Vitamins Flashcards
Basic Vitamin B and Fe Deficiency
Diarrhea, Dermatitis, and Glossitis. (Cheilosis) type of dermatitis
Vit A (Retinol) Function
Stored in Liver, and found in Leafy vegetables
Antioxidant
Constituent of Visual Pigments (retina)
Essential for normal differentiation of epithelial cells into specialized Cells (Pancreatic, mucus secreting cells)
Prevents Squamous Metaplasia
Treats: Measles, AML Subtype M3
Vision, Growth, Repro of epithelial
Topical: Acne Vulgaris and Psoriasis
Vitamin A Deficiency
Often Seen in Alcoholics
Night Blindess (Nyctalopia)
Dry Scaly Skin (Xerosis Cutis)
Xeropthalmia (Dry Eyes)/Corneal Ulcer
Alopecia
Corneal Degeneration (Keratomalacia)
Immune Suppresion
Bitot’s Spots –> Dry Gray spots on conjunctiva
Vitamin A Overdose
Headache, Nausea, Vomiting, Stupor
Arthralgias,
Skin Changes: Scaliness (itchy)
Alopecia
Cerebral Edema
Pseudotumor Cerebri (Increase ICP)
Osteoperosis & Hypercalcemia
Increase Lung Ca in smokers
Liver: Cirrhrotic and enlarged
Teratogenic: Effects Neural Crest Migration
Cleft Palate, Cardiac abnormalities
Stored in liver via Stellate cells (perisinusoidal space)
Vitamin A therapies
Meales
AML Subype M3
Topical: Acne Vulgaris, Psoriasis
Isotretinoin = Accutane
Retinol = Vit A.
Retin-A Tx Acne and Wrinkles
Vitamin B1 (Thiamine) Deficiency
ATP Depletion (impaired Glucose breakdown
Worsened With Glucose Infusion. (Drives Free Thiamine intracellularly –> nerve dmg)
Highly Aerobic Tissues Effected First (Heart and Brain)
Seen in Malnutrition and ETOH)
Dx: by increase RBC transketolase activity with thiamine infusion
Wernicke-Korsakoff - Triad: Confusion, Opthalmoplegia, Ataxia
Also, Confabulation, personality change, permanent memory loss.
Damages Medial Dorsal nucelus of thalamus and mamillary bodies
Dry Beri Beri: Polyneuritis, Symmetrical muscle wasting
From nonsepcific neuropathy via myelin degenration (toe, wrist, foot drop), Areflexia
Rice is major diet
Wet Beri Beri: HighOut Put Cardiac Failure (dilated cardiomyopathy (S3 sound), edema) Peripheral Vasodilation
Vitamin B1 (Thiamine) Function
TPP (Thiamine Pyrophosphate) Bioactive form
Cofactor for dehydrogenase reactions
Pyruvate Dehydrogenase
Alpha Ketoglutarate Dehydrogenase
Transketolase (HMP Shunt) (non oxidative)
and Branched- Chain Ketoacid Dehydrogenase
Think ATP (alpha keto glutarate, Transketolase, Pyruvate Dehydrogenase)
Vitamin B12 (Cobalamin) FXN
Cofactor for Homocysteine Methyltransferase (shared with B9) and Methylmalonyl Mutase (specific for B12)
Found in animal products.
3 year store
Vitamin B12 Cobalamin Deficiency
3 Year store in liver. Usually from insufficient intake (vegan, malasoprtion, lack of IF (Pernicious anemia, gastric bypass) or absence of terminal ileum (Crohns)
Anti-IF = Pernicious Anemia
Get Macrocytic Megaloblastic Anemia
Hypersegmented PMNs
Pasthesia and Subacute combined degeneration of doral colum and lateral tracts and spinocerebellar tracts via abnormal myelin)
Increas homocystenuria AND Methylmalonyl CoA
Prolonged = irreversible nerve damage
Vitamin B2 (Riboflavin) Deficiency
2 C’s of B2
Cheilosis (inflammation of lips, scaling and fissues of corner of mounth), Corneal vascularization
Dermatitis/(type of dermatitis Cheilosis (agular stomatitis)), diarrhea, glossitis are general B and Fe deficiencies
Vitamin B2 (Riboflavin) Function
Component Of FAD and FMN (B2 = 2ATP), get to ATP per FAD’s.
Used as cofactor in Redox.
Succinate Dehydrogenase reaction in TCA
Vitamin B3 Niacin Deficiency
Can be caused by Hartnup Disease: Poor absorption of nonpolar aminoacids in PCT –> deficiency of Niacin, Serotonin and Melanin
By Malignant Carcinoid Syndrome (increase Tryptophan metabolism)
By Isonizid (decrease Vit B6)
Leads to Pellagra (3D’s of B3)
Diarhea, Dementia (w/ Hallucinations), and Dermatitis (casal necklace or hyperpigmentation of sun exposed limbs)
Can add Death too
Vitamin B3 Niacin Excess
Facial Flushing (induced by PG, not histamine), hyperglycemia, and hyperuricemia
Can be lessened with aspirin (blocks PG)
PG = Prostaglandins
Vitamin B3 Niacin Function
Nad and NADP (Redox reaction)
Derived from Tryptophan
Synthesis requires B2 (riboflavin and B6 pyridoxine)
Treats Dyslipidemia (Raise HDL (Best at this), and decrease VLDL) (Inhibits Hormone Dependent Lipolysis in adipose and inhibits hepatic VLDL synthesis)
Minor Decrease in TG
Vitamin B5 Pantothenate Function
Essential component of coenzyme A (CoA is a cofractor for Acyl Transfers) and fatty acid synthase
Pento = 5 (B5)
Vitamin B5 Pantothenate Deficiency
Dermatitis, Enteritis, Alopecia, Adrenal Insufficiency
Vitamin B6 (pyridoxine) Function
Converted to Pyridoxal Phosphate (active),
Cofactor for transamination (ALT and AST), decarboxylation rxns,
glycogen phosphorylase.
Synthesis of Cystathione, Heme, Niacin, histamine, NT (5HT, epinephrine, norepinephrine, dopamine, and GABA)
Vitamin B6 Pyridoxine Deficiency
Convulsions (unique), hyperiritability, peripheral neuropathy (indeuced by INH and OCP), sideroblastic anemia from impaired Hg synthesis and iron excess
Glossitis and ankylosis
Vitamin B7 (biotin) FXN
Cofactor for carboxylation enzymes (adding a C group)
Pyruvate carboxylase (Pyruvate 3C -> oxaloacetate)
Acetyl-CoA Carboxylase (Acetyl -CoA (2C) -> malonyl- CoA (3C)
Propionyl-CoA carboxylase: 3C -> methylmalonyl CoA
Eggs can bind it, cause deficiency
Vitamin B7 Biotin Deficiency
Rare.
Dermatitis, alopecia, enteritis.
Ab use or excessive ingestion of raw egg whites (avidin binds B7)
Vitamin B9 (Folic Acid) Fxn
Converted To THF (tetrahydrofolate), coenzyme for 1 carbon transfer/methylation rxns
Important for synthesis of nitrogenous bases in RNA and DNA
Foudn in leafy green vegetables,
Small Reserve in Liver
Vitamin B9 Deficiency
1 deficiency in US. Pregnancy and ETOH
Macrocytic, Megaloblastic anemia (from decrease in DNA/RNA synthesis) increase growth of cells
Hypersegmented PMNs
Glossitis
NO NEUROSYMPTOMS, differs from B12
Increase homocysteine, normal methylmalonic acid.
Can be cause by: Phenytoin, Sulofnamides, MTX)
Increase risk of Neural tube defects
Excess can exacerbate B12 deficiency
Vitamin C (Ascorbic acid) Deficiency
Scurvy: Swollen gums, bruising, hemarthrosis, anemia, poor wound healing, perifollicular and subperiosteal hemorrhage, “Corkscrew hair”,w
Weakened Immunit
Can only get Vit C via Ingestion
Vitamin C (ascorbic acid) Funxion
Antioxidant, protects RBC
Facilitates Fe absorption by reducing it to Fe State (Ferrous)
Required from hydroxylation of proline and lyseine in collagen synthesis
Required for dopamine B hydroxylase (Doapmine to NE)
Found in fruits and veges
Ancillary for methemoglobenima, reduces Fe+3. but Methylene blue is #1 treatment
Vitamin C Excess
Nausea, Vomiting, Diarhea, Fatigue, Calcium oxalatate nephrolithiasis. Increase risk of Iron toxicity in predisposed (transfusions and HH)
Vitamin D eficiency
Leads to hypocalcemia, increase PTH –> Phosphate wasting and increased bone turnover.
Leads to hypophosphatemia.
Rickets in children (bone pain and eformity)
Osteomalacia in adults (bone pain and muscle weakness)
Hypocalemia –> tetany
Give Vitamin to breast fed babies,
Deficiency exacerbated by black skin, decrease exposure and prematurity
Vitamin D Excess
Hypercalcemia, hyperaclicuria, loss of appeitie, Stupor
Seen in Sarcoid: Increase activation of Vit D by Epithelioid macrophages.
Vitamin D FXN
Increases Intestinal and Bone Absorption of Ca and PO3
Vitamin E Tocopherol Deficiency
Hemolytic anemia, acanthocytosis (spiculated RBC), muslce weakness, posterior column and cerebellar tract demyelination
Ataxia and peripheral neuropathy
Similar Neuro to B12, but w/o megaloblastic anemi,a hypersegment PMNs or increase Methylmalonic acid
Vitamin E Tocopherol FXN
Antioxidant (protects RBCs from Free radicals
Can enhance anticoag effects of warfarin
Vitamin K Deficiency
Neonatal hemorrhage, Increase PT and aPTT but nromal BT.
Neonates have sterile intestines and can synthesis
Also can be from prolonged Broad Specturm antibiotics
Anticonvulsants, AB, Coumadin can all cause deficiency
Toxicity: Hemolytic anemia nad Jaundice
Vitamin K Fxn
Cofactor for gamma carboxylation of glutamic acid Residues. (post translation mod of Clotting factors)
clotting facotrs II, VII, IX, and X
Also Protein C and S and prothrombin
Warfarin = Vit K antagonist
Vitmain D
D2 = Ergocalciferol (from plants D3 = Cholecalciferol (from milk/supplements/sun=exposed skin (stratum basale)
25OH D3 –> Storage form (25hydoxylase in liver)
1,25OH D3 (calcitriol) –> active form, 25 hydroxylase in kidney
Like a steroid hormone
Upregulated by PTH, decrease Ca, Decrease phosphate
own feedback inhibiton
Zinc Defficiency
Delayed Wound healing Hypogonadism w/ Infertility Decrease adult hair Dysguesia Anosmia, Acrodermatitis enterpathica
Predispose to alcoholic cirrhosis
Zine FXN
Esesential for 100+ enzymes. Formation of Transcription factor motif (zinc finger)
