Vitamin deficiencies and hypervitaminoses

Question 1

What are the significant lipid soluble and water soluble vitamins?

Answer 1

lipid soluble: ADEK

water soluble: B and C vitamins

B1 - Thiamine. Deficient TPP

B2 - Riboflavin. Deficient Flavoproteins, FAD containing, deficient glycolysis

B3 - Niacin. Nicotinamide Adenine Dinuclotide, NAD/NADP

B6 - Pyridoxine, PrP, lots of metabolic reactions

B9 - Folate - megaloblastic anemia

B12 - Cobalamin - pernicious anemia

Question 2

Vitamin A deficiency

Answer 2

Vitamin A, a group of compounds, Retinol, Retinal, Retinoic acid,
Beta-carotene = provitamin A

Deficiency: Night blindness, then further impaired vision

Epithelial metaplasia and keratinization, especially of the cornea =
Xerophthalmia or dry eye, followed by Keratomalacia, destruction of the cornea and total blindness.

Mucocilliary destruction in the airways and pulmonary infections

Mucous membrane malfuction of GI tract and Iron Deficient Anemia.

Immune deficiency.

Question 3

Vitamin A toxicity

Answer 3

Headaches, dizziness, stupor
vomiting,
bluirred vision

Question 4

Vitamin D toxicity

Answer 4

This causes the most significant toxicities of all the vitamins when overdosed.

Causes hypercalcemia and hyperphosphatemia due to excessive bone resorption, GI absorption, and renal retention.

Osteomalaciea
Metastatic calcification of soft tissue
Nephrolithiasis
Cholelithiasis

Question 5

Vitamin D deficiency

Answer 5

Ricketts in children, deficient serum calcium and phosphate, and deficient bone matrix deposition by osteoblasts

Osteomalacia, bone demineralization in adults.
Pseudofractures
Bone pain
Compression vertebral fractures.

Question 6

Causes of Vitamin D deficiency

Answer 6

Dietary lack

Insufficient sun exposure, and decreased skin production with age.

Obesity, dilution of lipid soluble vitamin effect in adipose.

Malabsorption syndrome

Liver cirrhosis and deficient 25 alpha hydroxylase

Renal failure and deficient 1 alpha hydroxylase

Resistant vitamin D receptor, type 2 vitamin D dependent rickets.

Question 7

Vitamin E, name and function

Answer 7

Tocopherols, multiple compounds

Free radical scavenger and antioxidant

Protects membranes and lowers LDL oxidation

May lower cholesterol

Inhibits platelet aggregation

Question 8

Vitamin E deficiency

Answer 8

not a major one,

may cause Spinocerebellar degeneration.

Question 9

Vitamin K deficiency

Answer 9

Causes bleeding diathesis/coagulopathy

Prothrombin, factor 7, 9, 10 protein C and protein S.

Question 10

Vitamin K excess

Answer 10

No major toxicity

Question 11

Vitamin C name function

Answer 11

Ascorbic Acid -

Vitamin C - Oranges - Scurvy

A major cofactor for many enzymes involved in Collagen synthesis and maturation. Prolyl hydroxylase.

Also an antioxidant with many functions and a cofactor in many enzymes of the immune system.

Question 12

Vitamin C deficiency

Answer 12

weakness,

gum disease, infectious lesions and tooth loss

skin haemorrhages

petechia on the skin and mucous membranes

Can be fatal if deficiency lasts long enough - hemorrhages, infections.

Question 13

Vitamin C excess

Answer 13

None

Question 14

Vitamin B excesses

Answer 14

None

Question 15

Vitamin B1 deficiency

Answer 15

3 forms:
Dry beriberi, a peripheral neuropathy, peripheral wasting and neuropathy,
endemic neuritis.
Ataxia, loss of reflexes, pains, nystagmus

Wet beriberi: alcoholic dilative cardiomyopathy. Eventual heart failure.
Weakening of capillary walls, vasodilation and edema.

Wernicke Korsakoff syndrome
Wernickes encephalitis, acute
Korsakoff neurologic syndrome chronically afterwards.

Question 16

Vitamin B2 deficiency

Answer 16

rare deficiency
FAD and flavoprotein deficiency with distinct features

Angular cheliosis
Dermatitis of the face
Glossitis.
Dermatitis of the scrotum or vulva

Question 17

Vitamin B3 deficiency

Answer 17

Niacin.

From deficiency of both B3 and Tryptophan, niacin can be synthesized from tryptophan.

Also can occur during Isoniazid treatment of TB

manifestation is Pellagra

Pellagra: the 3 D’s (not the 3 P’s, its the 3 D’s)

Dementia, Dermatitis, and Diarrhea.

Question 18

Vitamin B6 deficiency

Answer 18

Pryidoxine, for porphyrin synthesis, heme precursor, CYP enzymes, hemoglobin.

an uncommon dificiency, but also seen in alcoholics, and in some drug treatments.

Main symptoms are decreased GABA production, convulsions in infants
and
symptoms similar to B2 deficiency
Dermatitis of the face
Glossitis. 
Dermatitis of the scrotum or vulva

Question 19

B9 deficiency

Answer 19

Folate
Megaloblastic anemia
Immune deficiencies
Neural tube defects

Question 20

B12 deficiency

Answer 20

Pernicious anemia

Immune deficiencies