Trace Elements and Vitamins

Question 1

how are trace elements measured?

Answer 1

absorbance spectrophotometry

Question 2

iron is found where? How is it stored?

Answer 2

found in hemoglobin, myoglobin, tissue, and plasma (either bound to transferrin or albumin)

stored as ferritin or hemosiderin in bone marrow, liver, and spleen

Question 3

where is iron absorbed and excreted?

Answer 3

absorbed in the intestine

excreted through skin epithelial cells or RBC in urine or feces daily

Question 4

iron overload is called ________. It causes what to the skin? What are the iron study indices for iron overload?

Answer 4

hemochromatosis: can be hereditary or secondary

hyperpigmentation of the skin

increased: serum iron, ferritin, and transferrin saturation

decreased: TIBC and transferrin

Question 5

what are the iron study indices for IDA?

Answer 5

decreased: serum iron, ferritin, and transferrin saturation

increased: transferrin and TIBC

Question 6

what are the iron study indices for ACD?

Answer 6

decreased: serum iron, transferrin, transferrin saturation and TIBC

increased: ferritin

Question 7

what are the iron study indices for malnutrition, chronic infection, and acute liver disease?

Answer 7

malnutrition: decrease all indices

chronic infection:
- decreased everything but ferritin

acute liver disease:
- increased serum iron, ferritin and transferrin saturation

Question 8

transferrin saturation is the ratio of ______ ______ to ______

Answer 8

ratio of serum iron to TIBC
- where TIBC is transferrin x 1.18

Question 9

serum iron should be collected when in the day?

Answer 9

in the morning

Question 10

copper is critical for ____ of iron in ____ synthesis. Where is it predominantly found in?

Answer 10

needed for reduction of iron in heme synthesis. Mostly found in liver, brain, heart, and kidneys

Question 11

copper deficiency is due to/found in what four things? What are signs of copper deficiency?

Answer 11

premature infants, malnutrition, malabsorption, and chronic diarrhea

neutropenia/hypochromic anemia, and osteoporosis

Question 12

copper toxicity is an irritant to what two things? What can it cause? What is the disease of increased copper, and what is the marker for it?

Answer 12

irritant to epithelia and mucosal membranes

cause hepatic and renal damage

increased copper: Wilson’s disease with decreased alpha-1 ceruloplasmin protein

Question 13

Zinc is used for treatment for what disease? What is zinc used for the synthesis and metabolism of? What are symptoms of zinc deficiency and dosage?

Answer 13

used to reduce copper = used to treat Wilson’s disease

used for the synthesis and metabolism of DNA and RNA

deficiency: growth retardation, testicular trophy, slow skeletal muscle maturation, reduce taste perception

increased dosage: GI symptoms and decreased heme synthesis

Question 14

what are symptoms of lead toxicity?

Answer 14

respiratory problems, GI issues, CNS clumsiness, abnormal hair, headache/seizures

Question 15

acute arsenic (most common poison in human history) exposure affects what bodily sites? Chronic exposure affects what sites?

Answer 15

Acute: GI, bone marrow, heart, CNS, renal, and liver

Chronic: skin and cardiac issues, liver disorders/malignancies
- Blackfoot disease

Question 16

selenium is used in electronic, pigment, pesticides, rubber production, and dandruff shampoo.

What are deficiencies of it associated with? Negative correlation between selenium intake what?

Answer 16

deficiencies: cardiomyopathy, skeletal muscle weakness, and osteoarthritis

neg correlation between rates of leukemia and cancer of large intestine, rectum prostate, breast, ovaries, and lung

Question 17

too much selenium may produce what symptoms?

Answer 17

GI symptoms or heart symptoms tachycardia

chronic exposure: skin and hair loss as well as unsteady gait and paralysis

Question 18

mercury (quicksilver) is ____ at room temp. It is toxic to both the ______ and ______ nervous systems

Answer 18

liquid at room temp. Affects the central and peripheral nervous system

bloodbrain barrier

(also digestive tract, immune system, and lungs and kidneys)

Question 19

chromium is an essential dietary element in what five things? Deficiency can lead to what four things?

Answer 19

in: bread, fish, veggies, meat, and beer

deficiency: insulin resistance, glucose intolerance, diabetes, and heart disease

(transferrin and albumin involved in absorption and transport)

Question 20

what are the fat and water soluble vitamins?

Answer 20

fat: A, D, E, and K
water: B and C

Question 21

vitamin A is also called? Where is it stored, and how is it transported to circulation? Increased vitamin A seen in _______ _________

Answer 21

called beta-carotene

store in the liver, transported to circulation by retinol

seen in liver damage

Question 22

Vitamin D is important for what two body functions? Vitamin D stimulates what for bone growth? Deficiency leads to? How is vitamin D toxic to children?

Answer 22

needed for skeleton formation and mineral homeostasis

stimulates intestinal absorption of calcium and phosphate for bone growth

deficiency: rickets/osteomalacia

toxic via heart damage

Question 23

vitamin E is a powerful _________. It protects the _________ membrane from stress. Deficiency leads to what disorder?

Answer 23

powerful antioxidant

protects the RBC membrane from stress, so a deficiency leads to hemolytic anemia

(people with abetalipoproteinemia and cystic fibrosis susceptible to vitamin E deficiency)

Question 24

Vitamin K is important for what bodily function? Deficiency leads to?

Answer 24

formation of prothrombin via creating factors II, VII, IX, and X and proteins C and S, so decrease leads to hemorrhage and increased PT
- defiance can be due to antibiotic therapy (decrease in bacteria that make vitamin K)

Question 25

Vitamin B1 is also called __________? what is the main disease caused by a. deficiency of vitamin B1?

Answer 25

Thiamine

beriberi

also cardiac failure and vomiting in infants, and anorexia/irritability/peripheral neuropathy/edema in adults

Question 26

vitamin B2 is also called ________? What is its role in the body, and what four things can happen if there’s a deficiency of it? Excess goes where?

Answer 26

riboflavin catalyzes oxidation-reduction reactions

1. mouth lesions
2. dermatitis
3. photophobia
4. neurologic damages

excess peed out

Question 27

vitamin B3 is also called _________. It functions as component of what two enzymes? What is the clinical syndrome resulting from B3 deficiency? What does large doses of B3 lead to?

Answer 27

niacin is a component of NAD+ and NADP+ for metabolic processes

pellagra: diarrhea, dermatitis, dementia, and death

large Vitamin B3 doses: skin flushing/vasodilation

Question 28

vitamin B5 is also called ________ _____. It’s a _______ factor that is an important component of _________ __. What are 5 symptoms of deficiency of this vitamin?

Answer 28

pantothenic acid is a growth facto that is also a essential component of coenzyme A

fatigue, headaches, muscle cramps, nausea, and malaise

Question 29

Vitamin B6 is also called ____________? it’s a coenzyme for ___________. What five things can be seen in B6 deficiency?

Answer 29

pyridoxine / folic acid is a coenzyme for transaminases.

seizures, normocytic anemia, dermatitis, glossitis, and depression

(usually not toxic due to being water-soluble)

Question 30

Vitamin B7 is also called _______. What is its job in the body? What can it cause if there’s a deficiency?

Answer 30

biotin transports carboxyl units in tissue and plays a role in glycogenesis, lipogenesis, and fatty acid synthesis

causes alopecia, dermatitis, hypotonia, and developmental delay

Question 31

vitamin B9 is also called _______. It’s job is similar to Via B___. It’s facilitates ____ transfer reactions and is a key component of _________. . What two things can it cause if there’s a deficiency?

Answer 31

folate has a similar job to vit B12.

facilitates carbon transfer reactions, and is a component of methylation

megaloblastic anemia and neural tube defects

Question 32

vitamin B12 is called __________, and has what two roles in the body? Who is most likely to be deficient in this vitamin, and what three things can happen as a vitamin B12 deficiency?

Answer 32

cobalamin plays a role in hematopoiesis and fatty acid metabolism

vegetarians (due to not eating eggs, meat, milk)

pernicious anemia, megaloblastic anemia, and neurologic abnormalities

also key component in methylation cycle like Vitamin B9

Question 33

Vitamin C is also called ________ ____. It is an ____________. what four things can be a consequence of low vitamin C? what can increase urinary excretion of this vitamin?

Answer 33

ascorbic acid is an antioxidant

survey, anemia, DM, and osteoporosis

aspirin/barbiturates increase vitamin C in urine

Question 34

what are three ways to test vitamin levels? Vitamin K is tested how? Vitamin B1? B2? And what can excess vitamin C cause with urine strip testing?

Answer 34

high performance liquid chromatography, immunoassay, and LC-MS (liquid chromatography/mass spectrometry)

Vitamin K with PT
B1 with erythrocyte transketolase activity
B2 with reduced glutathione reductase activity
excess vitamin C = false pos glucose