Water Soluble Vitamins

Question 1

General rules

Answer 1

Not stored (except B12)
Low toxicity (except B6)
High absorption
Urinary excretion
Breast milk reflects maternal status (except Folate)

Question 2

B1 (Thiamine) sources

Answer 2

Whole/enriched grains, Pork and legumes

Question 3

B1 deficiency

Answer 3

Beriberi
Dry: peripheral neuropathy, weakness, foot drop
Wet: edema, circulatory collapse, CHF
Wernicke-Korsakoff–opthalmoplegia, ataxia, memory loss

Question 4

Risks of B1 deficiency

Answer 4

Alcoholism, bariatric surgery, anorexia, TPN, re-feeding

Endemic in SEA bc of polished rice

Question 5

B1 def Tx

Answer 5

High dose thiamine

Question 6

B2 (Riboflavin) sources

Answer 6

Whole/enriched grains, dairy, meat, eggs

Question 7

B2 deficiency

Answer 7

angular stomatitis, cheilosis

Question 8

B3 (Niacin) sources

Answer 8

Whole/enriched grains, meat & poultry. tryptophan is a precursor

Question 9

B3 deficiency

Answer 9

Pellagra:
Diarrhea
Dermatitis-scaly hyperpigmented/depigmented
Dementia
Death

Question 10

B3 def risks

Answer 10

Cornmeal-based diet, malabsorption syndromes, alcoholism

Metabolic shunt: carcinoid tumor –> increased serotonin –>decreased tryptophan levels –> deficiency

Question 11

Folic acid roles

Answer 11

single carbon transfer reactions (homocysteine to methionine, nucleic acid synthesis, DNA methylation)

Question 12

FA sources

Answer 12

Foliage, OJ, whole grains.

Destroyed w cooking

Question 13

FA deficiency

Answer 13

Macrocytic anema
Hypersegmented neutrophils
Homocysteinemia
Glossitis
Neural tube defects--reason why all women of child-bearing age should take supplements

Question 14

B12 (cobalamin)

Answer 14

1 Carbon transfers (homocysteine–>methionine, regenerates THF from methylfolate)
Stored in liver
Animal products ONLY source

Question 15

B12 lab tests

Answer 15

Homocysteine, methylmethionine

Question 16

B12 def RFs

Answer 16

Inadequate IF/antibodies to IF

Gastrectomy, ileal resection, vegan diet/vegan mother to deficient child

Question 17

B12 def Sx

Answer 17

Macrocytic anemia
hypersegmented neuts
Irreversible Neurological disturbances: burning tongue, depression, gait disturbances

Question 18

Vit C

Answer 18

Reversible antioxidant
Provides reducing equivalents for enzymes (increased Fe absorption)
Co-substrate in hydroxylation rxns–collagen cross-linking by hydroxyproline/lysine
tryptophan—>seratonin
DA—>NE

Question 19

Vit C sources

Answer 19

fruits and vegetables

Question 20

Vit C absorption

Answer 20

Saturatable process: the higher the intake, the lower the % absorbed. rest excreted in urine

Question 21

Scurvy

Answer 21

Hemmorhagic
Hyperkeratosis of hair follicles
Hypochondriasis (depression/weakness)
Hematologic abnormalities (anemia)
bleeding gums, tooth loss, periuncal bleeds, pettichiae