Step 1 - Nutrition

Front 1

Fat soluble vitamins

Back 1

ADEK
Absorption depends on ileum and pancreas
Toxicity from accumulation in fat
Malabsorption syndromes (CF, sprue) or mineral oil intake can cause deficiencies

Front 2

Water soluble vitamins

Back 2

B vitamins, C, biotin, folate
B vitamin deficiencies often cause dermatitis, glossitis, and diarrhea

Front 3

Vitamin A

Back 3

Function: antioxident, part of retinal visual pigments
Deficiency: night blindness, dry skin
Excess, arthralgias, fatigue, headaches, skin changes, sore throat, alopecia, teratogenic
Source: liver and leafy vegetables

Front 4

Vitamin B1 (thiamine)

Back 4

Function: cofactor for pyruvate dehydrogenase (glycolysis), alpha-ketoglutarate dehydrogenase (TCA cycle), transketolase (HMP shunt), and branched chain AA deydrogenase
Deficiency: Wernicke-Korsakoff syndrome and beriberi, seen in malnutrition and alcoholism

Front 5

Wernicke-Korsakoff syndrome

Back 5

Symptoms: confusion, ophthalmoplegia, ataxia, memory loss, confabulation, personality change
Pathogenesis: thiamine deficiency

Front 6

Beriberi

Back 6

Symptoms: polyneuritis, symmetric muscle wasting, dilated cardiomyopathy, edema
Pathogenesis: thiamine deficiency

Front 7

Vitamin B2 (riboflavin)

Back 7

Function: cofactor in oxidation and reduction
Deficiency: cheilosis (inflammation of lips, scaling and fissues at corners of mouth), corneal vascularization

Front 8

Vitamin B3 (niacin)

Back 8

Function: constituent of NAD+ and NADP+ used in redox reactions, synthesis requires B6
Deficiency: glossitis, pellagra (diarrhea, dermatitis, dementia), malignant carcinoid syndrome (tryptophan metabolism, INH (low B6)
Excess: facial flushing (from high pharmacologic doses for hyperlipidemia)

Front 9

Vitamin B5 (pantothenate)

Back 9

Function: essential component of CoA and fatty acid synthase
Deficiency: dermatitis, enteritis, alopecia, adrenal insufficiency

Front 10

Vitamin B6 (pyridoxine)

Back 10

Function: converted to pyridoxal phosphate (used in transamination, decarboxylation, glycogen phosphorylase, heme synthesis), required for B3 synthesis from tryptophan
Deficiency: convulsions, hyperirritability, peripheral neuropathy

Front 11

Vitamin B12 (cobalomin)

Back 11

Function: cofactor for homocysteine and methyltransferase
Deficiency: macrocytic megaloblastic anemia, paresthesias, subacute combined degeneration (abnormal myelin)
Source: animal products, synthesized by microorganisms, large pool in liver
Pathogenesis of deficiency: malabsorption (sprue, fish tapeworm), lack of IF, or absence of terminal ileum

Front 12

Folic acid

Back 12

Function: converted to THF for 1-carbon transfer reactions, synthesis of nitrogenous bases in DNA and RNA
Source: green leaves
Deficiency: macrocytic megaloblastic anemia
Causes of deficiency: alcoholism, pregnancy, drugs (phenytoin, sulfonamides, MTX)

Front 13

Biotin

Back 13

Function: cofactor for carboxylation enzymes (pyruvate carboxylase, acetyl-CoA carboxylase, propionyl-CoA carboxylase)
Deficiency: dermatitis, alopecia, enteritis
Causes of deficiency: antibiotic use, excessive raw egg ingestion

Front 14

Vitamin C (ascorbic acid)

Back 14

Function: antioxidant, facilitates iron absorption by keeping it in 2+ state, hydroxylation of proline and lysine in collagen synthesis, dopamine beta-hydroxylase cofactor
Source:fruits and vegetables
Deficiency: scurvy - swollen gums, bruising, anemia, poor wound healing

Front 15

Vitamin D

Back 15

Function: increases intestinal absorption of Ca and P, increase bone resorption
Deficiency: rickets in children, osteomalacia in adults, hypocalcemic tetany
Excess: hypercalcemia, loss of appetite, stupor, seen in sarcoid

Front 16

Vitamin E

Back 16

Function: antioxidant (protects erythrocytes and membranes from free radical damage)
Deficiency: increase fragility of erythrocytes (hemolytic anemia), muscle weakness, neurodysfunction

Front 17

Vitamin K

Back 17

Function: catalyzes gamma-carboxylation of glutamic acid residues on blood clotting factors II, VII, IX, X, protein C and S, synthesized by intestinal flora
Deficiency: neonatal hemorrhage with increased PT and PTT but normal BT

Front 18

Zinc

Back 18

Function: essential for enzyme activity, formation of zinc finger transcription factor motif
Deficiency: delayed wound healing, hypogonadism, decreased adult hair, alcoholic cirrhosis

Front 19

Ethanol metabolism

Back 19

Ethanol -alcohol dehydrogenase-> acetaldehyde -acetaldehyde dehydrogenase-> acetate
NAD+ is limiting reagent
Zero order kinetics

Front 20

Ethanol hypoglycemia

Back 20

Ethanol metabolism increases NADH/NAD+ ratio, diverts pyruvate to lactate and OAA to malate
Inhibits gluconeogenesis - hypoglycemia
Stimulates fat synthesis - fatty liver change

Front 21

Kwashiorkor

Back 21

Synptoms: skin lesions, edema, fatty liver, swollen belly
Pathogenesis: protein-deficiency

Front 22

Marasmus

Back 22

Symptoms: tissue and muscle wasting, loss of subcutaneous fat, variable edema
Pathogenesis: energy malnutrition