Vitamins

Question 1

Fat soluble

Answer 1

A, D, E, K

Accumulated stores in body. Require absorption of dietary fat & carrier system for blood transport

Question 2

Vitamin A

Answer 2

Essential in photochemical basis of vision
Preformed Vit A (retinol/retinal): liver, dairy products, egg yolks, fish oil
Precursor (carotenoids e.g. beta- carotene): abundant in deep • yellow/orange & green vegetables

Question 3

Vitamin A Def

Answer 3

Night blindness, xerophthalmiam Bitot's spots
Immune deficiency (measles, GI, children)

Question 4

Vit A Tox

Answer 4

Only preformed (cod liver oil)
Vomiting, increased ICP, HA, bone pain (periosteal proliferation), bone mineral loss (↑ fractures & ↑ osteoporosis), liver damage (hepatitis, fibrosis, liver failure); birth defects (acutane)

Question 5

Vit D

Answer 5

Hormone. Maintains intra/extracellular Ca++
 Stimulates intestinal absorption and
renal reabsorption of Ca++ and P
Innate immune function
Cellular growth and differentiation
RDA=600 IU/d (

Question 6

Vit D Metabolism

Answer 6

Precursor (dehydrocholesterol) in skin converted to cholecalciferol (Vit D3)
by UV light
 Vitamin D2 or D3 hydroxylated in
liver to 25-OH-cholecalciferol1,25- dihydroxy-cholecalciferol (calcitriol) in kidney = active form

Question 7

Vit D Deficiency

Answer 7

Deficient: 25OH-D 30 ng/mL (>80 nmol/L)
Classic Triad in Serum: low C + low P + high alk phos (late)
Classic: Childhood ricketts. Adults osteoporosis

Question 8

Vit D Tox

Answer 8

nephrocalcinosis & soft tissue calcification

Question 9

Vit E

Answer 9

Antioxidant

Polyunsaturated vegetable oils, wheat germ

Question 10

Vit E Def

Answer 10

Neurologic degeneration: with loss of reflexes (DTR’s)
hemolytic
anemia

Question 11

Vit E Tox

Answer 11

coagulopathy (very large doses inhibit Vit K dependent factors)

Question 12

Vit K

Answer 12

ssential for carboxylation of coagulation proteins (Factors “1972”X, IX, VII, II)
All newborns should receive single IM dose of 0.5-1.0 mg
Leafy vegetables, fruits, seeds

Question 13

Vit K Def

Answer 13

Prolonged coagulation times; hemorrhagic disease of newborn: bleeding into skin (purpura), GI tract, CNS

Question 14

B1

Answer 14

Thiamine. In metabolism. Whole grains, enriched grains, pork, legumes.
RDA: 1.1-1.2 mg/d

Question 15

B1 Deficiency

Answer 15

Beriberi, dry: peripheral neuropathy distal, wrist/foot drop.
Wet berberi: edema, high output CF
Wernicke/Korsakoff: Triad = ocular signs (nystagmus, ophthalmoplegia), ataxia, and amnesia/confusion.

Question 16

B1 risk groups

Answer 16

Alcoholics
Anorexia refeeding
Bariatric surgery

Question 17

B2

Answer 17

Riboflavin. Part of 2 coenzymes - FAD, FMN (Krebs & oxidative)
Liver, wheat germ, dairy the most, meats/poultry, almonds, leafy greens. (UV destroys)
RDA: 1.1-1.3 mg/d

Question 18

B2 Deficiency

Answer 18

Oral-ocular-genital syndrome   Cheilosis (cracking of lips) and angular stomatitis (sores at 
corner of mouth)
 Increased vascularization of conjunctiva and photophobia
 Seborrheic dermatitis and scrotal dermatitis.

Question 19

B3

Answer 19

Niacin. In NAD & NADP - energy. Meats, poultry, fish, peanut butter, legumes=sources of preformed niacin.
 Tryptophan is a precursor of niacinlarge amounts
of milk and eggs
RDA: 14-16 mg/d

Question 20

B3 Def

Answer 20

Pellagra - 4 Ds
Dermatitis: characteristic symmetric pattern; aggravated by sun, 
heat exposure
 Dementia - confusion, dizziness, and hallcucinations   Diarrhea
 Death

Question 21

B3 Tox

Answer 21

vasodilation & flushing

Question 22

B3 Risk

Answer 22

Corn is major source of protein.
Metabolic “shunting” (eg carcinoid tumors producing excessive serotonin and shunt tryptophan
Reaction w/ isoniazid
Hartnup disease

Question 23

Folate

Answer 23

1-carbon transfers, “Foliage” - deep green leaves, broccoli,
orange juice, whole grains (easily
destroyed w/ prolong cooking)
 Fortification of grains in U.S. in 1998 → increased intakes
RDA: 400 μg/d

Question 24

Folate Risk

Answer 24

Pregnant women, premature infants, Dilantin, sulfasalazine Chronic hemolytic anemia or blood loss

Question 25

Folate Def

Answer 25

MACROcytic anemia, hypersegmented  neutrophils, glossitis
 Increased plasma homocysteine;   Increased occurrence and recurrence of neural
tube defects

Question 26

B12

Answer 26

Cobalamin. Critical in metabolism of odd chain length fatty acids
 Re-form tetrahydrafolate. Animal products only! 1 carbon transfer
RDA: 2.4 μg/d

Question 27

B12 def

Answer 27

MACROcytic anemia, hypersegmented
neutrophils, neurologic disturbances; Treatment with folate will correct anemia but 
has NO effect on neurologic symptoms

Question 28

B12 risk

Answer 28

inadequate absorption.
Pernicious anemia: hereditary condition with gastric atrophy in which IF is not produced or secreted
Strict vegetarian/vegan

Question 29

B6

Answer 29

Pyridoxine. AA metabolism.
Animal products, vegetables, whole grains
RDA: 1.3-1.7 mg/day

Question 30

Vit C

Answer 30

Ascorbic Acid. Antioxidant/reducing agent (electron donor)
 Roles in collagen synthesis
 Reduction of Fe3+ → Fe2+
leukocyte function. Fruits and vegetables.
RDA: 75-90 mg/d

Question 31

Vit C Def

Answer 31

Scurvy: defective collagen formation
petechiae, bleeding
gums, anemia, bruising;

Question 32

B6 Def

Answer 32

Anemia, seizures, glossitis; +/- depression

Question 33

B6 Tox

Answer 33

Doses > 500 mg/d associated with sensory ataxia, impaired position/vibratory sensation

Question 34

B6 Risk

Answer 34

Primarily associated with use of Isoniazid  End-stage renal diseases,