Vitamins and vitamin deficiencies

Question 1

Sources of vitamin a?

Answer 1

preformed (retinol/al): egg yolk, dairy, fish oil

precursor (carotenoids): yellow/orange/green veggies

Question 2

Signs of Vitamin A deficiency

Answer 2

Night blindness
Xerophtalmia
keratinized epithelium
contributes to measles mortality

Question 3

what does vitamin A do?

Answer 3

vision

epithelial cell differentiation

Question 4

what does vitamin D do?

Answer 4

maintain Ca and P levels
works as a hormone
innate and adaptive immune fnxn

Question 5

sources of vitamin D

Answer 5

egg yolks, fortified milk
fatty fish and fish oils
plants (d2, ergocalciferol)

sun (converts precursor to d3 in the skin)

Question 6

signs of vitamin d deficiency

Answer 6

Rickets (bowed legs, widened metaphyses, painful bones, rachitic rosary on ribs)
hypocalcemia and hypophosphatemia

Question 7

populations esp at risk for vit d deficiency

Answer 7

dark pigment
liver or renal dz
obesity (vit d sequestered in fat)
breastfed infants not receiving vit d drops

Question 8

vitamin d toxicity: what does it look like, in whom do you see it most

Answer 8

higher risk for vit d toxicity in pts with sarcoidosis

hypercalcemia: vomiting, sz, nephrocalcinosis, soft tissue calcification

Question 9

vitamin e job

Answer 9

antioxidant

membrane stabilizer

Question 10

vitamin e sources

Answer 10

vegetable oils

wheat germ

Question 11

signs of vitamin e deficiency

Answer 11

neuro problems
loss of DTRs
hemolytic anemia (normocytic)

Question 12

suspect these vitamin deficiencies when someone presents with a rash/skin issue:

Answer 12

A
K
niacin
C
zinc

Question 13

what vit deficiencies might contribute to mouth lesions?

Answer 13

riboflavin
niacin
C
folate
b12
b6

Question 14

what vitamin deficiencies cause neuro issues?

Answer 14

E
thiamin
C
b12
b6
niacin

Question 15

what vitamin deficiencies cause anemias, and what kind?

Answer 15

E (normocytic hemolytic)
folate (megaloblastic)
b12 (megaloblastic)
C (normocyic, from blood loss)

Question 16

job of vit b1 (thiamine)

Answer 16

decarboxylation and transketolation rxns

nerve conduction

Question 17

sources of b1

Answer 17

whole and enriched grains
legumes
lean pork

Question 18

signs of b1 deficiency

Answer 18

wet beriberi: heart failure, edema, and dry signs

dry beriberi: distal neuropathy (foot drop), impaired sensory, motor, and reflex fnxns

Wernicke/Korsakoff: ataxia, confusion, nystagmus, opthalmoplegia

Question 19

who’s most at risk for b1 deficiency

Answer 19

alcoholics
anorexia pts during refeeding
ppl who only eat rice

Question 20

job of b2 (riboflavin)

Answer 20

FMN, FAD

also metab of vits K, folate, b6, b3

Question 21

sources of riboflavin

Answer 21

**dairy
wheat germ
meats
leafy greens

Question 22

signs of b2 deficiency

Answer 22

cheilosis, angular stomatitis
vascularization of conjunctiva
dermatitis (seborrheic or scrotal)

Question 23

job of niacin

Answer 23

NAD, NADP

Question 24

sources of niacin

Answer 24

meat and fish
PB and other legumes

or, tryptophan is precursor (milk and eggs)

Question 25

signs of niacin deficiency

Answer 25

``` pellagra: dermatitis (symmetric sun-exposed pattern, scaling, hyper and hypopigmented, painful) diarrhea death dementai ```

Question 26

signs of niacin toxicity

Answer 26

flushing

Question 27

job of folate

Answer 27

methylation

Question 28

sources of folate

Answer 28

foliage (leafy greens) OJ whole grains and fortified grains

Question 29

signs of folate deficiency

Answer 29

NTDs macrocytic anemia elevated homocysteine glossitis

Question 30

jobs of cobalamin

Answer 30

methylation | odd-chain fatty acid metabolism

Question 31

sources of b12

Answer 31

animal products

Question 32

signs of b12 deficiency

Answer 32

neuro issues | increased mma and homocysteine

Question 33

sources of b6

Answer 33

animal products vegetables whole grains (not enriched grains)

Question 34

signs of pyridoxine deficiency

Answer 34

anemia, seizures, glossitis ps you can have toxicity with this one

Question 35

job of b6

Answer 35

AA metabolism

Question 36

jobs of vitamin c

Answer 36

antioxidant/reducing agent collagen synthesis enhanced Fe absorption wound healing

Question 37

sources of vitamin c

Answer 37

fruits, veggies, potatoes

Question 38

symps of scurvy

Answer 38

``` petechia bruising bleeding gums painful joints (can present as refusal to walk) hyperkeratosis of hair follicles ```

Question 39

sources of iron

Answer 39

heme: meat non-heme: legumes, nuts, whole grains, enriched grains, leafy greens

Question 40

what decreases iron absorption?

Answer 40

``` phytate, tannins lots of zinc or copper high stores of iron inflammation hepcidin ```

Question 41

what do you need to check along with ferritin levels when looking for iron deficiency?

Answer 41

ESR or CRP

Question 42

what does zinc do?

Answer 42

regulates gene expression growth and cellular/tissue proliferation sexual maturation immune function reduces child mortality

Question 43

sources of zinc

Answer 43

animal products whole grains legumes seeds

Question 44

who's at risk for zinc deficiency?

Answer 44

kids and babies, especially if breastfed preggers monotonous plant based diets (esp high in phytate) burn victims

Question 45

signs of zinc deficiency

Answer 45

``` worst diaper rash you've ever seen stunting impaired immune function neurocognitive delays acrodermatitis enteropathica diarrhea anorexia ```

Question 46

signs of iodine deficiency

Answer 46

goiter (enarged thyroid as compensation for decrease in iodine, which causes decreased thyroid hormone synth) cretinism (deaf mutism, mental retardation, large tongue, dull facies) risk to fetus: abortion