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Biochemistry > Vitamins > Flashcards

Vitamins Flashcards

1
Q

The intake of what kind of oil can cause deficiencies in fat soluble vitamins?

A

Mineral Oil

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2
Q

All vitamins are washed out of the body except what vitamins?

A

B12 and B9 (folate)

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3
Q

In what kind of vitamins Fat or Water soluble is there more toxicity? Why?

A

Fat soluble vitamins

Reason: They accumulate in fat.

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4
Q

Vitamin A is used to treat two things what are they?

A

Measles and AML subtype M3 (15;17t)

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5
Q

Vitamin A deficiency can cause 3 things with the eye, what are they? Why?

A
  1. Night Blindness: Nyctalopia (vit. A used in retina)
  2. Bitot spots (opaque ulcers on cornea)
  3. Keratomalacia (keratinization)
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6
Q

How does Vitamin A treat AML?

A

Causes differentiation to PMNs

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7
Q

B vitamin deficiencies commonly result in the what kind of symptoms?

A
  1. Dermatitis 2. Glossitis 3. Diarrhea
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8
Q

Thiamine acronym? Where is Thiamine needed? Explain the 4 places.

How do you Dx Thiamine Def.?

A

TPP

“Think ATP”

  1. Alpha ketoglutarate
  2. Transketolase
  3. Pyruvate Dehydrogenase

(Branched Chain Ketoacid dehydrogenase)

Dx: Increased RBC Transketolase after administration of Thiamine.

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9
Q

KQ A heavy drinker has ataxia, sluggish pupillary light reflex. Follow up a week later, he shows short term memory impairment and frank confabulation. Dx? What is the cause? What other problems can this cause? Why?

A

Wernicke Korsakoff syndrome

Cause: Thiamine Def.

Associated with

  1. Dry Beriberi=polyneuritis
  2. Wet Beriberi=Dilated Cardiomyopathy (think CHF)

Thiamine def. affects aerobic tissues.

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10
Q

B2 Vitamin Def leads to what kind of symptoms? What is B2? B2 makes what two molecules?

A
  1. Magneta colored tongue,
  2. Chelosis: inflammation and fissures at the corners of the mouth
  3. Corneal vascularization Riboflavin

“Two C’s of B2”

FAD, FMN

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11
Q

Diarrhea, Dementia and Dermatitis (Broad Collar rash) are indicative of what vitamin deficiency? What other amino acid can cause this def.? With what drug can you see a deficiency of this vitamin?

A

Niacin def.

Decreased Tryptophan absorption (Hartnup disease); Increased Tryptophan metabolism (malignant carcinoid syndrome)

INH and oral contraceptives because it decreases B6

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12
Q

In Hartnup’s Disease, which amino acids are unchanged?

A

Proline, hydroxyProline and Arginine. “PA’s salary remains unchanged”

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13
Q

What is B3? What two other vitamins does it need as cofactors and what amino acid is it made from? B3 makes what two molecules? B3 causes Flushing that is induced by what chemical? How can you treat the flushing?

A

Niacin (Nicotinic acid)

Tryptophan, B6 and B2 (“6/2=3”)

NAD+, NADP+

PGE

By giving aspirin.

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14
Q

B3 decreases what and elevates what? In which patients should you avoid giving excess niacin and why?

A

Decreases VLDL and Increased HDL.

  1. Diabetics because increases glucose levels
  2. Gout because increases uric acid levels
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15
Q

What is B5 and its acronym? Deficiency leads to what kind of syndrome?

A

Pantothenic acid (coA);

Burning feet syndrome

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16
Q

What is B6 and its acronym? What is it normally used for? It can be depleted by what two drugs? What are the symptoms after depletion?

A

(pyridoxine: PLP)

Production of 1. transaminases (ALT, AST, GGT); 2. Neurotransmitters: Serotonin, Dopamine, NE and Epi 3. Heme

Depleted by INH and Oral contraceptives: Peripheral neuropathy and sideroblastic anemia

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17
Q

What can be deficient if you just eat raw egg whites? This vitamin is B___? Where are these reactions used?

A

Biotin

B7

For: carboxylation enzymes

pyruvate to oxaloacetate

acetyl-coA to malonyl-coA

proprionyl coA to methylmalonyl-coA

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18
Q

Which Vitamin is the first to be depleted by in cellular division? This vitamin is important in pregnancy because? When should you start supplementing a pregnant patient with this vitamin?

A

Folate (B9) Neural tube defects 12th week.

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19
Q

Vitamin B9 vs Vitamin B12?

A

B12 has two things: 1. Increased MMA levels 2. Neurological changes

20
Q

An Alcoholic with megaloblastic anemia. Is it due to B9 or B12 def?

A

B9 because it takes years to develop B12 def.

21
Q

What neurological changes do you see in B12 def.? Why? Also with B12, you will see elevated levels of ________ and ________?

A

Impaired position and vibration sense and ataxic gait

Subacute combined degeneration (combine: descending and ascending tracts)

Methylmalonic Acid and homocysteine

22
Q

MCC of perncious anemia? Why? Dx antibody for perncious anemia? Why does it combine with IF? In what other disease or causes will you see loss of vitamin B12?

A

Vitamin B12 Def.; loss of parietal cells

Anti-Intrsinsic factor

Because it becomes resistant to proteolysis

Causes:

  1. Insufficent intake (veganism)
  2. malabsorption (Diphyllobothrium latum)
  3. lack of IF (gastric bypass)
  4. Absence of terminal ileum (Crohns)
23
Q

B12 is normally found in which two reactions? Why do you need these two reactions? Def of B12 leads to ________ and ________ and why?

A
  1. Homocysteine methyltransferase: for DNA production
  2. Methyl Malonyl CoA mutase: Myelin production

Megaloblastic Anemia (because of lack of DNA production) and Subacute Combined Degeneration (because of lack of myelin)

24
Q

MC vitamin Def. in the US? This vitamin is B_? Why?

A

Folate (B9)

Overcooking of vegetables

25
Q

Vitamin C is needed in 3 places? How is it used to treat diseases?

A
  1. Hydroxylation of proline and lysine
  2. Necessary for dopamine B-hydroxylase
  3. Faciliates Iron absorption to Fe2+

Vit. C can be used as a temporary treatment for methemoglobinemia

26
Q

“Corkscrew” hair with poor wound healing is indicative of what disease?

A

Scurvy

27
Q

Painful gums and subperiosteal hematomas are indicative of?

A

Vit. C def

28
Q

In which patients should Vitamin C be avoided?

A
  1. Calcium oxalate stones
  2. Increased risk of iron overload (hemachromatosis and transfusions)
29
Q

Vitamin D3 is commonly found in which part of the skin? Therefore, in which two people will vitamin D be most deficient?

A

Stratum Basale

Premature (undeveloped skin) and Pigmented individuals (too much pigment)

30
Q

Vitamin D def leads to what kind of symptoms? Vitamin D symptoms of excess and in what diseases do you find it most commonly?

A

Def.: Rickets, Osteomalacia, Hypocalcemia=> tetany

Excess Symptoms: Loss of Appetite and stupor (unconsciousness)

31
Q

Vitamin Def. that just has the neurologic symptoms of Vit. B12?

A

Vitamin E

32
Q

Vitamin E is what kind of a molecule? What does this molecule do? What is the second function of this molecule? Therefore, what symptoms can you expect in a def. of this molecule?

A

antioxidant (protects RBCs and membranes from free radical damage)

enhance effect of warfarin

Symptoms: hemolytic anemia (loss of protected RBCs), posterior column and spinocerebellar tract dysfunction, acanthocytes (loss of protected membranes)

33
Q

Vitamin K (phytomenadione) def. is esp. found in what kind of patients? Name 3. With vitamin K, you have increased ______ but normal ________?

A
  1. Cystic Fibrosis patients (malabsorption of Fat soluble vitamins)
  2. Neonates and Antibiotics (sterile intestines)

PT, PTT and normal bleeding time

34
Q

Delayed wound healing is indicative of what def.? What is purpose of this vitamin?

A

Zinc Def.

Zinc:

  1. required to go from Collagen 3 to 1
  2. Zinc finger (transcription factor motif)
35
Q

Zinc def. patients are affected in three organ systems where are they? They may predispose to what disease?

A

Gonads (hypogonadism), Skin (acrodermatitis enteropathica), Taste/smell (dysgeusia and anosmia)

May predispose to alcoholic cirrhosis

36
Q

Summarize Kwashiorkor in one phrase? Why do each occur?

A

Decreased proteins in the blood=> “MEAL”

Malnutrition

Edema (decreased oncotic pressure)

Anemia (decreased proteins in RBCs)

Liver (fatty) (decreased lipoprotein synthesis)

37
Q

Marasmus results in?

A

Muscle wasting

38
Q

Fomepizole inhibits? Disulfram inhibits?

A

Alcohol dehydrogenase (fomepizole inhibits the First Step)

Acetaldehyde dehydrogenase (responsible for hangover symptoms)

39
Q

What is the rate limiting agent in alcohol metabolism? And what kind of kinetics does alcohol operate by?

A

NAD+

Zero order kinetics

40
Q

Ethanol is used to tx methanol b/c it has a ?

A

lower Km

41
Q

What ratio does Ethanol metabolism increase? What is the result of this increase?

A

NADH/NAD+

Not enough NAD+:

  1. Lactic acidosis
  2. Increased malate (prevents gluconeogensis=>hypoglycemia)
  3. increased glycerol 3-phosphate=> increased triglycerides=> fatty liver
  4. Increased use of Acetyl-coA to make ketoacids=>fatty liver
42
Q

What vitamins are deficient in Breast milk?

A

D and K

43
Q

For the question with Wernicke Korsakoff syndrome, what group of reactions does it affect the most?

A

“think ATP” Alphaketoglutarate Transketolase Pyruvate dehydrogenase

44
Q

A patient with increased irritability, abdominal pain, reduced reflexes in all extremities with a treatment of EDTA. Dx? What metabolic cycle does it affect the most? Where else can you see this toxin? What is end effect of this toxin and why?

A

Lead poisoning

Heme synthesis

Gum and Bone (Lead lines)

Inhibition of ALA dehydratase and ferrochelatase+ inhibits 5’ nucleotidase activity=>microcytic hypochromic anemia+basophilic stippling of erythrocytes

45
Q

Tx for lead poisoning?

A
  1. Dimercaprol 2. EDTA

Biochemistry (21 decks)

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