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57 Cards in this Set

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  • Back
Which are the fat-soluble vitamins?
Cystic fibrosis and celiac sprue can lead to deficiencies of which vitamins?
fat-soluble ones (KADE)
B-complex deficiencies often results in which 3 signs?
dermatitis, glossitis, diarrhea
Name 9 water-soluble vitamins:
B1, B2, B3, B5, B6, B12, C, biotin, folate
Where is B12 stored in the body?
Vitamin A (retinol) is needed because:
constituent of visual pigments (retinal)
VitA deficiency -->
night blindness, dry skin, dec. immune response
VitA overdose -->
arthralgias, fatigue, HA, skin changes, sore throat, alopecia
Vitamin B1 (thiamine) is needed for:
thiamine pyrophosphate cofactor for oxidative decarboxylation of a-ketoacids (pyr, aKG), and cofactor in HMP shunt
Thiamine deficiency -->
1) Beriberi
- dry: polyneuritis, muscle wasting
- wet: high output cardiac failure (dilated), edema
2) Wernicke-Korsakoff
- confusion, ophthalmoplegia, ataxia
- memory loss, confabulation, personality change
- periventricular hemorrhage in mamillary bodies
Vitamin B2 (riboflavin) needed for:
cofactor in oxidation and reduction (FADH2)
Riboflavin deficiency -->
angular stomatitis, cheilosis (inflamed cracked lips), corneal vascularization
Vitamin B3 (niacin) is needed for:
constituent of NAD & NADP (redox), derived from Tryptophan USING VITB6!!
Niacin deficiency -->
pellagra (diarrhea, dermatitis, dementia, glossitis)
What can cause pellagra, aka niacin deficiency? (3)
- Hartnup disease: dec. Trp absorption
- malignant carcinoid syndrome: inc. Trp metabolism
- INH: dec. vitamin B6
Vitamin B5 (pantothenate) is needed for:
CoA (cofactor for acyl transfers), fatty acid synthase
Pantothenate deficiency -->
dermatitis, enteritis, alopecia, adrenal insufficiency
Vitamin B6 (pyridoxine) is needed for:
converted to pyridoxal phosphate (cofactor in transamination), decarboxylation, and heme synthesis
*recall: homocystinuria! B6 cofactor for cystathionine synthase!
Pyridoxine deficiency -->
convulsions, hyperirritability, peripheral neuropathy
Pyridoxine deficiency can be induced by: (2)
- oral contraceptives
Vitamin B12 (cobalamin) is needed for:
cofactor for homocysteine methylation (to methionine), and methylmalonyl-CoA (to succinyl-CoA)
Can humans make B12?
No, it is made only by microorganisms. Found only in animal products.
Cobalamin deficiency -->
macrocytic megaloblastic anemia, neurologic sxs (optic, paresthesia, subacute combined degeneration), beefy glossitis
Name 3 general causes of B12 deficiency:
- malabsorption (sprue, D. latum, enteritis)
- pernicious anemia
- no terminal ileum
What is the test to detect B12 deficiency?
Schilling test
You see abnormal ___ in B12 deficiency due to dec. methionine or inc. methylmalonic acid.
What is the most common vitamin deficiency in the US?
Folate is needed for:
coenzyme (tetrahydrofolate) for 1-carbon transfer; methylation reactions; nucleotide synthesis
Folate deficiency -->
megaloblastic anemia (no neuro sxs)
What should you eat to get folate?
green leaves (FOLiage) - and don't overcook!!!
How do sulfa drugs and dapsone work?
PABA analogs (PABA is bacterial folate precursor)
Biotin is needed for: (3)
cofactor for carboxylations:
- pyruvate --> oxaloacetate
- acetyl CoA --> malonyl CoA
- proprionyl CoA --> methylmalonyl CoA
Biotin deficiency -->
dermatitis, enteritis
What 2 things can cause biotin deficiency?
- eat raw eggs
- antibiotic use
Vitamin C (ascorbic acid) is needed for:
hydroxylation of Pro & Lys in preprocollagen; iron absorption by maintaining Fe2 reduced state (VitC is antioxidant); cofactor for Dopamine --> NE
VitC deficiency -->
scurvy: swollen gums, bruising, poor wound healing
Vitamin D is needed for:
inc. intestinal absorption of calcium and phosphate
VitD2 =
ergocalciferol, in milk
VitD3 =
cholecalciferal, formed in sunexposed skin
What is the active form of VitD3?
1,25-(OH)2 D3
(recall: 1-a-hydroxylase in kidney)
VitD deficiency -->
rickets, osteomalacia, hypocalcemic tetany
VitD overdose -->
hypercalcemia, loss appetite, stupor, seen in SARCOIDOSIS!
(recall: macs make active D3)
Vitamin E is needed for:
antioxidant protects RBC from hemolysis
VitE deficiency -->
fragile RBC
Vitamin K is needed for:
catalyzing gamma-carboxylation of glutamate residues on certain clotting factors (II, VII, IX, X, C, S)
Why can you be VitK deficient after prolonged use of wide spectrum antibiotics?
VitK made by intestinal flora
VitK deficiency -->
neonatal hemorrhage with prolonged PT and PTT (but normal bleeding time)
Zinc deficiency -->
delayed wound healing, hypogonadism, dec. adult hair, may predispose to alcoholic cirrhosis
Enzymes that catalyze:
ethanol --> acetaldehyde --> acetate
*how many NADH are made?
alcohol dehydrogenase, acetaldehyde dehydrogenase
*2 NADH made
What is the limiting reagent in ethanol breakdown?
How does Disulfiram/Antabuse work?
inhibit acetaldehyde dehydrogenase, so acetaldehyde accumulates and worsens hangover
Ethanol metabolism ___ the NADH/NAD+ ratio in Liver.
With chronic ethanol use, OAA is diverted to making malate and then you can't do ___ which leads to ___.
Why do chronic alcoholics have fatty livers?
inc. NADH/NAD+ ratio shunts substrates away from glycolysis toward fatty acid synthesis
With inc. NADH/NAD+ ratio from chronic heavy alcohol use:
pyruvate --> ___
OAA --> ___
Kwashiokor =
protein malnutrition resulting in skin lesions, edema, liver fatty change (think child with swollen belly)
Marasmus =
protein-calorie malnutrition resulting in tissue wasting