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75 Cards in this Set
- Front
- Back
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What are the fat-soluble vitamins?
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ADEK
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What are the water-soluble vitamins?
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B1, B2, B6, niacin, folic acid, B12, C
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Name of Vitamin A
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retinol
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Importance of Vitamin A
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- rhodopsin from retinal and opsin
- allows dim light vision (night vision) |
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Vitamin A Deficiency
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night blindness and dry skin
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Vitamin A Toxicity is from eating too much what and what does it cause?
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- intake of large quantities of fish oils
- causes liver damage |
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How do you detect Vit A and what are some special considerations?
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- HPLC of retinol esters
- protect sample from light |
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What are sources of Vit A?
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fruits and vegetables containing carotene
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Why is Vit E important?
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- antioxidant: protection from peroxidation and free radical formation
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What are sources of Vit E?
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leafy veggies, veggy ois, legumes
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Name of Vit E
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tocopherol
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Vit E Deficiency
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- rare
- may produce mild hemolytic anemia in newborns |
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How do you detect Vit E and considerations?
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- HPLC to detect active alpha form
- protect sample from light |
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Why is Vit D important?
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- skeletal formation and mineral homeostasis
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How is cholecalciferol (D3) produced?
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- in the presence of sunlight -> 7-dehydrocholcalciferol
- produced natually |
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How is ergocalciferol (D2) produced?
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- irradiation of yeast
- get it from milk, supplements |
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Source of Vit D
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fortified milk or sun
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What is the major circulating form of Vit D?
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25-OH Vitamin D
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What is the most active form of Vit D?
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- 1,25-diOH Vitamin D
- promotes intestinal absorption of Ca and PO4 - w/ PTH, stimulates Ca and PO4 mobilization by bones |
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How is 1,25-diOH Vit D increase synthesis?
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- inc PTH
- dec PO4 - dec Ca |
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Def of Vit D in children
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rickets
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Defi of Vit D in adults
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osteomalacia
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Vit D Toxicity
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- children especially sensitive
- Ca deposition in tissues, renal and cardiac damamge |
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25 OH form is an indicator of what and how is it detected?
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- HPLC
- indicator of nutritional adequacy |
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How is 1,25-diOH Vit D detected?
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- requires extraction and purification steps, prior to assay
- RIA or HPLC |
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A decrease in 1,25 di OH vit D indicates what?
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- renal failure
- hypoparathyroidism |
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An increase in 1,25 di OH vit D indicates what?
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- hypophophatemia
- hyperparathyroidism |
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An increase in Vit D does what to PTH
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increase
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An increase in Vit D does what to PO4?
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decrease
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What are the coagulation factors that need Vit K?
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2, 7, 9, 10, protein C, and protein S
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Source of Vit K
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- 50% synthesized by intestinal bacteria
- cabbage and cauliflower |
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Def in Vit K
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- antibiotic therapy
- causes bruising to hemmhorage |
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How do you detect Vit K?
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- rarely tested
- HPLC, protect from light |
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What drug is against Vit K?
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- coumadin proloning the PT (prothrombin time a functional indicator)
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Name of Vit B12
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cobalamin
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Sources of Vit B12
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- bacterial synthesis
- meat, eggs, and milk |
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Function of B12
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- methylation rxns
- cellular maturation - nerve tissue integrity |
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What is needed for B12 absorption?
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- intrinsic factor as a binding protein
- IF secreted by parietal cells |
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B12 Deficiency
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- dietary, malabsorption, or lack of IF, a consequence of autoimmune atrophic gastritis (pernicious anemia)
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Symptoms of B12 Def
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- megaloblastic anemia
- neurologic symptoms |
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Treatment for B12 def
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- Vit B12 megadoses
- method: similar to folate method except HRP-intrinsic factor is used |
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What cpd is affected by folate and/or Vit B12 Def?
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- elevated homocysteine
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What cpd is affected by Vit B12 Def?
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- decreased methylmalonic acid
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Name of folate
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pteroylglutamic acid and folic acid
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Why is folate important?
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-CH3 transfer rxns
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Source of folate
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greens, fruits, organ meats, yeast
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Folate Def
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- megaloblastic anemia
- neural tube defects in newborn (prevention: dietary supplement during pregnancy) |
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What is the most sensitive indicator of true folate?
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RBC folate
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Wha interferes with folate absorption and retention?
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dilantin (phenytoin)
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Folate Method
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- competitive binding assay
- folate and HRP-folate compete for limited binding sites on biotinylated folate binding protein in a streptavidin coated test tube * wash step removes unbound reagents * the binding protein becomes bound to the test tube * HRP, the enzyme portion of HRP-folate catalyzes oxidation of luminol, producing light |
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Name of Vit C
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ascorbic acid
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Why is C important?
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- antioxidant and collagen formation
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Method of Vit C
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- capillary electrophoresis
- protect sample from light |
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Why is biotin important?
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- carboxyl grp transfer
- gluconeogenesis, lipogenesis |
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Biotin Def
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- long term parenteral nutrition
- genetic defects of carboxylase and biotinase enzymes - ingestion of raw egg whites * avidin binds to biotin |
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What is carnitine?
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- a macronutrient
- "a conditionally essential nutrient" |
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Source of carnitine
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meat, poultry, fish and synthesized in our liver, brain, and kidney
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What is the function of carnitine?
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- facilitates long chain FA entry into mitochondria to be burned
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Carnitine Def
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- Hereditary
- Acquired * valproic acid * parenteral nutrition * hemodialysis |
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Symptoms of carnitine def
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muscle weakness & fatigue
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Carnitine method
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- Enzymatic spectrophotometric assay
* enzyme carnitine acetyltransferase * color reagent 5,5'-dithiobis(2-nitrobenzoic acid) |
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Markers used in nutritional assessment
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1.) Transthyretin
2.) Insulin Growth Factor-1 (IGF-1, somatomedin C) |
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Transthyretin
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- (prealbumin)
- Low level: poor nutritional status - sensitive to changes in nutritional status - T1/2 of 2 days |
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Insulin Growth Factor-1 (IGF-1, somatomedin C)
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- A peptide hormone produced in response to growth hormone and nutritional uptake
- Stimulates growth - Low levels * malnutrition * hypopituitarism |
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Vit A fat or water soluble?
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fat
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Vit E fat or water
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fat
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folate
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water
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biotin
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water
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vit K fat or water?
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fat
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Which of the following describes the correct source, function, and deficient state of the vit listed?
A.) Vitamin E-plant tissue, antioxidant, osteomalacia B.) Thiamine (B1)-whole grains, carbohydrate metabolism, beriberi C.) Niacin-meat, oxidation-reduction rxns, scurvy D.) Folic acid-diary products, myelin formation |
B.) Thiamine (B1)-whole grains, carbohydrate metabolism, beriberi
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Which vitamin would be affected if a patient was diagnosed with a disorder involving fat absorption?
A.) Vit B12 B.) Ascorbic acid C.) Thiamine D.) Vitamin K |
D.) Vitamin K
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Which vitamin is a powerful antioxidant, found primarily in vegetable oils, that protects the RBC membrane from oxidative stress?
A.) Vit K B.) Vit C C.) Vit E D.) Folic acid |
C.) Vit E
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A 70-year-old man presented to his physician with a broken arm. Lab work indicated an elevated PT, w/ all other lab results normal. The man was taking an antibiotic for an earlier respiratory infection. Which, if any, of the following vitamins might be involved?
A.) Vit K B.) Vit D C.) Biotin D.) None of the above |
A.) Vit K
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The percentage of hospitalized patients who may be malnourished is:
A.) 5-8% B.) 10-15 C.) 20-25 D.) 30-50 |
D.) 30-50
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Which nutritional marker has been found to be the most sensitive and helpful indicator of nutritional status in very ill patients?
A.) Transthyretin B.) Transferrin C.) Albumin D.) Insulin growth factor-1 |
A.) Transthyretin
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