PANCE review: Vitamin deficiencies

Question 1

Vitamin A

Answer 1

Worsening vision in dim or dark environments. Night blindness, conjunctival dryness with white patches (Bitot spots), diffuse dry itchy peeling skin.

Question 2

What Vitamin is Thiamine

Answer 2

Vitamin B1

Question 3

Vitamin B1

Answer 3

ALCOHOLICS! Marked by beriberi (altered proprioception, mental confusion, nystagmus, hyporeflexia). Ocular disturbances, confusion, and ataxia (unsteady gait). Also Amnesia, impairment of memory w/o dysfunction of intellectual abilities.

Question 4

B1 deficiency Wernicke

Answer 4

Ocular disturbances, confusion, and ataxia (unsteady gait).

Question 5

B1 deficiency Korsakoff

Answer 5

Amnesia, impairment of memory w/o dysfunction of intellectual abilities.

Question 6

B1 (Thiamine)

Answer 6

Wernicke-Korsakoff syndrome (WKS). Wernicke’s=ocular disturbances, confusion, and ataxia (unsteady gait). Korsakoff=amnesia, impairment of memory w/o dysfunction of intellectual abilities. ALCOHOLICS!, malnourished, and immunocompromised. Marked by beriberi (altered proprioception, mental confusion, nystagmus, hyporeflexia). Other findings include tachycardia, leg edema, pain in upper and lower extremities.

Question 7

What vitamin is Riboflavin?

Answer 7

Vitamin B2

Question 8

B2 (riboflavin)

Answer 8

Rash, cracked red skin in the corner of the mouth, a painful smooth purplish tongue and light sensitivity.

Question 9

What vitamin is Niacin?

Answer 9

Vitamin B3

Question 10

B3 (Niacin)

Answer 10

PELLAGRA! (photosensitive dermatitis, diarrhea, and dementia). Dermatitis will present as a symmetric hyperpigmented rash. This triad of Sx seen with this deficiency.

Question 11

B6 (pyridoxine)

Answer 11

Seborrheic dermatitis, atrophic glossitis, angular cheilitis, conjunctivitis, confusion, neuropathy, ucoordinated gait, and sideroblastic anemia due to impaired heme synthesis. Can be found in individuals with alcoholism, autoimmune disorders and those taking isoniazid, anticonvulsants and hydrocortisone.

Question 12

What vitamin Pyridoxine?

Answer 12

Vitamin B6

Question 13

B9 (Folate)

Answer 13

Sore tongue or glossitis + megaloblastic anemia (easy bruising). No neurological changes like in B12 deficiency.

Question 14

Vitamin B6

Answer 14

Given concomitantly when a person is taking Isoniazid. Also for alcoholics

Question 15

What vitamin is Cobalamin

Answer 15

B12

Question 16

Vitamin C (ascorbic acid)

Answer 16

SCURVY! Anemia, abdominal complaints, frequent infections, bleeding gums, loose teeth, bruising, poor wound healing, myalgia, headache, fatigue and bone disorders.

Question 16

Ascorbic acid

Answer 16

Vitamin C

Question 17

Vitamin D

Answer 17

Breastfeeding does not provide adequate amounts. Exclusive formula feeding probably provides adequate levels of this vitamin, but infants who consume less than 1 liter of formula per day need supplementation with 400 IU daily.

Question 18

Vitamin E

Answer 18

Reduced RBC hemolysis in premature infants and loss of neural integrity.

Question 19

B12 (Cobalamin)

Answer 19

Strict vegetarian, paresthesias (weakness), ataxia (fatigue/unsteady gait), megaloblastic anemia (easy bruising), glossitis, peripheral neuropathy, depression, irritability, personality changes. Px: decreased or absent reflexes. LAB: MCV >100, Increase homocysteine and methylalonic acid (MMA). THE ONLY DEF. THAT RESULTS IN NEURO/PERSONALITY CHANGES.

Question 20

Phenylalanine dehydroxylase deficiency

Answer 20

Phenylketonuria (PKU). Musty odor, microcephalic, developmental delays, mental retardation