Nutrition Module 8: Micronutrients Review Flashcards
1
Q
What are the 4 lipid soluble vitamins?
A
ADEK
2
Q
What is needed to digest lipid soluble vitamins?
A
Micelles
3
Q
Out of the 4 lipid soluble vitamins, which one is poorly stored in the body?
A
Vitamin K: only last a few days
4
Q
What can limit the absorption of lipid soluble vitamins?
A
Meal w/o fat
5
Q
Vitamin A: sources? 6
A
- Sweet potatoes
- Carrots
- Green leafy veggies
- Eggs
- cheese
- Milk
6
Q
Vitamin A: functions? 3
A
- Vision
- Immune function
- Growth
7
Q
Vitamin A: deficiency? Common for who? 7
A
- Visual impairment and other occular symptoms
- Loss of appetite
- Susceptibility to infections
- Chronic skin xerosis
- Follicular hyperkeratosis with no bleeding
- Bitot’s spots
- Night blindness
Extremely common in children in underdeveloped countries
8
Q
Vitamin A: toxicity? 4 + 1
A
RETINOL ONLY
- Liver and bone damage
- Vomiting
- Dry mucous membranes
- Headaches
+ Mutagenic potential of retinol during early pregnancy
9
Q
Vitamin D: sources? 3
A
- Fortified milk/formula
- Fish
- Eggs
*Produced in sun-exposed skin
10
Q
Vitamin D: functions? 4
A
- Growth regulation
- Immune function
- Calcium/Phosphorus absorption
- Bone health
11
Q
Vitamin D: deficiency? Common for who? 11
A
- Rickets,
- Osteomalacia (softening of the bones)
- Osteoporosis
- Lax muscles
- Risk of falls
- Diminished calcium absorption and retention
- Cancer
- Bowed legs
- Epiphyseal enlargement of the wrists
- Craniotabes
- Thorax deformities
12
Q
Vitamin D: toxicity? 2
A
- Brain damage in young infants
2. Calcification of arteries and other soft tissues
13
Q
Vitamin E: sources? 3
A
- Vegetable oils
- Nuts and seeds
- Margarine
14
Q
What is the natural form of Vitamin E? Bioavailability?
A
RRR-a-tocopherol: highly available
15
Q
What does synthetic Vitamin E contain? Which ones ate bioavailable?
A
Equal amounts of 8 stereoisomers; only half (the 2-S forms) are highly bioavailable
16
Q
Vitamin E: functions? 1
A
- Antioxidant in lipid-rich components
17
Q
Vitamin E: deficiency? 2
A
- Peripheral neuropathy
2. Hemolysis
18
Q
Vitamin E: toxicity? 2
A
- Bleeding
2. Hemorrhagic stroke
19
Q
Vitamin K: sources? 4
A
- Cooked greens
- Green vegetables
- Canola and soybean oil
- Intestinal bacteria
20
Q
Vitamin K: functions? 2
A
- Blood coagulation
2. Protein synthesis involved in mineralization (eg: involved in calcification inhibition)
21
Q
Vitamin K: deficiency? 2
A
- Prolonged bleeding time/episodes
2. Purpura
22
Q
Vitamin K: toxicity? 1
A
- Interferes with anticoagulant meds
23
Q
What are fortified foods?
A
Foods with added nutrients
24
Q
Are water soluble vitamins stored extensively?
A
NOPE except for B12
25
After how long can you tell you have a water soluble vitamin deficiency?
Few weeks
26
Vitamin C: sources? 2
1. Fruits
| 2. Veggies
27
Vitamin C: functions? 5
1. AA metabolism
2. Bone/Teeth formation
3. Collagen formation through proline and lysine hydroxylation
4. Antioxidant for cell membranes
5. Vitamin E regeneration
28
Vitamin C: deficiency? 11
SCURVY:
1. Poor wound healing
2. Bleeding of gums
3. Perifollicular petechiae (broken capillaries)
4. Cork-screw body hair
5. Fatigue
6. Pain
7. Death
8. Weakness, joint pain
9. Subperiosteal bleeding
10. Follicular hyperkeratosis with petechiae
11. Splinter hemorrhages (nail bed)
29
Vitamin C: toxicity? 3
1. Osmotic diarrhea
2. Gastrointestinal disease
3. Kidney stones (oxalate)
30
What are the 9 non-specific symptoms of folate deficiency?
1. Loss of appetite
2. Irritability*
3. Hostility
4. Diarrhea*
5. Paranoia
6. Forgetfulness
7. Depression*
8. Macrocytic anemia*
9. Increased homocysteine blood concentration
31
What is the risk of folate deficiency in adults?
Cancer and CVD
32
What do polyglutamate folate serve as? Which kind?
Coenzyme that accept or donate 1 C units in :
1. . Catabolism or interconversion of Met, His, Ser, and Gly (esp. homocysteine to cysteine)
2. Choline synthesis and degradation
3. Serotonin and epi synthesis
+ DNA SYNTHESIS
Fully reduced tetrahydrofolate
33
What are 8 good food sources of folate?
1. Fresh dark leafy veggies
2. Legumes
3. Cereal
4. Citrus fruits
5. Organ meats
6. Yeast
7. Fortified grains
8. Flour-based foods
34
Folate: toxicity? 2
1. Masks B12 deficiency
| 2. Risk of tumors when taking supplements
35
What are the 9 water soluble vitamins?
1. Vitamin C
2. Folate
3. Thiamin
4. Riboflavin (B2)
5. Niacin (B3)
6. Pyridoxine (B6)
7. Cobalamin (B12)
8. Pantothenate
9. Biotin
36
Thiamin: sources? 4
1. Pork
2. Meat substitutes
3. Green peas
4. Enriched grains
37
Thiamin: functions? 3
1. Cofactor for alphaketoglutarate dehydrogenase, pyruvate dehydrogenase, etc.
2. Neuron function
38
Thiamin: deficiency? 3
| 2 at risk peeps?
1. Dry Beri Beri
2. Wet Beri Beri
3. Muscle weakness
1. Alcoholics
2. Hyperemesis gravidarum (pregnancy complication)
39
What are the symptoms of Dry Beri Beri? 4
1. Neuropathy
2. Confusion
3. Confabulation
4. Demention
40
What are the symptoms of Wet Beri Beri? 2
1. Heart failure
| 2. Edema
41
Thiamin: toxicity? 1
None
42
Riboflavin: sources? 3
1. Milk
2. Eggs
3. Broccoli
43
Where is riboflavin absorbed?
Proximal small intestine
44
Which vitamin has a saturable transport uptake mechanism?
Riboflavin
45
How is riboflavin excreted?
Urine
46
Where is riboflavin stored? 3
1. Liver
2. Kidney
3. Muscle
47
Riboflavin: functions? 1
1. Catalyzes redox rxns
48
Riboflavin: deficiency? 9
1. Edema
2. Dermatitis
3. Angular stomatitis (inflammation of mouth mucosa)
4. Anemia
5. Niacin deficiency
6. B6 deficiency
7. Impairs folate function
8. Nasolabial seborrhea
9. Angular cheilosis and stomatitis
49
What can riboflavin deficiency result from? 3
1. Cancer
2. Diabetes
3. CVD
50
Riboflavin: toxicity? 1
None
51
Niacin: sources? 4
1. Fortified dry cereal
2. Beef
3. Eggs
4. Milk
52
Niacin: functions? 2
1. Fuel metabolism
| 2. Synthesis/removal of many compounds
53
What is pellagra? 6 symptoms
| Common in what peeps?
Deficiency of tryptophan and niacin:
1. Weight loss
2. Diarrhea
3. Dermatitis
4. Depression
5. Dementia
6. Death
7. Scarlet-colored tongue
8. Hyperpigmented skin
Alcoholics
54
Niacin: toxicity? 5
1. Flushing
2. GI things
3. Liver dysfunction
4. Glucose intolerance
5. Ocular effects
55
Pyridoxine: sources? 6
1. Meat
2. Poultry
3. Fish
4. Corn
5. Bananes
6. Potatoes (sweet and normal)
56
Pyridoxine: functions? 2
1. Transamination of AAs
| 2. Cofactor for many enzymes
57
Pyridoxine: deficiency? 8
1. Slow growth
2. Cerebral/Peripheral neuron damage
3. Confusion
4. Cheilosis (dry edges of mouth)
5. Depression
6. Microcytic anemia
7. Glossitis (tongue soreness)
8. Sideroblastic anemia, anisocytosis
58
Pyridoxine: toxicity? 1
1. Sensory neuropathy
59
Cobalamin: sources? 4
1. Meat
2. Poultry
3. Dairy
4. Eggs
Only foods of animal origin
60
Cobalamin: functions? 3
1. Cofactor for methionine synthase and L-methylmalonyl CoA
| 2. Conversion of homocysteine to methionine
61
Pantothenate: deficiency? 6
1. Fatigue
2. Depression
3. Anemia
4. Loss of hair color
5. Infertility
6. Impaired immune response
62
Cobalamin: deficiency? 4
SAME AS FOLATE +
1. Neuropathy
2. Depression
3. Confusion
4. Dementia
63
Cobalamin: toxicity? 1
None
64
Pantothenate: sources? 4
1. Sweet potatoes
2. Legumes
3. Yogurt
4. Chicken
65
What are the 3 precursors for the synthesis of CoA?
1. Pantothenate
2. Cysteine
3. ATP
66
Pantothenate: functions? 1
1. Acyl carrier protein in fatty acid synthase
67
What are the 6 functions of CoA?
1. Fuel metabolism
2. Protein modification
3. Synthesis of fatty acids
4. Phospholipids synthesis
5. Cholesterol synthesis
6. Steroid hormones
68
Pantothenate: toxicity? 1
None
69
Biotin: sources? 5
1. Intestinal flora
2. Cauliflower
3. Soybeans
4. Eggs
5. Mushrooms
70
Biotin: function? 1
Coenzyme for carboxylases
71
Biotinidase function? 1
Absorption and recycling of protein-bound biotin
72
In what people is biotin deficiency seen?
People with biotinidase defect
73
Biotin: toxicity? 1
None
74
Where is pyridoxine stored?
Muscles
75
Overall, what are water soluble vitamins used for?
Cofactors for fuel metabolism
76
Are mineral/trace elements stored extensively?
YES (weeks storage)
77
Where are mineral/trace elements stored?
1. Bone
| 2. Metalloproteins
78
What effects do trace elements cause in excess?
Severe toxic effects
79
Iron: sources? 2 types: which one is better absorbed?
1. 100% non-heme iron: fortified grains, legumes, broccoli
| 2. 40% heme iron: meat (BETTER ABSORBED)
80
Iron: functions? 8
1. O2 transport
2. Respiration
3. Antioxidant
4. Hormone synthesis
5. AA metabolism
6. Lipid metabolism
7. Vitamin A metabolism
8. Sulfite metabolism
81
Iron: deficiency? 6
1. Microcytic, hypochromic anemia
2. Cancerrisk
3. Growth/Brain development delay
4. Alter hair/nail texture
5. Impaired immune function
6. Angular cheilosis
82
Which 2 deficiencies can cause microcytic anemia?
1. Pyridoxine
| 2. Iron
83
What 5 deficiencies have increased cancer risk?
1. Vitamin D
2. Riboflavin
3. Folate
4. Iron
5. Zinc
84
What are the 4 inhibitors of iron absorption?
1. Phytates
2. Polyphenols
3. Oxalate
4. Competing nutrients: Ca2+. Zn2+, Mg2+
85
Iron: toxicity?
1. Skin discoloration
2. Cirrhosis
3. Hepatosplenomegaly
4. Cardiomyopathy
86
What compounds can enhance iron absorption? Eg?
What trace element shares some of the absorption mechanisms?
Organic acids (Vitamin C)
Iron
87
What is the leading cause of poisoning in kids?
Accidental iron overdose
88
Copper: sources? 4
1. Chicken
2. Chocolate
3. Beans
4. Instant cereal
89
Copper: functions? 5
1. Cofactor for cytochrome c
2. Cofactor for superoxide dismutase
3. Iron metabolism
4. Catecholamine formation
5. Cross-linking of collagen and elastin
90
Copper: deficiency? 5
1. Impaired brain function
2. Impaired vascular/bone integrity
3. Impaired metabolic control
4. Neutropenia
5. Sideroblastic anemia, anisocytosis
91
Copper: toxicity?
1. Liver damage
| 2. DNA damage
92
Zinc: sources? 4
1. Milk
2. Meat
3. Yogurt
4. Beans
93
Zinc: functions? 7
1. Constituents of 300+ enzymes: Cell growth and division, DNA replication, gene transcription, RNA synthesis, protein synthesis
2. Immune health
3. Wound healing
4. Increases folate absorption
5. Antioxidant
6. Modulates insulin activity
94
Zinc: deficiency? 13
1. Growth retardation via decreased appetitie
2. Delayed wound healing
3. Immune dysfunction
4. Skin lesions
5. General malnutrition
6. Anemia
7. Cognitive impairment
8. Delayed sexual maturation
9. Hypogonadism
10. Impaired taste
11. Decreased appetite
12. Cancer risk
13. White spots on nails = leukonychia
14. Night blindness
95
Zinc: toxicity? 4
1. Interfers with copper and iron absorption
2. GI irritation with vomiting
3. Anemia
4. CNS disturbance
96
Calcium: sources? 7
1. Dairy
2. Calcium-fortified juice
3. Cereal
4. Tofu
5. Chinese cabbage
6. Kale
7. Broccoli
97
What does maximum absorption of calcium by the small intestine depend on?
Adequate vitamin D
98
What 2 nutrients consumed in high amounts can greatly reduce calcium uptake by the small intestine?
1. Oxalate
| 2. Phosphate
99
Calcium: functions? 4
1. Intracellular hormone-like signaling
2. Neurotransmission
3. Regulation of cell growth and differentiation
4. Blood clotting
100
What groups of people are at risk for calcium deficiency? 2
1. Vegans
| 2. Those who do not eat dairy
101
What does fractional calcium absorption mean?
Calcium absorption efficiency
102
When does higher fractional calcium absorption occur? How does it evolve over time?
Infancy and gradually declines with age
103
Selenium: sources? 4
1. Seafood
2. Meat
3. Grains
4. Nuts
104
Selenium: functions?3
1. ROS protection (glutathione peroxidase cofactor)
2. TH action regulation
3. Regulation of redox status of Vitamin C
105
What disease is associated with selenium deficiency?
Keshan disease = cardiomyopathy in China
106
Does selenium deficiency cause any symptoms?
NOPE
107
What can selenium deficiency increase the risk of?
Certain cancers
108
Selenium: toxicity? 6
1. Hair/Nail brittleness and loss
2. GI disturbances
3. Skin rash
4. Fatigue
5. Irritability
6. NS abnormalities
109
Potassium: rich sources? 4
1. Fruits
2. Veggies
3. Fresh meats
4. Milk
110
Potassium: functions? 5
1. Body water distribution
2. Acid/Base balance
3. Membrane transport and polarization
4. Neuromuscular and cardiac function
5. Protects against high BP
111
Vitamin K: what can cause deficiency?
Diuretics and other medications can increase losses and oral antibiotics can kill digestive bacteria that produce it
112
What can cause excess potassium? What does this lead to?
Kidney problems = cardiac arrest
113
What can cause potassium and sodium deficiency?
Prolonged diarrhea or vomiting
114
Magnesium: sources? 5
1. Whole grains
2. Legumes
3. Nuts
4. Dark green veggies
5. Some fruit
115
Magnesium: functions? 2
1. Maintain normal BP
| 2. Needed for all reactions involving ATP
116
Magnesium: deficiency? 5
1. Increased BP
2. Increased insulin resistance
3. Accelerated atherosclerosis
4. Arrhythmia
5. Bone mineral loss
117
Magnesium: toxicity? 1
Osmotic diarrhea with 350mg or more of non-food magnesium
118
Sodium: sources? 5
1. Processed foods
2. Smoked foods
3. Pickled foods
4. Cured meets
5. Condiments
119
Sodium: functions? 4
1. Extracellular volume regulation
2. Osmotic fluid shifts
3. RMP
4. Co-transport across plasma membrane
120
Sodium: toxicity? 1
HT in salt-sensitive peeps
121
Chromium: sources? 7
1. Brewer's yeast
2. Whole grains
3. Wheat germ
4. Broccoli
5. Nuts
6. Cheese
7. Organ meats
122
Chromium: functions? 2
1. Binds to nuclear receptors to increase the number of initiation sites for RNS synthesis
2. Enhances insulin sensitivity
123
Chromium: deficiency? 2
1. Impaired carb utilization
| 2. Increased insulin resistance
124
Chromium: toxicity? What kind of chromium?
Chromium picolinate => ROS formation
125
What is a trace element for which deficiency has never been observed?
Arsenic
126
What are trace elements?
Metals needed in very small quantities
127
Which 3 trace elements cause the worse toxicity effects?
1. Iron
2. Copper
3. Selenium
128
Which 3 minerals are stored in bone?
1. Calcium
2. Mg
3. Phosphate
129
Which is more common: copper toxicity or deficiency?
Toxicity
130
What can increase the retention of calcium in bones?
Weight-bearing exercise
131
What does the selenium content of food depend on?
Selenium content of the soil
132
Phosphate: sources? 3
1. Protein-rich foods
2. Processed cheese
3. Soda
133
Which is more of an issue: phosphate deficiency or toxicity?
Toxicity
134
Phosphate: functions? 3
1. Energy metabolism and storage
2. Buffer
3. Anions in bones and teeth
135
For what group of people is phosphate deficiency more common?
Elderly
136
Phosphate: toxicity? 3
1. Reduces intestinal calcium absorption
2. Promotes calcium mobilization from bone
3. Increases renal calcium loss
137
Potassium: deficiency?
1. Muscle cramps
2. Heartbeat irregularity
3. Confusion
4. Loss of appetite
138
Which group of people are most vulnerable to magnesium deficiency?
Elderly
139
Which group of people are most vulnerable to chromium deficiency?
Elderly
140
What are the 6 minerals/trace elements stored as part of metalloproteins?
1. Iron
2. Copper
3. Zinc
4. Iodine
5. Selenium
6. Molybdenum
141
Choline: sources? 4
1. Milk
2. Eggs
3. Peanuts
4. Liver
142
Choline: functions? 5
1. Precursor for phospholipids
2. Precursor for NT ACh
3. Methyl donor via regeneration of homocysteine
4. Membrane signaling
5. Lipid/cholesterol transport/metabolism
143
Choline: deficiency? 2
1. Liver damage
| 2. Muscle damage
144
Choline: toxicity? 5
1. Hypotension
2. Sweating
3. Diarrhea
4. Fishy body odor
5. Promotion of tumor growth
145
Carotenoids: sources? 5
1. Leafy green vegetables
2. Cantaloupe
3. Tomatoes
4. Sweet potato
5. Carrots
146
Carotenoids: functions? 1
AO
147
Source of AO activity of carotenoids: from pro-vitamin A or no?
BOTH
148
Carotenoids: deficiency? 1
Vitamin A deficiency only when intake of pre-formed vitamin A is inadequate
149
Carotenoids: toxicity?
1. Palms turn orange
| 2. Supplements cause increased cancer risk in smokers
150
When is choline an essential nutrient?
Pregnancy and 1st year of life
151
What amount of protein will provide all essential AAs in enough amounts?
0.8 g/kg
152
What groups of people may require more proteins than normal? 3
1. Elderly
2. Athletes
3. Premature babies
153
Which AAs are important energy fuel for muscle?
Branched ones: valine, isoleucine and leucine
154
Pro-vitamin A carotenoids: 3 examples and 2 functions?
Eg: beta/alpha-carotene, cryptoxanthin
1. Vision (RETINAL)
2. Growth (RETINOL/RETINOIC ACID)
155
3 examples of non-provitamin A carotenoids?
1. Lycopene
2. Lutein
3. Zeaxanthin
156
What are the 3 potential nutritional deficiency when pallor is noticed?
1. Iron
2. Folate
3. Vitamin B12
157
What is the potential nutritional deficiency when ascites is noticed?
Protein
158
What are the 2 potential nutritional deficiencies when peripheral subcutaneous tissue edema is noticed?
1. Protein
| 2. Thiamin
159
What is the potential nutritional deficiency when myxedema is noticed?
Iodine
160
What is myxedema?
Puffy eyes, non-pitting edema
161
What are the 2 potential nutritional deficiencies when goiter is noticed?
1. Iodine
| 2. Selenium
162
What are the 5 potential nutritional deficiency when impaired wound healing or pressure ulcer is noticed?
1. Energy
2. Protein
3. Vitamin C
4. Vitamin A
5. Trace elements
163
in a child presenting with failure to thrive, you should assess for which dietary components?
1. Energy
2. Protein
3. Vitamins
4. Trace elements
164
Niacin: deficiency? 2
1. Local hyperpigmentation w/o UV exposure
| 2. Icthyosis
165
What 4 nutrient deficiencies can cause koilonychia = spoon nails?
1. Iron
2. Zinc
3. Copper
4. Protein
166
What nutritional deficiencies cause banded hair-color variation?
Protein/energy
167
What 7 nutritional deficiencies be caused by glossitis = beeffy red tongue?
1. Energy
2. Protein
3. Riboflavin
4. Iron
5. Vitamin B12
6. Folate
7. Niacin
168
What deficiency causes magenta tongue?
Riboflavin
169
What deficiency causes scarlet, raw tongue?
Niacin
170
What deficiency causes swollen tongue with submucosal bleeding?
Vitamin C
171
What deficiency causes pale, spongy, receding, bleeding gums?
Vitamin C
172
What is pernicious anemia? What is it due to?
VB12 deficiency due to autoimmune attack on intrinsic factor or life-long lack of minimal intakes
173
What is Beriberi due to? Symptoms?
Thiamin deficiency
Symptoms: cardiac or neural pathologies
174
What does beriberi with edema point to?
Cardiac = wet Beriberi
175
What are the 6 symptoms of Wernicke-Korsakoff syndrome?
1. Polyneuropathy
2. Oculomotor palsy
3. Paresis
4. Ataxia
5. Confusion with confabulation
6. Disorientation
176
What is xerophtalmia due to? 3 symptoms?
```
Vitamin A deficiency
Symptoms:
1. Bidot's spots
2. Corneal ulcers
3. Keratomalacia
```
177
Deficiency of which 2 nutrients can cause angular cheilosis?
1. Riboflavin
| 2. Iron
178
What is the alarm threshold for folate deficiency?
Fewer than 3 servings of folate rich foods
179
What is the alarm threshold for Vitamin B6 deficiency?
Fewer than 3 servings of VB6 rich foods
180
What is the alarm threshold for Vitamin B12 deficiency?
Fewer than 1 serving of VB12 rich foods
181
What is the alarm threshold for Vitamin E deficiency?
People who avoid oils, fats, nuts, and seeds
182
What is the alarm threshold for Vitamin C deficiency?
Fewer than 1 serving of VC rich foods
183
What is the alarm threshold for Carotenoids deficiency?
Fewer than 1 serving of carotenoids rich foods
184
What is the alarm threshold for calcium deficiency?
Fewer than 2 servings of calcium rich foods
185
Which 3 nutrients should also be evaluated together?
1. Calcium
2. Vitamin D
3. Phosphate
186
What is the alarm threshold for Vitamin D deficiency?
Fewer than 2 servings of VD rich foods and less than 15 min in sun
187
What is the alarm threshold for phosphate excess intake?
MORE than 5 servings of phosphate rich foods
188
What is the alarm threshold for thiamin deficiency?
Avoids pork, tuna, meat substitutes and gets fewer than 3 servings of grains
189
What is the alarm threshold for riboflavin deficiency?
Fewer than 3 servings of thiamin rich foods
190
What is the alarm threshold for excess protein?
More than 1 oz per 10 lbs
191
What nutrient can only be absorbed along with fat?
Vitamin D
192
What is Kwashiorkor?
Sufficient calories but insufficient proteins leading to:
1. Abdominal edema due to low serum album causing a decrease in oncotic pressure
2. Slowed growth because reduced GH and TH
3. Recurrent infections due to lack of immunoglobulins and other immune cells (often diarrhea)
4. Apathy and weakness due
5. Pale nail beds
6. Reddish easily plucked hair
7. Low hematocrit
8. Low K+ due to high aldosterone and diarrhea
193
Why would providing food to a child with Kwashiorkor cause diarrhea?
Because the bolus of chyme triggers GI tract contractions worsening the diarrhea
194
What is Marasmus?
Insufficient calories AND proteins = muscle wasting and emaciation
