Vitamin Deficiencies

Front 1

B1 is also known as what?

Back 1

Thiamine: TPP

Front 2

B2 is also known as what?

Back 2

riboflavin: FAD, FMN

Front 3

B3 is also known as what?

Back 3

Niacin: NAD+

Front 4

B5 is also known as what?

Back 4

Pantothenic acid: CoA

Front 5

B6 is also known as what?

Back 5

Pyridoxine: PLP

Front 6

B12 is also known as what?

Back 6

Cobalamin

Front 7

C is also known as what?

Back 7

ascorbic acid

Front 8

A is also known as?

Back 8

Retinol

Front 9

What are the functions of vitamin A

Back 9

Antioxidant; constituent of visual pigments (retinal), essential for normal differentiation of epithelial cells into specialized tissue (pancreatic cells, mucus-secreting cells). Used to treat measles, AML (all-trans retinoic acid overcomes block by myeloid cell differentiation, allowing leukemia cells to diff. into PMN which die by apoptosis)

Front 10

What are the findings in vit. A deficiency?

Back 10

Night blindness, dry skin,

(metaplasia/kertinization --> bitot spots --> keratoalacia --> blindness)

Front 11

Where is vit. A found?

Back 11

liver and leafy vegetables

Front 12

Acute excess of vit. A causes?

Back 12

headache, vomiting, stupor, blurred vision, stimulates osteoclasts --> inc. resorption --> inc. fractures

Front 13

Chronic excess of vit. A

Back 13

alopecia, dry skin, hyperlipidemia, hepatotoxicity, heptaosplenomegaly, visual difficulties, intracrania HTN --> papilledema

Front 14

(First Aid) Excess vit. A

Back 14

arthralgias, fatigue, headaches, skin cahnges, sore throat, alopecia. Teratogenic (cardiac abns, cleft palate) so pregnancy test before Rx isotretinoin for acne

Front 15

Functions of B1

Back 15

In thiamine pyrophosphate (TPP), a cofactor for several enzymes
(1) pyruvate dehydrogenase (glycolysis)
(2) a-ketoglutarate dehydrogenase (TCA cycle)
(3) transketolase (HMP shunt)
(4) branched-chain AA dehydrogenase

Front 16

Deficiency of B1

Back 16

Impaired glucose breakdown --> ATP depletion (glucose infusion can worsen)
highly aerobic tissues (heart, brain) are affected first.
Wernicke-Korsakoff syndrome and beriberi. (malnutrition, also 2o alcoholism)

Front 17

What characterizes Wernicke-Korsakoff

Back 17

confusion, opthalmoplegia, ataxia + confabulation, personality change, memory loss (permanent).

Front 18

What is damaged in Wernicke-Korsakoff

Back 18

medial dorsal nucleus of thalamus, mamillary bodies

Front 19

What is Dry beriberi characterized by

Back 19

polyneuritis, symmetrical muscle wasting

Front 20

What is Wet beriberi characterized by

Back 20

high-output cardiac failure (dilated cardiomyopathy) edema, neuropathy

Front 21

What is the function of vit B2 (riboflavin)

Back 21

cofactor in oxidation and reduction ex. FADH2

Front 22

Findings in B2 deficiency

Back 22

Cheilosis (inflamm of lips, scaling, fissures at corners of mouth), Corneal vascularization

Front 23

What are derivatives of of roboflavin

Back 23

FAD, RMN

Front 24

functions of vit. B3 (niacin)

Back 24

constituent of NAD+, NADP+ (used in redox rxns). Derived from tryptophan.

Front 25

synthesis of B3 requires what else?

Back 25

B6

Front 26

Vit. B3 deficiency

Back 26

glossities, severe deficiency leads to pellagra, malignant carcinoid syndrome (inc. tryp metab), INH (dev. vit B6)

Front 27

What other syndrome causes pellagra and how

Back 27

Hartnup disease - dec. tryp absorption

Front 28

What are the 4D's of pellagra

Back 28

diarrhea, dermatitis, dementia, death

Front 29

Vit. B3 excress

Back 29

facial flushing (ex. in tx. of hyperlipidemia)

Front 30

Function of B5 (panthothenate)

Back 30

essential component of CoA and FA synthesis

Front 31

Deficiency of B5

Back 31

dermatitis, enteritis, alopecia, adrenal insufficiency

Front 32

Function of B6 (pyridoxine)

Back 32

converted to pyridoxal phosphate, a cofactor used in transamination (eg. ALT, AST), decarboxylation rxns, glycogen phosphorylase, cystathionine synthesis, heme synthesis.

Required for niacine synthesis from tryptophan

Front 33

B6 deficiency

Back 33

convulsions, hyperirritability, peripheral neuropathy, (deficiency indicuble by INH and oral contraceptives), sideroblastic anemia

Front 34

Where is B12 found?

Back 34

animal products

synthesized only by microorganisms

Front 35

Where is B12 stored

Back 35

liver, large reserve pool (years)

Front 36

Function of B12 (cobalamin)

Back 36

cofactor for homocysteine methyltranserase (transfers CH3 groups as methylcobalamin) and methylmalonyl-CoA mutase

Front 37

B12 deficiency

Back 37

macrocytic, megaloblastic anemia, hypersegmented PMNs, neurologic symptos (paresthesias, subacute combined degeneration) due to abnormal myelin.
Prolonged deficiency leads to irreversible nervous system damage

Front 38

Folic acid is found in?

Back 38

leafy greens

Front 39

Where is folic acid stored?

Back 39

Liver - small reserve pool

Front 40

What drugs cause folic acid deficiency

Back 40

phenytoin, sulfonamides, MTX

Front 41

function of folic acid

Back 41

converted to THF, a coenzyme for 1-C transfer/methylation rxns.

Impt for synthesis of nitrogenous bases in DNA and RNA

Front 42

Deficiency of folic acid

Back 42

macrocytic, megaloblasic anemia, no neurologic symptoms, seem in alcoholism and pregnancy (def. can lead to neural tube defects)

Front 43

Function of S-adenosyl-methionine

Back 43

transfers methyl units,

req. for conversion of NE to E

regeneration depends onf B12 and folate

Front 44

Biotin functions

Back 44

cofactor for carboxylation enzymes (which as 1-C group)
(1)pyruvate carboxylase: pyruvate (3C) --> oxaloacetate (4C)
(2)acetyl-CoA carboxylase: acetyl coA (2C) --> malonyl CoA (3C)
(3) propionyl CoA carboxylase: propionyl CoA (3C) --> methylmalonyl CoA (4C)

Front 45

Biotin deficiency

Back 45

relatively rare

Dermatitis, alopecia, enteritis,

Caused by antibiotic use of XS ingestion of raw eggs

Front 46

Function of vit. C

Back 46

Antioxidant

facilitates iron absorption by keeping iron in Fe2+ reduced state (more absorbable)

necessary for hydroxylation of proline and lysinei n collagen synthesis

necessary for dopamine, B-hydroxylase, which converts dopamine to NE

Front 47

vit C deficiency

Back 47

scurcy - swollen gumes, brusing, hemarthrosis, anemia, poor wound healing, hyperkertotic papular rash,

weakened immune response

Front 48

where is vit. c found

Back 48

fruits and veggies

Front 49

What is the storage form of vit. D

Back 49

25-OH D3

Front 50

What is the active form of vit. D

Back 50

1,25-(OH)2 D3 (calcitrol)

Front 51

What is ergocalciferol

Back 51

D2, ingested from plants

Front 52

What is cholecalciferol

Back 52

D3 - milk, formed in sun-exposed skin

Front 53

Function of vit.D

Back 53

inc. intestinal absorption of calcium and phosphate, inc. bone resportion

Front 54

Deficiency of vit.D

Back 54

<20 ng/mL

rickets in kids, osteomalacia in adults, hypcalcemic tetany,

breast milk has dec. vit. D - supplement in dark skin pts

Front 55

Excess of vit. D

Back 55

> 100 ng/mL

hypercalcemia, hypercalciuria, loss of apetitie, stupor.

seen in sarcoidosis,

Front 56

vit E functions

Back 56

antioxidant (protects erythrocytes and membranes from free radical damage)

Front 57

vit. E deficiency

Back 57

inc. fragility of erythrocytes (hemolytic anemia), muscle weakness, posterior column and spinocerebellar tract demyelination

Front 58

Which clotting factors requires vit. K for synthesis

Back 58

2,7,9,10, protein C and S

Front 59

Which drug blocks vit. K

Back 59

warfarin

Front 60

Why are neonates given vit. K injections are birth

Back 60

to prevent hemorrhage

Front 61

function of vit.K

Back 61

catalyzes gamma-carboxylation of glutamic acid residues on various proteins concerned with blood clotting,

Front 62

where is vit. K produces

Back 62

synthesized by intestinal flora

Front 63

vit. K deficiency

Back 63

neonatal hemorrhage, with inc. PT and aPTT but normal bleeding time

can occur d/t broad spectrum antibiotics

Front 64

Why do neonates have risk of hemorrhage

Back 64

because have sterile intestines and are unable to synthesize vit. K

Front 65

Functin of zinc

Back 65

essential for activity of 100+ enzymes.

impt in formation of zinc fingers

Front 66

zinc deficiency

Back 66

delayed wound healing, hypogonadism, dec. adult hair (axillary, facial, pubic), dysgeusia, anosmia

may predispose to alcoholic cirrhosis

Front 67

Kwashikor

Back 67

protein malnutriion resultignin skin lesions, edema, livermalfunction (fatty change d/t dec. apolipoprotein synth). swollen belly

Front 68

Marasmus

Back 68

energy malnutrition resulting in tissue and muscle wasting, loss of subcutaneous fat and variable edema.