Vitamins: B-complex, C

Question 1

PYRIDOXINE - Vitamin B6 Includes three compounds which are ____ derivatives:

____(____ form)

____ (___ form)

____ (____ form)

Answer 1

Includes three compounds which are pyridine derivatives: Pyridoxal (Aldehyde form) Pyridoxine (Alcohol form) Pyridoxamine (Amine form)

Question 2

Active Coenzyme Form

____ _____ (___ )

All three forms of pyridoxine can be converted to the active coenzyme form by ____

Answer 2

Pyridoxal phosphate (PLP) All three forms of pyridoxine can be converted to the active coenzyme form by phosphorylation.

Question 3

Primary Role of PLP in the Body

As a coenzyme, pyridoxine is involved in more than ___ enzymatic reactions.

Answer 3

Primary Role of PLP in the Body As a coenzyme, pyridoxine is involved in more than 100 enzymatic reactions.

Question 4

Primary Functions of Pyridoxine

Reactions related to

___ ___metabolism

___ ___ and ____ metabolism

Conversion of ___ to ____

Synthesis of____

Synthesis of ____

Maintenance of ___ ___

Answer 4

Reactions related to amino acid metabolism Fatty acid and glucose metabolism Conversion of tryptophan to niacin Synthesis of neurotransmitters Synthesis of heme (part of hemoglobin) Maintenance of immune system

Question 5

RDA for Pyridoxine Males and Females (19-50 yrs) ___mg/day

Tolerable upper level (TUL): ___mg/day

Answer 5

Males and Females (19-50 yrs) 1.3mg/day Tolerable upper level (TUL): 100mg/day

Question 6

Factors that Affect Pyridoxine Requirement

____ such as____ (used to treat Parkinson’s disease) and ____.

___ consumption

____ in pregnant women

Answer 6

Medications such as L-DOPA (used to treat Parkinson’s disease) and Isoniazid. Alcohol consumption Preeclampsia in pregnant women

Question 7

Deficiency Early symptoms: -

____ ____ ____

Answer 7

Early symptoms: - Weakness - Irritability - Insomnia

Question 8

Advanced symptoms (particularly in i___s and ____n): -

____(microcytic, hypochromic) -

___ ___

___ ___ ___

_____

Answer 8

Advanced symptoms (particularly in infants and children): - Anemia (microcytic, hypochromic) - Growth failure - Impaired motor function - Convulsions

Question 9

Food Sources Protein rich foods Veggies/Fruits

Answer 9

Protein rich foods Veggies/Fruits

Question 10

Significant Food Sources of Pyridoxine

___
___

_____

____
___

Answer 10

Meat Fish Poultry Legumes Bananas

Question 11

Clinical Applications

___
____
____
____
____
____
____

Answer 11

Premenstrual syndrome (PMS)

Gestational diabetes

Carpal tunnel syndrome

Hyperemesis Gravidarum (nausea associated with pregnancy)

Meds: Patients receiving drugs such as Isoniazid, Cycloserine, Penicillamine

Alzheimer’s disease

ADHD (Attention deficit-hyperactivity disorder).

Question 12

Pantothenic Acid

Greek word “pantothen” meaning, “__ ___”.

Ample supply of this vitamin is present in __ ___

. Deficiency of this vitamin is ___

Answer 12

Greek word “pantothen” meaning, “every side”. Ample supply of this vitamin is present in all foods. Deficiency of this vitamin is unlikely.

Question 13

Primary Function

Pantothenic acid is an essential component of ______

. Acetyl coenzyme A or acetyl Co A is an important molecule that participates in many ____ reactions.

Its primary function is to____ the ___ atoms within the____ group to the _____(TCA cycle) to be ___ for production of ___

Answer 13

Pantothenic acid is an essential component of acetyl coenzyme A. Acetyl coenzyme A or acetyl Co A is an important molecule that participates in many biochemical reactions. Its primary function is to transfer the carbon atoms within the acetyl group to the citric acid cycle (TCA cycle) to be oxidized for production of energy.

Question 14

Metabolic Pathways Involving B Vitamins

Answer 14

Metabolic Pathways Involving B Vitamins

Question 15

RDA - _____

Adequate intake (AI) – ___

Answer 15

Adequate intake (AI) – 5mg/day

Question 16

Biotin

___ ___ are one of the most nutrient-dense sources of biotin.

Answer 16

Egg yolks are one of the most nutrient-dense sources of biotin.

Question 17

Avidin Definition:

A ___ found in ___ ___ ___ that can__ __ and inhibit ___; cooking destroys ___

Answer 17

Definition: A protein found in raw egg whites that can bind biotin and inhibit absorption; cooking destroys avidin.

Question 18

Functions of Biotin Essential ___ for ___ carboxylase enzymes:

• ___ ____ carboxylase
• ____ carboxylase
• ___ ___ carboxylase

___ ____ ____carboxylase

Specific roles in ____, __ __ synthesis, and catabolism of ____

Answer 18

Essential cofactor for four carboxylase enzymes: - Acetyl Co A carboxylase - Pyruvate carboxylase - Propionyl Co A carboxylase - Beta-methylcrotonyl Co A carboxylase Specific roles in gluconeogenesis, fatty acid synthesis, and catabolism of glucose

Question 19

Folic Acid (Folate, Folacin)

Primary Function

Primary coenzyme form is ___ ____

___ of___ ___ fragments

Metabolism of ____, ___ and ___

Vital for ___ ___

Synthesis of __s and ____ (essential for cell division)

Answer 19

Folic Acid (Folate, Folacin) Primary coenzyme form is tetrahydrofolate (THF) Transfer of one-carbon fragments Metabolism of serine, methionine and histidine Vital for DNA metabolism Synthesis of purines and pyrimidines (essential for cell division)

Question 20

RDA for Folate Males and Females (____ yrs.): _____

Answer 20

Males and Females (19-70 yrs.): 400 µg/day

Question 21

Folate and ___ ___ Defects

Answer 21

Folate and Neural Tube Defects

Question 22

Deficiency

____ ____ (red blood cells are ____ than normal and not ___ ___)

_____ abnormalities (___, ____, etc.)

Answer 22

Megaloblastic anemia (red blood cells are larger than normal and not fully developed) Gastrointestinal abnormalities (diarrhea, malabsorption, etc.)

Question 23

Food Sources

_____
____
____
_____

Answer 23

Food Sources

Leafy Green Veggies (spinach/broccoli)

Legumes (black beans, kidney beans, black eyed peas)

Liver

Fruits (Oranges)

Question 24

Clinical Applications

Prevention of ___ __ ___

• ___ ___
• _____ (absence of part of____).

Possible prevention of___ ___ (along with other B-vitamins).

Control of plasma ______.

Treatment of ____ diseases.

Answer 24

Prevention of neural tube defects (NTDs) - Spina bifida - Anencephaly (absence of part of brain). Possible prevention of heart disease (along with other B-vitamins). Control of plasma homocysteinemia. Treatment of thrombotic diseases.

Question 25

Clinical Applications (continued)

Treatment of ____

Possible prevention of ___ ___

Many other clinical conditions

Answer 25

Treatment of depression Possible prevention of Alzheimer’s disease Many other clinical conditions

Question 26

VITAMIN B12 - Cobalamin Several Chemical Forms

____cobalamin

___cobalamin

____cobalamin

____cobalamin

*:

Answer 26

Methylcobalamin* Cyanocobalamin Hydroxycobalamin Adenosylcobalamin *

Question 27

Relationship with Folate

Both vitamins are essential for normal___ ___ ___formation.

Deficiency of both vitamins leads to ____ ____

Answer 27

Both vitamins are essential for normal red blood cell formation. Deficiency of both vitamins leads to megaloblastic anemia.

Question 28

Unique Function of Cobalamin

___ function: maintenance of ___ ___ that insulates nerve fibers.

Deficiency of cobalamin is a risk factor for ____ disease that can cause___ ___

Answer 28

Nerve function: maintenance of myelin sheath that insulates nerve fibers. Deficiency of cobalamin is a risk factor for neurodegenerative disease that can cause irreversible damage.

Question 29

The B-Vitamins: In Concert

Many ____ relationships of several B-vitamins.

Supplements of ___ ____ and ___ may lower___ ____which may be a marker for ___ ___

Answer 29

Many interdependent relationships of several B-vitamins. Supplements of cobalamin, pyridoxine and folate may lower plasma homocysteine which may be a marker for heart disease.

Question 30

Absorption of Cobalamin

Vitamin B12 in ___

___ protein in ___ ___

B12 released as food is digested in ___

B12 R protein ___ formed in ___ pH, protecting B12 from ___ ___

Intrinsic factor released from ___ ___ in ___

___ from ___

___ __ released by trypsin

B12-IF: B12 intrinsic factor ___ formed. This is needed for __ ___

B12 absorbed into ___ and bound to __ ___, ____ ___

Answer 30

Absorption of Cobalamin

Absorption of Colbalmin:

Vitamin B12 in food.

R Protein in salivary glands

B12 released as food is digested in stomach

B12 R protein link formed in acid pH, protecting B12 from intestinal bacteria

Intrinsic factor released from parietal cells in stomach

Trypsin from pancreas

R protein released by trypsin

B12-IF: B12 intrinsic factor link formed. This is needed for B12 absorption

B12 absorbed into blood and bound to transport protein, transcobalamin II

Question 31

Pernicious Anemia

____ or ___ of ___ ___ which is synthesized in the ___.

Some people (over 60 mostly) may develop ___ ___and hence lack of intrinsic factor.

Rarely, some individuals may inherit a __ ___ for intrinsic factor.

Answer 31

Absence or deficiency of intrinsic factor which is synthesized in the stomach. Some people (over 60 mostly) may develop atrophic gastritis and hence lack of intrinsic factor. Rarely, some individuals may inherit a defective gene for intrinsic factor.

Question 32

Deficiency of Cobalamin

___
___
____ patients

Answer 32

Elderly Alcoholics Gastrectomy patients

Question 33

Megaloblastic Anemia

Answer 33

Megaloblastic Anemia

Question 34

RDA for Cobalamin Adults (males & females) – _____

Answer 34

Adults (males & females) – 2.4 µg/day

Question 35

Food Sources

Answer 35

Food Sources

FISH/Seafood

Question 36

Treatment of Megaloblastic Anemia

Diagnose____of anemia

Treat with appropriate___ - ___, ___ or both

Answer 36

Diagnose cause of anemia Treat with appropriate vitamin - Folate, Cobalamin or both

Question 37

Vitamin C – Ascorbic Acid

Primary Role

Formation of ____(involved in several ___ ___).

Necessary for normal ___ and ___

Answer 37

Formation of collagen (involved in several enzymatic reactions). Necessary for normal growth and development.

Question 38

Formation of Strong ___ ___

Vitamin C Present: Collagen is ____ (____) by ____ enzyme need Vit C as cofactor.

Answer 38

Formation of Strong Connective Tissue

Vitamin C Present: Collagen is Hydroxylated (Proline) by hydroxylase enzyme need Vit C as cofactor.

Question 39

Other Roles

Synthesis of ____

Synthesis of ___

Absorption of ___

____

Answer 39

Synthesis of catecholamines Synthesis of thyroxine Absorption of iron Antioxidant

Question 40

RDA for Vitamin C Adults (males & females):_____

Smokers:_____

Answer 40

Adults (males & females): 60 mg/day Smokers: 100 mg/day

Question 41

Deficiency of Vitamin C -

Scurvy

Worldwide, scurvy is associated with ____ and ____

Symptoms of scurvy include:

___, ___ ___
___ ___

___ ___
___ ___ __
____ ____ such as ___ and___

Answer 41

Worldwide, scurvy is associated with poverty and malnutrition. Symptoms of scurvy include: Rough, brown skin Scorbutic gums Pinpoint hemorrhages Poor wound healing Psychological signs such as hysteria and depression

Question 42

Food Sources

C
G
S
T
B
P

Answer 42

Citrus Fruits

Green Peppers

Strawberries

Tomatoes

Broccili

Sweet and White Potatoes

Question 43

Clinical Applications

Common___ and ____ infections

____

____ disease

____

Answer 43

Common cold and respiratory infections Stress Cardiovascular disease Cancer

Question 44

Alcohol and B and C-Vitamins

_____ can have an adverse influence on metabolism of B-vitamins.

Answer 44

Alcohol can have an adverse influence on metabolism of B-vitamins.

Question 45

Vitamin C Supplements and___ ____

Answer 45

Vitamin C Supplements and Dental Surgery?

Question 46

Arguments for Vitamin C and B-Vitamin Supplements

Answer 46

Arguments for Vitamin C and B-Vitamin Supplements