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Biochem First aid > Nutriton > Flashcards

Nutriton Flashcards

0
Q

Which vitamins are fat soluble?

A

A, D, E, K

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1
Q

Which vitamins are more likely to cause toxicity and why?

A

Fat soluble because they distribute into tissue

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2
Q

Who is at risk for fat soluble vitamin deficiencies?

A

Patients with CF, celiac sprue, or who take mineral oil

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3
Q

What is vitamin A?

A

An antioxidant used for normal differentiation of epithelial cells to specialized tissue cells
Prevents squamous metaplasia

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4
Q

What is vitamin A used to treat?

A

AML M3

Measles

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5
Q

What are the signs of deficiency of vitamin A?

A

Night blindness

Dry skin

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6
Q

What are the signs of vitamin A toxicity?

A 
Arthalgia
Fatigue
Headache
Skin changes
Sore throat
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7
Q

What is required before prescribing isoretinoin for acne and why?

A

A negative pregnancy test and a reliable contraception because vitamin a is teratogenic

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8
Q

What foods contain vitamin A?

A

Liver and leafy vegetables

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9
Q

What is vitamin B1?

A

Thiamine pyrophosphate = TPP

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10
Q

What is the function of vitamin B1?

A

Participates in de carboxylation reactions
Alpha-ketoglutarate dehydrogenase
Transketolase
Pyruvate dehydrogenase
All of the above enzymes are required for ATP synthesis

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11
Q

What happens in the deficiency of vit B1?

A

There is impaired glucose breakdown –> can’t make ATP –> depletion

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12
Q

Which organs are affected first by B1 deficiency?

A

Brain and heart ( highly aerobic)

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13
Q

What makes the B1 deficiency worse?

A

Infusion of glucose

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14
Q

What is wernicke’s syndrome?

A

Ataxia + ophthalmoplegia + confusion

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15
Q

What is Korsakoff’s syndrome?

A

Wernicke’s + confabulation, personality change, memory loss

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16
Q

Where is the lesion in wernicke’s-Korsakoff’s?

A

In the medial dorsal nucleus of the thalamus and the mammillary bodies

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17
Q

What is dry beriberi?

A

Polyneuritis

Symmetrical muscle wasting

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18
Q

What is wet beriberi?

A

High output cardiac failure

Edema

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19
Q

Who is at risk for thiamine deficiency?

A

Alcoholics

People who. Are malnourished

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20
Q

What is the function of vitamin B2?

A

It is a cofactors in oxidation and reduction reactions

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21
Q

What is vitamin B2?

A

Riboflavin = FAD and FMN

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22
Q

What are the signs of vitamin B2 deficiency?

A

Cheilosis (inflammation of lips, scaling and fissures at the corners of the mouth)
Corneal vascularization

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23
Q

What is vitamin B3?

A

Niacin = NAD

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24
Q

What does the synthesis of vit B3 require?

A

Vit B6

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25
Q

What is the function of vit B3?

A

Used in redox reactions

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26
Q

Which amino acid is vit B3 derived from?

A

Tryptophan

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27
Q

What are the signs of vit B3 deficiency?

A

Glossitis

Pellagra

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28
Q

What is pellagra?

A

Vit B3 deficiency : diarrhea, dementia, dermatitis, death

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29
Q

What can cause pellagra?

A

carcinoid syndrome = increased tryptophan metabolism
Hartnup disease = decreased tryptophan absorption
INH = vit B6 deficiency

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30
Q

What are the signs of excess niacin?

A

Facial flushing

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31
Q

What can niacin be used to treat?

A

Hyperlipidemia

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32
Q

What is vit B5?

A

Pantothenate

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33
Q

What is the function of vit B5?

A

It is a cofactors for acyl transfer (essential component of CoA)
Cofactors for fatty acid synthase

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34
Q

What are the signs of vit B5 deficiency?

A

Dermatitis
Enteritis
Alopecia
Adrenal insufficiency

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35
Q

What is vitamin B6?

A

Pyridoxine

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36
Q

What is the function of vit B6?

A

It is a cofactors for transamination decarboxylation reactions and glycogen phosphorylase.
Needed for the synthesis of cystathionine, heme, niacin, histamine, NTs (serotonin, epi, norepinephrine, GABA)

37
Q

What are the signs of vit B6 deficiency?

A

Convulsions
Irritability
Peripheral neuropathy
Sideroblastic anemia

38
Q

What can vit B6 deficiency be induced by?

A

INH

Oral contraceptives

39
Q

What is vit B7?

40
Q

What is the function of biotin?

A

Cofactor for carboxylation enzymes:
Pyruvate carboxylase
Acetyl-CoA carboxylase
Propionyl-CoA carboxylase

41
Q

What are the signs of biotin defiency?

A

Dermatitis
Alopecia
Enteritis

42
Q

What is biotin deficiency caused by?

A

Antibiotics

Ingestion of raw eggs

43
Q

Which vitamin deficiencies cause alopecia?

A

Vit A, B5, B7

44
Q

What is vit B9?

A

Folic acid

45
Q

What is the function of vit B9?

A

Converted to THF then coenzyme for 1 carbon transfer/methylation reactions
Important for synthesis of nitrogenous bases in DNA and RNA

46
Q

What food is vit B9 found in?

A

Leafy green vegetables

47
Q

How long do folate reserves last?

A

Couple of months

48
Q

What are the signs of float deficiency?

A

Macrocytic, megaloblastic anemia

49
Q

What are the causes of folate deficiency?

A 
Alcoholism
Pregnancy (increased need)
Phenytoin 
Sulfonamides 
MTX
50
Q

What is the most common vitamin deficiency in the US?

51
Q

What is B12?

52
Q

What is the function of vit B12?

A

Cofactors for homocysteine methyltransferase and methylmalonyl-CoA mutase

53
Q

What are the signs of B12 deficiency?

A 
Macrocytic, megaloblastic anemia
Peripheral neuropathy
Ataxia/falls
Spasticity
Dementia
Hyper segmented PMNs
54
Q

What are the levels of homocysteine and methylmalonic acid in B12 deficiency?

A

Both are high

55
Q

What foods have B12 in them?

A

Animal products

56
Q

What can cause B12 deficiency?

A 
Strict vegan diet
Sickle cell anemia (increased need)
Malabsorption (sprue, enteritis, Diphyllobothrium latum)
Pernicious anemia
Gastric bypass surgery
Chron's disease
Resection of the terminal ileum
57
Q

Where is folic acid absorbed in the gut?

58
Q

Where is B12 absorbed in the gut?

59
Q

What is SAM?

A

s-adenosyl methionine = ATP + methionine

60
Q

What is the function of SAM?

A

Transfers methyl units

61
Q

What is SAM required for?

A

The conversion of NE to epi

62
Q

What is the regeneration of methionine/SAM dependent on?

A

Folate and B12

63
Q

What is vit C?

A

Antioxidant that facilitates iron absorption by keeping in iron reduced state.
Necessary for hydroxylation of proline and lysine in collagen synthesis. And dopamine b-hydroxylase (converting dopamine to NE)
Ascorbic acid

64
Q

What does deficiency of vitamin C cause?

A

Scurvy - swollen gums, bruising, hemarthrosis, anemia, poor wound healing
Weakened immune response

65
Q

What are the signs of excess vitamin C?

A

N/v, diarrhea, fatigue, sleep problems

Predisposes to iron toxicity in people with hemochromatosis or transfusions

66
Q

What is vit D2 and D3?

A

D2- Ergocalciferol consumed from plants

D3 - cholecalciferol - from milk and sun

67
Q

What is the storage form of vit D?

68
Q

What is the active form of vitamin D?

A

1,25-(OH)2 = calcitriol

69
Q

What is the function of vit D?

A

Increases intestinal absorption of calcium and phosphate

Increases bone mineralization

70
Q

What does vit D deficiency cause?

A

Rickets - children, bone pain and deformity
Osteomalacia - adults, bone pain and muscle weakness
Hypocalcemic tetany

71
Q

What are the signs of excess vit D?

A

Hypercalcemia
Hypercalciuria
Loss of appetite
Stupor

72
Q

In what condition is excess vit D seen?

A

Sarcoidosis from increased activation of vit D by the macrophages

73
Q

What is vit E?

A

An antioxidant that protects RBCs from free radical damage

74
Q

What are the signs of vit E deficiency?

A

Increased fragility of erythrocytes (hemolytic anemia)
Muscle weakness
Posterior column and spinocerebellar tract demyelination (ataxia, falls, paresthesia)

75
Q

Who makes B12?

A

Microorganisms

76
Q

Where does vit K come from?

A

Synthesized by intestinal flora

77
Q

What is the function of vitamin K?

A

Catalyzes gamma carboxylation of glutamic acid residues on factor II, VII, IX, X, C, S

78
Q

What enzyme is necessary for the reduction of vitamin K?

A

Epoxied reductase

79
Q

What drug antagonizes vit K?

A

Warfarin blocks epoxied reductase

80
Q

What are the sx of vit K deficiency?

A

Neonatal hemorrhage with increased PT and PTT time, but normal bleeding time

81
Q

What are the causes of vit K deficiency?

A

New born
Malabsorption (CF, sprue)
Antibiotics

82
Q

What is the function of Zinc?

A

Important for function of enzymes and zinc fingers of the transcription factor motif for altering DNA expression

83
Q

What are the signs of zinc deficiency?

A 
Delayed wound healing
Hypogonadism 
Decreased adult hair
Dysgeusia(distortion of taste)
Anosmia
Increased risk for alcoholic cirrhosis
84
Q

What are the two enzymes involved in alcohol metabolism?

A

Alcohol dehydrogenase in the cytosol

Acetaldehyde dehydrogenase in the mitochondria

85
Q

What is the limiting agent in alcohol metabolism?

A

NAD - needed to convert ethanol to acetaldehyde and acetaldehyde to acetate

86
Q

What are the pharmacokinetics by which alcohol dehydrogenase works?

A

Operates via zero order kinetics

87
Q

Why do you get hypoglycemia and fatty acid synthesis after alcohol ingestion?

A

Because NAD is converted to NADH during the metabolism of alcohol. You have so much NADH that the liver starts using it to convert pyruvate to lactate and oxaloacetate to malate. This inhibits gluconeogenesis and stimulates fatty acid synthesis

88
Q

Why do you get acidosis after alcohol ingestion?

A

From overproduction of lactate

Ketone body production from depletion of oxaloacetate

89
Q

Why do you get increased FA synthesis after alcohol ingestion?

A

From increased NADPH from the breakdown of excess malate

Biochem First aid (3 decks)

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