vitamin deficiency

Question 1

what is deficiency of vitamin A associated with
(retinol)

(2)

Answer 1

ocular defects (esp xerophthalmia - dry eye)
increased susceptibility to infections

Question 2

how common is vitamin A deficiency in UK

Answer 2

rare

Question 3

true or false - deficiency of vitamin B is common

Answer 3

false. deficiency of B vitamins, other than B12, is rare in the UK

Question 4

when is IV nutrition given & what are the 2 methods

Answer 4

adequate nutrition not possible
given via 2 methods: supplemental parenteral nutrition (addition to ordinary feeding) or total parenteral nutrition (sole source of nutrition)

Question 5

How is parenteral nutrition infused

Answer 5

through central venous catheter or peripheral vein

Question 6

what is the preferred carb given in IV nutrition

Answer 6

glucose

Question 7

name the fat soluble vitamins

Answer 7

ADEK

Question 8

vitamin A deficiency can cause

Answer 8

ocular defects
increased risk of infections

Question 9

vitamin A is found in the following foods

Answer 9

cheese
eggs
oily fish
milk
yoghurt
liver
liver products e.g. pate

Question 10

vitamin D deficiency leads to

Answer 10

rickets

Question 11

normal dose of vitamin D

Answer 11

400 units (10mcg)

Question 12

vitamin D is found in the following foods

Answer 12

oily fish
red meat
liver
egg yolk
fortified food e.g. cereal

Question 13

what is vitamin E also known as

Answer 13

tocopherol

Question 14

what is tocopherol

Answer 14

vit E

Question 15

vit E deficiency leads to

Answer 15

neuromuscular abnormalities

Question 16

vit E is found in which foods

Answer 16

plant oil, nuts, seeds, wheatgerm

Question 17

what foods is vit K found in

Answer 17

green leafy vegetables, vegetable oils, cereal grains

Question 18

What is the vitam K water soluble derivative given orally in malabsorption states

Answer 18

menadiol

(this has possible risk of causing acute haemolysis in some pt with G6PD Deficiency (a (aspirin) curious (chloroquine) man (menadiol) quietly (quinine) sips (SU) nectar (naphthalene in moth balls)

Question 19

name the water soluble vitamins

Answer 19

vit C (ascorbic acid)
vit B

Question 20

what is B1 and what is it used for

Answer 20

thiamine - used in wernickes encephalopathy/ in deficiency e.g. alcohol dependent pt

Question 21

what is B2 and what does it do

Answer 21

riboflavin
keeps skin, eyes and NS healthy

Question 22

what is B6 and what is it useful for

Answer 22

pyridoxine
treat peipheral neurpahy associated with isoniazid

Question 23

what is B12 and what is it used for a

Answer 23

hydroxycobalamin
used in treatment of B12 megaloblastic anameia

Question 24

vitamin B is found in what foods

Answer 24

meat
cereal
veg

Question 25

Vit C deficiency causes

Answer 25

scurvy

Question 26

what does vit D help with

Answer 26

wound healing
maintains healthy skin blood vessels bone and cartilage

Question 27

foods rich in vit C

Answer 27

oranges peppers strawberries blackcurrant broccoli sprouts potatoes

Question 28

what is vit k necessary for

Answer 28

production of clotting factors

Question 29

pt with fat malabsorption esp in biliary obstruction and hepatic disease may be defienct in

Answer 29

fat soluble e.g ADEK

but not really for A or E

Question 30

specific populations at risk of vit D deficiency include

Answer 30

dark skin (such as those of African, African-Caribbean or South Asian origin) as their skin is less efficient at synthesising vitamin D

individuals aged over 65 years

individuals who have low or no exposure to the sun (such as those who are housebound or confined indoors, or who cover their skin for cultural reasons)

pregnant and breastfeeding women (particularly teenagers and young women)

and children aged under 4 years.

Question 31

Supplements containing vitamin D (e.g. Healthy Start) should be considered for who?

Answer 31

all pregnant and breastfeeding women, and children aged under 4 years, to prevent vitamin D deficiency (if clinically appropriate)

Question 32

what should be prescribed to pt with severe RI who require vit D therapy and why

Answer 32

Vitamin D requires hydroxylation by the kidney to its active form, therefore the hydroxylated derivatives alfacalcidol or calcitriol should be prescribed if patients with severe renal impairment require vitamin D therapy.

Question 33

Mr. Eze Timibe visits the pharmacy seeking advice about his skin. He reports that his skin bruises and bleeds easily, and wounds are taking longer to heal. He has also noticed that his teeth feel slightly loose, and he generally feels tired and unwell. When asked about his diet, he mentions that he primarily eats ready-made meals and avoids fresh fruits and vegetables due to frequent work travel. Given his symptoms, which vitamin deficiency is he most likely experiencing?

Answer 33

Scurvy - vitamin C deficinecy

Question 34

Symptoms of scurvy

Answer 34

this is caused by low vit C

feeling very tired and weak all the time
feeling irritable and sad all the time
joint, muscle or leg pain
swollen, bleeding gums (sometimes teeth can fall out)
developing red or blue spots on the skin, usually on the legs and feet, although this may be less noticeable on brown or black skin
skin that bruises easily

Question 35

what increases risk of scurvy (diet etc)

Answer 35

have no fresh fruits or vegetables in your diet for a while
eat very little food at all – possible reasons include treatments that make you feel very sick all the time (such as chemotherapy) or an eating disorder such as anorexia
smoke, as smoking reduces how much vitamin C your body gets from food
have a long-term dependency on drugs or alcohol that affects your diet
have a poor diet while pregnant or breastfeeding, because the body needs more vitamin C at these times

Question 36

what is rickets

Answer 36

A lack of vitamin D or calcium is the most common cause of rickets.

Rickets is a condition that affects bone development in children. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities.

Question 37

A 48-year-old man with a history of peptic ulcer disease and angina recently had his creatinine and electrolyte levels checked as part of a routine health assessment. He is currently taking naproxen 500 mg tablets and omeprazole 20 mg gastro-resistant capsules and has a past medical history of alcoholism. His most recent test results show signs of hypomagnesaemia. What is the recommended treatment for this patient?

Choose only ONE best answer.

A:Magnesium hydroxide
B:Magnesium sulfate
C:Magnesium aspartate
D:Magnesium glycerophosphate
E:Magnesium citrate

Answer 37

B – For symptomatic hypomagnesemia, the treatment of choice is intravenous (IV) or intramuscular (IM) magnesium sulfate.

Question 38

A patient has come out from the pharmacy health check-up and has been told that their blood cholesterol levels have increased since the last review. The patient would like to take some supplements to help reduce this rather than risk taking statins in the future. Which of the following vitamins can they take?

A. Vitamin B1
B. Vitamin B2
C. Vitamin B3
D. Vitamin B5
E. Vitamin B6
F. Vitamin B7
G. Vitamin B9
H. Vitamin B12

Answer 38

C – Vitamin B3 (niacin) comes as nicotinic acid and nicotinamide. Nicotinic acid can inhibit the synthesis of cholesterol and triglycerides, reducing blood cholesterol levels.

Question 39

Miss Lizzi Nopril, the trainee pharmacist has come and asked which types of vitamins should be used prior to pregnancy. Which of the following vitamins should be recommended to someone prior to pregnancy?

A. Vitamin B1
B. Vitamin B2
C. Vitamin B3
D. Vitamin B5
E. Vitamin B6
F. Vitamin B7
G. Vitamin B9
H. Vitamin B12

Answer 39

G – Vitamin B9 (folic acid) should be recommended in patients who are trying to conceive at a dose of 400mcg per day. A 5mg dose may be recommended in patient groups at risk of neural tube defects.