin
cofactor for homocysteine methyltransferase
synthesized by microorganisms so only in animal products
vit B12 deficiency
cobalamin
macrocytic, megaloblastic anemia
hypersegmented neutros
neuro symptoms
neuro path of vit B12 deficiency
cobalamin
abnormal myelin -> degeneration of DCMS, LCST, spinocerebellar tracts
vit B12 deficiency labs
cobalamin
increased homocysteine AND methylmalonic acid
increased MCV
causes vit B12 deficiency
cobalamin veganism malabsorption (sprue, enteriits, diphyllobothrium latum) lack of IF (pernicious anemia) absence of terminal ileum (Chrons)
vit C fnx
ascorbic acid antioxidant Fe absorption (reduces to Fe2+) hyroxylation of proline and lysine in collagen dopamine -> NE
vit C deficiency
ascorbic acid
scurvy
swollen gums, bruising, petechiae, hemarthrosis, anemia, poor wound healing
perifollicular and subperiosteal hemorrhages
corkscrew hari
weakened immune response
excess vit C
ascorbic acid
nausea, vomiting, diarrhea, fatigue, Ca oxalate nephrolithiasis
increased Fe toxicity in predisposed (transfusion, hemochromatosis)
vit D types
D2 ergocalciferol (from plants)
D3 cholecalciferol (milk and sun exposure)
25-OH D3 (storage form)
1,25 (OH)2 D3/calcitriol (active form)
vit D fnxs
increased GI absorption of Ca and phosphate
increase bone mineralization
vit D deficiency
rickets in kids, osteomalacia in adults
hypocalcemic tetany
breast fed infants need supplementation
vit D excess
hypercalcemia, hypercalciuria
loss of appetite
stupor
seen in granulomatous diseases d/t increased activation of vitD by epithelioid macros
vit E fnx
tocopherol/tocotrienol
antioxidant (protects RBCs and membranes)
can enhance anticoagulant effects of warfarin
vit E deficiency
hemolytic anemia
acanthrocytosis
mm weakness
posterior column and spinocerebellar tract demylination
vit E vs vit B12 deficiency
presents w/similar neuro symptoms
but vitE deficiency does NOT have megaloblastic anemia, hypersegmented neutrophils, or increased serum methylmalonic acid levels
kwashikors
protein malnutrition skin lesions edema fatty liver MEAL: malnutrition edema anemia liver fatty
marsamus
total calorie malnutrition
tissue and mm wasting
loss of subQ fat and variable edema
ethanol meta
zero order kinetics NAD limiting reagent d/t increased NADH/NAD ratio: -lactic acidosis -fasting hypoglycemia -hepatosteatosis -ketoacidosis -lipogenesis
fomepizole
inhibits alcohol dehydrogenase and antidote for methanol or ethylene glycol poisoing
disulfuram
inhibits acetaldehyde dehyrdogenase -> very sick
