Water soluble vitamins

Question 1

Energy releasing

Answer 1

B1 Thiamine, B2 RIboflavin, B3 Niacin

Question 2

Sources B1, B2, B3

Answer 2

B1 T: whole grains, lean pork legumes
B2 R: Liver and wheat germ, DAIRY (UV destroys it!) meats and poultry
B3 N: Tryptophan is precursor so milk and eggs in large quantities can be enough, meats, poultry, fish, legumes, PNB

Question 3

B1 thiamine defic

Answer 3

Beriberi
- dry: paralytic/nervous (periph neuropahty, atrophy, foot drop, LE weakness)
- wet: cardiac with edema, CHF
Wernicke-Korsakoff (cerebral beriberi)
- ocular, ataxia, confusion (can be unmasked by EtOH)

Question 4

B1 thiamine (4 risks for defic)

Answer 4

EtOH
Anorexia nervosa (and refeeding after starvation)
Bariatic surgery
Elderly, renal dialysis, thos eon high carbs diets

Question 5

B2 riboflavin defic

Answer 5

Oral-ocular-gential syndrome
Cheilosis (cracks in lips)
Increased vasc of conjunctive
LACK OF DAIRY

Question 6

B3 niaicin (risks for defic)

Answer 6

Dietary restiction (corn as proetein source)
Malabsorption
Alcoholism
Metabolic shunting (carcinoid tumor –> incr 5HT –> decr tryptophan –> no precursor to niaicin

Question 7

B3 niacin (defic)

Answer 7

Pellagra “the 4 Ds” - after months of poor intake
Dermatitis (symmetric, aggrav by sun/heat, LOOKS AWFUL, scaly rash)
Dementia
Diarrhea
Death

Question 8

Hematopoietic Vits

Answer 8

Folate (folic acid) - 1-carbon transfers, homocyst–>methionine
B12 (cobalamin)

Question 9

Folate source

Answer 9

Foliage! deep greens, OJ, whole grains - but easily destroyed by cooking

Question 10

Folate (risks for defic)

Answer 10

Pregancy, EtOH
Chronic hemolytic anemia
DDIs

Question 11

Folate (signs of defic)

Answer 11

MACROcytic anemia
Hypersegmented neutrophils (more that 5-6)
Glossitis, irritability
Homocysteinemia (more in plasma as folate converts homocysteine to methionine)
Neural tube defects

Question 12

Folate (RDA)

Answer 12

women of child bearing age: 400-800 ug/d to prevent neural tube defects (spina bifida etc.)
otherwsie RDA = 400

Question 13

B12 cobalamin fxn

Answer 13

methylation, 1- carbon transfers
ODD CHAIN FATTY ACID metabolism
and MORE, LOOK AT THIS

Question 14

B12 cobalamin source

Answer 14

ONLY ANIMAL PRODUCTS, synthesized in soil bacteria

Low turnover rates, LOW AT THIS

Question 15

B12 (4 risks for defic)

Answer 15

Inadequate IF for absorption or Ab to IF
Gastric atrophy
Ileal resection
Breast fed infant of defic mother (eg, vegan, veggie mom)

Question 16

B12 defic signs

Answer 16

MACROcytic anemia, hypersegged segs
BUT differenitates from folate as B12 has NEURO SX
So don’t treat megaloblastic anemia should NOT be treated with folate unless B12 defic has been ruled out

Question 17

Vit C (fxn)

Answer 17

Reverisible antioxidant
Co-substrate in hydroxylation - makes COLLAGEN SYNTHESIS
Reduction of Fe3+ –> F3 2+
Important in LEUKOCYTE FXN

Question 18

Vit C (sources)

Answer 18

fruit and veg!

Question 19

Absorption & HOMEOSTASIS

Answer 19

B12 CAN BE STORED IN LIVER unlike others

IF needed for absorption FROM distal ileum into portal circulation

Question 20

Vit C defic signs

Answer 20

SCURVY - defective collagen
Hemorrhagic
Hyperkeratosis
Hypochondriasis (depression, weakness)
Hematologic abnormality

Question 21

Vit C defic risks

Answer 21

ASD kids and see others

Question 22

Vit C megadoses?

Answer 22

V little evidence for colds

Question 23

CLINICAL PEARLS?

Answer 23

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