Path 1 Quiz 5 - B vitamins Flashcards
Vita means
Life
Kazimierz Funk discovered the term vitamin T/F
True
Fredrick Hopkins experimented with animals - fed them refined food and then natural food - he noticed that growth stopped due to consumption of refined food - he discovered _______
Accessory Food Factors
Japanese scientists Umertaro suzuki discovered what substance?
America Acid - vitamin B1
Date that vitamin B1 is truly described
1935
The water soluble vitamins are what vitamins?
The B vitamins
B1 vitamin’s common name is?
Thiamine
What is the function of B1/Thiamine?
maintains integrity of the neural membranes and promote nerve conduction through the neurons - usually peripheral nerves
Where is thiamine/B1 found?
Found in most foods - it is high in unrefined natural foods
A efficiency in thiamine will lead to
neurological dysfunctions
China experienced many deaths due to refining their white rice - the people were truly lacking what vitamin?
B1 - thiamine
25% of people with a B1/thiamine deficiency are
alcoholics
*alcohol and B1 fight with each other - alcohol wins - usually alcoholics consume more alcohol then they do actual food
Disease that are associated with Thiamine / B1 deficiency
Berberi (dry, wet, wernicke - korsakoff)
Who discovered beriberi?
Christiaan Eijkman *first to find the connection between food and B1 deficiency
When christiaan eijkman discovered beriberi he went to the most common place of the disease in the 19th century that being
Indonesia *chickens got better eating real food
What sequence do the three types of beriberi occur in
Dry, wet, Wernicke - korsakoff syndrome)
Dry Beriberi is characterized by
- Symmetrical nonspecific peripheral polyneuropathy with myelin degeneration
- Destruction of sensory motor and reflex functions
- loss of reflexes
paresthesia - painful tender mm
- numbness of feet
- Great weakness Neuropathy development
Physical sign of beriberi
First toe drop
Foot Drop
Wrist Drop
Wet Beriberi is characterized by
Pathology of the heart = enlargement and thinning of the heart wall - flabby myocardium
- peripheral vasodilation
- development of high cardiac output failure - real cardiac failure - slow blood flow = dyspnea
- peripheral edema (characteristic of cardiac failure) = pitting edema
- ** dramatic inflammation of the heart
Types of Wernicke Korsakoff syndrome
Wernicke encephalopathy
Korsakoff’s psychosis
Wernicke Encephalopathy:
very serious - affects the nervous system
- global confusion
- apathy
- listlessness
- disorientation
- ophthalmoplegia (asymmetrical movement of the eyeballs *this is a prediction of death)
- confusion —> coma —> death
Korsakoff’s psychosis
Interesting situation that is related to areas of damage in the brain
- amnesia, BOTH retrograde and anterograde
Inability to acquire new info
cofabulation
Define cofabulation
memory disturbance defined as a production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive
**** because of destruction of mamillary bodies in the brain
Function of mamillary bodies is
account for memory
B2 is ______
Produced partially by _____
riboflavin
gut flora
Deficiency in riboflavin is called ________.
Ariboflavinosis
Deficiency in riboflavin/B2 is characterized by
cheilosis (chelitits) aka angular cheilitits
Glossitis
Cheilosis
Cracks on the angle of mouth due to tissue degeneration due to deficiency of vitamin B2 - as soon as tissue cracks lead to infection of that area - THIS IS A PRIMARY PROBLEM
Chelitis
Inflammation of around the lips —-> due to cheiolosis
Angular cheilitis
area of angle by the mouth
Glossitis
atrophy of the tongue - effects taste - people with long term of vitamin B2 deficiency leads to loss of taste - very red almost maroon
Explain “superficial interstitial keratitis”
Inflammation of cornea
- cornea is rich in nociceptors and has NO blood vessel
- corneal scarring is the end result of the initial invasion of blood vessels into the corneal stroma as part of the inflammatory response.
- result of B2 deficiency
Cornea receives nutrition from
tears
Describe corneal ulcers
very painful ,so many nociceptors there makes it very painful - healing of this ulcer will lead to CT (white tissue) healing the ulcer and leads to loss of vision)
Vitamin B3 is called
Niacin
B3 can be used as medication as a vaso_____.
Vasodilation
Niacin is produced predominantly by _____ from _____
Gut Flora from tryptophan
Function of B3
decreased production of LDL —-> prevention of atherosclerosis
A deficiency of B3 results in what disease?
Pellagra
What are the characteristics of pellagra?
4 D's" Dementia Dermatitis Diarrhea Death
Characteristics of dermatitis in pellagra
Casal’s necklace
Any areas of sun exposure
glove and stocking lesion
Dementai is a characteristic of pellagra and results in
generation of cortisol neurons/grey matter = damage of the spinal cord
T/F Those that are deficient in B3 can present with Glossitis and Cheilosis
True
Vitamin B6 is known as
Pyridoxine
B6 can be destroyed by what?
thermolabile - small amount o cheat will destroy it
List the medications that can compete with B6 - what are these medications for?
Izoniazid - antituberculosis medication, thought probably not used as often today
Estrogen - high production of estrogens or home treatment (birth control)
D-penicillamine - medication used for wilson’s disease and system sclerosis - has great chelating components
Symptoms of B6 deficiency
Cheilosis/cheiolitis Glossitis Peripheral polyneuropathy Convulsions - esp. in babies Increased sloughing of epithelial cells ---> leads to Nidus which are urniary tract stones Seborrheic dermatitis aka Dandruff
Organic core of unitary stores - that clumps together epithelial cells from inside the bladder - the core grows larger and larger to form stones in the unready tract this is called a
Nidus
Vitamin B12 is known as
Cyanocobalamin
AKA for Vitamin B12
Cyanocobalamin AKA extrinsic factor of Castle
Where can be B12 be found in?
Only animal foods
Thought to be found in deep sea plants
T/F Vitamin B12 can NOT be absorbed directly into the body
True
Explain the process of how Vitamin B12 is taken up by the body
- Protein is consumed
- Salivary glands release R-binding factor
- R-binder binds to B12 and carries it form the stomach to the duodenum where they dissociate
- “stomach parietal cells” produce and secrete intrinsic factor which then moves into the duodenum
- Ileum has receptors for Intrinsic factor - Intrinsic factor and extrinsic factor bind and then move intrinsic factor into the blood circulation where intrinsic and extrinsic factor dissociate
Causes of B12 deficiency
Diet
Autoimmune
What are the three cases of autoimmune disorders (idiopathic) that can lead to a B12 deficiency
Autoimmune chronic gastritis
Blocking Antibodies
Binding Antibodies
Which autoimmune disorder produces parietal canalicular antibodies which destroy parietal cells in the stomach?
- What does this result in?
- What type of AB is this?
Autoimmune Chronic Gastritis
Results in no production of intrinsic factor and B12 cannot be absorbed
Type III
Which autoimmune disorder binds to intrinsic factor - blocking the receptor for B12/extrinsic factor of castle?
- What does this result in?
- What type of AB is this?
Block AB
B12 cannot bind to intrinsic factor
Type I
Which autoimmune disorder binds to rectors for intrinsic factor in the ileum?
- What is the result?
- What type of AB is this?
Binding AB
Bounded intrinsic and extrinsic factor cannot pass through to the GI wall and enter the blood circulation where they would normally dissociate
Type II
Which autoimmune disorder leads to NO production of B12
Chronic Gastritis
Which autoimmune disorder does not allow B12 to bind to intrinsic factor?
Blocking AB
Which autoimmune disorder can not make it to the GI wall and blood circulation?
Binding AB
Vitamin B12 deficiency Anemia (because it travels in the blood) would result in
Hemopoietic problems
Nervous system pathologies
Situations for Vitamin B12 deficiency causes
Inadequate dietary intake of vitamin B12 Surgical removal of stomach or Ileum Malnutrition or alcoholism Celiac disease, Crohn's disease Intake of medications Vegans
What medications cause a problem with B12 absorption and why?
Ranitidine: most common GI medication for stomach hyperacidity
Metformin: drug for diabetes type II
Diseases associated with Vitamin B12
Pernicious (malignant anemia)
Mesoblastic anemias
Demyelination
Pathological Mechanism of Pernicious anemia
- some claim absent of intrinsic factor
- chronic gastritis
- blocking AB
- Binding AB
AKA for pernicious anemia
Malignant anemia
Megaloblastic anemia
Means all blood cells are larger than normal
In their immature form
This includes: RBCs, WBCs and platelets
What are the two types of anemias that will cause Megaloblastic anemia
Vitamin B12 - deficient anemia
Folic acid - deficient anemia
Vitamin B12 deficiency anemia
Macrocytes = monocytes - these are in the mature cells found in the peripheral blood
Folic acid deficiency anemia
Folic acid participates in hemopoiesis - if absent = anemia
Vitamin B12 activates
tetrahydrafolate
Biochemical pathway of folic acid
Folic acid is eaten - converted to mono glutamate in the blood circulation - reductase converts mono glutamate into tetrahydrofolate (active form) - this donates carbon to DNA in blood - now it is inactive - Vitamin B12 converts inactive tetrahydrofolate into active so that it can now donate more carbon
*reusable material for higher speed of production
Anemia means
there is a decreased amount of RBCs/hemoglobin
If a pt. is anemic you would also notice that they also had hyperchormic anemia which would mean
They have a iron deficiency as well
With pernicious anemia, the RBS are too large to fit in the capillaries - they are not able to bend - sine the cell membranes are so right the RBC cannot enter the ________ which means that there would be __________
capillaries so it would result in a decreased amount of O2 to the tissues
Demyelination
- where does it occur
- results in
Myelin degeneration = decreased rate of conduction
- Posterior and lateral column tracts of the spinal cord, peripheral nerves and DRG
- Results in: numbness and tingling in hands and feet, ataxia, paraplegia, pathological reflexes
Ataxia in myelin degeneration involves what tract?
spinocerebellar tract
Define Paraplegia
subacute combined degernation of the spinal cord
- affects PNS and may affect CNS
Paraplegia that affects the CNS is called
Megaloblastic madness
What differentiation can we make between Vitamin B12 and Folic acid deficiencies?
Folic acid results in cheilosis/cheilitis and glossitis - vitamin B12 does not
Folic Acid does not affect the nervous system but Vitamin B12 does
Explain Methotrexate
Leukemia drug
Prevents formation of too many blood cells - point is to stop production of the blood cells so that the disease will stop spreading
- inhibits reductase
- surpasses immune system because it would there fore decrease WBCs
