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USMLE Year 1 > Vitamins + Associated Deficiency Syndromes > Flashcards

Vitamins + Associated Deficiency Syndromes Flashcards

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USMLE® Step 1 flashcards
1
Q

Dry, scaly skin + corneal degeneration + night blindness + immunosuppression + bitot spots on conjunctiva

A

Vitamin A deficiency

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2
Q

N/V + vertigo + blurred vision

A

Acute Vitamin A toxicity

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3
Q

Alopecia, dry skin, hepatotoxicity and enlargement, arthralgias, pseudotumor cerebri

A

Chronic Vitamin A toxicity

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4
Q

Which vitamins are teratogenic?

A

Vitamin A (need negative UPT before Isotretinoin for acne)

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5
Q

Confusion, ophthalmoplegia, ataxia + confabulation, personality change, permanent memory loss

A

Wernicke-Korsakoff syndrome = Vitamin B1 (thiamine) deficiency in alcoholics

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6
Q

Polyneuritis, symmetrical muscle wasting

A

Dry Beriberi = Vitamin B1 (thiamine) deficiency in malnutrition

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7
Q

High-output cardiac failure (dilated cardiomyopathy) + edema

A

Wet Beriberi = Vitamin B1 (thiamine) deficiency in malnutrition

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8
Q

Which vitamin deficiency is characterized by impaired glucose breakdown and worsened ATP depletion following glucose infusion?

A

Vitamin B1 (Thiamine)

B1 is a cofactor for pyruvate dehydrogenase (links glycolysis to TCA), alpha-ketoglutarate dehydrogenase (TCA), transketolase (HMP shunt), and branched-chain ketoacid dehydrogenase

Diagnosis = increase in RBC transketolase activity following B1 administration

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9
Q

Cheilosis (inflammation of lips, scaling, and fissures at corners of mouth) + corneal vascularization

A

Vitamin B2 (riboflavin) deficiency

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10
Q

Which vitamin is a component of FAD and FMN, two cofactors in redox reactions?

A

B2 (riboflavin)

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11
Q

Macrocytic, megaloblastic anemia + hypersegmented PMNs + glossitis + NO neurologic symptoms

A

Vitamin B9 (folate) deficiency

Can be caused by several drugs– phenytoin, sulfonamides, MTX

Commonly seen in alcoholism and pregnancy (can cause NTDs)

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12
Q

Decreased homocysteine, normal methylamalonic acid level = what vitamin deficiency?

A

Vitamin B9 (folate)

Contrast with B12 deficiency:
- increased serum homocystein and methylmalonic acid levels

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13
Q

Which vitamin is important for the synthesis of nitrogenous bases in DNA and RNA?

A

Folate (B9) which is converted to THF in order to do so

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14
Q

Dermatitis + alopecia + enteritis in someone who was just on antibiotics or consumes a lot of raw egg whites

A

Biotin (B7) deficiency

Avidin in egg whites avidly binds B7 –> decreased biotin

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15
Q

Which vitamin is a cofactor for carboxylation enzymes (which add a 1-carbon group)?

A

Vitamin B7 (biotin)

cofactor for:

  • pyruvate carboxylase (Glycolysis)
  • AcCoA carboxylase (FA ox)
  • propionyl-CoA carboxylase (FA ox)
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16
Q

Glossitis

If severe: Diarrhea, Dementia, Dermatitis (broad collar/casal’s necklace + hyperpigmentation)

A

Vitamin B3 (Niacin)

3 Ds = Pellagra

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17
Q

Niacin synthesis requires what 3 things?

A

Tryptophan = Niacin precursor

Vitamin B2 (riboflavin)
Vitamin B6 (pyridoxine)
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18
Q

Which vitamin can be used to treat dyslipidemia?

A

Niacin (B3) lowers VLDL, increases HDL

19
Q

Which vitamin is a constituent of NAD+ and NADP+?

A

Niacin (B3)

20
Q

What are some causes of Niacin deficiency?

A

Hartnup disease (decreased tryptophan absorption)

Malignant carcinoid syndrome (increased tryptophan metabloism)

Isoniazid use (depletes B6)

21
Q

Facial flushing, hyperglycemia, hyperuricemia

A

Vitamin B3 (Niacin) excess

avoid facial flushing by taking Aspirin with Niacin

22
Q

Dermatitis, enteritis, alopecia, adrenal insufficiency

A

Vitamin B5 (Pantothenic acid) deficiency

23
Q

Which vitamin is an essential component of CoA and FA synthase?

A

Vitamin B5 (Pantothenic acid)

24
Q

Convulsions, hyperirritability, peripheral neuropathy (inducible by isoniazid and OCPs), sideroblastic anemia (d/t impaired Hb synthesis and iron excess)

A

Vitamin B6 (pyridoxine) deficiency

25
Q

Which vitamin can be converted to a cofactor used in transamination and carboxylation reactions?

A

Vitamin B6 (pyridoxine)

26
Q

Which vitamin is important in the syntehsis of cystathionine, heme, niacin, histamine, and NTs (including serotonin, Epi, NE, DA, and GABA)

A

Vitamin B6 (pyridoxine)

27
Q

Macrocytic, megaloblastic anemia + hypersegmented PMNs + paresthesias and subacute combined degeneration

A

Vitamin B12 (cobalamin) deficiency

28
Q

What is subacute combined degeneration and which vitamin deficiency causes it?

A

Degeneration of dorsal columns, lateral corticospinal tracts and spinocerebellar tracts

Due to B12 (Cobalamin) deficiency

29
Q

Which vitamin deficiency manifests as increased serum homocysteine and increased methylmalonic acid levels?

A

B12 (cobalamin)

30
Q

What causes vitamin B12 deficiency

A

B12 is found only in animal products

Insufficient intake (veganism)

Malabsorption (sprue, enteritis, diphyllobothrium latum)

Lack of IF (pernicious anemia, gastric bypass)

Absence of terminal ileum (crohn’s)

31
Q

Which vitamin facilitates iron absorption by reducing it to Fe2+?

A

Vitamin C (ascorbic acid)

can be used as ancillary treatment for methemoglobinemia

32
Q

What is vitamin C’s role in collagen synthesis?

A

hydroxylation of proline and lysine

33
Q

What does vitamin C have to do with dopamine?

A

Vitamin C is necessary for dopamine B-hydroxylase, which converts dopamine to NE

34
Q

swollen gums, bruising, petechiae, hemarthrosis, anemia, poor wound healing, perifollicular and subperiosteal hemorrhages, “corkscrew hair” + weakened immune response

A

Vitamin C (ascorbic acid) deficiency

AKA

Scurvy

35
Q

N/V/D, fatigue, calcium oxalate nephrolithiasis, increased risk of iron toxicity in predisposed individuals

A

Vitamin C (ascorbic acid) excess

36
Q

What is the active form of Vitamin D

A

1,25-(OH)2 D3 = calcitrol = active form

D2 is ingested from plants (ergocalciferol)
D3 is consumed in milk, found in sun-exposed skin (cholecalciferol)

25-OH D3 = storage form

37
Q

Bone pain and deformity (rickets) in children

Bone pain and muscle weakness (osteomalacia) in adults

can also cause hypocalcemic tetany

A

Vitamin D deficiency

Vit D should be supplemented in breastfed infants

hypocalcemic tetany because D increases intestinal absorption of calcium and phosphate

38
Q

Hypercalcemia, hypercalciuria, loss of appetite, stupor

A

Vitamin D excess

Seen in granulomatous disease (increased activation of vitamin D by epithelioid macrophages)

39
Q

Which vitamin can enhance the anticoagulant effects of Warfarin

A

Vitamin E (tocopherol/tocotrienol)

40
Q

Hemolytic anemia, acanthocytosis, muscle weakness, posterior column and spinocerebellar tract demyelination

A

Vitamin E deficiency

Similar to B12 deficiency but lacks megaloblastic anemia, hypersegmented PMNs, and increase in serum methylmalonic acid

41
Q

Which clotting factors require vitamin K for maturation

A

II, VII, IX, X + proteins C and S

Vit K = cofactor for gamma-carboxylation of glutamic acid residues

42
Q

Neonatal hemorrhage with increased PT and aPTT but normal bleeding time

A

Vitamin K deficiency

Hemorrhage can also occur after prolonged use of broad-spectrum abx, as Vit K is synthesized by intestinal flora

43
Q

Delayed wound healing, hypogonadism, decrease in adult hair, dysgeuisa, anosmia, acrodermatitis enteropathica

A

Zinc deficiency

Zinc is essential for the activity of 100+ enzymes (zinc fingers = TF motif)

USMLE Year 1 (6 decks)

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