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DEMS unit 3 > Vitamins > Flashcards

Vitamins Flashcards

1
Q

Fat soluble vitamins

A

ADEK

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2
Q

vitamin B1

A

thiamine: TPP

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3
Q

vitamin B2

A

riboflavin: FAD, FMN

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4
Q

vitamin B3

A

niacin: NAD

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5
Q

vitamin B5

A

pantothenic acid: CoA

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6
Q

vitaminB6

A

pyridoxine: PLP

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7
Q

vitamin B7

A

biotin

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8
Q

vitamin B9

A

folate

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9
Q

vitamin B12

A

cobalamin

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10
Q

vitamin C

A

ascorbic acid

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11
Q

vitamin A

A

retinol

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12
Q

what diseases do you treat with vitamin A

A

measles, AML subtype M3

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13
Q

vitamin A deficiency

A

night blindness, dry, scaly skin, corneal degeneration, Bitot spots on conjunctiva, immunosuppression

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14
Q

most common vitamin deficiency in US

A

folate (B9)

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15
Q

vitamin deficiency seen in alcoholism and pregnancy

A

folate

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16
Q

enzymes requiring biotin (B7)

A

pyruvate carboxylase, Acetyl-CoA carboxylase, propionyl-coA carboxylase

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17
Q

vitamin B6 involved in what

A

synthesis of cystathionine, heme, niacin, histamine, and neurotransmitters (serotonin, NE, epi, dopamine, GABA)

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18
Q

from what is niacin derived

A

tryptophan; synthesis requires B2 and B6

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19
Q

where is folate absorbed

A

jejunum

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20
Q

which B vitamins stored in liver

A

B12 and folate (B9)

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21
Q

vitamin D deficiency

A

causes Rickets in children, osteomalacia in adults hypocalcemic tetany

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22
Q

main source of vitamin D

A

D2 from plants, D3 from milk, also from sun

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23
Q

vitamin B12 cofactor in what reactions

A

methylmalonyl-CoA mutase (odd chain FA and branched aa –> succinyl-CoA for TCA entry) and homocysteine methyltransferase (homocysteine to methionine)

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24
Q

vitamin deficiencies giving you macrocytic, megaloblastic anemia

A

folate, cobalamin (b9, b12)

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25
Q

vitamin E

A

tocopherol/tocotrienol; protects RBCs and membranes from free radical damage

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26
Q

which vitamins are antioxidants

A

A, C, E,

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27
Q

vitamin K

A

important in coagulation; synthesized by intestinal flora

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28
Q

vitamin K deficiency

A

neonatal hemorrhage with increased PT/aPTT but nl bleeding time; can also occur after prolonged use of broad spec antibiotics

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29
Q

types of malnutrition

A

Kwashiorkor, Marasmus

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30
Q

Marasmus

A

total calorie malnutrition –> tissue and muscle wasting, loss of subcutaneous fat, variable edema

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31
Q

Kwashiorkor

A

protein malnutrition –> skin lesions, edema due to decreased oncotic pressure, liver malfunction (fatty change due to decreased apolipoprotein synthesis)

clinical picture = small child with swollen abdomen

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32
Q

Kwashiorkor pneumonic

A 
arises from deficient MEAL:
M- Malnutrition
E- Edema
A-Anemia
L-Liver (fatty)
33
Q

food sources of vitamin A

A

preformed vit A: liver, dairy, egg yolks, fish oil

Precursor (carotenoids, ie. beta carotene): deep yellow/orange and green veggies (spinach carrots broccoli, pumpkin)

34
Q

risk of vit A deficiency

A

low intake/low fat intake

35
Q

vitamin A toxicity

A

only with preformed vit A retinol: vomting, increased intracranial pressure, headache, bone pain, bone mineral loss (increased fractures/osteoporosis), liver damage, death; birth defects

36
Q

evaluate vitamin A levels

A

serum retinol (levels remain WNL until liver stores nearly exhausted; decreased with acute phase reaction)

37
Q

Vitamin D

A

hormone; maintains intra/extracellular Ca within physiologic range; stimulates intestinal absorption of Ca and Phosphorous, renal reabsorption, mobilization from bone; innate immune function, cell growth and differentiation via vit D receptors on many cells

38
Q

vitamin D sources

A

precursor in skin converted to cholecalciferol (vit D3) by light

Dietary sources: fish liver oils, fatty fish, egg yolks, fortified milk/formula, D2 ergocalciferol from plant algae sources

D3 activity 2-3x that of D2

39
Q

vit d metabolism

A

absorbed via chylomicrons; D2 or D3 hydroxylated in liver to (25-hydroxy-cholecalciferol) then again in kidney to 1,25-dihydroxy-cholecalciferol = active form

40
Q

vitamin a function

A

important in photochemical basis of vision (signals inr etina–> brain visual cortex); maintain conjunctival membranes and cornea; important for epithelial cell differentiation and proliferation

41
Q

Vitamin D deficiency

A

when 25OH-D

42
Q

what will labs show in vit d deficiency

A

low serum Ca and P, increased alk phos; low 25(OH)VitD and increased PTH

43
Q

risk of vit D deficiency

A

lack enough sun exposure, low dietary intake, breastfed infant, fat malabsorption, dark skin, obese, liver/renal dz; elderly with decreased outdoor exposure/decreased conversion

44
Q

Vitamin D RDA

A

600 IU/d children and adults 70

4000 IU/d is tolerated upper limit

45
Q

vitamin D toxicity

A

(>10,000 IU/d x wks)

hypercalcemia, vomiting, seizures; nephrocalcinosis and soft tissue calcification

46
Q

how to measure vitamin D

A

serum 25(OH) Vit D levels reflect nutritional status

47
Q

Vitamin E function

A

antioxidant, free radical scavenger; stabilize cell membranes

48
Q

food sources of vitamin E

A

polyunsaturated vegetable oils, wheat germ

49
Q

vitamin E deficiency

A

neurologic degeneration with loss of reflexes, spinocerebellar ataxia, neuropathy, ophthalmoplegia; incoordination, loss of vibeation and position sense; hemolytic anemia

50
Q

risk of vitamin E deficiency

A

premature, fat malabsorption syndromes, short gut syndromes, CF

51
Q

vitamin E toxicity

A

low

coabulopathy (very large doses inhibit vitamin K dependent factors)

52
Q

vitamin K function

A

essential for coagulation proteins (factors II, VII, IX, X)

53
Q

vitamin K sources

A

leafy vegetables, fruits, seeds; synthesized by intestinal bacteria

54
Q

vitamin K deficiency

A

prolonged coagulation times; hemorrhagic disease of newborn–bleeding into skin, GI tract, CNS

55
Q

Vitamin K deficiency risk

A

newborns;late, esp breastfed infants, fat malabsorption syndromes, chronic antibiotic use

56
Q

vitamin K recommendation

A

all newborns get single IM dose of 0.5-1.0 mg

57
Q

which vitamin deficiencies manifest with neuro sxs

A

Vitamin E, thiamin, (Niacin), B12, B6, (vit C)

58
Q

which vitamin deficiencies manifest with anemia

A

E, (K), Folate, B12, B6, vitamin C

59
Q

which vitamin deficiencies manifest with Rash/skin findings

A

(A), K, Niacin, vitamin C

60
Q

which B vitamins important in energy metabolism

A

thiamine, niacin, riboflavin, pantothenic acid

61
Q

which B vitamins important in hematopoiesis

A

folic acid, vit B12

62
Q

“Other” B vitamins

A

B6, choline, inositol, biotin

63
Q

water soluble vitamin characteristics

A

not stored (except B12), highly absorbed in diet, excreted in urine, low toxicity

64
Q

characteristics of fat sol vitamins

A

accumulate in “stores”, require dietary fat absorption, +/- blood transport system, potentially toxicity with excess intake

65
Q

which vitamin deficiencies manifest with mouth lesions

A

Riboflavin, folate, B12, B6, vitamin C

66
Q

sources of thiamine

A

whole grains, enriched grains, lean pork, legumes

67
Q

sources of Riboflavin

A
  • Richest sources: liver, wheat germ
  • Dairy = largest contribution to intake in US (UV light destroys vitamin)
  • meats and poultry
  • leafy greens
68
Q

sources of Niacin

A

meats, poultry, fish, peanut butter, legumes = major sources of preformed niacin

Tryptophan = precursor; diets with liberal amounts of milk and eggs likely adequate for niacin even if low in preformed niacin

69
Q

sources of folate

A

“foliage”- deep green leaves, broccoli,orange juice, whole grains (easily destroyed with prolonged cooking); fortification of grains in US in 1998 –> increased intake

70
Q

sources of vitamin B12

A

animal products only

71
Q

vitamin B6 sources

A

animal products, veggies, whole grains (lost in processing, not enriched)

72
Q

evaluate thiamine levels

A

erythrocyte transketolase activity; blood thiamine levels

73
Q

riboflavin evaluation

A

erythrocyte glutathione reductase activity co-efficient (EGRAC) (increased in deficiency)

74
Q

niacin evaluation

A

urinary excretion of N1-metylnicotinamide and 2-pyridone (ration

75
Q

folate evaluation

A

RBC folate reflects tissue stores and chronic status; serum folate reflects recent intake

76
Q

B12 evaluation

A
  • serum B12 level
  • urine or blood methylmelonic acid (increased in deficiency)
  • serum homocysteine (increased in def)
  • CBC (increased MCV-nonspecific)
77
Q

vitamin C eval

A

leukocyte or plasma ascorbic acid levels

78
Q

vitamin B6 evaluation

A

pyridoxal phosphate

homocysteine

DEMS unit 3 (9 decks)

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