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STEP1 > Vitamins > Flashcards

Vitamins Flashcards

1
Q

List the fat soluble vitamins

A

DAKE

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2
Q

List the water soluble vitamins

A

B(1, 2, 3, 5, 6, 7, 9, 12), C

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3
Q

Vitamin A Function

A

AKA retinol; antioxidant, visual pigment component, needed for epithelial cell differentiation into specialized tissue, used as tx is all trans retinoic acid for for AML subtype (promyelocytic)

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4
Q

Vitamin A found in which food

A

Leafy vegetables

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5
Q

Vitamin A toxicity

A

Teratogenic (causes cleft palate, cardiac abnormalities; must do pregnancy test!);
acute=blurred vision, nausea, vomiting, vertigo;
chronic=dry skin, alopecia, hepatic toxicity, arthralgias, pseudotumor cerebri

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6
Q

Vitamin B1 name

A

Thiamine

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7
Q

Vitamin B1 function

A

Think ATP to remember which enzymes TPP is a cofactor for

Part of TPP, which is an enzyme cofactor for: pyruvate dehydrogenase (glycolysis-TCA cycle link),
alphaketogluterate dehydrog (TCA cycle),
transkelotase (HMP shunt, which is an NADPH source important in RBCs for glutathione),
and branched chain ketoacid dehydrogenase

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8
Q

Vitamin B1 deficiency

A

In malnutrition and alcoholism

Impaired glucose breakdown–>ATP depletion, which is worsened by glucose infusion (remember, don’t give someone with Wernicke encephelopathy just glucose!)
Very aerobic tissues are affected first (brain, heart)

Wernicke-Korsakoff: confusion, opthalmoplegia, ataxia is classic triad; personality change, memory loss (mammillary body damage)

Wet beriberi=dilated cardiomyopathy, edema

Dry beriberi=polyneuritis, symmetrical muscle wasting

Diagnosis: increase in RBC transkelotase activity after B1 replacement

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9
Q

Vitamin B2 name

A

Riboflavin

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10
Q

Vitamin B2 function

A

Think riboFlavin in Fad and FMN (TCA cycle cofactors); B2–>2 ATP

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11
Q

Vitamin B2 deficiency

A

2 C’s: cheilosis (inflammation of lips, scaling at the corners of the mouth), corneal vascularization

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12
Q

Vitamin B3 name

A

Niacin

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13
Q

Vitamin B3 synthesis

A

Derived from tryptophan

Requires B2 and B6 for synthesis

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14
Q

Vitamin B3 function

A

Niacin for NAD (B3–>3ATP); NAD is used in redox rxns

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15
Q

Vitamin B3 as treatment for

A

Dyslipidemia; lowers VLDL, raises LDL

NIACIN FLUSH* is a common side effect

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16
Q

Vitamin B3 deficiency symptoms

A

3Ds: diarrhea, dementia (+ hallucinations), dermatitis (Cassals “necklace” rash)
Hyperpigmentation of syn exposed limbs
Glossitis
Pellagra

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17
Q

Causes for Vitamin B3 deficiency

A

Hartnup disease: deficiency of tryptophan transporters in proximal renal tubular cells AND on enterocytes–>aminoaciduria, low tryptophan absorp from gut–>low tryptophan causes low niacin–>pellagra

Malignant carcinoid syndrome: increased tryptophan metabolism into serotonin pathway; diarrhea

Isoniazid: decreases vitamin B6 (pyridoxine), which is needed for B3 synthesis

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18
Q

Vitamin B5 name

A

Pantothenic acid (think 5=pento)

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19
Q

Vitamin B5 function

A

Component of CoA and fatty acid synthase

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20
Q

Vitamin B5 deficiency

A

Dermatitis, enteritis, alopecia, adrenal insufficiency

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21
Q

Vitamin B6 name

A

Pyridoxine

22
Q

Vitamin B6 function

A

Cofactor used in transamination, decarboxylation rxns, glycogen phosphorylase
Used for synthesis of heme, niacin, histamine, neurotrans (serotonin, epineph, norepi, dopamine, GABA)

23
Q

Vitamin B6 deficiency

A

Can be caused by isoniazid and OCPs

Convulsions, irritability, peripheral neuropathy, sideroblastic anemias (part of porph synthesis, ALAS enzyme, which is Hb component; microcytic anemia)

24
Q

Vitamin B7 name

A

Biotin

25
Q

Vitamin B7 fn

A

Cofactor for carboxylation enzymes that add 1-C group

Examples
pyruvate–>oxaloacetate
Acetyl CoA–>malonyl CoA
Propionyl CoA–>methylmalonyl CoA

26
Q

Vitamin B7 deficiency

A

Caused by: antibiotics, excessive raw egg white ingestion
Avidin in egg whites avidly binds biotin
Dermatitis, alopecia, enteritis

27
Q

Vitamin B9 name + food it is found in

A

Folate; leafy greens (folate from foliage)

28
Q

B9 absorbed in

A

Jejunum; small storage site in liver

29
Q

B9 function

A

Made into THF, which is part of nitrogenous base synthesis (pyramidine) for DNA and RNA

30
Q

B9 deficiency cause

A

Drugs: methotrexate, phenytoin, sulfonamides
B12 deficiency causes folate “trap”
Small bowel disease or after resection

31
Q

B9 deficiency signs/symptoms/labs

A

Macrocytic, megaloblastic anemia with hypersegmented neutrophils
Glossitis
NO neuro symptoms! (vs B12)

Labs: high homocysteine, nml methylmalonic acid

Most common deficiency in US; esp in alcoholism and pregnancy

Supplement in pregnant women to decrease risk of neural tube defects

32
Q

B12 name and found in what food

A

Cobalamin; in animal products; large storage reserves in liver

33
Q

B12 function

A

Cofactor for methionine synthase (needed for THF) and for methylmalonyl CoA mutase (needed for converting methylmalonyl CoA–>succinyl CoA)

34
Q

B12 deficiency signs/symptoms/labs

A

Macrocytic, megaloblastic anemia with hypersegmented neutrophils

Paresthesias, subacute combined degeneration (degen of dorsal columns , lateral CST, spinocerebellar tracts), due to abnml myelin

Labs: increased homocysteine AND methylmalonic acid levels

35
Q

B12 deficiency caused by

A

Malabsorption,
lack of intrinsic factor (pernicious anemia dx with anti-IF Abs, gastric bypass surg),
absence of terminal ileum (surg resection)
insufficient intake (vegans)

36
Q

B12 site of absorption

A

Terminal ileum; needs intrinsic fator

37
Q

Vitamin C name, which foods

A

Ascorbic acid; fruits and veggies

38
Q

Vitamin C fn

A

Antiox
facilitates iron absorp,
Needed for collagen synthesis (proline and lysine hydroxylation)
Needed for dopamine–>NE rxn

Used as ancillary tx for methemoglobinemia

39
Q

Vit C Deficiency

A

Scurvy due to collagen synthesis defect: swollen gums, bruising, petichiae, anemia, poor wound healing, perifollicular hemorrhages, corkscrew hair

Weakened immune response

40
Q

Vitamin C excess

A

Nausea, vomiting, diarrhea, nephrolithiasis (calcium oxalate)
Can increase risk of iron toxicity in predisposed individuals

41
Q

Vitamin D forms

A

D2=plants
D3=milk, sun exposed skin
25-OH D3=storage form
1,25OH D3 (calcitriol)=active form (made in kidney)

42
Q

Vitamin D fn

A

Increase intestinal absorp of calcium and phosphate

Increase bone mineralization at low levels, bone resorption at high levels

43
Q

Vit D deficiency

A

Rickets in children (bone pain & deformity)

Osteomalacia in adults (bone pain, musc weakness)

44
Q

Vit D excess

A

Hypercalcemia, hypercalciuria, loss of appetite

Seen in granulomatous disease bc increased activation of vit D by epithelioid macrophages

45
Q

Vitamin E fn

A

Antiox (protects from free radical damage)

Enhances anticoag effects of warfarin bc high vitamin E dose alters metabolism of vitamin K

46
Q

Vitamin E deficiency

A

Hemolytic anemia,
acanthocytosis,
musc weakness,
posterior column and spinocerebellar tract demyelination

Presents similar to B12 deficiency (ie neuro) but without peripheral smear findings or high methylmal acid levels)

47
Q

Vitamin K fn

A

Coagulation (factors 2, 7, 9, 10, C, S)
Warfarin=vit K antag
Synthesized by intestinal flora

48
Q

Vitamin K deficiency

A

Neonatal hemorrhage
Increased PT and PTT (coag factor determined)
Nml bleeding time (platelet determined)
Neonates cannot synthesize vit K (injection at birth; not in breast milk)

49
Q

Zinc fn

A

Essential mineral for activity of a lot of enzymes

Important for zinc finger (transcription factor motif)

50
Q

Zinc deficiency

A

Delayed wound healing
Hypogonadism
Decreased adult hair (axillary, facial, pubic)
(Remember androgens are steroid hormones that bind intranuclear TFs)
Anosmia
Acrodermatitis enteropathica (enormous dark rash on skin)
May predispose to alcoholic cirrhosis

STEP1 (11 decks)

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