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38 Cards in this Set

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Vitamin A:
F
S
P
C
fxn: vision embryo develompent
stored in liver, years
Predisp: fat malabsorption poor diet smoking
C: follicular hyperkeratosis, dry skin, night blind,
do pts normally have one def or many?
many, usually a constellation
Vitamin A
Treat
Lab
Tox
tx: high doses 20,000
lab:maybe check retinol?
tox: dry skin, hair loss headaches, liver injury, predis to fractures
too much beta carotene can turn you oraneg: white sclera
Thiamin B1
F
S
P
C
fxn: coenzyme in decarboxylation and transketolation rxn (necessary for glucose metabolism
store: very little, def rapidly
predis: alcoholics, poor diet, gastric bypass
clinical: wet beriberi: cardiomeg, tachy HOCHF
dry beriberi: periph neuropathy
WKS- disorented opthalmoplegia
what is opthalmoplegia? what def is it assoc with?
eyes not moving same way: Thiamin (B1)
Thiamin
Tx
Lab
Tox
tx: large doses first IV then orally for long time
lab: usuallly treat empirically
tox: no tox
pyridoxine (B6)
F
S
P
C
Fxn: AAmetabolism (transamination)
store: water solubel, no storage
predisp: drug interactions, INH
Clinical: neruopathy, dermatitis, microcytic anemia, slick tongue, craking of lips (non specific)
what can cause glositis and cheilitis?
pyroxidine def, riboflavin def, etc
what are some symptoms of glossitis?
loss of papillae, painful to drink liquids
what vitamin def can lead to oculo orogenital syndrome?
B2 and B6
riboflavin and pyroxidine
pyroxidine B6
Tx
Lab
Tox
Tx large doeses orally
Lab:treated empirically
tox:high levels, long time: neuropathy
folic acid B9
F
S
P
C
fxn: methylation related to purine choline and serine, DNA and RNA methylation
Store: some in liver, months before def
Predisp: poor diet, intestinal malabsorp, preggers, smoking, anitfolates (methotrexate)
Clinic: macrocytic anemia, low WBC, low platelets, glossits, stomatitis, neural tube defects
folic acid B9
tx
lab
tx: easy, RA on methotrexate, 1mg day
lab: plasma folate and RBC folate
what should women w/ child bearing potential take?
400micrograms of folic acid B9 per day
what do you assay for when giving folate? why?
B12 bc metabolisms overlap; giving folate could mask cerebellar signs of B12 def
macrocytic anemia occur in both
Vitamin B12
F
S
P
C
Fxn: methmaolny CoA to succinyl CoA metabolism, related to methionine metabolism (overlap with folate)
S: large, found in animal products
predisp: pernicious anemia, gastric bypass, vegan,
clinic: macrocytic anemia, sotmatitis, glossitis, proprioception problems (cerebro spinal atrophy)
unsteady gait, poor proprioception, cant feel vibrations
vitamin B12 def,
cerebral spinal atrophy
Vitamin B12
tx
lab
tx: large doses orally, IF also needd injection if absorption problems
lab: serum mthymalonic acid
Iron
F
S
P
C
Fxn: oxygen transport, electron transport
store: bone marrow, liver, spleen, months
p: children babies women gastrectomies, gastic bypass
C: pale conjunctiva and nail beds,glossitits, microytic anemia, tachy cardia
what can cause microcytic anemia?
iron and pyridoxine def
iron
tx
lab
tox
tx: long erm iron supplement determine cause, vita C helps with non heme absorption, give with foods to help abosrpiotn
lab: serumiron, ferritin
tox: iron overload, hemochormatosis, hemosiderous
Vitamin C
F
S
P
C
fxn: collagen synthesis, bone metabolism, hydroxylation of proline and lysine
Store: low water solubel
predis: lack of fruits, veggies, smokin, stress,
clinic: scurvy, follicular hyperkeratosis, corkscrew hairs, perifollicular petichiae, bleeding gums, sheet hemmorhage Emergency!!
what can cause follicular hyperkeratosis?
vitamin C or Vitamin A def vita A excess
why can vitamin c def cause perifollicular petechiae?
bc its realted to abnoraml collagen metabolism
vitamin C
tx
lab
tox
tx: large doses iv and oral
lab:assay, but oxidizes quickly
tox: diarrhea, incre uric aci secrioin, inerfere with stool blood tests, not many problems
Zince
F
S
P
C
Fxn:oles in the metabolism of RNA and DNA, signal transduction, and gene expression. It also regulates apoptosis
S:none
P: stessed populations,
clinic: growth retard, hypogonad, ppor smell, taste, poor wound heal (ulcers),
Zince

tox
Tox: iron/copper def
Niacin B3
Fxn
s
P
C
fxn: component of NADP to NADPH
stores: little
pred: poor diet,no tryptophan
clinic: pellagra: 4 Ds
hyper/ hypo pigmentatin
likely have other def
4Ds
pellagra (niacin B3 def)
Niacin B3
tx
lab
tox
tx: oral of iv
lab: available, too long dx clinically
tox: flushing, liver injury
Vitamin D
F
S
C
P
F: absorb calcium and phosphorus
S: some, mde in ksin w/ sun exposure
P: lack of sunligh w/o supplementain, common
C: rickets, osteomalacia, osteporosis
Vitamin D
lab
lab:25 hydroxy D, 1,25 hydroxy D good for renal pts (2nd hydrox is done in kidneys)
sit to stand test (use arms, def)
Vitamin E
F
S
P
C
f: anitoxidant
s: liver and cell membranes
p: fast malabsorption
cliinc: constellaiton
Vitamin E
tx
lab
tox
tx: large doses
lab: serum tocopherol levels
tox: non, concern with high doses
vitamin K
F
S
P
C
F: clotting pathway factors 2, 7, 9, 10
store: made in instesitn by bacteria, absorption?
predisp: braod spec abx, inadequate diet, interaction w/ warfarin
clinic: increase PT, ecchymoses (bruising)
Vitamin K
tx
lab
Tox
tx: large doese Iv or IM, can b give PO
lab::
tox: little
Selenium
f
s
p
c
fxn: antioxidant micronutrient
s: little, get from veggies, soil
p: pts w/ long term iv nutrion and malabsop
clinic: carimypomathy (keshan disease) incrased cancer rates
selenium
tx
lab
tox
tx: 200-400 micrograms day
lab: serum or whole blood
tox: hair loss brittle finger nails, fatigue, irritability