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USMLE REVIEW > Vitamins & Minerals > Flashcards

Vitamins & Minerals Flashcards

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USMLE® Step 1 flashcards
1
Q

Cause of death in Iron poisoning

A

Cell death due to peroxidation of membrane lipids

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2
Q

Treatment for Iron poisoning

A

Chelation! = IV deferoxamine, oral deferasirox

Dialysis

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3
Q

Primary iron storage protein of body

A

Ferritin = cellular storage protein for iron

*Acute phase reactant, elevated in inflammation,

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4
Q

What happens to transferrin concentration in iron deficiency?

A

Increased

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5
Q

Iron overdose causes what acid/base disorder?

A

Anion Gap Metabolic Acidosis

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6
Q

What two enzymes require zinc?

A

Carbonic anhydrase

Lactate dehydrogenase

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7
Q

Peripheral neuropathy - wrist drop and foot drop

Burton Lines on gingivae and metaphyses of long bones

Abdominal pain

Sideroblastic anemia
Basophilic stippling on RBCs

A

Lead poisoning

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8
Q

What enzymes does lead inhibit?

A

Ferrochelatase
ALA- dehydratase

(Decreased heme synthesis and increased RBC protoporphyrin)

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9
Q

Treatment for lead poisoning

A

Succimer
EDTA
Dimercaprol

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10
Q

Where does mercury toxicity accumulate?

A

Kidney and brain

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11
Q

What is the physiologic active form of Vit D?

A

1,25 (OH)2 D3 = calictriol

1 st hydroxylation = liver
2nd hydroxylation = kidney

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12
Q

Bones
Stones
Groans
Psychiatric Overtones

A

Hypercalcemia

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13
Q

Why are neonates deficient in Vit. K?

A

They have a sterile gut, and Vit is synthesized by intestinal flora

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14
Q

Why is vit K necessary fro coagulation?

A

Cofactor for gamma carboxylation of factors 10, 9, 7, 2

“DISCo started in 1972”

*Newborns receive single dose of IM Vit K at birth

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15
Q

Bitot spots on conjunctiva

Keratomalacia (conreal degeneration)

A

Vit. A. deficiency

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16
Q

Megaloblastic Anemia
Hypersegmented neutrophils
Increased serum methylmalonic acid levels

A

Vit. B12 deficiency = cobalamin

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17
Q

Antioxidant vitamins?

A

Vitamin E

Vitamin C = ascorbic acid

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18
Q

Main reactions of Vit. C?

A
  • Hydroxylation of prolyl and lysyl residues of collagen
  • Required for dopamine to NE reaction
  • Antioxidant
  • Facilities Fe absorption in gut - deficiency can cause Fe deficient anemia!
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19
Q

Sore, spongy gums
Poor wound healing
Bleed mucous membranes
Spots on the skin

A

Vit. C. deficiency = Scurvy

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20
Q

Encephalopathy
Oculomotor dysfunction
Gait Ataxia

A

Wernicke Encephalopathy

21
Q

Memory loss - retrograde and anterograde
Confabulation
Personality changes
Apathy

A

Korsakoff Syndrome = consequences of chronic wernkicke encephalopathy

Atrophy of mamillary bodies, and medial thalamus

22
Q

Vit. B1 deficiency (Thiamine)

A

Wet BeriBeri = high out put cardiac failure (dialated cardiomyopathy), edema

Dry BeriBeri = affecting nerves

23
Q

Treament for Wernkick-Korsakoff?

A

THIAMINE SUPPLEMENTATION!!! Before glucose!!! Glucose will make it worse without thiamine!

24
Q

Enzymes requiring Vit. B1

A

THIAMINE! = TPP

  • Pyruvate dehydrogenase
  • alpha ketoglutarate dehydrogenase
  • Transketolase
  • Branched-chain ketoacid dehydrogenase
25
Q

B2 = riboflavin

A

FAD, FMN
Cofactors in redox reactions

*If it has dehydrogenase in the name, likely requires FAD!

26
Q

What Vit. deficiency causes Cheilosis and corneal vascularization?

A

Vit. B2 = riboflavin

27
Q

B3

A

Niacin

28
Q

Dermatitis
Dementia
Diarrhea

Broad collar rash
Hyperpigmentation of sun-exposed areas

A

3 D’s of pellegra! Niacin deficiency

Can be caused by:

  • Hartnup disease (decreased tryptophan absorbtion)
  • Malignant carcinoid syndrome (increased tryptophan metabolism)
  • Isoniazide (decreased Vit. B6)
29
Q 
Angular cheilosis
Glossitis
Convulsions
Peripheral neuropathy
Sideroblastic Anemia
A

Vit B6 deficiency = Pyridoxine

Cofactor for transaminations, synthesis of heme, niacin, histamine, NTs (including GABA… why you get convulsions, loss of inhibition)

30
Q

What enzymes require Biotin? (B7)

A

Carboxylation reactions

31
Q

What can cause a Vit. B7 deficiency?

A

B7 = Biotin

AVIDIN (egg whites) prevents absorption of biotin

32
Q 
Marocytic, megaloblastic anemia
Hypersegmented polymorphonuclear cells
Glossitis
No neuro symptoms
Normal methylmalonic acid levels
A

Vit B9 = folate deficiency

33
Q

Macrocytic megaloblastic anemia
Hypersegmented PMNs
Paresthesia
Increased serum methylmalonic acid levels

A

Vit. B12 deficiency = Cobalamin

34
Q

Vitamin deficiency causing convulsions and irritability?

A

B6 = pyridoxine

Needed in synthesis of heme, niacin, histamine, and NTs (5HT, Epi, NE, DA and GABA)

Loss of GABA causes the convulsion (loss of inhibition)

35
Q

Where is B12 absorbed?

A

Termianl Ileum

36
Q

Pernicious Anemia

A

Autoimmune attack of intrinsic factor, can’t abosorb B12 = megalobalstic anemia

37
Q

Vitamin deficiency associated with peripheral neuropathy, glossitis?

A 
B6 = pyridoxine
B12 = cobalamin
38
Q

Vitamin deficiency associated with neural tube defects?

A

B9 = Folate

39
Q

Vitamin used by pyruvate dehydrogenase and alpha ketoglutarate dehydrogenase?

A

B1 = Thiamine

40
Q

Vitamin used to elevate HDL and lower LDL?

A

B3= Niacin

41
Q

Vitamin deficiency can be caused by isoniazide use?

A

B6 = pyridoxine

*Can also cause Niacin (B3) deficiency because B6 is required to make niacin from tryptophan

42
Q

Vitamins critical for DNA synthesis

A 
B9= Folate
B12 = Cobalamin
43
Q

Most common vitamin deficiency in the US?

A

Foalte

44
Q

Hypersegmented neutrophils

A 
B9 = Folate
B12= cobalamin

*megaloblastic anemia

45
Q

Dilated cardiomyopathy
Edema
Polyneuropathy

A

B1 = Thiamine deficiency = Wet BeriBeri

46
Q

Differential for inflammation of sunexposed regions of the body?

A
  • Pellegra
  • Xeroderma pigmentosa
  • Porphria Cutena Tarda
47
Q

Role of NADPH in body

A

Oxidative burst in phagolysosomes

HMP shunt

48
Q

Enzyme and co-factor needed to recycle folic acid?

A

Homocysteine methyl transferase (cofactor = B12)

USMLE REVIEW (25 decks)

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