Vitamins

Front 1

Vitamin A

Back 1

1. Antioxidant
2. Visual pigments
3. Differentiation of epithelial cells into specialized tissue (panc cells, GU, resp)
4. Tx. MEASLES

def: night blindness, dry skin, dry eyes, vuln to infxn (esp measles)

excess: arthralgias, teratogen, fatigue, HA, alopecia

Front 2

Vit B1

Back 2

cofactor TPP: thiamine pyrophosphate
1. Pyruvate DH (glycolysis)
2. alpha-ketoglutarate DH (TCA)
3. Transketolase (HMP)
4. Branched-chain AA DH

def: impaired glucose breakdown --> ATP depletion
Wernicke-Korsakoff
Dry Beriberi
Wet Beriberi

Front 3

Wernicke-Korsakoff

Back 3

MONA:
mental status
ophthalmoplegia
nystagmus
ataxia

Korsakoff:
personality change
memory loss
confabulation

*damage to medial dorsal nucleus of thalamus, mammillary bodies (both important for memory)

Front 4

Dry Beriberi

Back 4

Polyneuritis, symmetrical muscle wasting (esp distal

Front 5

Wet Beriberi

Back 5

high-output cardiac failure (DCM)
edema
tachycardia
cyanosis, dyspnea, vomiting

*more common in infants

Front 6

Vit B2

Back 6

Riboflavin
cofactor in REDOX (FADH2)

FAD and FMN are derivatives
B2 for 2ATP

def: 2 Cs
Cheilosis & Corneal vascularization
stomatitis, periph neuropathy

Front 7

Vit B3

Back 7

Niacin
NAD+, NADP+ (redox reactions)
**derived from TRYPTOPHAN
synthesis requires B6

B3 = 3ATP

Pellagra: 3Ds:
diarrhea, dermatitis, dementia
+glossitis
*can be caused by Hartnup disease (decreased tryp absorption), malignant carcinoid syndrome (increased tryp metab), and INH (decreased B6)

excess: facial flushing, hyperuricemia, increased insulin resistance/acanthosis nigricans, decreased BP

*SE mediated by PGs (so can give ASA before)

Front 8

Vit B5

Back 8

Pantothenate
Pantothen-A is in Co-A

Component of CoA, cofactor for Acyl transfers, and fatty Acid synthase

Def: dermatitis, enteritis, alopecia, adrenal insufficiency

Front 9

Vit B6

Back 9

Pyridoxine
Converted to pyridoxal phosphate, cofactor:
1. TRANSAMINATION (AA metabolism, ALT, AST)
2. Decarboxylation
3. Glycogen phosphorylase
4. Cystathionine synthesis
5. Heme synthesis
6. Tryp--> Niacin

PPCHeNGG
PD (increased periph metabolism of Levodopa)
Porphyrin (get sideroblastic anemia bc accum Fe)
Cysteine (increased homocysteine)
Histamine
Niacin (pellagra)
GABA (Glutamate to GABA; convulsions, irritability, periph neuropathy)
Glycogenolysis

*deficiency inducible by INH and OCPs

Front 10

Vit B12

Back 10

Cobalamin (cofactor for homocystein methyltransferase (transfers methyl groups as methylcobalamin) and methylmalonyl-CoA mutase

*found in animal products, synthesized only by microorganisms; very large reserve pool (years); stored in liver

Def: due to malabsorption, Diphyllobothrium latum, pernicious anemia or gastric bypass (IF def), absence of terminal ileum (Crohn's)

*Schilling test to detect etiology

Sxs: Macrocytic, megaloblastic anemia, hyperseg PMNs, neuro (paresthesias, subacute combined degeneration) due to abnl myelin

**see increased homocysteine and methylmalonyl-CoA

Front 11

Folate

Back 11

MC vit def in US

Converted to THF, a coenzyme for 1-carbon transfer reactions
*for synthesis of nitrogenous bases in DNA and RNA

from FOLiage; small reserve pool in liver

Def: can be caused by drugs (phenytoin, sulfonamides, MTX)

Sxs: macrocytic, megaloblastic anemia
NO neuro sxs

*increased homocysteine, but NORMAL methylmalonyl-CoA

Front 12

SAM

Back 12

S-adenosyl-methionine
ATP + Met --> SAM

"I Met SAM, the homo methyl donor man from the NE"

Converts Met to Homocysteine
*need B12 and folate to regenerate Met and SAM

*required for conversion of NE to EPI

Front 13

Biotin

Back 13

cofactor for carboxylation enzymes (add 1 carbon group)

1. Pyruvate carboxylase: Pyr --> oxaloacetate (TCA)
2. Acetyl-CoA carboxylase: Acetyl-CoA --> malonyl-CoA (FA synthesis)
3. Propionyl-CoA carboxylase: Propionyl-CoA --> methylmalonyl-CoA (odd-chain FA metabolism)

Def: dermatitis, alopecia, enteritis. Cuased by abx use or excessive ingestion of raw eggs (AVIDin in egg whites AVIDly binds biotin)

Front 14

Vit C

Back 14

1. Antioxidant
2. Faciliates Fe absorption by keeping in Fe2+ reduced state (more absorbable)
3. Hydroxylation of Pro and Lys in collagen synthesis
4. Dopamine beta-hydroxylase, which converts DA --> NE

Def: Scurvy: swollen gums, bruising, hemarthrosis, anemia, poor wound healing, weakened immune response

Front 15

Vit D

Back 15

D2: ergocalciferol (plants)
D3: cholecalciferol (milk, UV)
25-OH D3: storage
1,25(OH)2D3: calcitriol, active

*breast milk: decreased vit D

Excess in Sarcoidosis (activation by epithelioid macs); increased sensitivity in Williams

Front 16

Vit E

Back 16

Antioxidant
protects Erythrocytes and membranes from free-radical damage

Def:
hemolytic anemia, muscle weakness, posterior column and spinocerebellar tract demyelination, infertility, decreased serum phospholipids

*give Vit E for Abetalipoproteinemia

Front 17

Vit K

Back 17

Catalyzes gamma-carboxylation of glutamate residues on proteins involved in clotting
-synthesized in intestinal flora

2,7,9,10,C,S

Def: neonatal hemorrhage
increased PT, aPTT, nl BT
-can occur after prolonged use of broad-spectrum abx

Front 18

Zinc

Back 18

essential for activity of 100+ enzymes
formation of zinc fingers (transcription factor motif)

"Food, Sex, Hair"
Dysgeusia, anosmia
Hypogonadism
Decreased adult hair
Delayed wound healing

may presdispose to alcoholic cirrhosis

Front 19

Kwashiorkor

Back 19

Protein malnutrition
MEAL:
Malnutrition
Edema
Anemia
Liver (fatty)