Vitamins Flashcards
Vitamin B1 (thiamine) deficiency
Wernicke-Korsakoff syndrome and beriberi.
polyneuritis, symmetrical muscle wasting.
Dry beriberi; thiamine deficiency
high-output cardiac failure (dilated cardiomyopathy), edema.
Wet beriberi; thiamine deficiency
confusion, ophthalmoplegia, ataxia + confabulation, personality change, memory loss (permanent); dx/ damage where?
Wernicke-Korsakoff syndrome; Damage to medial dorsal nucleus of thalamus, mammillary bodies.
Vitamin A deficiency
Night blindness (nyctalopia); hypoparathyroidism; dry, scaly skin (xerosis cutis); alopecia; corneal degeneration (keratomalacia); immune suppression.
Vitamin A toxicity
Arthralgias, skin changes (scaliness), alopecia, cerebral edema, pseudotumor cerebri, hyperparathyroidism, osteoporosis, hepatic abnormalities. Teratogenic (cleft palate, cardiac abnormalities)
Vitamin B2 deficiency
Cheilosis (inflammation of lips, scaling and fissures at the corners of the mouth), Corneal vascularization, Stomatitis, Glossitis, normocytic Anemia, seborrheic dermatitis
Vitamin B3 Niacin deficiency
Glossitis. Severe deficiency leads to pellagra w/ Diarrhea, Dementia, Dermatitis, Death
Diarrhea, Dementia (also hallucinations), Dermatitis (Casal necklace or hyperpigmentation of sun-exposed limbs). Dx? Etiologies?
Pellagra: severe vitamin B2 deficiency, Hartnup disease (decreased tryptophan absorption), malignant carcinoid syndrome (increased tryptophan metabolism), and isoniazid (decreased vitamin B6).
Vitamin B5 Pantothenate deficiency
Burning feet syndrome, Dermatitis, enteritis, alopecia, adrenal insufficiency.
Vitamin B6 Pyridoxine deficiency
Convulsions, hyperirritability, Peripheral neuropathy (via isoniazid, oral contraceptives), sideroblastic anemias due to impaired hemoglobin synthesis and iron excess.
Vitamin B9 (folic acid) deficiency sx?
Macrocytic, megaloblastic anemia; hypersegmented polymorphonuclear cells (PMNs); glossitis; no neurologic symptoms (as opposed to vitamin B12 deficiency)
Vitamin B9 (folic acid) deficiency labs? Drugs inducing?
Increased Homocysteine, NORMAL methylmalonic acid; worst w/ phenytoin, sulfonamides, methotrexate
Vitamin B12 (cobalamin) deficiency sx?
Macrocytic, megaloblastic anemia; hypersegmented PMNs; paresthesias, and subacute combined degeneration (degeneration of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts) due to abnormal myelin.
Vitamin B12 (cobalamin) deficiency labs?
Increased serum homocysteine AND methylmalonic acid levels. Prolonged deficiency leads to irreversible nerve damage.
Vitamin B12 (cobalamin) deficiency etiology?
Veganism, malabsorption (e.g., sprue, enteritis, Diphyllobothrium latum), lack of intrinsic factor (pernicious anemia, gastric bypass surgery), or absence of terminal ileum (Crohn disease). Anti-intrinsic factor antibodies diagnostic for pernicious anemia.
Vitamin C (ascorbic acid) deficiency?
Scurvy: bleeding swollen gums, petechiae, bruising, hemarthrosis, anemia (Fe absorption), poor wound healing (collagen defect), perifollicular and subperiosteal hemorrhages, “corkscrew” hair. Weakened immune response.
Vitamin D deficiency?
Rickets in children (bone pain and deformity), osteomalacia in adults (bone pain and muscle weakness), hypocalcemic tetany
Vitamin D toxicity?
Hypercalcemia, polydipsia, polyuria, hypercalciuria, loss of appetite, stupor. Sarcoidosis (increased activation of vitamin D by epithelioid macrophages).
Vitamin E (tocopherol/tocotrienol) deficiency?
Hemolytic anemia, acanthocytosis, muscle weakness, posterior column and spinocerebellar tract demyelination (similar to B12 def w/o hypersegmented PMNs)
Vitamin K deficiency?
Neonatal hemorrhage with increased PT and INR, but normal bleeding time. Can also occur after prolonged use of broad-spectrum antibiotics.
Zinc deficiency
Delayed wound healing, hypogonadism, alopecia (axillary, facial, pubic), dysgeusia, anosmia, acrodermatitis enteropathica. May predispose to alcoholic cirrhosis.
Dermatitis, diarrhea, and alopecia while on long-term total parenteral nutrition (TPN); deficiency?
Zinc deficiency
