Vitamins and Minerals

Question 1

Two types of Vitamins
Storage
Toxicity

Answer 1

1. Fat soluble and water soluble
2. Fat in adipose tissue and water soluble in small amounts in the body
3. Fat» water toxicity when in excess
   water can be excreted in urine

Question 2

List Fat and water soluble vitamins

Answer 2

Fat: ADEK

Water:
B-complex
B1-Thiamine
B2-Ribofalvin
B3-Niacin
B5-Pantothenic acid
B6-Pyridoxin
B7-Biotin
B9-Folic acid
B12-Caynocobalamin (B12)

non-B complex-Ascorbic acid (C)

Question 3

Vit C
Absorption
Foods
Function
Deficiency
Toxicity
Assessment status

Answer 3

Absorption-ileum
Foods-citrous fruits
Function-collagen & carnitine synthesis
Deficiency- scurvy, anemia, bleeding gum, weaker cartilage in bone, teeth, fatigue, depression
Toxicity-gastric irritation, renal dysfunction, stones in renal failure pt
Assessment status-plasma ascorbic acid

Question 4

Thiamine
Absorption
Function
Deficiency
Assessment status

Answer 4

Absorption-jejunum
Function-ADP synthesis, co-factor for Pyruvate dehydrogenase
Deficiency- TPN, polished rice, alcoholism, wet and dry beriberi
Assessment status-deficiency in transketolase activity, MRI changes

Question 5

Riboflavin
Absorption
Foods
Function
Deficiency
Assessment status

Answer 5

Absorption-proximal SI
Function-carb, fat, aa metabolism
Deficiency-angular stomatitis, chelosis, dermatitis, anemia
Assessment status-measurement of erythrocyte glutathione reductase

Question 6

Niacin
Absorption
Foods
Function
Deficiency
Toxicity
Assessment status

Answer 6

Absorption-stomach and intestine
Function-cellular metabolism and DNA repair
Deficiency- 4 Ds (diarrhea, dermatitis, dementia, death)
Toxicity-vasodilation, itching
Assessment status-urine excretion of niacin methylated metabolites

Question 7

Pyridoxin
Absorption
Function
Deficiency
Toxicity
Assessment status

Answer 7

Absorption-jejunum
Function-Hb synthesis
Deficiency-dermatitis, glossitis, depression, anemia
Toxicity-ataxia, sensory neuropathy
Assessment status-plasma pyridoxal phosphate

Question 8

Biotin
Absorption
Function
Deficiency
Assessment status

Answer 8

Absorption-proximal SI
Function-co-enzyme for carboxylase
Deficiency-raw eggs, prolonged ABX, AED, TPN, seizure, ataxia, depression
Assessment status-serum or urine biotin

Question 9

Folic acid
Absorption
Function
Deficiency
Assessment status

Answer 9

Absorption-jejunum
Function-DNA repair synthesis
Deficiency- NTD, anemia, diarrhea, HA
Toxicity-seizures
Assessment status-plasma folate

Question 10

Cyanocobalamin (B12)
Absorption
Function
Deficiency
Assessment status

Answer 10

Absorption-terminal ileum
Function-Hb synthesis, fat/pro metabolism
Deficiency-megaloblastic anemia, neurological symp (weakness, paresthesia, confusion)
RF: chronic gastritis, vegan, atrophic gastritis, terminal ileum disease, SBS, bariatric surgery
Assessment status-B12 level, MMA, homocysteine level

Question 11

Calcium
Absorption
Foods
Deficiency
Assessment status

Answer 11

Absorption-duodenum
Foods-milk, cheese, seaweed
Deficiency-night blindness, xeropthalmia, bitot spots, keratomalcia
RF: PA insufficiency, cholestatic liver disease, malabsorption
Assessment status-serum retinol and retinol binding protein

Question 12

Chromium
Absorption
Foods
Deficiency
Assessment status

Answer 12

Absorption-jejunum
Foods-cheese, whole grain, wheat, meat, fruits, veggies
Deficiency-rickets, osteomalacia, dental carries, hypoCA, P, inc ALP
RF: cholestatic liver disease, Fat malabsorption
Assessment status-25-OH vit D and PTH

Question 13

Copper
Absorption
Foods
Deficiency
Assessment status

Answer 13

Absorption-stomach & proximal SI
Foods-liver, veal, shellfish
Deficiency-abnormal bone matrix, coagulation probelms, inc PT
Assessment status-Plasma alpha tocopherol

Question 14

Iodide
Absorption
Foods
Deficiency
Assessment status

Answer 14

Absorption-stomach & proximal SI
Foods: egg, milk, fish, iodized salt
Deficiency : goiter, short stature, developmental delay
Assessment status-goiter, hypothyroidm urine iodine level

Question 15

Iron
Absorption
Foods
Deficiency
Assessment status

Answer 15

Absorption- duodenum, jejunum
F2+ easily absorbed with help of Vit C, HCl, Lactic acid, amino acid (aspartic and glutamic acid)
Foods-meat, fish, poultry
Deficiency -dec concentration, exercise intolerance, fatigue
Assessment status-CBC, Ferritin, plasma iron, TIBC, Transferrin receptor

Question 16

Magnesium
Absorption
Foods
Deficiency
Assessment status

Answer 16

Absorption-distal jej and ileum
Foods -whole grain, nuts, green veggies
Deficiency -seizures, cramps, dysarrythmias, resistant hypoCa and K
Assessment status-serum levels

Question 17

Manganese
Absorption
Foods
Deficiency
Assessment status

Answer 17

Absorption-all SI
Foods-green leafy vegetables, maple syrup
Deficiency-dermatitis, dec clotting factors, abnormal bone and cartilage, dec nail/hair growth, defects in carb/lipid metabolism
Assessment status-blood levels

Question 18

Selenium
Absorption
Foods
Deficiency
Assessment status

Answer 18

Absorption- SI
Foods - meat, tuna, nuts
Deficiency - arrhythmias, cardiomyopathy, CHF, muscle cramps, weakness
Assessment status-serum level

Question 19

Zinc
Absorption
Foods
Deficiency
Assessment status

Answer 19

Absorption- SI
Foods - oyster, beef, pork, lobster
Deficiency - acrodermatitis enteropathica, hair loss, skin lesions, impaired immune function, diarrhea
Assessment status-serum level, low ALP