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58 Cards in this Set
- Front
- Back
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defect in excreting copper into bile
decrease in synthesis of ceruloplasmin |
wilson's disease
total Cu decreased free Cu increased |
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useful in tx diabetes mellitus
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chromium
glucose tolerance factor- enhances insulin activity |
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neutralizes peroxides in cytosol
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selenium
cofactor for glutathione peroxidase- neutralizes H2O2 |
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dysgenusa, anosmia, facial rash, defective wound remodeling
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zinc disorder
cofactor for collagenase- type III col --> type I col increased tensile strength to a wound |
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increases collagen tensile strength- crosslinking collagen and elastic tissue
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copper
cofactor lysyl oxidase - connects tropocollagen to eachother at gydroxylated binding sites |
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acrodermatitis enteropathica
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AR-
zinc deficiency- skin abnormalities & hypogonadism |
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prevents stomach cancer by inhibiting nitrosylation
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vit c- food preservatives nitrites
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synthesis of succinyl CoA and nuclear maturation
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vit B12
odd chain fatty acid (propionyl CoA --> succinyl CoA) mutase (methylmalonyl CoA --> succinyl CoA) |
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neurotransmitter synthesis
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tryptophan- niacin & serotonin
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confusion, ataxia, nystagmus
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thiamine deficiency - wernicke's encephalopathy
DRY BERI BERI (demyelination syndrome) |
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sideroblastic anemia - TB
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tx with isoniazid
pyridoxine deficiency cofactor for ALA synthase glycine + succinyl CoA --> delta-aminolevulinic acid (first step in heme synthesis) iron accumulates in mitochondria- ringed sideroblast |
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Pyr --> ace CoA
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thiamine (vit B1)
pyr dehydrogenase |
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Pyr --> oxa
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biotin
pyr carboxylase (remember to cross mito membrane --> oxa // malate // oxa this is the 1st step in gluconeogenesis |
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Ala --> Pyr
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pyridoxine (vit B6)
ALT removal of amino group from ala |
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Oxa --> Asp
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Pyridoxine (vit B6)
AST adding amino group to oxa |
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methylmalonyl CoA --> succinyl CoA
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Cobalamine (vit B12)
TCA cycle |
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Acetoacetate --> B hydroxytutyrate
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niacin
alcoholics -- standard test for ketone bodies CANNOT detect B-OHB |
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Propionyl CoA --> methylmalonyl CoA
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biotin
carboxylase rx - 1st step in odd chain fatty acids |
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malate --> oxa
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niacin
into cytosol.. |
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G6P --> 6-phosphogluconate
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niacin
1st irreversivle step in PPP G6PDH |
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reduced glutathione + peroxide --> H2O
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selenium
PPP glutathione peroxidase |
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follicular hyperkeratosis
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vit A deficiency
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perifollicular hemorrhages
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vit C deficiency
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prolonged prothrombin time
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vit K deficiency
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sideroblastic anemia
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pyridoxine (vit B6)
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positive Chvostek's sign
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vit D deficiency --> hypocalcemia
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toxicity produces papilledema & seizures (increased intracranial pressure), hepatitis, bone pain (periosteal proliferation
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vit A
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Bitot's spot
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squamous metaplasia of corneal epithelium --> can lead to keratomalacia --> blindness
vit A, also night vision |
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hemarthrosis, anemia (combined iron & folate), loosened teeth, glossitis
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vit C deficiency
also- bleeding gums, corkscrew hairs, poor wound healing |
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reduces non-heme iron (+3) into ferrous (+2)
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vit C
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skin hyperpigmentation on sun exposure
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niacin deficiency (vit B3)
Pellagra- Dermatitis, Dementia, Ddiarrhea |
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ophthalmoplegia
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decreased thiamine (vit B1)
causing wernicke's encephalopathy eye m. weakness |
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nyctalopia
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vit A deficiency
night blindness |
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hemolytic anemia
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vit E deficiency
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pt on warfarin and has mega increased PT
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vit E toxicity- synergistic effect with warfarin
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bile salt carcinogen cleared faster with insoluble fiber
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lithocholic acid
decreased incidence of C-R cancer |
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alcoholic IV
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ADD THIAMINE
pyruvate dehydrogenase (pyr --> acetyl CoA) --wernicke's encephalopathy |
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Dry beriberi
Wet beriberi |
dry- peripheral neuropathy, Wernicke's, Korsakoff's
wet- congestive cardiomyopthy with biventricular failure |
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tell the difference btw B12 from folate deficiency
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B12-
increased urine methylmalonic acid + Romberg BOTH increased MCV hypersegmented neutrophils increased plasma homocysteine |
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pure vegan PG
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folate
vit B12 iron |
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vit D deficiency
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child:
rickets craniotabes increased unmineralized epiphyseal cartilage rachitic rosary adult: osteomalacia BOTH: osteopenia bowed legs hypocalcemia pathologic fractures excess osteoid |
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glossitis
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folate
B12 vit C Riboflavin (vit B2) |
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glossitis, cheilosis, angylar stomatitis, magenta tongue, corneal neovascularization
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Riboflavin deficiency (bit B2)
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side effect: flushing
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nicotinic acid
lowers CH & TG cheapest lipid lowering drug, flushing relieved by taking asa 30 min prior |
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TB tx
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pyrioxine (vit B6) deficiency
Isoniazid, sideroblastic anemia |
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goat's milk
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deficient in:
folate vit B6 |
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eating 20 raw eggs a day
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biotin deficiency
Abidin in eggs binds biotin dermatitis, alopecia, lactic acidoses (pyr --> lactate) |
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inhibit reabsortion of monoglutamates in the jejunum
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OCP
alcohol |
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inhibit dihydrofolate reductase
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MTX
TMP/SMX |
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breast fed newborn whose mother is vegan.. macrocytic anemia
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vit B12 deficiency
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dementia causes
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niacin (vit B3)
vit B12 |
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microcytic anemia
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iron
copper copper is cofactor for ferroxidase (ferric --> ferrous) for binding to transferrin |
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decreased synthesis of vit K dependent coagulation factors
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vit E tox
II, VII, X, XI |
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associated with defects of collagen & poor wound healing
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copper
lysyl oxidase- cross-links tropocollagen fivers zinc collagenase- converts type III collagen in a wound into type I collagen vit C hydroxylates pro & lys alpha chain |
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blocks intestinal conjugase to convert polyglutamate form of folic acid into monoglutamate (absorbed type)
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Phenytoin (seizure med)
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things that effect vit B12 absoption
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backterial overgrowth in small bowel
chronic pancreatitis crohn's disease fish tapeworm pernicious anemia effect BOTH vit B12 & bile salts: bacterial overgrown in sm. bowel crohn's disease |
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what is responsible for neuologic findings in vit B12 deficiency?
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increase in propionates (odd chain fatty acid met usually met this)
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decreased synthesis of dTMP (deoxyribose thymidine monophosphate)
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vit B12 deficiency
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