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Classic Presentations > Vitamin & Mineral-Related Pathologies > Flashcards

Vitamin & Mineral-Related Pathologies Flashcards

0
Q

Vitamin A Deficiency OR Excess

Common Pres (2)?

A

PRES:

  • Alopecia
  • Scaly skin
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1
Q

Fat-Soluble Vitamin Deficiency

Causes (2)?

A

CAUSES:

  • Malabsorption Sx (ie Cystic Fibrosis, Sprue)
  • Mineral oil intake
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2
Q

Vitamin A Deficiency

Mech, Pres (7)?

A

Vit A = necessary for differentiation of epithelial cells -> specialized tis (ie mucus-secreting cells, pancreatic cells).
Deficiency -> Metaplasia.

PRES:
- Immune suppression
- Alopecia
- Xerosis Cutis (dry scaly skin)
- Keratomalacia (Corneal degen / softening)
- Nyctalopia (night blindness)
- Xerophthalmia
- Periductal Mastitis (squamous metaplasia of lactiferous ducts ->
duct infl + blockage)

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3
Q

Vitamin A Excess

Pres (7), CI?

A

PRES:

  • Alopecia
  • Scaly skin
  • Arthralgias
  • Osteoporosis
  • Cerebral Edema
  • Pseudotumor Cerebri
  • Hepatic abnormalities

CI: ** Teratogenic **

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4
Q

Vitamin B Deficiencies

Pres (3 KEYS)?

A

PRES:

  • Dermatitis
  • Glossitis
  • Diarrhea
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5
Q

Vitamin B1 (Thiamine) Deficiency

Causes (2), Mech (2), Pres (2 Conditions), DX?

A

CAUSES: malnutrition + malabsorption

  • Malnutrition
  • Alcoholism

MECH:
- Impaired glucose B/D -> ATP depletion
(worsened by glucose infusion)
** Highly aerobic tis (ie brain, heart) affected first **
- Def of dehydrogenase enz for which Vit B1 is a cofactor: “ATP”
- a-ketoglutarate dehydrogenase (Maple Syrup Urine Dz)
- Transketolase
- Pyruvate dehydrogenase

PRES:

  • Beriberi (Wet + Dry)
  • Wernicke-Korsakoff Sx

DX:
-↑RBC Transketolase activity (following B1 admin)

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6
Q

Wernicke-Korsakoff Sx

Locations (2), Pres (TRIAD + 3)?

A
  • MD nucleus (Thalamus)
  • Mamillary Bodies (Hypothalamus)

PRES:

  • “Ataxia + Confusion + Opthalmoplegia”
  • Confabulation
  • Personality change
  • Memory loss (permanent)
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7
Q

Dry Beriberi

Pres (2)?

A

PRES:

  • Symmetrical muscle wasting
  • Polyneuritis
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8
Q

Wet Beriberi

Pres (2)?

A

PRES:

  • Edema
  • Dilated Cardiomyopathy (high-output HF)
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8
Q

Vitamin B2 (Riboflavin) Deficiency

Pres (2)?
THINK: 2 Cs of B2

A

PRES:

  • Cheilosis
  • Corneal vascularization
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9
Q

Vitamin B3 (Niacin) Deficiency

Pres?
THINK: 3 Ds of B3

A

PRES: Pellagra

- “Dementia”, “Dermatitis”, “Diarrhea”

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11
Q

Vitamin B3 (Niacin) Excess

Pres, Labs (2)?

A

PRES:
- Facial flushing (induced by Prostaglandin)

LABS:

  • HYPERglycemia
  • HYPERuricemia
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12
Q

Pellagra

Causes (3), Pres (3)?

A

CAUSES:

  • Hartnup dz (↓Tryptophan abs)
  • Malignant Carcinoid Sx (↑Tryptophan metab)
  • Isoniazid (↓Vitamin B6)

PRES:

  • Dementia (incl hallucinations)
  • Diarrhea
  • Dermatitis (“casal necklace” or hyperpigmentation of sun-exposed limbs)
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13
Q

Vitamin B5 (Pantothenate) Deficiency

A

Adrenal Insufficiency

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14
Q

Vitamin B6 (Pyridoxine) Deficiency

Mech,↓By, Pres (4: 1 Heme + 3 Neuro)?

A

Vit B6 = cofactor for δ-ALA Synthase.

↓BY:
- Isoniazid

PRES:

  • Sideroblastic Anemia (due to Fe excess + impaired Hb syn)
  • Peripheral Neuropathy
  • Convulsions
  • Hyperirritability
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14
Q

Vitamin B7 (Biotin) Deficiency RARE

Causes (2)?

A

CAUSES:

  • Ingestion of raw egg whites
  • Antibiotic use
15
Q

Vitamin B9 (Folate) Deficiency

Causes / Seen In (3), Pres (2), Micro Finding, Labs?

A
  • Folate involved in nucleic acid / DNA synthesis and is needed in rapidly-dividing cells. *

CAUSES:

  • Malnutrition (eg alcoholics) / malabsorption
  • Impaired metab (drug-induced: MTX, Phenytoin, Sulfonamides)
  • ↑requirement (eg pregnancy, hemolytic anemia)

PRES: ** NO NEURO s + s = distinguishing factor from B12 def **

  • Glossitis
  • Megaloblastic Anemia (Macrocytic)

FINDING:
- Hypersegmented Neutrophils

LABS:
- Homocysteine↑(however normal methylmalonic acid)

16
Q

Vitamin B12 (Cobalamin) Deficiency

Causes (4), Pres (2 + 5 Neuro), Micro Finding, Labs (2), DX?

A

CAUSES:
- Malnutrition (insufficient intake eg strict vegans) /
Malabsorption (ie Enteritis, Sprue)
- Diphyllobothrium latum (fish tapeworm)
- Absence of Terminal Ileum (ie Crohn’s)
- Lack of Intrinsic Factor (ie Pernicious Anemia, Gastric Bypass surgery)
- PPIs

PRES:
- Glossitis
- Megaloblastic Anemia (Macrocytic)
- Neuro s + s (due to involvement of B12 in
F.A pathways and Myelin synthesis):
- Dementia
- Peripheral Neuropathy
- Dorsal Column tract (proprioception problems)
- Lateral Corticospinal tract (spasticity)
- Spinocerebellar tract

FINDING:
- Hypersegmented Neutrophils

LABS:

  • Homocysteine↑
  • Methylmalonic acid ↑

DX: Schilling Test (etiology of def)

18
Q

Vitamin C Deficiency

Pres (Name of Condition + 6)?

A

PRES: Scurvy (Collagen syn defect)

  • “Corkscrew hair”
  • Swollen gums
  • Poor wound healing
  • Anemia
  • Mucosal bleeding / Bruising / Hemarthrosis
  • Perifollicular + Subperiosteal Hemorrhages
18
Q

Vitamin C Excess

Pres (3), Comp?

A

PRES:

  • Nausea / Vomiting / Diarrhea
  • Fatigue
  • Ca Oxalate Nephrolithiasis

COMP:
- Fe toxicity (in predisposed ppl)

20
Q

Vitamin D Deficiency

Name of Conditions (Children vs Adults),
Exacerbations (3),
Pres (common to both), Labs (4: 2 and 2)?

A
  • Rickets (Children: bone pain + DEFORMITY)
  • Osteomalacia (Adults: bone pain + MUSCLE WEAKNESS)

EXACERBATIONS:

  • Prematurity
  • Pigmented skin
  • Low sun exposure

PRES:
- Increased risk for bone fractures

LABS:

  • ↓serum Ca + P
  • ↑serum PTH + Alkaline Phosphatase
20
Q

Vitamin D- Resistant / Hypophosphatemic Rickets

Inher, Mech, Causes / Assoc, Pres (3)?

A

XD.

MECH = Phosphate wasting at proximal tubule

CAUSES / ASSOC:
- Fanconi Sx (PCT reabs defect ->↓P reabs)

PRES:

  • Bowing of legs
  • Enlarged forehead (osteoid deposition on skull)
  • “Pigeon breast” deformity: Ant protrusion of sternum + inward bending of ribs
21
Q

Vitamin D Excess

Causes (3), Pres (2), Labs (2), Urine?

A

CAUSES:

  • Over-supplementation
  • Granulomatous disease
  • Sarcoidosis (↑ACTIVATION of Vit D by epithelioid macrophages)

PRES:

  • Loss of appetite
  • Stupor

LABS:

  • ↑Ca + P
  • ↓PTH

URINE:
-↑Ca

23
Q

Vitamin K Deficiency

Causes (2)?

A

CAUSES:

  • Neonates (sterile intestines that are unable to syn Vit K)
  • Prolonged use of broad-spectrum Antibiotics
24
Q

Copper Deficiency

Pres?

A

PRES:

- Sideroblastic Anemia

25
Q

Zinc Deficiency

Pres (5), Comp?

A

PRES:

  • ↓adult hair
  • Delayed wound healing
  • Anosmia + Dysgeusia
  • Acrodermatitis Enteropathica
  • Hypogonadism

COMP (can predispose to):
- Alcoholic Cirrhosis

Classic Presentations (18 decks)

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