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112 Cards in this Set
- Front
- Back
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what can cause fat soluble vitamin deificiency |
Malabsorption syndromes with steatorrhea -CF -celiac/tropical sprue -mineral oil intake |
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what are the only two water soluble vitamins that arent easily washed out from body and why |
B9/B12 stored in liver |
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what is B1 |
thiamine |
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what is B2 |
riboflavin |
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what is B3 |
niacin |
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what is B5 |
pantothenic acid |
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what is B6 |
pyridoxine |
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what is B7 |
biotin |
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what is B9 |
folate |
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what is B12 |
cobalamin |
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what is ascorbic acid |
Vit C |
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what is function of Vit A (4) |
-Antioxidant -Component of retinal visual pigment -essential for normal differentiation of epithelial cells into specialized tissue -prevents squamous metaplasia |
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what is Vit A used to treat |
-Measles -AML subtype M3 (All trans retinoic acid) |
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what does Vit A deficiency cause |
-night blindness (nyctalopia) -dry/sacly skin (xerosis cutis) -corneal degeneration (keratomalacia) -bitot spots on conjunctiva -immunosuppression |
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what does Vit A acute excess cause |
-nausea -vomiting -vertigo -blurred vision |
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what does chronic Vit A excess cause |
-alopecia -dry skin -hepatic tox/enlargement -arthralgias -pseudotumor cerebri |
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why is negative pregnacy test and reliable contraception required before isoreinoin prescription for severe acne |
-teratogen causing cleft palate and cardiac abnormalities |
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what is thiamine function |
needed for TPP cofactor for several dehydrogenase reactions: -pyruvate dehydrogenase -alpha ketoglutarate dehydrogenase -transketolate -branched chain ketoacid dehydrogenase |
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what does thiamine deificency cause |
-impaired glucose breakdown leading to decreased ATP that gets worsened by glucose infusino especially in aerobic tissues like brain/heart -Wernicke Korsdakoff -Beri Beri |
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who is B1 deficiency seen in |
-malnourished -alcoholics (bad diet and bad absorption) |
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how is B1 defiency diagnoses |
-increased RBC transketolase activity following B1 administration |
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what structures damaged in wernicke korsakoff |
-mammillary bodies -medial dorsal nucleus of thalamus |
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what are manifestations of wernicke korsakoff |
-confusion -ophthalmoplegia -ataxia -confabulation -personality change -permanent memory loss |
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what is prentation of dry beriberi |
polyneuritis symmetrical muscle wasting |
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what is presentation of wet beriberi |
-high output cardiac failure with dilated cardiomyopathy -edema |
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what is riboflavin function |
needed for FAD/FMN needed cofactor for -succinate dehydrogenase in TCA |
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what does B2 deficiency cause |
-cheilosis (inflammation of lips, scalng and fissures as ocrners of mouth -corneal vascularization |
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what is niacin function |
Needed for NAD/NADP used in redox reactions |
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what is required for niacin synthesis |
-tryptophan -Vit B2 -Vit B6 |
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what can niacin be used to treat |
-decreases VLDL -increased HDL |
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what does niacin deficiency cause |
-pellagra -glossitis |
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what are symptoms of pellagra |
-diarrhea -dementia -dermatitis |
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what is dermatitis seen in pellagra |
C3/4 dermatome circumferential broad collar rash and hyperpigmentation of sun exposed areas |
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what can cause niacin deficiency |
-hartnup disease -malignant carcinoid syndrome -isoniazid |
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how does hartnup cause niacin deficiency |
decreased tryptophan absorption |
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how does carcinoid syndrome cause niacin deficiency |
increased tryptophan metabolism |
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how does INH cause niacin deficiency |
decreased Vit B6 |
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what does niacin excess cause |
-facial flushing -hyperglycemia -hyperuricemia |
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what causes the facial flushing in niacin excess and how can it be avoided |
prostaglandins aspirin |
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what is function of B5 |
needed for CoA and fatty acid synthase |
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what does B5 deficiency cause |
-dermatitis -enteritis -alopecia -adrenal insufficiency |
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what is Vit B6 function |
needed for PLP cofactor for: transaminations decarboxylations glycogen phosphyrlase |
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synthesis of what substances required B6 |
-cystathionine -heme -niacin -histamine -serotonin -epi -NE -dopamine -GABA |
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what does B6 deficiency cause |
-convulsions -irritable -peripheral neuropathy -sideroblastic anemia |
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what is function of B7 |
carboxylation enzyme cofactors: -pyruvate carboxylase taking pyruvate to oxaloacetate -acetyl CoA carbyoxylase taking acetyl Coa to malonyl CoA -propionyl Co carboxylase taking priopionyl Coa to methylmalonyl CoA |
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what is manifestation of B7 deficiency |
-dermatitis -alopecia -enteritis |
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what can can cause B7 deficiency |
very rare but can be caused by excessive egg white ingestion or antibiotics |
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what is function of B9 |
-needed for 1 carbon transfer/methylation -syntehsis of nitrogenous bases for RNA/DNA |
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what is source of folate |
leafy green veges |
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where is folate absorbed |
jejunum |
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is there a large or small reserve pool in liver |
small |
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what is manifestation of B6 deficiency |
-macrocytic megaloblastic anemia -hypersegmented PMNs -glossitis |
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what are lab findings of folate deficiency |
-increased homocysteine -normal methymalonic acid |
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what can cause deficiency of folate |
-drugs -increased demand like in pregnancy -decreased absorption from jejunum |
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what drugs can cause folate deficiency |
-phenytoin -sulfonamides -methotrexate |
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who is folate deficiency seen in |
pregnancy alcoholism |
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what is most common vitamin deficiency in US |
folate |
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what is funciton of B12 |
cofactor for homocysteine methytransferase cofactor for methylmalonyl CoA mutase |
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what is source of B12 |
animal products |
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what synthesizes B12 |
microbes |
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is there a large or small reserve pool in liver |
large |
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what does B12 deficiency cause |
-macrocytic/megaloblastic anemia -hypersegmented PMNs -paresthesias -degenerated posterior column and lateral corticospinal tract and spinocerebellar tract |
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what are lab findings in B12 |
-increased homocysteine -increased methylmalonic acid |
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what can prolonged B12 deficiency cause |
IRreversible nerve damage |
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where is B12 absorbed |
terminal ileum |
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what is needed for B12 absorption |
IF from parietal cells in body/fundus of stomach |
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what can cause B12 deficiency |
-insufficient intake like in vegans -lack of IF (pernicious anemia, gastric bypass_ -absence of terminal ileum (Crohns disease) -Diphyllobothrium latum worm infection |
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what is diagnostic for pernicious anemia |
anti IF antibodies |
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what is vitamin A function |
-antioxidant -iron absorption by promoting reduction of iron -hydroxylation of proline/lysine for collagen -going from dopamine to NE (needed for dopamine beta hydroxylase) |
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what is source of Vit C |
-fruits/veges |
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what can Vit C be an ancillary treatment in |
ancillary to methylene blue in methemoglobinemia |
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what does Vit C deficiency cause |
-scurvy -weakened immune response |
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what is scurvy presentation |
-swollen gums -bruising -petechiae -hemarthrosis -anemia -poor wound healing -perifollicular/subperiosteal hemorrhages -corkscrew hair |
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what is Vit C excess manifestation |
-nausea -vomiting -diarrhea -fatigue -calcium oxalate nephrolithiasis -increased risk of iron tox in predisposed individuals like hemochromotosis /transfused patients |
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what is Vit D2 |
ergocalciferol |
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what is source of Vit D2 |
plant ingestion |
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what is Vit D3 |
cholecalciferol |
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what is source of Vit D3 |
consumed in milk formed in sun exposed skin in stratum basale |
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what is storage form of Vit D |
25-OH D3 |
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what is active form of Vit D |
1,25 OH2 D3 calcitriol |
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what is Vit D function |
-increased gut absorption of calcium and phosphate -increased bone mineralization |
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what is Vit D deficiency manifestation |
-Rickets with bone pain/deformity -Osteomalacia in adults with bone pain/muscle weakness -hypocalcemic tetany |
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what population should receive oral vitamin D |
breastfed infants |
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what can exacerbate Vit D deficiency |
-low sun exposure -pigmented skin -prematurity |
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what is excess Vit D manifestation |
-hypercalcemia -hypercalciuria -loss of appetite stupor |
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when is Vit D excess seen |
granulomatous disease |
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what is tocopherol/tocotrienol |
Vitamin E |
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what is function of Vit E |
Antioxidant that protects membranes and RBCs from damage |
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what is Vit E drug interaction |
enhances warfarin action |
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What does Vit E deficiency cause |
-Hemolytic anemia -acanthocytosis -muscle weakness -posterior column, spinocerebellar tract problems |
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what can Vit E deficieny mimic |
B12 deficiency in terms of neuro presentation |
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what is phytomenadione phylloquinone phytoadione |
Vit K |
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what is function of Vit K |
-cofactor for gamma carboxylation of glutamic acid residues of clotting factors 2,7,9,10, C,S |
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what is source of Vit K |
intestinal microbes |
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what is a Vit K antagonist |
warfarin |
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what are causes of Vit K deficiency |
-neonates before intestinal flora develops -prolonged antiobiotic use wiping out intestinal flora |
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what is function of zinc |
needed for many enzymes |
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what does zinc defiency cause |
-delayed wound healing -hypogonadism -decreased adult hair -dysgeusia -anosmia -acrodermatitis enteropathica (scaly plaque in intertriginous area) |
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what can zinc deficiency predispose someone to |
alcoholic cirrhosis |
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what is defect in kwashiorkor |
protein intake malnourished |
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what is manifestation of kwashiorkor |
-skin lesions -edema -fatty change liver -anemia |
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what is edema in kwashiorkor caused by |
decreased oncotic pressure because not enough protein to make albumin protein |
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why is fatty change seen in liver in kwashiorkor |
liver cant make apolipoproteins so cant package cholesterol |
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what is marasmus defect |
total calorie malnutrition |
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what is manifestation of marasmus |
-muscle wasting
-loss of subq fat -variable edema |
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what is fomepizole mechanism |
inhibits alochol dehydrogenase |
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what is fomepizole used for |
antidote for methanol or ehtylene glycol poisoning |
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what is disulfiram mechanism |
inhibits acetaldehyde dehydrogenase |
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what is disulfiram use |
increases hangover symptoms (prevent alcohol abuse) |
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what is limiting reagent in ethanol metabolism |
NAD+ |
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what order kinetics is alcohol dehydrogenase |
zero |
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what does ethanol metabolism do to NADH/NAD+ ratio in liver |
increases it
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