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Foundations exam 3 > Vitamins > Flashcards

Vitamins Flashcards

1
Q

What are the physical exam findings of Vitamin A deficiency?

A

Papular Keratitis “goose bump rash”

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2
Q

What are the physical exam findings of Vitamin C deficiency?

A

Perifollicular hemorrhages

Hypertrophied bleeding gums

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3
Q

What are the physical exam findings of Vitamin B12 deficiency?

A

Loss of distal vibratory and position sense

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4
Q

What are the physical exam findings of Vitamin K deficiency?

A

Ecchymosis

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5
Q

What are the physical exam findings of Riboflavin or Niacin deficiency?

A

Angular stomatitis or Cheilosis

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6
Q

What are the physical exam findings of Thiamine deficiency?

A

Nystagmus

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7
Q

What are the physical exam findings of Iron deficiency?

A

Spooning of nails

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8
Q

What are the physical exam findings of Zinc deficiency?

A

LE rash “Flaky paint”

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9
Q

What are the physical findings of protein deficiency?

A
  1. Hollowing of the temporal muscles
  2. Wasting of upper arms and thigh muscles
  3. Easily plucked hair
  4. Peripheral edema
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10
Q

What are fat soluble vitamins?

A

A, D, E, K

These vitamins are stored in fat so can be toxic

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11
Q

What are water soluble vitamins?

A

B vitamins: B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (Pantothenic acid), B6 (pyridoxine), B12 (Cobalamin)

Vitamin C (ascorbic acid)

Folate

Biotin

**these are all vitamins you can pee out excess of (so cant overdose)

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12
Q

What is vitamin A needed for

A

◦Retinol, retinal, retinoic acid/carotenes

◦Bile needed for absorption

◦Stored in the liver

◦Bone and tooth structure

◦Healthy skin and mucous membranes

◦Vision in dim light

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13
Q

What does Vitamin A deficiency cause?

A

◦Night blindness

◦Xeropthalmia

◦Keratomalacia

◦Follicular hyperkeratosis (goose bump rash)

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14
Q

What does excess vitamin A cause?

A

◦Chronic toxicity can lead to liver damage and increased pressure on the brain

◦Vision changes

◦Bone pain

◦Rough skin and dry cracked lips

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15
Q

Vitamin D

A
  1. Assists with calcium homeostasis & bone metabolism
  2. Helps intestinal absorption of calcium and phosphorous
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16
Q

What can chronic high doses of glucocoticoids cause?

A

inhibit intestinal Vitamin D-dependent calcium absorption

So if you give high dose steroids for a long time, you should also give a Vitamin D supplement

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17
Q

In what patients should you consider giving a higher dose supplement of Vitamin D to?

A

Elderly, malabsorptive d/o, lack of sunlight, CKD, liver failure (hydroxylation of Vit d impaired)

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18
Q

Vitamin D deficiency

A

–Rickets – soft bones, enlarged joints, enlarged skull, deformed chest, spinal curvature, bowed legs

–Osteomalacia

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19
Q

Vitamin D excess

A

–Anorexia, n/v, polydipsia, polyuria

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20
Q

What is the best laboratory indicator of vitamin D?

A

◦serum 25-hydroxyvitamin D

◦No consensus for optimal Vitamin D levels

◦IOM concluded 20 ng/ml (50 nmol/L) is sufficient for most individuals

◦American Geriatric Society suggests a minimal level of 30 ng/ml (75 nmol/L)

}RDA

◦Adult-70 yo 600 IU/day

◦>70 yo 800 IU/day

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21
Q

Vitamin E

A

◦AKA: Tocopherols

◦Important in vision & reproduction

◦Protects health of blood, brain, and skin

◦Protects cell membranes against oxidation and free radicals

◦Most people get sufficient Vitamin E in diet

◦May play a role in slowing progression of Alzheimers, but not conclusive

◦Supplementation may increase risk of prostate cancer

22
Q

What might supplementation of VItamin D cause?

A

MAY cause prostate cancer

RDA: 15 mg/day

23
Q

Vit E deficiency

A

–Neuropathy

–Red cell hemolysis in malnourished infants

24
Q

vitamin E excess

A

–Low toxicity

–Augments effects of anticoagulants

25
Q

Vitamin K

A

◦Forms prothrombin for normal blood clotting

◦Synthesized in the intestines

◦Antibiotics can kill Vitamin K producing bacteria in the intestine altering Vitamin K availability

◦Oral bile acid sequestrants, such as, cholestyramine for lowering cholesterol can reduce absorption of Vitamin K and other fat soluble vitamins

26
Q

Vitamin K deficiency

A

–Prolonged clotting time

–Hemorrhage, especially in newborn infants and biliary tract disease

27
Q

Vitamin K excess

A

–Large amounts toxic

28
Q

Vitamin C

A

◦Forms collagen

◦Teeth firm in gums

◦Hormone synthesis

◦Resistance to infection

◦Improve iron absorption (so give with iron supplements)

29
Q

Vitamin C deficiency

A

–Poor wound healing

–Poor bone, tooth development

–Dry skin

–Petechiae

–Fatigue

–Scurvy (Rare)–> Bruising and hemorrhage, bleeding gums, loose teeth

30
Q

Excess Vitamin C

A

–Can lead to oxalate urinary calculi = kidney stones

–Can cause false negative urinary glucose in diabetic patients

31
Q

Vitamin B1- Thiamine

A

◦Coenzyme for breakdown of glucose for energy

◦Healthy nerves

◦Good digestion

◦Normal appetite

◦Good mental outlook

32
Q

Vitamin B1 (Thiamine ) Deficiency

A

–-Aphonia

-–Peripheral neuropathy

–-Wernicke encephalopathy (nystagmus, ophthalmoplegia, ataxia)

–-Confusion/Coma

–-Beriberi disease (dry and wet)

-–Inflammation of the nerves and heart failure

**often seen in alcoholics

33
Q
A
34
Q

What do you give to all patients that present with encephalopathy and/or alcoholism?

A

treat ALL with supplemental thiamine

35
Q

Vitamin B2

A

AKA Riboflavin

◦Coenzymes for protein and glucose metabolism

◦Fatty acid synthesis

◦Catalyst in many mitochondrial oxidation-reduction reactions and function as electron transporters

◦Healthy skin

36
Q

Vitamin B2 (Riboflavin) deficiency

A

–Cheilitis (cracked/dry corners of mouth)

–Burning, itching, sensitive eyes

–Glossitis/Scarlet colored tongue (“Beefy Red tongue”

37
Q

Vitamin B3

A

AKA Niacin

◦Required by all cells and is a coenzyme for energy metabolism (turns food into energy)

◦Role in synthesis of macronutrients, needed for formation of RNA and DNA

◦Normal digestion

◦Healthy skin

◦Healthy nervous system

◦Tryptophan is a precursor, 60mg = 1mg niacin

38
Q

Vitamin B3 (Niacin) deficiency

A

–Pellagra (when Niacin and Tryptophan are limited):

–-Dermatitis, angular stomatitis, and the 4 Ds (diarrhea, depression, delirium, death)

-–Hyperpigmentation of sun exposed areas

–-Glossitis

–

Has been linked to birth defects

39
Q

Vitamin B3 (Niacin) Excess

A

–Flushing, itching, burning, tingling

–Liver failure (high doses)

–Diabetes (high doses)

–Gout (high doses)

–Hypotension

–Activate Peptic Ulcer Disease

40
Q
A
41
Q

Benefits of Niacin Supplementation

A

◦Releases fatty acids from adipose tissue

◦Reduces the amount of cholesterol in the blood”

–1. Positively effects HDL (Helps lower LDL)

–2. Lowers cardiovascular dz risk, but isn’t linked to lower rates of death, MI or stroke

–

–Therapeutic doses are high (1000-3000 mg)

42
Q

Vitamin B5- Pantothenic acid

A

◦Bioactive form=coenzyme A

◦Synthesis of sterols, fatty acids, heme

43
Q

Vitamin B6

A

AKA Pyridoxine

◦Coenzymes for protein metabolism

◦Conversion of tryptophan to niacin

◦Formation of heme

44
Q

Vitamin B6 (Pyridoxine) Deficiency

A

–Cheilosis

–Anemia

–Stomatitis

–Weak gait

–Irritability/Insomnia

–Nasolabial seborrheic dermatitis

45
Q

Vitamin B6 (Pyridoxine) excess

A

–Peripheral neuropathy

–Photosensitivity

–Nausea

46
Q
A
47
Q

Vitamin B12

A

◦Formation of mature red blood cells

◦Synthesis of DNA, RNA

◦Requires intrinsic factor from stomach for absorption (lack of IF results in no absorption of B12)

48
Q

Vitamin B12 deficiency

A
  1. Pernicious anemia: lack of intrinsic factor or after gastrectomy

–2. Macrocytic anemia

–

  1. Neurologic degeneration:

–-Impaired proprioception

–-Peripheral Neuropathy

–-Slowed mentation

–

  1. Pallor
49
Q

Vitamin- Folic Acid

A
  • Maturation or RBCs
  • Synthesis of DNA, RNA

AKA folate

50
Q

Folic Acid deficiency

A

–Macrocytic anemia

––>Needs supplementation in pregnancy to prevent neural tube defects

51
Q

Biotin

A

◦Components of coenzymes in metabolism

◦Synthesis in intestine

52
Q

Biotin deficiency

A

– AMS

–Myalgia

–Anorexia/Nausea

–Dermatitis around the eyes

–Alopecia

Foundations exam 3 (5 decks)

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