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GI Exam > Vitamins > Flashcards

Vitamins Flashcards

1
Q

vitamins - overview

A

*small organic molecules essential for: (1) DNA and protein synthesis; (2) enzyme & transporter function; (3) many other metabolic processes
*vitamins CANNOT be synthesized (must be acquired from the diet)

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2
Q

water soluble vitamins

A

*thiamine (B1)
*riboflavin (B2)
*niacin (B3)
*pantothenic acid (B5)
*pyridoxine (B6)
*biotin (B7)
*folic acid (B9)
*cobalamin (B12)
*ascorbate (C)

note - B vitamins and vitamin C are water-soluble

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3
Q

fat soluble vitamins

A

*retinol (A)
*calciferol (D)
*tocopherol (E)
*menaquinones (K)

ADEK vitamins are the fat-soluble vitamins

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4
Q

vitamin B1 - name

A

thiamine

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5
Q

vitamin B3 - name

A

niacin

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6
Q

vitamin B2 - name

A

riboflavin

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7
Q

vitamin B5 - name

A

pantothenic acid

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8
Q

vitamin B6 - name

A

pyridoxine

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9
Q

vitamin B7 - name

A

biotin

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10
Q

vitamin B9 - name

A

folic acid

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11
Q

vitamin B12 - name

A

cobalamin

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12
Q

vitamin C - name

A

ascorbate

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13
Q

vitamin A - name

A

retinol

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14
Q

vitamin D - name

A

calciferol

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15
Q

vitamin E - name

A

tocopherol

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16
Q

vitamin K - name

A

menaquinones

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17
Q

vitamin B1 (thiamine) - function

A

*coenzyme for:
-pyruvate dehydrogenase
-alpha-ketoglutarate dehydrogenase
-branched chain ketoacid dehydrogenase
*synthesis of neurotransmitters acetylcholine and GABA

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18
Q

vitamin B1 (thiamine) - sources

A

*origin = bacteria, fungi, & plants
*found in fortified breads and cereals, fish, lean meats and milk

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19
Q

vitamin B1 (thiamine) - populations at risk for deficiency

A

*chronic alcoholism!
*bariatric surgery patients
*poor diet (esp. in elderly)
*orthorexia
*severe malabsorption
*short gut syndrome

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20
Q

vitamin B1 (thiamine) - deficiency diseases

A

*beri-beri (wet or dry)
*Wernicke-Korsakoff syndrome

*marked by peripheral neurologic, cerebral, and cardiovascular abnormalities

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21
Q

Beri-Beri

A

*caused by vitamin B1 (thiamine) deficiency
*neurologic dysfunction (dry) or neuro dysfunction + heart dysfunction (wet)
*sx: ophthalmoplegia, peripheral edema, peripheral neuropathy, +/- congestive heart failure (wet)

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22
Q

Wernicke-Korsakoff Syndrome

A

*caused by vitamin B1 (thiamine) deficiency
*sx: short-term memory loss, ataxia
*often seen in alcoholics

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23
Q

vitamin B1 (thiamine) - pharmacologic uses

A

*management of alcoholism
*post-bariatric surgery (supplementation)
*pregnancy
*total parenteral nutrition (TPN)

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24
Q

vitamin B3 (niacin) - sources

A

*dairy, poultry, fish, lean meats, nut, eggs

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25
Q

vitamin B3 (niacin) - functions

A

*precursor of the coenzymes: NAD and NADP
*energy metabolism, cell signaling, DNA repair

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26
Q

vitamin B3 (niacin) - deficiency disease

A

pellagra

note - pellagra is characterized by dermatitis, diarrhea, and dementia

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27
Q

pellagra

A

*vitamin B3 (niacin) deficiency
*sx: dermatitis, diarrhea, & dementia (the 3 D’s); glossitis and cheilosis (swelling of tongue/lips)

28
Q

vitamin B3 (niacin) - populations at risk for deficiency

A

*corn as main dietary staple
*impoverished populations
*chronic alcoholism
*carcinoid syndrome

29
Q

vitamin B3 (niacin) - pharmacologic uses

A

*treatment of hyperlipidemia (rarely used now)
*post bariatric surgery

30
Q

vitamin B3 (niacin) - toxicity

A

*cutaneous flushing, diarrhea
*increased LFTs, hepatitis, glucose intolerance

31
Q

vitamin B9 (folic acid) - sources

A

*beans and legumes, citrus fruits and juices, whole grains, dark green leafy vegetables, poultry, pork, shellfish, liver

32
Q

vitamin B9 (folic acid) - functions

A

*cofactor in methyl group transfer reactions
*critical for synthesis of DNA, glutathione, hormones, phospholipids, and neurotransmitters

33
Q

vitamin B9 (folic acid) - deficiency diseases

A

*neural tube defects (in fetus)
*megaloblastic anemia

34
Q

vitamin B9 (folic acid) - populations at risk for deficiency

A

*severe malabsorption
*drug and food antagonists
*poor diet in the elderly
*bariatric surgery patients

35
Q

vitamin B9 (folic acid) - pharmacologic uses

A

*adequate amounts of folate BEFORE CONCEPTION and DURING PREGNANCY prevent neural tube defects such as spina bifida

36
Q

vitamin B12 (cobalamin) - sources

A

*synthesized only by microorganisms (product of bacterial metabolism)
*naturally found in: eggs, meat, poultry, shellfish, milk and milk products
*added to fortified grain products (cereals)

37
Q

vitamin B12 (cobalamin) - functions

A

*cofactor in methyl group transfer reactions
*critical for synthesis of DNA, glutathione, hormones, phospholipids

38
Q

vitamin B12 (cobalamin) - deficiency diseases

A

*megaloblastic anemia
*subacute combined degeneration (posterior columns of spinal cord; irreversible)

39
Q

vitamin C (ascorbic acid) - sources

A

*citrus fruits, green peppers, strawberries, tomatoes, broccoli and sweet and white potatoes

40
Q

vitamin C (ascorbic acid) - function

A

*aqueous phase antioxidant (protects us from free radicals)
*cofactor for collagen biosynthesis
*facilitates dietary iron absorption (reduces Fe3+ to Fe2+)
*regenerates vitamin E radicals
*role in folate activation

41
Q

vitamin C (ascorbic acid) - deficiency disease

A

scurvy

42
Q

scurvy

A

*deficiency in vitamin C (ascorbic acid)
*sx: severe periodontal disease, cutaneous hemorrhage, poor wound healing

43
Q

vitamin C (ascorbic acid) - populations at risk for deficiency

A

*cigarette smokers
*severe malnutrition, cachexia

44
Q

fat soluble vitamins - differences from water soluble vitamins

A

*absorption of fat soluble vitamins requires the presence and efficient absorption of dietary fat!!
*can be stored (in liver and adipose tissue)
*can be toxic in excess

45
Q

fat soluble vitamins - absorption

A

*solubilized in lumen in mixed micelles
*packaged in chylomicrons and secreted into lymph
*taken up by the liver in chylomicron remnants
*secreted in plasma bound to transport proteins

46
Q

vitamin A (retinol) - sources

A

*animal sources such as eggs, meat, and dairy products
*produced from beta-carotene, which comes from green, leafy veggies and intensely colored fruits and veggies

47
Q

vitamin A (retinol) - functions

A

*visual pigment synthesis
*maintains ocular structures
*transport by retinol-binding protein
*bone growth & development
*modulates epithelial cell function
*key role in embryo development

48
Q

vitamin A (retinol) - deficiency diseases

A

*keratomalacia
*hyperkeratosis
*night blindness

49
Q

vitamin A (retinol) - toxicity

A

*teratogenic effects
*hypervitaminous A syndrome
*hepatotoxicity

50
Q

vitamin A (retinol) - populations at risk for deficiency

A

*fat malabsorption syndromes!!!
*poor diet in the elderly
*some underdeveloped countries

51
Q

vitamin D (calciferol) - sources

A

*the body itself makes vitamin D when it is exposed to the sun (UV-B light); we make it out of cholesterol
*cheese, butter, margarine, fortified milk, fish, fortified cereals

52
Q

vitamin D (calciferol) - physiologic actions

A

*gut: increased calcium and phosphorous absorption
*kidney: increased distal calcium reabsorption
*bone: facilitates mineralization
*multiple effects on growth, cell repair, and immune function

53
Q

vitamin D (calciferol) - deficiency diseases

A

*RICKETS (in children)
*osteoporosis (in adults)

54
Q

vitamin D (calciferol) - populations at risk for deficiency

A

*fat malabsorption syndromes!
*elderly & homebound
*populations in northern latitudes (less sun)
*advanced kidney disease

55
Q

vitamin D (calciferol) - toxicity

A

*hypercalcemia, weakness
*kidney stones

56
Q

vitamin D (calciferol) - pharmacologic use

A

*prevention of hypocalcemia in renal failure and after parathyroidectomy
*used as an adjunct in treating osteopenia and osteoporosis

57
Q

vitamin E (tocopherol) - sources

A

*corn, nuts, olives, green leafy veggies, vegetable oils, wheat germ

58
Q

vitamin E (tocopherol) - functions

A

*membrane antioxidant (protects from free radicals)

59
Q

vitamin E (tocopherol) - deficiency disease

A

*hemolytic anemia (rare, seen only in those with severe fat malabsorption)

60
Q

vitamin E (tocopherol) - populations at risk for deficiency

A

*biliary atresia
*cystic fibrosis
*short bowel syndrome
*severe pancreatic insufficiency
*genetic abnormalities

61
Q

vitamin K (menaquinones) - sources

A

*plant sources: cabbage, cauliflower, spinach, other green leafy veggies, cereals
*bacterial sources also

62
Q

vitamin K (menaquinones) - function

A

*liver synthesis of CLOTTING FACTORS II, VII, IX, X, prothrombin, proteins S and C
*bone homestasis
*reduced vitamin K is a cofactor for conversion of glutamic acid residues in target proteins to gamma glutamic acid
*brain development
*bone synthesis

63
Q

vitamin K (menaquinones) - deficiency disease

A

*bruisability & bleeding

64
Q

vitamin K (menaquinones) - populations at risk for deficiency

A

*premies & neonates
*fat malabsorption syndromes
*patients on chronic antibiotics (because bacteria supplement our vitamin K pool)
*short bowel syndrome

65
Q

vitamin K (menaquinones) - pharmacologic uses

A

*acute reversal of coumarin (warfarin) induced anticoagulation
*stabilization of anticoagulation in patients taking coumarin Rx

GI Exam (54 decks)

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