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Clinical Chemistry > Vitamins and Nutrition > Flashcards

Vitamins and Nutrition Flashcards

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1
Q

Vitamins

A

Small molecules important as cofactors in many biological/enzymatic reactions

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2
Q

Deficiency

A

Due to either inadequate diet, inadequate GI absorption, competing organisms (e.g., parasites)

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3
Q

Insufficiency

A

Due to increased metabolism that mandates intake and absorption of greater than normal levels

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4
Q

Toxicity

A

Abnormally high intake that can lead to pathology (mostly leading to either hepatic or kidney damage)

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5
Q

Vitamin B1 other name and function

A
  • Thiamine
  • Coenzyme for energy metabolism
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6
Q

Vitamin B2 other name and function

A
  • Riboflavin
  • Precursor for coenzymes FMN or FAD, redox reactions
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7
Q

Vitamin B3 other name and function

A
  • Niacin
  • Precursor to coenzyme NAD, dehydrogenase reactions
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8
Q

Vitamin B5 other name and function

A
  • Pantothenic acid
  • Component of Coenzyme A
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9
Q

Vitamin B6 other name and function

A
  • Pyridoxine
  • Aa metabolism and transport, heme synthesis
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10
Q

Vitamin B7 other name and function

A
  • Biotin
  • Coenzyme for carboxyl unit transfer
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11
Q

Vitamin B12 other name and function

A
  • Cyanocobalamin
  • Hematopoiesis, fatty acid metabolism
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12
Q

Folate/folic acid (vit B9) function

A

Coenzyme for one-carbon transfer reactions and aa metabolism

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13
Q

Vitamin C (ascorbic acid) function

A
  • hydrogen ion transfer
  • redox reactions
  • aa metabolism
  • collagen synthesis
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14
Q

Vit A (retinol) function

A
  • Vision
  • Cell differentiation
  • Growth
  • Reproduction
  • Immune system function
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15
Q

Vitamin D function

A

controls calcium and phosphate metabolism

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16
Q

Vitamin E function

A
  • Antioxidant
  • Peroxide breakdown
  • Cellular integrity
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17
Q

Vitamin K function

A

Cofactor for post-translational carboxylation of many proteins and clotting factors. Give Vit K shots to newborns to aid clotting

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18
Q

Biochemically, vitamins are most easily studied within groups defined by ___

A

hydrophobicity

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19
Q

List fat-soluble vitamins

A

A, D, E, K

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20
Q

Water soluble-vitamins

A

Vit C
B1, B3, riboflavin, B5, B6, B7, B12

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21
Q

Fat soluble vitamin solubility properties

A
  • Dissolve in fat before bloodstream absorption
  • Process requires bile acids from the liver
  • Carried by lipoproteins
22
Q

Vit E carried by which lipoprotein?

A

LDL

23
Q

Fat soluble vitamins mainly stored where? Where do they go if not stored?

A
  • Intestines, liver, and fatty tissues
  • Greater risk of toxicity due to storage
  • Excreted in feces if not stored
24
Q

Water soluble vitamin storage and elimination

A
  • Not stored in body, so less chance of toxicity
  • Regularly eliminated in urine and feces
  • Constant re-supply needed
25
Q

Water soluble vitamin toxicity

A

Less chance of toxicity BUT impaired secretion in renal damage

26
Q

Major site of vitamin absorption

A

Small intestine

27
Q

Vitamin metabolism pathway

A
  1. Nutrients enter at cellular level
  2. Picked up and absorbed by blood capillaries and lymph fluids thru active transport/diffusion/osmosis
28
Q

Where are Vitamin B12 and Vitamin K metabolized?

A

Large intestine

29
Q

List most commonly assayed vitamines

A
  • Folate (Vit B9)
  • Vit B12
  • Vit D
30
Q

ID the vitamin
Most common vitamin deficiency
Can lead to megaloblastic anemia

A

Folate (Vit B9)

31
Q

Which pathologies depend on normal folate levels (feature folate deficiency)?

A
  • Megaloblastic anemia
  • Neural tube defects
  • Increased levels of atherosclerosis related to homocysteine turnover on appropos vitamin levels
32
Q

Folate tested on which sample types?

A

Serum and RBC hemolysate

33
Q

ID the vitamin
Absorption dependent on Intrinsic Factor
Associated with megaloblastic anemia/pernicious anemia
Transcobalamins transport this vitamin

A

Vit B12 (cyanocobalamin)

34
Q

Vit B12 testing

A

Serum or plasma
Similar to folate assays

35
Q

T/F
Lots of foods contain Vit D

A

False

36
Q

Vit D important for assessing what?

A
  • parathyroid function
  • bone development
  • chronic renal failure
  • monitoring vit D therapy
  • vit D toxicity
  • small bowel disease
  • pancreatic insufficiency
  • drug-related hypovitaminosis
37
Q

Vit D from the diet or skin synthesis is biologically ___

A

inactive

38
Q

What is required for Vit D activation?

A

Enzymatic conversion in liver and kidney

39
Q

Marasmus

A
  • Diet deficient in both protein and calories
  • Most severe -> general wasting
40
Q

Kwashiorkor

A
  • Diet adequate in calories but deficient in protein
  • Less severe than marasmus
  • Visceral muscle protein loss but no skeletal muscle loss
41
Q

Negative outcomes of malnutrition

A
  • Increased mortality/morbidity
  • Impaired wound healing
  • Increased rate of infection
  • Increased length of hospital stay
42
Q

Lab methods to assess nutritional status

A
  • selected protein markers most useful
  • hematology assays (Hgb, Hct, WBC, lymphs)
  • immunology assays (increased TDT, cytokine levels)
  • non-protein chemistry (vitamin analysis, BUN/creatinine, cholesterol/triglyceride, mineral levels)
43
Q

List protein markers used to assess nutritional status

A
  • transferrin
  • pre-albumin (transports T4 and retinol)
  • retinol-binding protein (RBP) (vit A transport)
  • albumin/aa/IGF-1/leptin
44
Q

T/F
One single protein marker can assess overall nutritional status

A

False, need more

45
Q

Protein markers may provide info on:

A
  • metabolic status
  • determining prognosis
  • monitoring of nutrition support
46
Q

Useful protein combo to assess nutritional status

A

Plasma markers (usually pre-albumin/transthyretin) + acute phase reactant like CRP

47
Q

What does the following indicate:
Normal CRP
Low pre-albumin

A

Protein malnutrition

48
Q

What does the following indicate:
Significantly increased CRP
Low pre–albumin

A

There may be false decrease in pre-albumin

49
Q

What CRP and pre-albumin lab results indicate improving protein nutrition status?

A

Decreasing CRP and increasing pre-albumin

50
Q

Total parenteral nutrition (TPN)

A

Necessary if GIT not properly functioning or when patient cannot take anything by mouth

51
Q

TPN complications

A
  • fluid/electrolyte imbalance
  • acid-base imbalance
  • glycosuria
  • hyperglycemia
  • liver/hematologic abnormalities
  • vitamin/mineral deficiencies

Clinical Chemistry (21 decks)

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