vit deficiency

Question 1

Vitamin

Answer 1

deficiency

Question 2

vitamin A (retinol)

Answer 2

Night blindness; dry, scaly skin; corneal degeneration; Bitot spots on conjunctiva, immunosuppression

Question 3

Vitamin B1 (thiamine)

Answer 3

wernickes: confusion, ophthalmoplegia, ataxia; also confabulation, personality change (due to damage to mamillary bodies)

dry beriberi: polyneuritis, symmetrical muscle wasting
wet beriberi: high output cardiac failure (dilated cardiomyopathy)

Question 4

Vitamin B2 (riboflavin)

Answer 4

cheilosis (inflammation of lips, scaling and fissures at corners of mouth); corneal vascularization (2Cs of B2)

Question 5

Vitamin B3 (niacin)

Answer 5

glossitis

pellagra: diarrhea, dementia, dermatitis (broad collar rash), hyperpigmentation of sun exposed limbs

severe deficiency caused by Hartnup disease (dec tryptophan absorption), malignant carcinoid syndrome (inc tryptophan metabolism) and isoniazid (low vit B6)

Question 6

Vitamin B5 (pantothenic acid)

Answer 6

dermatitis, enteritis, alopecia, adrenal insufficiency

Question 7

Vitamin B6 (pyridoxine)

Answer 7

convulsions, hyperirritability, peripheral neuropathy (deficiency inducible by isoniazid and OCPSs); can also have sideroblastic anemias due to impaired hemoglobin synthesis and iron excess

Question 8

Vitamin B7 (biotin)

Answer 8

rare; dermatitis, alopecia, entertitis (due to antibiotic use or excessive ingestion of raw egg whites- b/c avidin binds it

Question 9

Vitamin B9 (folate)

Answer 9

macrocytic, megaloblastic anemia; hypersegmented PMNs, glossitis (no neuro sxs) (labs: increased homocysteine)

deficiency is common (alcoholism, pregnancy); caused by several drugs (phenytoin, sulfonamides, methotrexate)

Question 10

vitamin B12 (cobalamin)

Answer 10

NOTE: b12 has a very large reserve pool (Stored in liver); deficiency due to insufficient intake, malabsorption, lack of intrinsic factor (pernicious anemia), or absence of terminal ileum (SEE THIS S/P GASTRIC BYPASS OR CROHN SURGERY)

macrocytic, megaloblastic anemia; hypersegmented PMNs, paresthesias and subacute combined degeneration (degeneration of dorsal columns, lateral corticospinal tract, and spinocerebellar tracts) due to abnormal myelin

increased serum homocysteine and methylmalonic acid

Question 11

Vitamin C (Ascorbic acid)

Answer 11

scurvy- swollen gums, bruising, petechiae, hemarthrosis, anemia, poor wound healing, perifollicular hemorrhages, corkscrew hair; weakened immune response

Question 12

vitamin D

Answer 12

rickets in children (bone pain, deformity), osteomalacia in adults (bone pain, muslce weakness), hypocalcemic tetany

Question 13

vitamin E

Answer 13

hemolytic anemia, acanthocytosis, muscle weakness, posterior column and spinocerebellar tract demyelination

(neuro sxs kind of like vit B12 deficiencyl byt no megaloblastic anemia, no hypersegmented PMNs, no increase in methylmalonic acid)

Question 14

vitamin K

Answer 14

neonatal hemorrhage with increased PT and aPTT, but normal bleeding time; give K injecton at birth to prevent hemorrhagic disease of the newborn

Question 15

zinc

Answer 15

delayed wound healing, hypogonadism, decrease in adult hair, weird taste in mouth, loss of sense of smell, acrodermatitis enteropathica (well demarcated, scaly plaques in intertriginous area)