Vitamins! Flashcards

1
Q

Water soluble Vitamins

A

B and C

Not stored extensively, excreted easily and therefore not very toxic

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2
Q

Fat Soluble Vitamins

A

A, D, E and K

A AND D CAN BE TOXIC IN EXCESS

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3
Q

importance of Thiamin (B1)

A

Forms TTP

Coenzyme in various reactions, importantly Pyruvate Dehydrogenase complex

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4
Q

Sources of Thiamin

A

Whole grain, pork, dairy, vegetables- black beans corn

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5
Q

DRV of Thiamin

A

0.5mg/day/1000kcal

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6
Q

Primary presentation of Thiamin Deficiency

A

Infantile beri beri (wet)- sudden cardiovascular symptoms; think soy based soya milks with inappropriate composition (Israel 2003)

Accute wet beriberi- congestive heart failure (enlarged finger tips and doughy legs)

Chronic dry beriberi- nerve damage; weakness, Ataxic gait (uncoordinated movements

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7
Q

What is Wernicke-Korsakoff syndrome (presentation of Thiamine deficiency)?

A

Wernicke’s encephalopathy- general confusion, vision issues i.e.double vision (opthalmoplegia- muscle paralysis), ataxia, Weakness

Korsakoff psychosis- Loss of short term memory, inability to form new memories

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8
Q

Why might alcoholics be thiamine deficient?

A

inactivation of gut active transporters

inactivation of phosphokinase (the activator of thiamin to TTP)

Cirrhotic livers impairs storage

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9
Q

Importance of Riboflavin(B2)

A

FAD/FMV redox

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10
Q

Sources of Riboflavin

A

Mainly milk, also eggs, broccoli, spinach

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11
Q

Riboflavin deficiency?

A

rare but usually presents alongside protein deficiency or alcoholism.

Presents as angular stomatitias

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12
Q

Importance of Niacin (B3)

A

NAD/NADP Redox (respiration)

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13
Q

Sources of Niacin

A

Some cereals, NOT MAZE

tryptophan containing foods- High protein diets

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14
Q

Niacin deficiency

A

Pellagra- Characterised by the 3 Ds

Dementia
Diarrhoea
Dermatitis

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15
Q

Importance of Pyridoxine (B6)

A

Forms pyridoxal phosphate

metabolism
5-HT and NA production
Heam production

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16
Q

Pyridoxine deficiency

A

Primary is rare

Secondary from certain drugs (isonazid) bind with prydoxine phosphate rendering it unavailable

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17
Q

Therapeutic uses of pyridoxine

A

treatment of seizures.

down syndrome, autism and PMS

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18
Q

Toxicity from pyridoxine?

A

Self medicating women in excess of 500mg daily developed polyneuropathy

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19
Q

Function of folate (B9)?

A

Folate- forms tetrahydrofolate, acts as 1C carrier

PURINE/PYRIMIDINE SYTHESIS

Amino acid metabolism i.e. Coverts homocystein to methionine

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20
Q

DRV of Folate and B12

A

Folate- 50 micrograms daily

B12- 1 microgram daily

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21
Q

Source of B12?

A

Only found in animal tissues

THEREFORE VEGANS WILL BE DEFICIENT- REQUIRE SUPPLEMENTS

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22
Q

Source of Folate?

A

Green vegetables (Spinach!)
liver
Whole grains

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23
Q

Function of B12

A

carrier of methyl groups

Coverts homocystein to methionine

Other conversions… (too complex)

24
Q

What does deficiencies in Folate/ B12 present as?

A

Weakness,
tiredness,
anorexia,
megaloblastosis (very large RBC due to lack of division), Anaemia-

25
Q

What factor is required on the absorption of B12?

A

Intrinsic factor, excreted by stomach

26
Q

Possible drug interactions that can interfere with B12/ folate

A

ALCOHOL FOR ALL

Folate- barbiturates, Anti-consultants, methotrexate

27
Q

What groups should be encouraged to take folate?

A

pregnant women - prevents neural tube defects.

Infants

Individuals with higher haematopoiesis need

28
Q

Sources of pantothenic acid (B5)

A

A wide range of foods,

Eggs, avocados, broccoli

29
Q

Function of pantothenic acid

A

Component of Co-enzyme A

Used by MANY metabolic pathways i.e. fatty acid oxidation

30
Q

Sources of Biotin (B7)

A

peanuts, chocolate, egg yolks

31
Q

Function of Biotin

A

Prosthetic group for carboxylations

32
Q

Causes for Deficiency of biotin

A

Raw eggs–> egg white protein binds to yolk- renders it unavailable

Long term antibiotic therapy which results in gut sterilisation

33
Q

Sources of Vitamin C

A

Citrus fruit!

Tomatoes, berries, kiwi

34
Q

Function of Vitamin C

A

VITAL antioxidant

Hydroxylation of proline to lysine

reduces dietary Fe in stomach

35
Q

What does vitamin c deficiency present as?

A

SCURVY!

Presents after 3 months of vitamin c free diet

Poor wound healing, haemorrhages and anaemia

36
Q

What groups should be encouraged to take vitamin C?

A

Smokers- require double to amount as turnover higher (80mg daily)

Elderly

37
Q

What are the risks of mega dosing Vitamin C?

A

Possible kidney stone, diarrhoea

Pregnant women may give birth to children with higher needs.

38
Q

Sources of retinol vitamin A

A

Animal liver
Fish liver oil
Whole milk
Egg yolk

39
Q

Sources of Plant carotenoid vitamin A

A

Green, yellow, orange vegetables and fruit

CARROTS AND SWEET POTATOES

40
Q

What are the Active forms of Vitamin A

A

Retinoic Acid- Hormone
Retinal- vision (binds to opsin)
Beta Carotene- antioxidant =

41
Q

What is the ratio of carotenoid conversion to retinal

A

6:1 due to inefficiency

42
Q

Function of Vitamin A

A

Retinoic Acid - controls protein synthesis–> binds to cytosol receptor then nucleus chromatin

Retinal- aids in low light, directly transducing

43
Q

How is vitamin A Transported?

A

Gut–>liver= chylomicrons as retinol esters

Liver–>tissue= Retinol binding protein/ pre-albumin

44
Q

What does vitamin A deficiency present as?

A

Initially affects retinol binding protein

Night blindness–>

followed by kertinisation of the cornea and finally keratomalacia

45
Q

Toxicity of Vitamin A

A

Dermatitis
Hair loss
MUCOUS MEMBRANE DEFECTS
RED GUMS

46
Q

TERATOGENICITY OF VITAMIN A??

A

Limit to 0.7mg men and 0.6 mg women, no more than 3.3

Liver has 13-40mg per 100g!

47
Q

Sources of Vitamin E

A

Vegetable oils- Sunflower
nuts
green vegetable
CANNED AND FROZEN FOODS DON’T COUNT

48
Q

Safe level of Vitamin E

A

3g daily

49
Q

Function for Vitamin E

A

Prevents oxidation of unsaturated fats (PUFA, preventing disruption to membrane integrity

50
Q

Presentation of Vitamin E deficiency

A

Very rare, only really seen in low birth weight infants

Presents as Haemolytic anaemia from fragility

51
Q

Sources of Vitamin D

A

D2- plant, fungi and moulds
D3- Animals–> dairy products, eggs

THE SUN

52
Q

Function of Vitamin D

A

Maintain correct levels of calcium and phosphate in blood

53
Q

Presentation of Vitamin D deficiency

A

Children - Rickets

Adults- Osteomalacia

54
Q

Toxicity of Vitamin D

A

Hypercalceamia
GI tract disturbances
Calcification of soft tissues

55
Q

Sources of Vitamin K

A

Green Leafy Vegetables
Small amounts in Milk
Eggs

A lot is actually comes from the bacterial flora in the jejunum and ileum

THEREFORE, babies can be deficient- sterile guts

56
Q

Presentation of deficiency

A

MAJOR disruptions in the blood clotting cascades