Vitamins part 2 Water soluble

Question 1

thiamine B1 function

Answer 1

• coenzyme for glycolysis, TCA, AA metabolism
• decarboxylation and transketolation reactions
• may alter membrane conductions

Question 2

thiamin B1 sources

Answer 2

whole grains
enriched grains
lean pork
legumes

Question 3

thiamin B1 test

Answer 3

erythrocyte transketolase activity

thiamine blood levels

Question 4

thiamin Deficiency/ toxicity

Answer 4

Beriberi syndrome:

• Dry/ nervous
• Wet/ Cardiac

Wernicke-Korsakoff:
Ocular + Ataxia + Confusion

Question 5

what type of nervous function is most effected in wernicke-korsakoff?

Answer 5

retentive memory

Question 6

riboflavin B2 function

Answer 6

• part of 2 coenzymes: FAD and FMN
• oxidation/ reduction reactions in TCA and oxidative phosphorylation
• AA and fatty acid metabolism
• metabolism of vitamin K, folate, b6, niacin

Question 7

riboflavin b2 is involved in the metabolism of what other vitamins?

Answer 7

vitamin k
folate
pyridoxine b6
niacin b3

Question 8

riboflavin b2 source

Answer 8

liver, wheat germ
dairy
meats, poultry
leafy greens

Question 9

riboflavin B2 test

Answer 9

erythrocyte glutathione reductase (EGRAC): increased in deficiency

Question 10

riboflavin b2 deficiency

Answer 10

oral-ocular-genital system:

• cheilosis: cracked lips
• stomatitis: sores at corner of moth
• increased vascularization of conjunctiva
• scrotal dermatitis

Question 11

niacin B3 function

Answer 11

• substituent of electron carrying NAD and NADP

- glycolysis, TCA, oxidative phosphorylation, fatty acid synthesis and oxidation

Question 12

niacin B3 sources

Answer 12

Preformed:

• meat, poultry, fish
• penut butter
• legumes

Precursor: Tryptophan
-milk, eggs

Question 13

niacin B3 test

Answer 13

serum niacin

urinary excretion of n1 methyl nicotinamide and 2-pyridone
*ratio

Question 14

niacin B3 deficiency

Answer 14

Pellagra: 4 Ds
Dermatitis: symmetric pattern
Dementia
Diarrhea
Death

Question 15

Niacin B3 toxicity

Answer 15

• nontoxic in doses 3-6 grams / day nicotinic acid
• lower serum LDL
• peripheral vasodilation/ flushing

Less common:

• increased serum uric acid
• glucose intolerance
• liver damage

Question 16

folate function

Answer 16

• 1 carbon transfers
• homocysteine –> methionine
• methy donor/ epigenetics

Question 17

folate source

Answer 17

foliage- deep green leaves
broccoli
orange juice
whole grains

Question 18

folate test

Answer 18

Folate RBC: Chronic Status

Serum Folate: Recent Intake

Question 19

Folate deficiency

Answer 19

• macrocytic anemia with hypersegmented neutrophils
• increased plasma homocysteine
• neural tube defects
• MTHFR gene indicates increased requirement

Question 20

pyridoxine b6 function

Answer 20

aa metabolism/ intercomversion

Question 21

pyridoxine b6 source

Answer 21

animal products
vegetables
whole grains

Question 22

pyridoxine b6 test

Answer 22

• pyridoxal phosphate

- homocysteine

Question 23

pyridoxine b6 deficiency

Answer 23

anemia
seizures
glositis

Question 24

pyridoxine b6 toxicity

Answer 24

+/- depression

• doses >500mg associated with sensory ataxia, impaired position/ vibration sense
• symptoms partially reversed with dc of supplement

Question 25

cobalamin b12 function

Answer 25

- 1 carbon transfers - metabolism of odd chain fatty acids - binds to IF that is secreted by gastric parietal cells

Question 26

cobalamin b12 absorption

Answer 26

``` Gastric Parietal: bound to IF --> Distal ilium: cobalamin-IF complex --> Portal Circulation: bound 2 transcobalamin II ```

Question 27

cobalamin b12 source

Answer 27

- ONLY IN ANIMAL PRODUCTS | - liver stores 1-10mg: can take years to develop deficiency unless damage to stomach, ileum, pancreas

Question 28

cobalamin b12 test

Answer 28

serum b12 level urine or blood methylmelonic acid: increased in b12 deficit serum homocysteine: increased in b12 deficit CBC: increased MCV: non specific

Question 29

cobalamin b12 deficiency

Answer 29

- macrocytic anemia with hyper-segmented neutrophils | - neurologic disturbances: paresthesias, gain problems, depressions

Question 30

cobalamin b12 corrections

Answer 30

-hemolytic effects reversible but neuro effects irreversible with long standing deficiencies

Question 31

vitamin c function

Answer 31

- antioxidant/ reducing agent: electron donor - collagen synthesis - Reduce Fe3+ --> Fe2+ - norepinephrine synthesis

Question 32

vitamin c source

Answer 32

``` fruits/ vegetables broccoli green pepper citrus potatoes ```

Question 33

vitamin c tests

Answer 33

leukocyte | plasma ascorbic acid level

Question 34

vitamin c deficiency

Answer 34

- scurvy - loss of precursors of catecholamines and vasoactive/ neurotropic substances - Symptoms: petechiae, bleeding gums, anemia, brusing, painful joints

Question 35

what is the safe upper limit of vitamin c

Answer 35

2g/day

Question 36

alcoholics are the highest risk group for what vitamin deficiency?

Answer 36

thiamine b1 also at risk: - re-feeding: body stores insufficient to handle increased demand - bariatric surgery

Question 37

what vitamin deficiency historically occurred in areas where corn was the major source of protein and calories in the diet?

Answer 37

niacin b3

Question 38

metabolic shunting carcinoid tumors increases risk for what vitamin deficiency?

Answer 38

niacin B3 -excessive serotonin shunts tryptophan away from usual metabolic pathway

Question 39

isoniazid for TB puts patients at risk for what vitamin deficiency?

Answer 39

niacin B3 | also pyridoxine b6

Question 40

what vitamin deficiency is especially concerning in pregnant women?

Answer 40

folate

Question 41

what vitamin deficiency are infants/ children fed unsupplemented goat's milk at risk of developing?

Answer 41

folate

Question 42

dilantin, sulfasalazine increase risk of deficiency of what vitamin?

Answer 42

folate

Question 43

pernicious anemia (IF not produced or secreted), resection of stomach/ ileum, and gastric atrophy increase risk of what deficiency?

Answer 43

cobalamin b12

Question 44

strict vegetarian diet w/o supplementation increases risk for what deficiency?

Answer 44

cobalamin b12

Question 45

increased requirements for wound healing/ burns increase risk of what vitamin deficiency?

Answer 45

vitamin C

Question 46

tryptophan is a precursor to what vitamin?

Answer 46

niacin b3