Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
133 Cards in this Set
- Front
- Back
|
What are the functions of vit A?
|
vision, embryo, growth, tissue differentiation
|
|
|
Where is vit A stored?
|
liver
|
|
|
How long would you last with minimal vit A intake?
|
>1 year
|
|
|
What can predispose you to a vit A deficiency?
|
fat malabsorption, poor diet, smoking
|
|
|
What are the signs of vit A deficiency?
|
follicular hyperkeratosis, scaling skin, night blindness, keratomalacia, blindness
|
|
|
What does vit A deficiency put you at risk for?
|
infection, morbidity from infection
|
|
|
How do you treat vit A deficiency?
|
5-30,000 IU/day orally
100,000 IU IM injection |
|
|
What do you test for vit A?
|
plasma retinol, carotene
|
|
|
What toxicity do you get with > 50,000 IU/day vit A?
|
dry, itchy skin, desquaation, hair loss, headache, bone/joint pain, liver injury, hypercalcemia
|
|
|
What at what vit A level do you get birth defects?
|
> 10,000 IU
|
|
|
What do you get with higher vit A intake?
|
decreased BMD, hip fracture in women
|
|
|
What happens if you give beta carotene to smokers?
|
increased lung cancer risk and mortality
|
|
|
What is the tolerable upper limit of vit A in adults?
|
10,000 IU/day
|
|
|
What is the function of thiamin?
|
coenzyme in decarboxylation and transketolation reactions
|
|
|
Where is thiamin stored?
|
no appreciable stores
|
|
|
How long do you last with minimal thiamin intake?
|
weeks
|
|
|
What can cause thiamin deficiency?
|
alocholism, inadequate diet with glucose lode, transketolase defect, gastric bypass
|
|
|
What is wet beriberi?
|
cardiomegaly, tachycardia, high-output CHF
|
|
|
What is dry beriberi?
|
peripheral neuropathy
|
|
|
What is alcoholic polyneuropathy?
|
myloepathy, cerebellar signs
|
|
|
What is Wernicke Korsakoff Syndrome?
|
confabulation, disorientation, opthalmoplegia, cerebellar ataxia
|
|
|
What syndromes are associated with thiamin deficiency?
|
wet beriberi, dry beriberi, alcoholic polyneuropathy, Wernicke-Korsakoff Syndrome
|
|
|
How do you treat thiamin deficiency?
|
50-100 mg IV followed by 10-15 mg daily
|
|
|
What do you lab test for thiamin deficiency?
|
generally treated empirically
whole blood or plasma thiamin RBC thiamin, RBC transketolase activity coefficient |
|
|
What are the indications for a therapeutic dose of thiamin?
|
transketolase defect, Wernicke-Korsakoff
|
|
|
What is the toxicity of thiamin?
|
none reporte
|
|
|
What does pyridoxine do?
|
cofactor in reactions, AA metabolism
|
|
|
What is thiamin?
|
B1
|
|
|
What is pyridoxine?
|
B6
|
|
|
What are the stores of pyridoxine?
|
none
|
|
|
How long do you live with minimal pyridoxine intake?
|
weeks
|
|
|
What predisposes you to pyridoxine deficiency?
|
inadequate intake, drug interaction
|
|
|
What are the sigs of pyridoxine deficiency?
|
polyneuropathy, oxalate stone formation, seborrheic dermatitis, microcytic anemia
glossitis and cheilosis |
|
|
What causes oculo-orogenital syndrome?
|
B2 and B6 deficiency
|
|
|
How do you treat pyridoxine deficiency?
|
at least 2 mg/day up to 50 mg/day po
|
|
|
How do yout est for pyridoxine deficiency?
|
plasma total pyridoxine RBC aspearate amniotransferase activity coefficient
|
|
|
What is the toxicity of pyridoxine?
|
ataxia, sensory neuropathy
|
|
|
At what dose do you get toxicity of pyridoxine?
|
200 mg/day for months
|
|
|
What is the function of folic acid?
|
1-carbon group transfer, synthesis of purine bases, histidine, choline, serine, methylation of biological molecules
|
|
|
Where is folic acid stored?
|
liver
|
|
|
What is the longevity with minimal folic acid intake?
|
months
|
|
|
What predisposes you to folic acid deficiency?
|
inadequate diet, intestinal malabosrption, preganancy, smoking, antifolate meds
|
|
|
What are the signs of folic acid deficiency?
|
macrocytic anemia, leukopenia, thrombocytopenia, glossitis, stomatitis, diarrhea, malabsorption
neural tube defects |
|
|
Hwo do you treat folic acid deficiency?
|
1 mg/day
|
|
|
How do you test for folic acid?
|
plasma folate, RBC folate
|
|
|
How much folic acid should you get if you're a woman of childbearing potential?
|
400 micrograms/day
|
|
|
Why would you need folic acid supplementation?
|
formiminotransferase deficiency, folate reductase deficiency, hyperhomocysteinemia, homocystinuria, reverse antifolates like methotrexate
|
|
|
What is the toxicity of folic acid?
|
can mask B12 deficiency
|
|
|
What does B12 do?
|
isomerize methylmalonyl CoA to succinyl CoA
itneracts with folic acid in methionine syntehtase homocystein/methionine conversion methylation reactions syntehsis of proteins, purines, pyrimidines |
|
|
Where is B12 stored?
|
liver
|
|
|
What predisposes you to B12 deficiency?
|
pernicious anemia, gastric bypass, resection/disease of terminal ileum/stomach, pancreatic insufficiency, intestinal bacterial overgrowth, strict vegetarianism advanced age
|
|
|
Where is B12 stored?
|
liver
|
|
|
How long do you last with little B12 intake?
|
years
|
|
|
What are the signs of B12 deficiency?
|
macrocytic anemia, leukopenia, thrombocytopenia, stomatitis, glossitis
|
|
|
What are the peripheral signs of B12 deficiency?
|
peripheral and central neuropathy with decreased vibratory and position senses, paresthesia, unsteady gait
|
|
|
How do you acutely treat B12 deficiency?
|
100 micrograms IM/day
1000 micgrograms IM all at once |
|
|
What is the maintenance dose of B12?
|
100 micrograms IM 500 micrograms nasal gel monthly
|
|
|
How do you test for B12 deficiency?
|
plasma B12, serum methylmalonic acid, Schilling test
|
|
|
What indicates therapeutic doses of B12?
|
congenital B12 metabolism defect, homocystinuria
|
|
|
What are the side effects of B12?
|
none
|
|
|
What is the function of iron?
|
oxygen transport, electron transport
|
|
|
Where is iron stored?
|
bone marrow, liver, spleen
|
|
|
How long do you last with minimal iron intake?
|
months
|
|
|
What predisposes you to iron deficiency?
|
blood loss, inadquate diet, gastrectomy, gastric bypass surgery, pregnancy
|
|
|
What are the signs of iron deficiency?
|
pallor fatigue, glossitis, tachycardia
|
|
|
What do you see with advanced iron deficiency?
|
microcytic anemia
|
|
|
How do you treat iron deficiency?
|
325 mg ferrous sulfate po tid, preferably with vit C for 2-6 months
|
|
|
How do you treat iron deficiency with impaired GI absorption?
|
1000 mg IV
|
|
|
How do you test for iron deficiency?
|
serum iron, total iron binding capacity, ferritin
|
|
|
What are the side effects of high iron?
|
hemochromatosis, hemosiderosis
|
|
|
What does vit C do?
|
hydroxylation of proline and lysine in collagen formation cartilage, bone, antioxidant, NT synthesis
enhances GI iron absorption, inhibits Cu absorption |
|
|
Where are vit C stores?
|
none
|
|
|
How long do you last with little vit C intake?
|
about 6 weeks
|
|
|
What can predispose you to vit C deficiency?
|
inadequate diet, smoking, physiologic stress from illness
|
|
|
What is scurvy?
|
follicular hyperkeratosis, corkscrew hairs, perifollicular petechiae, ecchymoses, bleeding gums, dry skin, impaired wound healing
|
|
|
How do you treat vitamin C deficiency?
|
up to 1-2g/day
|
|
|
How do you test for vit C deficiency?
|
plasma vit C normal = .4-2
scurvy <.2 mg/dL |
|
|
What is the toxicity of vitamin C?
|
occasional diarrhea, increased uric acid excretion, intereference iwth tests for uirne glucose, stool occult blood
supplements > 300 mg/d associated with increased CVD mortality in women with DM |
|
|
What does vitamin D do?
|
facilitates Ca and phosphorus absorption and utilization, maintenance of skeletal integrity
|
|
|
Where is vit D stored?
|
liver, skin
|
|
|
How long do you last with no vit D?
|
months to years
|
|
|
What predisposes you to vit D deficiency?
|
chronic fat malabsorption, gastric bypass surgery, renal insufficiency, breast feeding without supplemental vit D inadequate sun exposure, advanced age
|
|
|
What are the syndromes of vit D deficiency?
|
rickets in kids, osteomalacia in adults
|
|
|
How do you treat rickets?
|
1000 IU/day of vit D
|
|
|
How do you treat osteomalacia?
|
50000 IU/day D3 or 50 microgram/day calcifediol
|
|
|
How do you test for vit D deficiency?
|
serum 25-OH vit D, serum 1, 25 OH2 vit D
|
|
|
What indicates therapeutic vit D?
|
osteoporosis, vit D dependency, familial hypophosphatemia
|
|
|
What are the toxicity of vit D?
|
weakness, fatigue, headache, nausea, vomiting, hypercalccemia, impaired renal function, growth arrest in kids
|
|
|
At what level is your vit D too high?
|
> 400 ng/ml
|
|
|
What is the function of Zinc?
|
cofactor for enzymes in growth, sexual maturation, fertility, reproduction, night vision, taste, immune function
|
|
|
Where is zinc stored?
|
bone, muscle
|
|
|
What is the longevity with no zinc intake?
|
months
|
|
|
What conditions predispose you to zinc deficiency?
|
malabsorption, critical illness
|
|
|
What are the signs of zinc deficiency?
|
growth retardation, hypogonadism, impaired taste/smell, scaling skin, poor wound healing, acrodermatitis enteropathica
|
|
|
Hwo do you treat zinc deficiency?
|
60 mg elemental zinc po 1-3x daily
5-10 mg elemental zinc/day IV |
|
|
How do you test for zinc?
|
serum, urinary zinc
|
|
|
What are the indications for taking zinc?
|
compromised wound healing with high zinc losses or severe physio stress
|
|
|
What is the toxicity of zinc?
|
possibly interfere with iron or copper metabolism, immune function impairment
|
|
|
What are the functions of niacin?
|
components of coenzymes NAD, NADP glycolysis, tissue respiration
|
|
|
What are the niacin stores?
|
none
|
|
|
What predisposes you to niacin deficiency?
|
inadequate dietary niacin and tryptophan, alcohol abuse
|
|
|
What are the symptoms of niacin deficiency?
|
diarrhea, dermatitis in sun-exposed areas, dementia
tongue can be scarlet, raw, depapillated, fissured |
|
|
What is pellagra?
|
niacin deficiency, diarrhea, dermatitis in sun-exposed areas, dementia
|
|
|
How do you treat niacin deficiency?
|
50-500 mg/day po or IV
|
|
|
What are the indications for high doses of niacin?
|
elevated LDL/VLDL
Hartnup disease |
|
|
What are the side effects of niacin?
|
flushing, nausea, vomiting, diarrhea, liver injury
|
|
|
What are the functions of Vitamin E?
|
antioxidant, free radical scavenger
|
|
|
Where are the vit E stores?
|
liver, cell membranes, lipid-rich tissue
|
|
|
How long do you have stores of vitamin E?
|
years
|
|
|
What predisposes you to vitamin E deficiency?
|
long-term fat malabsorption, prematurity
|
|
|
What are the signs of vitamin E deficiency in premature infants?
|
hemolytic anemia, retinopathy, bronchopulmonary dysplasia
|
|
|
What are the signs of vit E deficiency in malabsorption?
|
neuropathy, myopathy with creatinuria
|
|
|
What is the treatment of vit E deficiency?
|
.2-2g per day po
|
|
|
Hod you test for vit E deficiency?
|
serum tocopherol
|
|
|
What are the indications for high doses of vitamin E?
|
premature birth, inborn errors of metabolism
chronic cholestasis, pancreatic insufficiency, malabsorption intermittent claudication |
|
|
What are the toxicities of vitamin E?
|
higher risk of hemorrhagic stroke, increased mortality with doses > 400 IU/day
|
|
|
What are the functions of vitamin K?
|
carboxylation of glutamic acid residues to form clotting factors II, VII, IX, X
|
|
|
Where is vitamin K stored?
|
liver, cell membranes
|
|
|
How long does vitamin K last?
|
weeks
|
|
|
What synthesizes vitamin K?
|
colonic bacteria
|
|
|
What causes vitamin K deficiency?
|
inadequate diet, antibiotic use, liver disease
|
|
|
What are the signs of vitamin K deficiency?
|
increased prothrombin time, ecchymoses, bleeding
|
|
|
How do you treat vitamin K deficiency?
|
5-10 mg Iv/IM to restore prothrombin time
newborn infants: dose of .5-1 mg IM at birth |
|
|
How do you test for vitamin K deficiency?
|
prothrombin time (INR)
|
|
|
What are the indications for high doses of vitamin K?
|
liver disease with hypoprothrombinemia
|
|
|
What are the functions of selenium?
|
ntioxidant, free radical scavenger, reduces lipid peroxidation with vitamin E
|
|
|
What are the selenium stores?
|
none
|
|
|
How long do you last with minimal selenium?
|
years
|
|
|
What predisposes you to low selenium?
|
low soil selenium, long-term low-selenium parenteral nutrition
|
|
|
What are the signs of lwo selenium?
|
cardiomyopathy, increased cancer
|
|
|
How do you treat selenium deficiency?
|
200-400 micrograms/day
|
|
|
How do you test selenium deficiency?
|
serum/ whole blood deficiency
|
|
|
What are the toxicities of selenium deficiency?
|
major hair loss, brittle fingernails, fatiuge, irritability
|
