Biochemistry Day 3

Front 1

Which are the fat-soluble vitamins?

Back 1

KADE

Front 2

Cystic fibrosis and celiac sprue can lead to deficiencies of which vitamins?

Back 2

fat-soluble ones (KADE)

Front 3

B-complex deficiencies often results in which 3 signs?

Back 3

dermatitis, glossitis, diarrhea

Front 4

Name 9 water-soluble vitamins:

Back 4

B1, B2, B3, B5, B6, B12, C, biotin, folate

Front 5

Where is B12 stored in the body?

Back 5

liver

Front 6

Vitamin A (retinol) is needed because:

Back 6

constituent of visual pigments (retinal)

Front 7

VitA deficiency -->

Back 7

night blindness, dry skin, dec. immune response

Front 8

VitA overdose -->

Back 8

arthralgias, fatigue, HA, skin changes, sore throat, alopecia

Front 9

Vitamin B1 (thiamine) is needed for:

Back 9

thiamine pyrophosphate cofactor for oxidative decarboxylation of a-ketoacids (pyr, aKG), and cofactor in HMP shunt

Front 10

Thiamine deficiency -->

Back 10

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

Front 11

Vitamin B2 (riboflavin) needed for:

Back 11

cofactor in oxidation and reduction (FADH2)

Front 12

Riboflavin deficiency -->

Back 12

angular stomatitis, cheilosis (inflamed cracked lips), corneal vascularization

Front 13

Vitamin B3 (niacin) is needed for:

Back 13

constituent of NAD & NADP (redox), derived from Tryptophan USING VITB6!!

Front 14

Niacin deficiency -->

Back 14

pellagra (diarrhea, dermatitis, dementia, glossitis)

Front 15

What can cause pellagra, aka niacin deficiency? (3)

Back 15

- Hartnup disease: dec. Trp absorption
- malignant carcinoid syndrome: inc. Trp metabolism
- INH: dec. vitamin B6

Front 16

Vitamin B5 (pantothenate) is needed for:

Back 16

CoA (cofactor for acyl transfers), fatty acid synthase

Front 17

Pantothenate deficiency -->

Back 17

dermatitis, enteritis, alopecia, adrenal insufficiency

Front 18

Vitamin B6 (pyridoxine) is needed for:

Back 18

converted to pyridoxal phosphate (cofactor in transamination), decarboxylation, and heme synthesis
*recall: homocystinuria! B6 cofactor for cystathionine synthase!

Front 19

Pyridoxine deficiency -->

Back 19

convulsions, hyperirritability, peripheral neuropathy

Front 20

Pyridoxine deficiency can be induced by: (2)

Back 20

- INH
- oral contraceptives

Front 21

Vitamin B12 (cobalamin) is needed for:

Back 21

cofactor for homocysteine methylation (to methionine), and methylmalonyl-CoA (to succinyl-CoA)

Front 22

Can humans make B12?

Back 22

No, it is made only by microorganisms. Found only in animal products.

Front 23

Cobalamin deficiency -->

Back 23

macrocytic megaloblastic anemia, neurologic sxs (optic, paresthesia, subacute combined degeneration), beefy glossitis

Front 24

Name 3 general causes of B12 deficiency:

Back 24

- malabsorption (sprue, D. latum, enteritis)
- pernicious anemia
- no terminal ileum

Front 25

What is the test to detect B12 deficiency?

Back 25

Schilling test

Front 26

You see abnormal ___ in B12 deficiency due to dec. methionine or inc. methylmalonic acid.

Back 26

myelin

Front 27

What is the most common vitamin deficiency in the US?

Back 27

folate

Front 28

Folate is needed for:

Back 28

coenzyme (tetrahydrofolate) for 1-carbon transfer; methylation reactions; nucleotide synthesis

Front 29

Folate deficiency -->

Back 29

megaloblastic anemia (no neuro sxs)

Front 30

What should you eat to get folate?

Back 30

green leaves (FOLiage) - and don't overcook!!!

Front 31

How do sulfa drugs and dapsone work?

Back 31

PABA analogs (PABA is bacterial folate precursor)

Front 32

Biotin is needed for: (3)

Back 32

cofactor for carboxylations:
- pyruvate --> oxaloacetate
- acetyl CoA --> malonyl CoA
- proprionyl CoA --> methylmalonyl CoA

Front 33

Biotin deficiency -->

Back 33

dermatitis, enteritis

Front 34

What 2 things can cause biotin deficiency?

Back 34

- eat raw eggs
- antibiotic use

Front 35

Vitamin C (ascorbic acid) is needed for:

Back 35

hydroxylation of Pro & Lys in preprocollagen; iron absorption by maintaining Fe2 reduced state (VitC is antioxidant); cofactor for Dopamine --> NE

Front 36

VitC deficiency -->

Back 36

scurvy: swollen gums, bruising, poor wound healing

Front 37

Vitamin D is needed for:

Back 37

inc. intestinal absorption of calcium and phosphate

Front 38

VitD2 =

Back 38

ergocalciferol, in milk

Front 39

VitD3 =

Back 39

cholecalciferal, formed in sunexposed skin

Front 40

What is the active form of VitD3?

Back 40

1,25-(OH)2 D3
(recall: 1-a-hydroxylase in kidney)

Front 41

VitD deficiency -->

Back 41

rickets, osteomalacia, hypocalcemic tetany

Front 42

VitD overdose -->

Back 42

hypercalcemia, loss appetite, stupor, seen in SARCOIDOSIS!
(recall: macs make active D3)

Front 43

Vitamin E is needed for:

Back 43

antioxidant protects RBC from hemolysis

Front 44

VitE deficiency -->

Back 44

fragile RBC

Front 45

Vitamin K is needed for:

Back 45

catalyzing gamma-carboxylation of glutamate residues on certain clotting factors (II, VII, IX, X, C, S)

Front 46

Why can you be VitK deficient after prolonged use of wide spectrum antibiotics?

Back 46

VitK made by intestinal flora

Front 47

VitK deficiency -->

Back 47

neonatal hemorrhage with prolonged PT and PTT (but normal bleeding time)

Front 48

Zinc deficiency -->

Back 48

delayed wound healing, hypogonadism, dec. adult hair, may predispose to alcoholic cirrhosis

Front 49

Enzymes that catalyze:
ethanol --> acetaldehyde --> acetate
*how many NADH are made?

Back 49

alcohol dehydrogenase, acetaldehyde dehydrogenase
*2 NADH made

Front 50

What is the limiting reagent in ethanol breakdown?

Back 50

NAD+

Front 51

How does Disulfiram/Antabuse work?

Back 51

inhibit acetaldehyde dehydrogenase, so acetaldehyde accumulates and worsens hangover

Front 52

Ethanol metabolism ___ the NADH/NAD+ ratio in Liver.

Back 52

increases

Front 53

With chronic ethanol use, OAA is diverted to making malate and then you can't do ___ which leads to ___.

Back 53

gluconeogenesis
hypoglycemia

Front 54

Why do chronic alcoholics have fatty livers?

Back 54

inc. NADH/NAD+ ratio shunts substrates away from glycolysis toward fatty acid synthesis

Front 55

With inc. NADH/NAD+ ratio from chronic heavy alcohol use:
pyruvate --> ___
OAA --> ___

Back 55

lactate
malate

Front 56

Kwashiokor =

Back 56

protein malnutrition resulting in skin lesions, edema, liver fatty change (think child with swollen belly)

Front 57

Marasmus =

Back 57

protein-calorie malnutrition resulting in tissue wasting