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Stuff You Can Never Remember > Vitamin Deficiency's > Flashcards

Vitamin Deficiency's Flashcards

1
Q

A patient comes into your office with swollen gums, bruising, petechiae, hemearthrosis, poor wound healing, subperiosteal hemorrhages and corkscrew hair. Synthesis of what molecule is being hindered? What vitamin is causing this?

A

Collagen Synthesis from Vit C deficiency

SCURVY

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2
Q

Cobalamin is important in the synthesis of what two things?

A

Heme (methylmalonyl CoA to Succinyl CoA)

Methionine (from homocysteine)

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3
Q

What are the components of riboflavin deficiency?

A

Cheilosis and Corneal vascularization

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4
Q

Vit C main function is in the synthesis of what?

A

Collagen

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5
Q

What TCA reaction will be affected with a deficiency in biotin?

A

Pyruvate to Oxaloacetate

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6
Q

Vit C is necessary for the hydroxylation of what two AA?

A

Proline and lysine

collagen synthesis

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7
Q

What reaction are the cofactors in B2 used for?

A

Succinate dehydrogenase enzyme in TCA cycle

also imp for glutathione reductase

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8
Q

What vitamin is important for the regulation of blood glucose during fasting?

A

Vit B6 due to it being a cofactor to glycogen phosphorylase used to break down glycogen

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9
Q

What neurotransmitters relay on B6 to be made?

A 
Serotonin
Epi
NE
Dopamine
GABA
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10
Q

Folate supplement can mask the hematologic symptoms of what deficiency?

A

B12

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11
Q

What vitamin is necessary for the conversion of dopamine to NE?

A

Vit C

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12
Q

What is the difference between wet beriberi and dry beriberi?

A

Wet beriberi has cardiac failure

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13
Q

What organism can cause a decrease in the absorption of Vit C?

A

Diphyllobothrium Latum

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14
Q

What vitamin is required for the production of Cholesterol, Ketone, and fat from acetyl coA?

A

Biotin or B7 is a cofactor to take acetyl coA to either acetoacetyl CoA (ketones and cholesterol) or Malonyl CoA (fats)

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15
Q

What is hartnup disease?

A

Deficiency of neutral amino acid transporters in proximal renal tubular cells and on enterocytes leading to neutral aminoaciduria and decrease absorption from the gut -> less tryptophan is converted into niacin leading to a deficiency

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16
Q

What is Vit D affect in Ca?

A

Vit D increases the intestinal absorption of calcium and therefore a decrease in Vit D can lead to hypocalcemia

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17
Q

Riboflavin is important for the de novo synthesis of what other vitamin?

A

Niacin from tryptophan

B2 and B6 are used in those reactions

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18
Q

What is another name for vitamin B3?

A

Niacin

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19
Q

Increase activation of Vit D by macrophages occurs in what disease?

A

Granulomatous Diseases

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20
Q

A patient is found to have an increase of lactic acid in a blood sample. You note that the same patient has symmetrical muscle wasting and neuropathy. What vitamin is deficient and what enzyme is causing the lactic acidosis?

A

Thiamine is the Vitamin (TPP the cofactor)

The enzyme is most likely pyruvate dehydrogenase - this enzyme takes pyruvate into the TCA cycle to continue oxidative phosphorylation

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21
Q

What test can be done to check for B12 deficiency?

A

Schilling Test

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22
Q

How do you diagnose a deficiency in thiamine?

A

Give B1 and see if there is an increase in transketolase activity

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23
Q

Where is Vitamin D converted to 25, D3

A

Liver

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24
Q

What enzyme deficiency can lead to adrenal insufficiency?

A

Vit B5 (pentothenic acid)

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25
Q

What is a near complication of Vitamin A toxicity?

A

Pseudotumor cerebri

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26
Q

What three other things can cause a deficiency in niacin?

A 
Hartnup Disease 
(deficiency in tryptophan)
Carcinoid Syndrome 
(tryptophan used to make serotonin)

Isoniazid
(decrease B6 which is needed to make niacin from tryptophan)

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27
Q

Propionyl CoA to Methylmalonyl CoA using the enzyme propionyl CoA decarboxylase requires what vitamin?

A

Biotin

eventually this reaction will regenerate succinyl CoA for TCA cycle

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28
Q

Where is vitamin D converted to 1,25 D3

A

Kidney

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29
Q

What three classic drugs can decrease folate?

A

phenytoin
Sulfonamides
methotrexate

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30
Q

Where is folate absorbed?

A

Jejunum

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31
Q

What vitamin is used as a cofactor in transaminase reactions?

A

Vit B6 (ALT and AST)

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32
Q

PLP is the cofactor of what vitamin?

A

B6 (pyridoxine)

33
Q

What are the three syndromes that can be caused by a deficiency in thiamine?

A

Wernicke-Lorsakoff
Dry Beriberi
Wet Beriberi

34
Q

Patient comes in complaint of tetany and muscle weakness. what vitamin might be deficient?

A

Vit D

35
Q

What is it called when rickets is caused by a defect in the vitamin D receptor?

A

Hypophosphatemic Rickets

36
Q

Niacin can be derived from what AA?

A

Tryptophan

37
Q

What drug is commonly given with B6 to prevent peripheral neuropathy?

A

Isoniazid

38
Q

How is hypophosphatemic Rickets transmitted?

A

X DOMINATE

39
Q

Deficiency in pyridoxine can cause what symptoms?

A

Convulsions, peripheral neuropathy, sideroblastic anemia

40
Q

What cofactor is pentathonic acid?

A

Coenzyme A

41
Q

Which vitamin is a co-factor for the enzyme alpha ketogluturate?

A

B1 Thiamine (TPP is the cofactor)

42
Q

What is it called when you have a deficiency in Vit C due to intrinsic factor?

A

Pernicious Anemia

43
Q

What type of anemia is caused by folate?

A

Macrocytic megaloblastic anemia with hyperhsegmented polymorphonuclear cells

44
Q

What vitamin is given to children with measles?

A

Vitamin A

45
Q

dry, scaly skin, corneal degradation, and Bitot Spots are seen in a patient. What is a CI to taking the vitamin that causes these deficiency symptoms?

A

Pregnancy due to teratogenicity

46
Q

What is the treatment for B1 deficiency?

A

GIVE B1 then glucose - if you give glucose first you will cause wernicke-korsakoff

47
Q

How can you distinguish the anemia caused by folate and the one caused by cobalamin?

A

B12 has neuro symptoms

48
Q

What is riboflavin?

A

Vitamin B2

49
Q

Vitamin A can be used to treat what cancer?

A

AML

can bind these cells are force them to differentiate

50
Q

Niacin is used to treat what common disorder?

A

Dyslipidemia

51
Q

Folate is important for the synthesis of what?

A

Nitrogenous bases in DNA and RNA

52
Q

Why does Pyridoxine deficiency cause anemia?

A

B6 is used by Delta aminolevulinic acid as the rate limiting step in heme synthesis -> can’t make heme then iron gets trapped in the cell and causes sideroblastic anemia

53
Q

What are the symptoms of niacin deficiency?

A

3 D’s

Diarrhea, Dementia, Dermititis

54
Q

Excess niacin leads to what common symptom that can be relieved by ASA?

A

Flushing

55
Q

Vit C can be used to treat what?

A

Methemoglobinemia

56
Q

What three regulation factors increase the production of 1.25 OHD3?

A

Increase in PTH
Decrease in Ca
Decrease in PO4

57
Q

What are the cofactors of B2?

A

FAD and FMN

58
Q

What do the labs look like in folate deficiency?

A

Increase in homocysteine

59
Q

What is another name for Vitamin E?

A

Tocopherol or tocotrienol

60
Q

What is tocopherol’s main function?

A

Antioxidant (protect RBC and membranes from free radical damage)
(Vit E)

61
Q

High does supplement of what vitamin can alter the metabolism of Vit K leading to an enhancing effect of wrfarin?

A

Vit E

62
Q

What Vitamin deficiency presents with muscle weakness, posterior column and spinocerebellar tract demyelination, and hemolytic anemia but DOES NOT HAVE megaloblastic anemia or hypersegmented neutrophils?

A

Vit E Deficiency

63
Q

What clotting factors require Vit K?

A

X, IX, XII, II, protein C and S

diSCo 1972

64
Q

What enzyme activated vitamin K?

A

Epoxide reductase

inhibited by warfarin

65
Q

Vit K is the cofactor for what kind of reaction?

A

gamma carboxylation of glutamic acid residues on various clotting proteins

66
Q

Who is at risk for a Vit K deficiency?

A

Neonates (sterile gut flora)
Long term Antibiotic patients

(gut flora makes Vit K)

67
Q

What will be increases in a patient with a deficiency of Vit K?

A

PT and aPTT

normal bleeding time

68
Q

Deficiency of what molecule may predispose individuals to alcoholic cirrhosis?

A

Zinc

69
Q

What molecule is important for the proper folding of proteins?

A

Zinc

70
Q

Hypogonadism, anosmia, and decrease in adult hair are all symptoms of a deficiency of what molecule?

A

Zinc

71
Q

What type of protein deficiency does not result in edema?

A

Marasmus

diet is deficient in calories but no nutrients are entirely absent

72
Q

What is the protein deficiency called that causes edema?

A

Kwashiorkor

73
Q

What drug inhibits alcohol dehydrogenase?

A

Fomepizole (antidote for methanol and ethylene glycol overdose)

74
Q

What causes the fatty liver changes in chronic alcohol use?

A

Increase in NADH favors the production of FA

75
Q

What inhibits acteylaldehyde dehydrogenase and can be used to discourage drinking?

A

Disulfiram

76
Q

In the setting of chronic alcohol abuse pyruvate is converted to what molecule?

A

Lactic Acid

disrupts gluconeogenesis

77
Q

In the setting of chronic alcohol use oxaloacntate is converted into what molecule?

A

Malate

disrupts gluconeogenesis

78
Q

What are the locations of the different enzymes in alcohol metabolism?

A

Alcohol Dehydrogenase - cytosol
Acetylaldehyde Dehydrogenase - mitochondria
Catalase - peroxisomes

Stuff You Can Never Remember (5 decks)

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