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Medical Biochemistry > Vitamins and Minerals > Flashcards

Vitamins and Minerals Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the lipid soluable vitamins? Water soluable?

A

Lipid soluable: A,D,K,E
Water Soluable: B vitamins, C

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2
Q

Vitamin A (functions, deficiencies, susceptible groups)

A

Functions:

  • visual cycle (rhodopsin and cone opsins)
  • synthesis of certain glycoproteins and mucopolysaccharides
  • retinoic acid - acts as hormone
  • antioxidant

Deficiency:

  • night blindness (early); xerophthalmia (advanced)
  • follicular hyperkeratosis
  • anemia (despite normal iron intake)
  • poor growth in children
  • increased susceptibility to infection and cancer

Susceptible groups: The poor (malnourishment.) Premature babies.

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3
Q

Vitamin D (functions, deficiencies, susceptible groups)

A

Functions:

  • maintaining bone
  • calcium homeostasis
  • acts as a hormone (receptors are present in many tissues, but full range of activity is unknown.)

Deficiency:

  • rickets in children
  • osteomalacia in adults
  • increased susceptibility to breast and other cancers, metabolic syndrome/diabetes, and infection.

Susceptible groups:

  • poor
  • elderly
  • alcoholics
  • the sun-deprived
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4
Q

What are the effects of vitamin D toxicity?

A
  • Bone loss
  • Excessive calcium
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5
Q

Vitamin K (functions, deficiencies, susceptible groups)

A

Function:

  • localization of enzymes required for blood clotting
  • Helps catalyze addition of γ-carboxyglutamate to clotting enzymes

Deficiency:

  • Results in easy bruising, bleeding
  • Hemorrhage

Susceptible groups:

  • Newborn infants (lack intestinal bacteria that make vitamin K)
  • Patients on long-term antibiotics (kills intestinal bacteria)
  • The elderly and others with defects in fat absorption
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6
Q

Vitamin E (functions, deficiencies, susceptible groups)

A

Function:

-Antioxidant: scavenge free radicals,protect membranes from damage, prevent oxidation of LDL

Deficiency:

  • Cardiovascular disease
  • Neurological symptoms

Susceptible groups:

-Patients with severe, prolonged defects in absorption (ex. celiac disease) or genetic defects (uncommon)

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7
Q

Vitamin C (functions, deficiencies, susceptible groups)

A

Function:

  • cofactor for prolyl and lysyl hydroxylases involved in collagen formation
  • required for synthesis of certain stress hormones (response to trauma)
  • aids absorption of iron
  • has antioxidant activity

Deficiency:

  • Mild: bruising, immunocompromise
  • Severe: SCURVY (decreased wound healing, osteoporosis, hemorrhage and anemia, fatigue)

Susceptible groups:

  • people with poor diet
  • smokers
  • patients undergoing long-term treatment with aspirin, oral contraceptives, and corticosteroids
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8
Q

What are the 2 sub-categories of B vitamins? Which B vitamins belong to each group?

A

Energy releasing:

Thiamine (B1)

Riboflavin (B2)

Niacin (B3)

Biotin (B7)

Pantothenic acid (B5)

Pyridoxine (B6)

Hematopoietic:

Folate (B9)

Cobalamin (B12)

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9
Q

Vitamin B1/Thiamine (functions, deficiencies, susceptible groups)

A

Function:

  • Required cofactor for several enzymes in cellular energy metabolism (TPP)
  • Particularly critical in nervous system

Deficiency:

  • Mild: GI symptoms, depression, fatigue (poor, elderly)
  • Moderate: Wernicke-Korsakoff syndrome (alcoholics)
  • Severe: Beriberi (people with diet dependent only on polished rice, sometimes alcoholics)
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10
Q

Vitamin B2/Riboflavin (functions, deficiencies, susceptible groups)

A

Function:

-Precursor of FAD and FMN (coenzymes important in redox reactions of energy metabolism)

Deficiency:

-Ariboflavinosis: rash around nose, inflammation of mouth and tongue, burning and itchy eyes, light sensitivity

Susceptible groups:

-Alcoholics, deficiency is quite uncommon

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11
Q

Vitamin B3/Niacin (functions, deficiencies, susceptible groups)

A

Function:

-Precursor of NAD and NADP (coenzymes important in redox reactions of energy metabolism)

Deficiency:

-Pellagra: Characterized by dermatitis, diarrhea, and “dementia” (confusion, memory loss, mania)

Susceptible groups:

-People with corn or millet based diets

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12
Q

Vitamin B7/Biotin (functions, deficiencies, susceptible groups)

A

Function:

-Coenzyme for several carboxylases

Deficiency:

-Rare, but can be caused by eating a lot of raw eggs

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13
Q

Vitamin B5/Pantothenic Acid (functions, deficiencies, susceptible groups)

A

Function:

  • Required for the synthesis of CoA: CoA is a coenzyme for up to 70 different enzymes
  • Required for TCA cycle and metabolism of all fats and proteins

Deficiency:

-Very rare. Symptoms are typical of B vitamins

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14
Q

Vitamin B6/Pyridoxine (functions, deficiencies, susceptible groups)

A

Function:

  • Precursor of pyridoxyl phosphate (PLP) enzyme cofactor
  • Required for glycogen breakdown, and synthesis of GABA and heme

Deficiency:

  • Mild: irritability, nervousness, depression
  • Severe: peripheral neuropathy, convulsions, decreased glucose tolerance, hyper-homocysteinemia (cardiovascular risk), anemia

Susceptible Groups:

-Patients treated with certain drugs (isoniazid for TB)

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15
Q

What symptoms are common to most vitamin B deficiencies?

A
  • Symptoms show up first in rapidly dividing tissues. Skin: dermatitis, tongue:glossitis, GI:diarrhea
  • Nervous system also affected because of high energy demand: peripheral neuropathy (tingling of extremities,) depression, confusion, lack of coordination, malaise
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16
Q

Vitamin B9/Folate (functions, deficiencies, susceptible groups)

A

Function:

-precursor of tetrahydrofolate, co-enzyme involved in generating precursors for DNA and protein synthesis.

Deficiency:

  • neural tube defects in newborns of deficient mothers
  • macrocytic anemia
  • hyperhomocysteinemia(cardiovascular risk)

Susceptible groups:

  • pregnant women
  • the elderly
  • alcoholics
  • patients with certain long-term drug treatments (Anticonvulsant drugs and oral contraceptives)
  • people with genetic polymorphisms in folate metabolism
17
Q

Vitamin B12/Cobalamin (functions, deficiencies, susceptible groups)

A

Function:

  • coenzyme in methionine synthesis and in conversion of methylmalonyl CoA to succinyl CoA
  • needed in folate metabolism

Deficiency:

-Pernicious anemia (megaloblastic anemia) with demyelination

Susceptible groups:

  • the elderly
  • patients with malabsorption diseases
  • long-term vegetarians
18
Q

Calcium (functions, deficiencies, susceptible groups)

A

Functions:

  • Major component of bone
  • Signaling
  • Coagulation
  • Muscle contraction
  • Neurotransmission

Deficiency:

  • Mild: muscle cramps, osteoporosis
  • Severe: rickets

Susceptible groups:

  • Children
  • Adult women
  • The elderly
19
Q

Magnesium (functions, deficiencies, susceptible groups)

A

Functions:

  • Essential for many enzymes (which use MgATP as substrate)
  • Present at high levels in bone

Deficiency:

-Weakness, tremors, cardiac arrhythmia

Susceptible groups:

  • Alcoholics
  • Patients taking diuretics, or experiencing severe vomiting and diarrhea
20
Q

Iron (functions, deficiencies, susceptible groups)

A

Function:

  • O2/CO2 transport in hemoglobin
  • oxidative phosphorylation
  • cofactor in several nonheme iron proteins and cytochromes (redox properties of iron are important)

Deficiency:

  • Microcytic hypochromic anemia
  • Decreased immunity

Susceptible groups:

  • Children and menstruating women, pregnant women (increased demand)
  • The elderly
21
Q

Phosphorus (functions, deficiencies, susceptible groups)

A

Functions:

  • Mostly present in phosphates
  • Major component of bone (hydroxyapatite)
  • Constituent of nucleic acids, membrane lipids
  • Required in all energy-producing reactions

Deficiency (Rare, abundant in many foods):

  • Rickets
  • Muscle weakness and breakdown
  • Seizure
22
Q

What are the effects of iron toxicity?

A

Long-term: Hemochromatosis

  • iron overload leads to iron deposits in multiple tissues. Leads to compromised liver, pancreatic, and cardiac function.
  • ultimately can compromise mitochondrial function leading to lactic acidosis.

Acute: most common cause of death due to toxicity in children under 6 (Medscape), comes from consumption of adult iron supplements

23
Q

Copper (functions, deficiencies, susceptible groups)

A

Functions:

  • Assists iron absorption through ceruloplasmin
  • Cofactor for enzymes required in collagen synthesis, fatty acid metabolism, and elimination of reactive oxygen species

Deficiency (quite rare):

-Symptoms include anemia, hypercholesterolemia, fragility of large arteries, bone demineralization demyelination

Susceptible Groups:

  • Those with genetic disease (Menkes’ syndrome)
  • Patients consuming excessive zinc
24
Q

Zinc (functions, deficiencies, susceptible groups)

A

Function:

  • Cofactor for over 300 metalloenyzmes
  • Plays a structural role in many proteins (Zn finger domains)

Deficiency:

  • Poor wound healing
  • Dermatitis (earliest symptom)
  • Reduced taste acuity
  • Poor growth and impaired sexual development in children

Susceptible groups:

  • Alcoholics
  • The elderly
  • People with malabsorption or kidney disease
25
Q

Chromium (functions, deficiencies, susceptible groups)

A

Function:

-Component of chromodulin: facilitates insulin binding to its receptor

Deficiency:

-Impaired glucose tolerance (from reduced insulin effectiveness)

Susceptible populations:

-Those with impaired glucose tolerance (Cr3+ hasn’t yet proven helpful in treatment of type 2 diabetics.)

26
Q

Iodine (functions, deficiencies, susceptible groups)

A

Function:

-Incorporated into triiodothyronine (T3) and thyroxine (T4) (Regulates basal metabolic rate)

Deficiency:

  • Goiter: enlarged thyroid gland
  • Hyperthyroidism or hypothyroidism

Susceptible Groups:

-Developing world populations (Iodized salt has reduced incidence)

27
Q

Selenium (functions, deficiencies, susceptible groups)

A

Function:

  • Component of antioxidant enzymes (ex. glutathione peroxidase)
  • Component of deiodinase enzymes involved in T3 and T4 metabolism

Deficiency:

-Keshan disease: cardiomyopathy and cretinism

Susceptible Groups:

-People living in areas with little selenium in soil

28
Q

What are the most common nutrient deficiencies among alcoholics?

A

Folate, B6, and thiamine (many others are common)

29
Q

What are the most common nutrient deficiencies among children?

A

Iron and calcium

30
Q

What are the most common nutrient deficiencies among teenagers?

A

calcium and magnesium, possibly vitamin A, C, and B6

31
Q

What are the most common nutrient deficiencies among women?

A

iron, calcium, magnesium, vitamin B6, folate

32
Q

What are the most common nutrient deficiencies among the elderly?

A

Vitamins B6, B12, D, possibly zinc and chromium

33
Q

What is the function of manganese?

A

Cofactor or structural component for arginase, pyruvate carboxylase, superoxide dismutase.

34
Q

What is the function of molybdenum?

A

cofactor/structural component for xanthene oxidase

35
Q

What is the function of fluoride?

A

It is incorporated into bones and teeth, strengthening them

36
Q

What is the function of boron?

A

it is involved in bone formation.

37
Q

What is the function of sulfur?

A

It is a component of amino acids. It is also used in certain post-translational modifications.

Medical Biochemistry (4 decks)

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