Vitamins and Minerals Flashcards
The most widely used method of assessing vitamin B6 status is by the activation of ______________ by pyridoxal phosphate added in vitro, expressed as the ________________.
erythrocyte transaminases
activation coefficient
In Excess, Vitamin B6 Causes:
Sensory Neuropathy
There is some slight evidence that taking 2 to 7 g of pyridoxine per day is effective in treating:
premenstrual syndrome
VITAMIN ____ IS FOUND ONLY IN FOODS OF ANIMAL ORIGIN
B12
Deficiency state that results from inadequate absorption
Secondary
Deficiency state that results from increased requirement
Secondary
Deficiency state that results from inadequate intake
Primary
Deficiency state that results from medication
Secondary
The nine B vitamins are considered as:
water soluble or fat soluble?
water soluble
(B1, B2, B3, B5, B6, B7, B9, B12)
also Non-B complex (ascorbic acid/ vitamin C)
Which classification of vitamins are mostly converted to co-enzymes and are used in metabolic pathways and hematopoiesis?
Water-soluble
Fat soluble vitamins are only absorbed with:
fatty acids, bile, and pancreatic secretions
Which classification of vitamins can be stored in the liver and adipose tissue?
Fat soluble
Which fat soluble vitamin has a coenzyme function?
Vitamin K
Which classification of vitamins is more likely to cause toxicity with overdose or megadose?
Fat-soluble
Which classification of vitamins is needed in frequent doses?
Water-soluble
Which classification of vitamins is needed in periodic doses (weeks to months)?
Fat-soluble
True or False:
Minerals regulate enzyme activity
true
True or False:
Minerals maintain acid balance and osmotic pressure
True
Which of the following is not characterized by minerals?
A. Facilitates membrane transfer of essential compounds
B. Helps in maintaining nerve and muscular activity or irritability
C. May be structural constituents to body tissue
D. Involved directly in the growth process
E. Regulates enzyme activity
D. involved INDIRECTLY in the growth process
Macrominerals are essential at levels ____ mg/day for adults
100 mg/day
Required intake of Trace elements is less than ____ mg/day
1000
Which of the following is a macromineral? A. Magnesium B. Manganese C. Chylomicron D. Copper
A. Magnesium
→ Macrominerals are calcium, phosphorus, magnesium, sulfur, sodium, potassium, chloride
Which of the following trace elements has no clear function? A. Cobalt B. Molybdenum C. Silicon D. Selenium
C. Silicon
Essential trace elements, function not clear
▪ Silicon, vanadium, nickel, tin, cadmium
Which macrominerals are important for tissue/bone structure?
Calcium
Magnesium
Sulfur
Which macrominerals are important for membrane function and have regulatory roles?
Sodium
Potassium
Chloride
Which trace element, though essential but with no clear function, is quite toxic in excess?
Cadmium
Main active form of Vitamin A
retinol (all-trans-retinol)
What are the other active forms of Vit A apart from retinol?
▪ Retinaldehyde (instead of OH group, has an aldehyde)
▪ Retinoic acid (all-trans retinoic acid; carboxyl group)
▪ Beta-carotene
Precursor of vitamin A
carotenoids or carotenes
The most important precursor of Vit A
beta-carotene
Which vitamin is formed from cryptoxanthines?
Vit A
Beta-carotene (carotenoids) is cleaved in the intestinal mucosa by ______ forming retinaldehyde or retinoic acid
carotene dioxygenase
lipoprotein that carries retinol to the liver
Chylomicron
Beta-ionone ring is found in which vitamin?
Vitamin A
True or False:
Conversion of carotenoids to retinol is nearly 100%
True
Which fat-soluble vitamin is important for the synthesis of transferrin?
Vit A
Which fat-soluble vitamin functions for Growth and maintenance of epithelial tissues?
Vit A (Retinol and retinoic acid)
Amino acid residue of opsin for combination with 11-cis retinal?
Lys
Which vitamin A receptor binds both all-trans-retinoic acid and 9-cis-retinoic acid?
retinoic acid receptor (RAR)
Which vitamin A receptor binds only 9-cis-retinoic acid?
retinoid X receptor (RXR)
__________ is a chain-breaking antioxidant that acts on radicals derived from PUFAs (Polyunsaturated fatty acids) in lipid peroxidation
β-carotene
True or False:
Vitamin A has a role in the differentiation of immune cells.
True
Foods that normally have pre-formed retinol
→ Liver, egg yolk, milk, butter
Main sources of carotenoids:
→ mainly from plant sources – dark green and yellow vegetables, tomatoes, sweet potatoes, oily fruits, and red palm oil
Vitamin deficiency of patient with abnormal dryness of the conjunctiva and cornea of the eye with inflammation with ridge formation (leading to total blindness)
Vit A (xerophthalmia = keratinization of cornea)
Vitamin A deficiency can be biochemically equivalent to which type of anemia?
Iron-deficiency anemia
but in the presence of adequate iron intake
Deficiency of which form of vitamin A can repress gene expression?
9-cis retinoic acid
Added micrograms retinol equivalent for lactating mothers
400
Added micrograms retinol equivalent for pregnant women
300
Patient presented with inflamed lips, bone pain (possible hip fracture or calcification), scaly dermatitis, enlargement of liver and spleen, nausea, and diarrhea. What vitamin state should be assessed?
Excess Vitamin A or Hypervitaminosis A
Initial sign of Hypervitaminosis A
Cheilitis (inflammation of lips) or dry lips
True or False:
Free vitamin A in circulation doesn’t usually cause membrane lysis and tissue damage
False:
Unbound vitamin A can cause membrane lysis and tissue damage
Headache, nausea, ataxia, anorexia is expected in hypervitaminosis A due to:
Increased cerebrospinal fluid pressure
Precursors of Vitamin D
→ 7-dehydrocholesterol (animals)
→ ergosterol (plants)
Active form of Vit D
1, 25 dihydroxycholecalciferol
also called calcitriol
How is calcidiol formed
Hydroxylation of cholecalciferol (Vit D3) in the liver
Calcidiol is aka 25-OHD or 25-hydroxycholechalciferol
Hydroxylation at which carbon yields an inactive dihydroxyvitamin D
24
Which form of vitamin D is present in the circulation and is used to measure in the laboratory for Vit D assay?
Calcidiol or 25-OHC or 25-hydroxycholcalciferol
Overall effect of calcitriol in the body in terms of macrominerals is:
increased plasma calcium and phosphate
Calcitriol is involved in the following processes EXCEPT
A. Modulation of cell proliferation
B. Increase production of interleukins
C. Insulin secretion
D. Synthesis and secretion of parathyroid and thyroid hormones
E. T-lymphocyte and immunoglobulin production by B-cells
B. should be → inhibition of production of interleukins
Vitamin D potency:
1 mcg cholecalciferol or ergocalciferol is equal to ___ IU
40 IU
True or False:
RDA for Vit D increases with age
True • Infants (months, μg) → 0-11: 5 (♂, ♀) • Children (years, μg) → 1-18: 5 (♂, ♀) • Adults (years, μg) → 19 – 49: 5 (♂, ♀) → 50-59: 10 (♂, ♀) → 60 ->70: 15 (♂, ♀)
True or False:
There is NO added requirements for Vit D for pregnant and lactating mothers
True
How are foods fortified with ergosterol (D2)?
irradiating ergosterol from yeast
e.g., milk and butter
What form of Vit D is absorbed from plants such as mushrooms?
ergocalciferol
True or Fals:
One food source of Vit D is freshwater fish
False:
Should be
• Saltwater fish (salmon, sardines, and herring), liver and egg yolk
The most common symptoms of vitamin D deficiency in young children
Rickets
The most common symptoms of vitamin D deficiency in adults
osteomalacia
Condition of under mineralized osteoid matrix resulting into soft, pliable bones due to poor Ca++ absorption in children
Rickets
Condition known as softening of bones due to demineralization of intact bone matrix
Ostomalacia
Recommended Vit D IU in 60–70-year-olds to prevent osteoporosis
600 IU or 15mcg
A chronic alcoholic patient is at risk of having deficiency with the following EXCEPT: A. Vit D B. Bit B2 C. Vit B7 D. Vit B1 E. NOTA
E. NOTA
A chronic alcoholic patient is at risk of having deficiency with the following EXCEPT: A. Vit D B. Bit B2 C. Vit B7 D. Vit B1 E. NOTA
E. NOTA
____________ stimulate the conversion of vitamin D to inactive metabolites and have been shown to cause bone demineralization when used for long periods of time
Corticosteroids
The following characterizes excess of vit D EXCEPT: A. blood vessel contraction B. high BP C. due to excessive sunlight exposure D. calcinosis
C. Excessive sunlight exposure does not lead to vitamin D poisoning
Secondary hyperparathyroidism may occur with deficiency to which vitamin?
Vitamin D
T/F:
Phosphate-binding drugs are also given in patients with Ca++ deficiency
True
Most active form of Vit E
D-alpha tocopherols
The most potent form of vit E and is used as the measure of potency.
D-alpha-tocopherol
Synthetic form of Vit E but not as potent as naturally occurring compounds
DL-alpha -tocopherol
The least toxic fat-soluble vitamin but may result to hemorrhage in case toxicity happends
Vit E
How does Vit E enhance heme synthesis?
by increasing the levels of aminolaevulinic acid (ALA) synthetase and ALA dehydratase
Although deficiency is virtually non-existent, vitamin E supplementation may be necessary with:
premature infants or in cases of fat malabsorption
Best food sources of Vitamin E
Nuts, seeds, vegetable oil
Others: Green leafy vegetables, soybeans, canola, corn
There may be increased risk of hemorrhagic stroke in patient with Hypervitaminosis of Vit ___
E
Core of vitamin K molecule
naphthoquinone
→ Aromatic ring + quinone unit
Most common dietary source of vitamin K
Phylloquinone (K1)
Form of Vit K produced by intestinal bacteria in humans
Menaquinone (K2)
Because of its lack of the long side chain of the natural vitamins, this form of Vit K is the most active form being 2x as potent
Menadione (K3)
Vitamin as Cofactor for the formation of amino acid gamma-carboxyglutamate
Vit K
Clotting factors involved with the function of Vitamin K
X, IX, VII, II, proteins C and S
Which Calcium-binding proteins is related to Vit K?
- Osteocalcin and matrix Gla-protein (in bone)
- Nephrocalcin (kidney)
- Protein product of the growth arrest specific gene (Gas6), forregulation of differentiation and development in the nervous system and apoptosis in other tissues
drugs that interfere with vitamin K metabolism
cephalosporin and high dose salicylates
High doses of vitamin K3 can interfere with the function of ______
glutathione
→ Results in oxidative damage to cell membranes
Aneurin is aka:
Thiamine (B1)
Sulfur is a component of the structure of these vitamins:
B1, B5, B7
Which active form of Vit B1 has a role in nerve conduction
Thiamine triphosphate
One way of assessing thiamin nutritional status is by activation of ___________ in erythrocyte lyase by TPP
apo-transketolase
Thiamine is absorbed in which part of the GIT?
jejunum
Anti-stress vitamin
Vit B1
Serves as coenzyme for oxidative decarboxylation reactions
Vit B1
Vitamin that activates conduction channels in neuroblastoma cells
Vit B1 (Thiamine triphosphate -phosphorylates a chloride channel in the nerve membrane; hence, nerve conduction)
Which of the following does not involve the function of vit B1? A. Carbohydrate metabolism (glycolysis) B. Citric acid cycle C. Branched Amino Acid Catabolic Pathway D. PPP E. NOTA
E.
→ Pyruvate dehydrogenase in carbohydrate metabolism
→ Alpha-ketoglutarate dehydrogenase complex in citric acid cycle (TPP for decarboxylation)
→ Branched-chain ketoacid dehydrogenase (BCKAD) in Branched Amino Acid Catabolic Pathway for oxidation
→ Pentose phosphate pathway (TPP acts as a coenzyme in transketolase reaction)
Most common effect of thiamin deficiency
Beriberi
Ascending peripheral polyneuropathy that affects elderly without cardiac involvement
Dry beriberi
Beriberi associated with heart failure in infants and metabolic abnormalities
Fulminating beriberi
→ Aka Shoshin beriberi
Alcoholic patient presents with ataxia, imbalances, ophthalmoplegia, nystagmus, and confusion. Which vitamin is probably deficient?
Vit B1
Vitamin that is important for Glutathione reductase mediated detoxification
B2: riboflavin
T/F: Toxicity does not occur in riboflavin since it is non-toxic even at high oral doses
True
Vitamin deficiency manifesting with angular cheilitis
Riboflavin deficiency
Patient was manifesting with seborrheic dermatitis and glossitis. Hence, you asked for measurement of the activation of erythrocyte glutathione reductase to test for Vit __ deficiency
B2 (riboflavin)
Niacin is synthesized from which AA?
W
Vit Source of ADP-Ribose for DNA repair
B3 or Niacin
Patient manifests with Pellagra or the triad of dermatitis, dementia and diarrhea. Deficiency is most likely:
Vit B3
> ____ mg/day of Vit B3 may cause liver damage
500
Most active form of Vit B6
Pyridoxal 5’phosphate
Prime reservoir of Vit B6
Muscle
Vitamin for Transamination and decarboxylation in amino acid metabolism
B6
Vitamin for the Formation of sphingolipids and development of myelin sheath
B6
Vitamin for synthesis of aminolaevulinic acid (precursor of heme)
B6
Vitamin that removes hormone receptor complex from DNA binding site
→ Results to termination of action of hormone
B6
Sideroblastic Anemia is seen in Vit ___ deficiency
B6
> ____mg/day of Vit B6 is associated with nerve damage and sensory neuropathy!
200
Vit. B 12 dependent enzymes:
→ Methylmalonyl CoA mutase
→ Leucine aminomutase
→ Methionine synthase
More stable form of Vit B12
cyanocobalamin
Vit for transfer of methyl groups in the nucleic acid synthesis
B12
What releases B12 from its peptide bond in the stomach?
HCl
Required for cobalamin absorption in the intestine (ileum)
Intrinsic factor (Castles intrinsic factor)
common deficiency in vegetarians
Vit B12
B12 deficiency may result in the irreversible degeneration of the spinal cord due to failure of methylation of one of the _______ residue on myelin sheath
arginine
Anemia with B12 deficiency
Pernicious anemia
→ B12 deficiency impairs metabolism of folic acid
or Megaloblastic anemia
Folic acid in the presence of NAD, is reduced to __________– active form
tetrahydrofolic acid (THFA)
Vitamin = pteridine ring
B9
Folate is important for the metab of which AA?
Serine/Glycine/Methionine/Histidine
Vitamin for the Formation and maturation of RBC and WBC in the bone marrow
B9
Maternal _____ deficiency can lead to occurrence of neural tube defects among infants due to inability of closure of the neural tube.
folate (B9)
Women who use oral contraceptives have impaired _____ metabolism
folate
Vitamin that Blocks degradation of ferritin to hemosiderin
C
Vit that acts as a co-enzyme and cofactor in metabolic processes due to its ability to lose or take H+
C
Oxidation of phenylalanine to tyrosine is facilitated by Vit ___
C
Vit constituent of coenzyme A
B5
Vit Important in synthesis of cholesterol, steroid hormones, phospholipids and porphyrin rings
B5
Coenzyme for reactions involving the addition or removal of CO2 to and from active compounds:
Biotin (B7)
Coenzyme for deamination of AA (Thr and Ser)
Biotin B7
Coenzyme/prosthetic group in carboxylation reactions
B7
vitamin important for liver gluconeogenesis
B7 - pyruvate carboxylase action
Most abundant mineral in the body
Calcium
T/F:
Calcium in Mostly transcellular in duodenum
true
Cofactor for prothrombin to thrombin conversion for blood clot formation
Calcium
Most common signal transduction element because of its ability to reversibly bind to proteins and to complex with anions
Calcium
Hypocalcemia is Serum Ca2+ < ___ mg/dL
8.5
Laryngismus:
Hypocalcemia
Hypercalcemia is Serum Ca2+ > ___ mg/dL
10.2
Most important systemic electrolyte
PHOSPHORUS
Normal serum phosphorus is
2.5-4.5mg/dL.
Most important metabolic reactions that require Pi is the function of the enxyme:
glycogen phosphorylase
Mineral Component of glutathione which has antioxidant properties
Sulfur
OVERTOXICITY of ___ causes Osmotic diarrhea and Ulcerative colitis
Sulfur
Which parts of the Renal tubules reabsorb Mg
65% in TAL and 30% in DCT
Mg++ is absorbed by active transport the intestinal mucosa by a process involving vitamin:
D
Renal conservation of magnesium is partly controlled by ___ and ____.
PTH
aldosterone
Deficiency in ___ causes:
Widening of QRS complex and atrial and ventricular dysrhythmia
Mg++
Hypokalemia and hypocalcemia cannot be corrected if the ___ is also low
Mg
Hyponatremia
→ Serum Na+ < __ mmol/L
135
Hypernatremia
→ Serum Na+ > __ mmol/L
145
Which parts of the Small intestines is K absorbed actively?
▪ Active transport in duodenum
▪ Passive in jejunum and ileum
Mineral that Helps transfer phosphate from ATP to pyruvic acid
K+
Hypokalemia
→ Serum K+ < ___ mEq/L
3.5
Mineral deficiency that may result with prolonged vomiting, diuretics, kidney disease, metabolic disturbances
K+
Ventricular and atrial arrhythmias may manifest with this mineral deficiency
K+
Hyperkalemia
→ Serum K+ > ___ mEq/L
5