Vitamin and Trace Element Deficiencies

Question 1

Vitamin A

Answer 1

(retinol)

• Found in dairy produce, eggs, fish oils, and liver
• Deficiency causes night blindness, xerophthalmia, keratomalacia (corneal thickening), and follicular hyperkeratosis

Question 2

Vitamin D

Answer 2

(cholecalciferol)

• Found in fish liver oils, dairy produce, and undergoes metabolism at the kidneys and the skin using UV light
• Deficiency causes rickets (in children) and osteomalacia (in adults). Proximal muscle weakness may be evident

Question 3

Vitamin E

Answer 3

(alpha-tocopherol)

• Widely distributed, green vegetables, and vegetable oils
• Deficiency causes haemolytic anaemia (premature infants) and gross ataxia

Question 4

Vitamin K

Answer 4

(K1 = phylloquinine, K2 = menaguinone)

• Widely distributed but particularly in green vegetables. Synthesized by intestinal bacteria.
• Deficiency causes coagulation defects seen as easy bruising and haemorrhage

Question 5

Fat soluble vitamins

Answer 5

Vitamin A
Vitamin D
Vitamin E
Vitamin K

Question 6

Vitamin B1

Answer 6

(Thiamine)

• Found in cereals, peas, beans, yeast, and wholemeal flour. An essential factor in carbohydrate metabolism and transketolation reactions.
• Deficiency causes dry beri-beri (sensory and motor peripheral neuropathy), wet beri-beri (high output cardiac failure and oedema), and Wernicke-Korsakoff syndrome

Question 7

Vitamin B2

Answer 7

(riboflavin)

• Found in wholemeal flour, meat, fish, and dairy produce. A coenzyme in reversible electron carriage in oxidation-reduction reactions.
• Deficiency gives angular stomatitis (fissuring and inflammation at the corners of the mouth), inflamed oral mucous membranes, seborrhoeic dermatitis, and peripheral neuropathy

Question 8

Vitamin B3

Answer 8

(niacin)

• Found in fish, liver, nutes, and wholemeal flour
• Deficiency causes pellagra: dermatitis, diarrhoea, and dementia

Question 9

Vitamin B6

Answer 9

(pyridoxine)

• Widespread distribution, also synthesized from tryptophan.
• Deficiency causes peripheral neuropathy, convulsions, and sideroblastic anaemia. Deficiency may be provoked by a number of commonly used drugs (isoniazid, hydralazine, penicillamine) and is also seen in alcoholism and pregnancy

Question 10

Vitamin B9

Answer 10

(folic acid)

• Deficiency can be caused by poor diet, malabsorption states, coeliac disease, Crohn’s disease, gastrectomy, drugs (methotrexate, phenytoin), excessive utilization (e.g. leukaemia, malignancy, inflammatory disease).
• Consequences of deficiency include megaloblastic anemia and glossitis

Question 11

Vitamin B12

Answer 11

(cyanocobalamin)

• Causes of a deficiency are numerous and include partial or total gastrectomy, Crohn’s disease, ileal resection, jejunal diverticulae, blind loop syndrome, and tapeworm
• Deficiency causes megaloblastic anaemia, peripheral neuropathy, subacute combined degeneration of the spinal cord, depression, psychosis, and optic atrophy.

Question 12

Vitamin C

Answer 12

(ascorbic acid)
-Deficiency causes scurvy )perifollicular haemorrhage, bleeding swollen gums, spontaneous bruising, corkscrew hair, failure of wound healing), anaemia, and osteoporosis

Question 13

Water-soluble vitamins

Answer 13

Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B6
Vitamin B9
Vitamin B12
Vitamin C

Question 14

Trace elements

Answer 14

Copper
Zinc
Magnesium
Iodine

Question 15

Copper

Answer 15

Deficiency results in hypochromic and microcytic anaemia, neutropenia, impaired bone mineralization, Menkes’ kinky hair syndrome (growth failure, mental deficiency, bone lesions, brittle hair, anaemia), sensory ataxia, muscle weakness, visual loss (optic neuropathy), peripheral neuropathy
-Usually caused by copper malabsorption

Question 16

Zinc

Answer 16

Deficiency causes achodromatosis enterpathica (infants develop growth retardation, hair loss, severe diarrheoea, candida and bacterial infections), impaired wound healing, skin ulcers, alopecia, night blindness, confusion, apathy, and depression

Question 17

Magnesium

Answer 17

Severe deficiency can cause cardiac arrhythmias, paraesthesia, and tetany

Question 18

Iodine

Answer 18

Severe deficiency can cause cretinisum (children), hypthyroidism, and goitre