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Vitamins, Minerals, and Trace Elements > Sherwood > Flashcards

Sherwood Flashcards

1
Q

what is the importance of vitamins, minerals and trace elements

A

-they play a role in enzymes which help us create energy

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2
Q

What vitamin is used for the maturity of cells in measles, cancer, infections that destroy cells, and burn patients

A

vitamin A

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3
Q

what vitamin is used for parathyroid hormone

A

vit A

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4
Q

what vitamin is used for CSF production

A

vit A

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5
Q

what vitamin is used for epithelial cell maturation

A

vit A

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6
Q

what vitamin is used as a mild antoxidant

A

vit A

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7
Q

If PTH is involved serum calcium and phosphorus will go in what direction?
What direction does calcium go in compared with PTH

A
  • opposite

- same direction as PTH

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8
Q

If you have low calcium and high phosphorus what disease do you have

A

hypoparathyroidism

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9
Q

If you have retinoic acid receptor defect what vitamin are you deficient in?

A

vit A

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10
Q

If a patient has moans, groans, bones and stones what vitamin are they deficient in and why?

A
  • vit A
  • moans and groans are from the pancreatitis b/c of the calcium deposits imitating fat behind the pancreas
  • bones are going to hurt b/c PTH is destroying the bones
  • stones can be caused by the excess of calcium causing gallstones, or kidney stones or calcification throughout out the body-metastatic calcification
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11
Q

what is the most common abdominal pain

A

pancreatitis

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12
Q

Most common cause of free radical formations in the body is

A

viral infections

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13
Q

How are free radicals formed

A

secreted by neutrophils through the enzyme NADPH oxidase

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14
Q

why do you get cancer after radiation therapy

A

b/c of the free radicals

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15
Q

what is the most common cause of pancreatitis in children

A
  • trauma
  • infections (cox sackie)
  • Increased triglycerides
  • increased calcium
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16
Q

what is the most common cause of pancreatitis in adults

A
  • gall stones
  • alcohol
  • Increased triglycerides
  • increased calcium
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17
Q

A patient comes complaining of a headache, has papilledema, CT scan shows enlarged ventricles in the CT scan. What does he have and is at risk for? treatment?

A

Pseudotumore cerebri

  • risk for blindness
  • tx: discontinue vitamin A, do serial lumbar punctures to rule out infections
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18
Q

Why remove less than 30 ccs of CSF/24hrs?

A

osmotic shift will occur in the brain damging the pons

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19
Q

what disease causes intracranial pressure without herniation

A

Pseudotumore cerebri

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20
Q

what carbonic anhydrase inhibitor decrease intracranial pressure

A

mannitol and acetazolamide

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21
Q

Pseudotumore cerebri mcc is

A

obesity and vitamin A deficiency

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22
Q

vitamin b1

A

thiamine

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23
Q

vit b1 is necessary for what important enzymes

A
  • pyruvate dehydrogenase
  • alpha-ketoglutamate dehydrogenase
  • branched chain amino acid dehydrogenase
  • transketolase
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24
Q

what dehydrogenase does the heart need

A
  • pyruvate dehydrogenase
  • alpha-ketoglutamate dehydrogenase
  • branched chain amino acid dehydrogenase
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25
Q

what enzyme does the heart use

A

-transketolase

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26
Q

a patient comes in being thiamine deficient, having short term memory, family says that they are always confabulating. You noticed during examination of the CT scan you seen mamillary bodies. What is the diagnosis

A

wernicke-korsakoff

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27
Q

a patient comes in having receptive aphasia and thiamine deficient

A

wernicke aphasia

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28
Q

wernicke encephalopathy

A

located in the posterior lobe

responsible for receiving spoken or written language

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29
Q

a patient heart has given out and has massive dilation. thiamine deficiency

A

beri beri

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30
Q

what is the difference between dry and wet beri beri

A

dry= heart failure

wet=when there is fluid in the lungs and have massive ventricular dilation

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31
Q

Best source for milk

A

vit b2

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32
Q

vit b2

A

riboflavin

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33
Q

used in cofactors like FAD

A

vit B2

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34
Q

vitamin deficiency associated with angular cheilosis

A

vit b2

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35
Q

necessary for cofactors NAD, NADH, NADP, NADPH

A

vit b3

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36
Q

This vitamin is needed by

  • pyruvate dehydrogenase
  • alpha-ketoglutamate dehydrogenase
  • branched chain amino acid dehydrogenase
A

niacin

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37
Q

a patient comes in with dermatitis, diarrhea, and dementia and ends up dying later on. What disease?

A

Pellagra

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38
Q

what is hartnup disease and what amino acid is needed?

A

-like pellagra but defective renal transport of tryptophan, causing it to leak out into the urine

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39
Q

how would you differentiate between hartnup and pellagra?

A

tryptophan in the urine

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40
Q

what amino acid is needed to make niacin

A

tryptophan

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41
Q

what does probucol do?

A

blocks VLDL receptor in the liver, treating hypertriglyceridemia

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42
Q

which drug increases HDL better than any other drug on the market

A

niacin

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43
Q

what are the side effects of niacin? Prevention? Treatment?

A
  • flushing, itching due to the release of prostaglandins, -blocks insulin receptors, leading to insulin resistance,
  • competes with uric acid causing gout
  • prevention is NSAIDS or aspirin
  • tx: anti-histamines
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44
Q

For management of gout what is the most effective treatment? MOA

A
  • colchine
  • blocks microtubules, which block all rapidly dividing cells
  • causes bone marrow suppression and renal failure
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45
Q

What is the current treatment of gout? MOA

A

indomethacin

-reversibly inhibits COX 1 and 2

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46
Q

what do you do if you have gout and and renal failure

A

-inject with an IV steroid with the indomethacin

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47
Q

What do you give for chronic/ recurrent gout? MOA

A
  • allopurinol-blocks xanthine oxidase
  • rasburicase-breaks the uric acid crystals
  • probenecid- increases excretion of uric acid
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48
Q

what is carcinoid syndrome?

A
  • uses up tryptophan

- secretes out serotonin and kallikrein

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49
Q
  • pyruvate dehydrogenase
  • alpha-ketoglutamate dehydrogenase
  • branched chain amino acid dehydrogenase

is needed by this vitamin and it has no deficiency state

A

vitamin B4-lipoic acid

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50
Q

what is the difference between vit b4 and vit b5

A

coenzyme A

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51
Q

what are the 3 vitamins that are needed by

  • pyruvate dehydrogenase
  • alpha-ketoglutamate dehydrogenase
  • branched chain amino acid dehydrogenase
A

vit B3, vit B4, vit B5

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52
Q

what vitamin is needed by heme

A

vit B6

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53
Q

what vitamin is needed by all transaminases

A

vit B6

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54
Q

what drug pulls pyridoxine out of the body?

A

INH

-must give B6 with INH

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55
Q

what vitamin is the cofactor to pyridoxal phosphate

A

vit b6

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56
Q

If you have a vit B6 deficiency you will have? Treatments?

A

neuropathy
-amytryptaline- blocks reuptake of catecholamine-so levels increase
-Gabapentin-also good for heart disease- blocks presynaptic-so block Ca2+
Carbamezapine-block Na+ and Ca2+, good for shooting pain (ex: syphilis) and seizures

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57
Q

Action of TCA drugs

A
  • block reuptake of catecholamines
  • Anticholinergic( sympathetic) cannot sweat
  • block alpha receptors
  • block sodium channels
  • block AV conduction
  • Antihistamines
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58
Q

if a patient has side effects with amytryptaline what would you give?

A

-SSRI

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59
Q

without this vitamine DNA cannot be formed

A

folate

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60
Q

how long can folate last

A

24 hours

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61
Q

what type of anemia do patients with folate deficiency have?

A

-megaloblastic anemia

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62
Q

what vitamin do you see hypersegmented neutrophils

A

-folate

cytoplasm divided, nucleus did not divide but tried to forming many segments

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63
Q

If you have a neural tube defect what vitamin is deficient? MCC

A
  • folate

- overcooked vegetables

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64
Q

when are cells most rapidly dividing?

A
  • Pregnancy
  • 0-2 years of age
  • 4-7 years of age
  • puberty
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65
Q

what groups of people have the highest life expectancy?

A

asians>whites>hispanics>blacks

66
Q

what vitamin lasts for 6-9 months in the liver?

A

vit b12

67
Q

what vitamin is needed by

  • homocysteine methyltransferase
  • methyl malonyl-CoA mutase
A

vit B12

68
Q

what vitamin is needed to recycle odd-numbered carbon fatty acids

A

cyanocobalamin-b12

69
Q

what vitamin is need to make tetrahydrofolate

A

cyanocobalamin-b12

70
Q

Vitamin B12 is used in treatment in what type of poisoning

A

cyanide

71
Q

when does B12 deficiency occur

A

3-4 years

72
Q

Vitamin B 12 deficiency mcc in the US is

A

`pernicious anemia -type A gastritis b/c its autoimmune and anti-parietal antibodies

73
Q

what are 3 ways to separate B12 from folate deficiency?

A
  • methylmalonic acid is the urine
  • neuropathy
  • chronic state
74
Q

what is the main antioxidant in the GI system

A

vitamin c

75
Q

what vitamin hydroxylates proline and lysine in collagen and elastin

A

vitamin C

76
Q

what vitamin is used for hydroxylation

A

vitamin C

77
Q

what disease are you bleeding from hair follicles and gums

A

scurvy

78
Q

what causes free radicals to be released into the body?what vitamin can you take to help fight with colds and flus

A

viruses

vit C

79
Q

what vitamin protects iron from being oxidized in the GI tract

A

vitamin C

80
Q

what infection causes anterior bowing of legs

A

syphillis

81
Q

what are some milder forms of anti-oxidants

A
  • vitamin A
  • beta carotene
  • trace elements
82
Q

where is vitamin E an antioxidant in

A

blood

83
Q

what vitamin is an antioxidant in the GI

A

vitamin c

84
Q

what vitamin mineralizes bone and teeth

A

vitamin D

85
Q

what vitamin stimulates osteoblastic activity and osteoclastic activity

A

vit D

86
Q

what vitamin stimulates calcium and phosphorus absorption from the GI tract

A

vit D

87
Q

what vitamin helps with reabsorption from the bone

A

vit D

88
Q

what vitamin helps with reabsorption from the kidney

A

vit D

89
Q

what vitamin supresses PTH

A

vit D

90
Q

what is number one vitamin deficiency in the US?why?

A

vitamin D

-due to obesity

91
Q

what is vitamin D deficiency is children? What do you see?

A
  • rickets

- lateral bowing of legs

92
Q

what is vitamin D deficiency is adults?

A

-osteomalacia

93
Q

vitamin D resistant rickets is diagnosed by? what would labs look like?

A
  • administering a dose of vitamin D

- low calcium, low phosphorus

94
Q

how is vitamin D resistant rickets passed down

A

-x-linked dominant

95
Q

what is resistant rickets caused

A

-defective renal absorption of phosphorus which leaks out, pulling calcium out with it.

96
Q

what vitamin absorbs free radicals and is the main antioxidants in your blood

A

vitamin E

97
Q

What diseases involve oxidation

A
  • cancer
  • alzheimer’s
  • coronary artery disease
  • hemolytic anemia-G6PD
98
Q

what vitamin is necessary for carboxylation

A

biotin

99
Q

what vitamin is needed for gamma-carboxylation?

A

-vitamin K

100
Q

what are the clotting factors for vitamin K

A

2,7,9, 10, Protein C and S

101
Q

which vitamin K clotting factor has the shortest

A

Protein C-6 hours

factor 7- 2 days

102
Q

which vitamin is a competitor of vitamin K

A

-warfarin

103
Q

what drug do you give first when you’re treating venous clots

A

-heparin then warfarin

104
Q

what anticoagulant drug is safe to give in a prengant women

A

heparin

105
Q

which drug crosses the placenta and is teratogenic

A

warfarin

106
Q

For heparin what do you follow PTT or PT or bleeding time?

A

PTT-intrinsic pathway

107
Q

what pathway does warfarin follow

A

PT-extrinsic pathway

108
Q

what is the INR in patients that take warfarin

A

-2 to 3x normal so less likely to form a clot

109
Q

If a patient PT is too high you give them

A

vitamin k IM

110
Q

if a patient is bleeding all over the floor your first give them

A

FFP bc it has all the clotting factors in it

111
Q

If a patient has its first clot and is of known/ reversible causes how long are they on warfarin

A

-3 months

112
Q

If a patient has a second clot/ or has a clot of unknown causes how long are they on warfarin

A

-12 months

113
Q

If a patient has a 3rd clot/ or clot has irreversible causes they are on warfarin for how long

A

life long

114
Q

why is heparin used before warfarin?

A

Protein C has half-life of 6 hours. Factor 7 has half-life of two days. Heparin activates anti-thrombin-3 so there is protection against clots till warfarin can kick in. That is why we stay on heparin for two days.

115
Q

Protein C deficiency and using warfarin causes

A

skin necrosis bc of hypercoagbility

-heparin block protein C

116
Q

what is cofactor for antithrombin 3

A

heparin

117
Q

what clotting factors does heparin block in the intrinsic pathway

A

9,10,11,12

118
Q

what is the goal of INR for venous clots? cardiolipin antibody syndrome?metallic valves present?

A
  • 2-3x venous clots
  • 2.5-3.5 cardiolipin antibody syndrome
  • 3-4 if mettalic valves
119
Q

if patient is given heparin and there is no PTT change, what are you deficient in? what are some diseases associated with it

A

you’re defeicient in antithrombin 3 (protein loss)

- kwashikor, CIrrhosis, and Nephrotic Syndrome

120
Q

what are some side effects of heparin

A
  • bleeding, hyperlipidemia by activating hormone sensitive lipase -producing a milky white plasma
  • HIT- thrombocytopenia precedes the clotting
  • heparin acts as a hapten on platelets causing antibody to form. They then attack the platelets that are floating around the blood vessels causing inflammation. This leads to vasculitis and clot to stick on the sticky endothelium.
121
Q

If a patient has HIT what other medications can they take

A
  • lepirudin, agatroban-block thrombin directly

- fondaparinux block factor 10a

122
Q

what type of drug can a patient take tha thas few side effects then heparin, cost less, and has less bleeding time

A

LMWH

123
Q

where is heparin contraindicated in

A
  • recent head injury
  • recent CPR
  • bleeding ulcer
  • use a greenfield filter/IVC
  • HTN
124
Q

what is the difference in type 1 HIT and type 2

A

Type 1 HIT- just follow platelet count
Type 2- platelet count should never be below 75,000- stop heparin and switch to a direct thrombin inhibitor which is agatroban

125
Q

If you have DVT that turns into a stroke what type of stroke is it

A

it is a pardoxical stroke and you have a shunt in your heart

126
Q

why do patient with DKA have hyperlipidemia

A

-they lack insulin which causes glucagon to activate HSL causing an excess of ketones and glucose. Causing hyperlipidemia. You will also see a milky white plasma in test tubes when blood settles. Showing glycogen

127
Q

what is the gut flora made up of? and what do they help absorb

A
  • 90% of vitamin K, biotin, folate, and pathothenic acid

- help absorb vitamin b12

128
Q

when do you not have enough gut flora

A
  • newborns- this is why we give vitamin K to all newborn IM and also hemorrhagic disease of the newborn can occur because they are vit k deficient and factor 7 is 2 day half life. which is why hemorrhagic disease can occur at day 2.
  • broad-spectrum antibiotics
129
Q

what 4 cephalosporins inhibit vitamin K

A
  • cefamandole
  • cefotetan
  • moxalactam
  • cefoperazone
130
Q

what are some minerals

A
  • calcium
  • magnesium
  • zinc
  • copper
  • iron
131
Q

what mineral is needed for all muscle contraction

A

calcium

132
Q

what type of muscle uses extracellular calcium for second messenger systems

A

smooth muscle

133
Q

what are two membranes that uses calcium to depolarize

A

atrium and thalmus

134
Q

Cardiac ventricles have a calcium-induced calcium released phenomenon which means

A

cardiac ventricles depend on extracellular calcium to trigger off its intracellular calcium

135
Q

what mineral is used for axonal support

A

calcium

136
Q

what mineral is needed for release of all neurotransmitters

A

presynaptic influx of calcium is needed

137
Q

If babies in utero do not get enough calcium what might be the end result

A

they may be born with mental retardation

138
Q

which mineral is a cofactor to all kinases and uses ATP

A

magnesium

139
Q

which mineral is cofactor for kinases and PTH

A

magnesium

140
Q

which mineral is a cotransport for potassium and calcium and where does it interact with potassium

A
  • early distal convoluted tubules of the kidneys

- magnesium

141
Q

If a patient is experiencing hypokalemia and is treated accordingly but potassium levels are not increase what might be the underlying issue?

A

magnesium

142
Q

this mineral is needed by hair, nails, and skin

A

zinc

143
Q

if you have zinc deficiency what can you not do

A

dysgeusia- cannot taste food

144
Q

what is copper needed for

A
  • lysine oxidase in the formation of collagen

- complex 4 in the ETC

145
Q

what disease do you have copper deficiency

A

menke kinky hair syndrome

  • orange hair color
  • hair feels copper wire
146
Q

what are some identifying symptoms or markers of wilson’s disease

A
  • autosomal recessive
  • low ceruloplasmin
  • copper deposition in the lenticular nucleus (basal ganglia)
  • kayser fleicher rings in the iris
  • cirrhosis in the liver
147
Q

How do you treat wilson’s disease

A

pencillamine

148
Q

what disease you have copper excess

A

wilson’s disease

149
Q

what is needed for the formation of heme and hemoglobin

A

iron

150
Q

what mineral is need by complex 3 and 4 of ETC

A

Iron

151
Q

what is the difference between ferrous iron and ferric iron

A

ferrous binds to oxygen and ferric has been oxidized

152
Q

what are the trace elements

A
  • chromium
  • selenium
  • molybdenum
  • manganese
  • tin
  • fluoride
153
Q

what enzyme is deficient in diabetic

A

-chromium

154
Q

what does chromium do?

A

enhance insulin action there fore delaying progression of the disease

155
Q

what is selenium primarily needed by

A

the heart

156
Q

selenium in excess smells like and leads to

A

garlic or arsenic and leads to dilated cardiomyopathy

157
Q

what two trace elements are needed by glycolysis

A

molybendum and manganese

158
Q

xanthine oxidase needs what two minerals

A

molybendum and manganese

159
Q

what is the enzyme needed to make uric acid

A

xanthine oxidase

160
Q

tin is needed to do what

A

hair growth

161
Q

what blocks eolase of glycolysis causing low energy state

A

fluoride

162
Q

what trace element is needed for teeth and bone growth

A

fluoride

Vitamins, Minerals, and Trace Elements (1 decks)

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