B Vitamins Quiz

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Questions and Answers

Which of the following B vitamins is considered effective in treating infantile beriberi?

  • Niacin (B3)
  • Cobalamin (B12)
  • Riboflavin (B2)
  • Thiamine (B1) (correct)

What is the effectiveness of niacin (B3) in treating dyslipidemia and pellagra?

  • Effective (correct)
  • No evidence
  • Possibly effective
  • Likely effective

Which statement is true regarding pyridoxine (B6)?

  • It is effective for pregnancy-induced nausea and vomiting.
  • It is ineffective to treat vitamin B6 deficiency.
  • It is effective to treat age-related macular degeneration.
  • It is effective to treat vitamin B6 deficiency. (correct)

Which of the following is a B vitamin that is effective in treating biotin deficiency?

<p>Biotin (B7) (D)</p> Signup and view all the answers

What is the effectiveness of folic acid (B9) in treating folate deficiency?

<p>Effective (C)</p> Signup and view all the answers

Which vitamin is known to cause blindness in children due to deficiency?

<p>Vitamin A (B)</p> Signup and view all the answers

What effect does high doses of vitamin C potentially have on the common cold?

<p>Reduces duration by 1-1.5 days (A)</p> Signup and view all the answers

Which vitamin is categorized as a fat-soluble vitamin?

<p>Vitamin A (A)</p> Signup and view all the answers

Which of the following is a key question to ask when providing recommendations during the patient care process?

<p>Is a supplement needed? (C)</p> Signup and view all the answers

What is one of the risks associated with vitamin A therapy?

<p>Increased risk of bleeding with warfarin (C)</p> Signup and view all the answers

What dietary source is rich in vitamin D?

<p>Fish liver oils (B)</p> Signup and view all the answers

Which factor does NOT contribute to vitamin D deficiency?

<p>Increased sun exposure (A)</p> Signup and view all the answers

Which vitamin is NOT classified as a water-soluble vitamin?

<p>Vitamin D (C)</p> Signup and view all the answers

What serious risk can arise from excessive supplementation of calcium?

<p>Hypercalcemia (C)</p> Signup and view all the answers

Which mineral can interfere with the absorption of both iron and zinc when taken together?

<p>Calcium (C)</p> Signup and view all the answers

Which treatment is vitamin K specifically effective for?

<p>Reversal of warfarin anticoagulation (A)</p> Signup and view all the answers

How much elemental calcium is recommended to be taken at once?

<p>500 mg (A)</p> Signup and view all the answers

What potential outcome can result from long-term high doses of iron supplementation?

<p>Iron overload (C)</p> Signup and view all the answers

What should be done to reduce medication absorption interference with calcium supplements?

<p>Separate doses by at least 2-4 hours (B)</p> Signup and view all the answers

Which of the following is NOT a form of potassium available over-the-counter?

<p>Bicarbonate (C)</p> Signup and view all the answers

Which dietary source provides 300 mg of calcium per serving?

<p>8 oz milk (D)</p> Signup and view all the answers

Which of the following conditions is associated with hypokalemia?

<p>Excessive laxative use (C)</p> Signup and view all the answers

Which medication is known to potentially cause hyperkalemia?

<p>ACE inhibitors (A)</p> Signup and view all the answers

Which of the following minerals is classified as likely safe when taken orally by non-pregnant adults?

<p>Calcium (B)</p> Signup and view all the answers

What is calcium classified as effective for treating?

<p>Osteoporosis (D)</p> Signup and view all the answers

Which of the following is iron classified as effective for treating?

<p>Restless leg syndrome (D)</p> Signup and view all the answers

Which condition is potassium classified as effective for treating?

<p>Hypokalemia (A)</p> Signup and view all the answers

Which of the following is classified as possibly effective for treating restless leg syndrome?

<p>Iron (D)</p> Signup and view all the answers

Which of the following minerals is classified as not having sufficient evidence for treating weight loss?

<p>Calcium (D)</p> Signup and view all the answers

What factor can contribute to chronic renal insufficiency affecting vitamin D metabolism?

<p>Inability to produce 1,25-dihydroxyvitamin D (C)</p> Signup and view all the answers

Which vitamin has dietary sources including wheat germ, sunflower oil, and green leafy vegetables?

<p>Vitamin E (A)</p> Signup and view all the answers

What is a key symptom associated with acute intoxication of vitamin D?

<p>Increased thirst (A)</p> Signup and view all the answers

Which of the following statements about vitamin E toxicity is true?

<p>Vitamin E toxicity is typically difficult to achieve. (C)</p> Signup and view all the answers

How might vitamin E interact with anticoagulant drugs?

<p>Inhibit platelet aggregation (D)</p> Signup and view all the answers

Which metabolic consequence is associated with chronic glucocorticoid use?

<p>Decreased calcium and phosphorus absorption (C)</p> Signup and view all the answers

What is a common cause of vitamin K deficiency?

<p>Intestinal obstruction or diseases like Crohn's (D)</p> Signup and view all the answers

Which potential effect of high doses of vitamin E is still debated in the medical community?

<p>Increased risk of prostate cancer (A)</p> Signup and view all the answers

In cases of vitamin D toxicity, which condition may manifest due to hypercalcemia?

<p>Confusion (C)</p> Signup and view all the answers

What age group is less effective at converting vitamin D through the skin?

<p>Individuals older than 70 years (C)</p> Signup and view all the answers

Which of the following is a symptom of Thiamine deficiency in adults?

<p>Symmetrical peripheral neuropathy (D)</p> Signup and view all the answers

What are the common symptoms of Pellagra caused by Niacin deficiency?

<p>Dermatitis, diarrhea, dementia (A)</p> Signup and view all the answers

What can lead to Biotin deficiency?

<p>Excessive consumption of raw egg whites (C)</p> Signup and view all the answers

Which vitamin deficiency is associated with Anemia and Tongue inflammation?

<p>Vitamin B2 (Riboflavin) (C)</p> Signup and view all the answers

Which patient group is at risk of developing a Thiamine deficiency leading to Wernicke-Korsakoff syndrome?

<p>Individuals with chronic alcohol abuse (B)</p> Signup and view all the answers

Which symptom is typically linked to Pantothenic acid (Vitamin B5) deficiency?

<p>Burning feet syndrome (B)</p> Signup and view all the answers

What is a common cause of Folic acid deficiency?

<p>Weight loss surgery (B)</p> Signup and view all the answers

Which condition is NOT associated with Riboflavin deficiency?

<p>Convulsions (A)</p> Signup and view all the answers

Which of the following vitamins is often associated with a deficiency in individuals undergoing total parenteral nutrition?

<p>Thiamine (A)</p> Signup and view all the answers

Which of the following is not a common symptom of Vitamin B6 deficiency?

<p>Constipation (A)</p> Signup and view all the answers

Which of these vitamins is essential for the prevention of neural tube defects?

<p>Vitamin B9 (B)</p> Signup and view all the answers

Which vitamin should not be used as an alternative to prescription Niacin for treating hyperlipidemia?

<p>Inositol hexanicotinate (D)</p> Signup and view all the answers

In long-term parenteral nutrition, deficiencies may include:

<p>Biotin (B)</p> Signup and view all the answers

Which condition is characterized by dermatologic symptoms and is primarily associated with chronic alcohol abuse?

<p>Pellagra (D)</p> Signup and view all the answers

Flashcards

What conditions is Thiamine (B1) effective in treating?

Thiamine (B1) is effective in treating infantile beriberi, Wernicke-Korsakoff syndrome, and adult beriberi.

What condition is Riboflavin (B2) effective in treating?

Riboflavin (B2) is effective in treating ariboflavinosis, which is a deficiency of riboflavin.

What is Niacin (B3) likely effective in treating?

Niacin (B3) is considered likely effective to treat dyslipidemia and pellagra. This means there is strong evidence to support its effectiveness in these conditions.

What is Pantothenic acid (B5) effective in treating?

Pantothenic acid (B5) is effective in treating pantothenic acid deficiency.

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What conditions is Pyridoxine (B6) effective or possibly effective in treating?

Pyridoxine (B6) is effective in treating vitamin B6 deficiency. It is also possibly effective in treating age-related macular degeneration and pregnancy-induced nausea and vomiting.

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What is Infantile Beriberi?

A deficiency of Thiamine (vitamin B1) that affects infants who are breastfed by mothers with thiamine deficiency, causing heart failure and lack of reflexes.

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What is Adult Beriberi?

A deficiency of Thiamine (vitamin B1) that can occur in adults, especially after weight loss surgery or complications with total parenteral nutrition.

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What is Wernicke-Korsakoff Syndrome?

A severe neurological condition caused by thiamine deficiency, often in individuals with chronic alcoholism.

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What is Wernicke's Encephalopathy?

The acute phase of Wernicke-Korsakoff syndrome characterized by confusion, eye movements, and balance problems.

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What is Korsakoff Syndrome?

The chronic phase of Wernicke-Korsakoff syndrome marked by memory loss, confusion, and difficulty recalling past experiences.

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What is Ariboflavinosis?

A deficiency of Riboflavin (vitamin B2) that can manifest in various ways.

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What is Pellagra?

A deficiency of Niacin (vitamin B3) that can occur due to chronic alcohol abuse, malnutrition, or certain medications.

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What is Pantothenic Acid Deficiency?

A deficiency of Pantothenic Acid (vitamin B5) that is rare and usually occurs in severely malnourished individuals.

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What is Vitamin B6 Deficiency?

A deficiency of Pyridoxine (vitamin B6) that is more common in individuals with certain health conditions, alcohol issues, or related to certain medications.

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What is Biotin Deficiency?

A deficiency of Biotin (vitamin B7) that can occur due to the consumption of raw egg whites or long-term parenteral nutrition.

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What is Folic Acid Deficiency?

A deficiency of Folic Acid (vitamin B9) that can result in various medical complications, especially for infants.

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What is Dosage?

The amount of a substance that is needed for a specific purpose or effect.

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What are Routes of Administration?

The ways a drug or supplement can be taken, like orally or intravenously.

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What are Side Effects?

Potential healthcare risks or unintended effects that may occur when taking a medicine or supplement.

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What is Efficacy and Safety?

The level of effectiveness and safety of a specific medicine or supplement, often assessed through research.

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Vitamin A Deficiency: Global Impact

A deficiency of vitamin A can be rare in developed countries but is the 3rd most common deficiency worldwide. It's a significant issue globally as 500,000 children become blind each year due to vitamin A deficiency.

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Vitamin A Toxicity

Vitamin A is highly toxic in large amounts, both acutely and chronically. This means taking too much vitamin A can lead to serious health problems.

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Vitamin A Interactions: Retinoids

Taking vitamin A supplements alongside certain medications like Acitretin, Isotretinoin, and Tretinoin can increase the risk of toxicity. These medications are derived from Vitamin A and can have additive effects.

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Vitamin A Interactions: Warfarin

Using Vitamin A supplements while taking Warfarin could increase the risk of bleeding. Warfarin reduces Vitamin K, and there's a potential interaction with Vitamin A.

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Beta-Carotene and Lung Cancer

Studies involving Beta-Carotene supplementation have shown an increased risk of lung cancer in former or current smokers, raising concerns about its use in this population.

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Vitamin D Sunlight Equivalence

Getting sufficient Vitamin D from sunlight involves brief exposure to arms and face, equivalent to ingesting 200 IU of Vitamin D.

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Causes of Vitamin D Deficiency

Vitamin D deficiency can be caused by low sun exposure, common in infants, disabled individuals, and older adults.

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Vitamin D and Bone Health

Vitamin D is important for bone health and calcium absorption. A deficiency can lead to weakened bones and increased risk of fractures.

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Vitamin D deficiency in older adults

Vitamin D deficiency can occur in older adults due to decreased conversion of vitamin D in the skin.

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Vitamin D deficiency in chronic kidney disease

Chronic kidney disease can lead to vitamin D deficiency because the kidneys are responsible for activating vitamin D.

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Vitamin D deficiency from glucocorticoids

High doses of glucocorticoids can interfere with vitamin D absorption in the intestines.

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Consequences of vitamin D deficiency

Vitamin D deficiency can lead to reduced absorption of calcium and phosphorus, which can cause osteoporosis and increased risk of fractures.

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Symptoms of vitamin D toxicity

Vitamin D toxicity symptoms are primarily due to hypercalcemia, which can cause confusion, increased urination, increased thirst, loss of appetite, vomiting, and muscle weakness.

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Dietary sources of vitamin E

Vitamin E is found in various foods including wheat germ, sunflower oil, almonds, hazelnuts, green leafy vegetables, tomatoes, pumpkin, and sweet potatoes.

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Vitamin E deficiency

Vitamin E deficiency is rare and usually occurs in cases of severe malnutrition or genetic defects.

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Vitamin E interactions

Vitamin E can interact with anticoagulants and antiplatelets, potentially increasing the risk of bleeding, and may affect the effectiveness of chemotherapy.

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What does Vitamin K treat?

Vitamin K is effective in stopping bleeding in newborns and reversing the effects of the blood thinner Warfarin.

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What are the different forms of Calcium?

Calcium carbonate and calcium citrate are forms of calcium taken orally, while calcium acetate and gluconate are available as oral and injection forms.

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How do different drugs affect Calcium absorption?

Calcium absorption can be increased with thiazide diuretics, and decreased with aluminum and magnesium-containing antacids.

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What are the risks of too much Calcium?

Excessive calcium supplementation can lead to hypercalcemia, renal insufficiency, vascular and soft tissue calcification, hypercalciuria, and kidney stones.

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What forms of iron are available?

Iron fumarate, iron gluconate, and iron sulfate are common oral forms of iron.

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How do other medications affect Iron absorption?

Iron absorption can be reduced by zinc supplements and PPIs.

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What are the dangers of excessive iron intake?

High doses of iron can be fatal, especially in children, and chronic iron overload can cause organ damage.

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How do supplements impact medication absorption?

Supplements like calcium, bisphosphonates, fluoroquinolones, levothyroxine, and tetracyclines should be taken at least 2-4 hours apart from medications.

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Hypokalemia

A condition where the blood potassium levels are too low, often caused by diuretics, excessive laxatives, or certain medications.

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Hyperkalemia

A condition where the blood potassium levels are too high, often caused by ACE inhibitors, ARBs, or potassium-sparing diuretics.

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Calcium: Safety

A mineral considered likely safe for oral consumption by adults in appropriate doses.

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Calcium: Effectiveness

Calcium is considered effective for treating conditions like antacids, phosphate binders in renal failure, and osteoporosis.

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Iron: Effectiveness

Iron is considered effective for treating iron deficiency anemia and anemia of chronic disease.

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Potassium: Effectiveness

A mineral that is considered effective in treating hypokalemia, but it can be dangerous in excess.

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Potassium: Possibly Effective

A mineral that can be helpful for managing hypertension, but its effectiveness isn't conclusively proven.

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Potassium: Importance

An electrolyte vital for nerve and muscle function, often affected by changes in insulin levels and certain medications.

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Study Notes

Vitamins and Minerals Notes

  • Learning Objectives:
    • Identify patients at risk of deficiencies
    • Determine if a vitamin/mineral is effective and safe for a patient
    • Provide counseling points on niacin, folic acid, vitamin D, calcium, and iron

Water Soluble Vitamins

  • Thiamine (Vitamin B1):
    • Forms: Oral (OTC), injection (RX)
    • Infantile Beriberi: Thiamine deficiency in breastfed infants, leading to heart failure and loss of reflexes
    • Adult Beriberi: Weight loss surgery complications or total parenteral nutrition complications, can cause symmetrical peripheral neuropathy or cardiac involvement
    • Wernicke-Korsakoff Syndrome: Chronic alcohol abuse, acute syndrome requiring immediate treatment to prevent death and neurologic disease. Includes Wernicke's encephalopathy (acute) and Korsakoff syndrome (chronic), impacting short-term memory
  • Riboflavin (Vitamin B2):
    • Form: Oral (OTC)

Niacin(Vitamin B3) Deficiency

  • Pellagra: Rough skin condition, aka pelle agra
  • Symptoms:
    • Dermatitis in sun-exposed areas
    • Diarrhea
    • Dementia
    • Death

Pantothenic Acid (Vitamin B5) Deficiency

  • Form: Oral (OTC)
  • Symptoms:
    • Numbness
    • Burning sensation (in feet, known as burning feet syndrome)
    • Gastrointestinal distress

Pyridoxine (Vitamin B6) Deficiency

  • Forms: Oral (OTC), injection (RX)
  • Symptoms:
    • Asthma
    • Heart disease
    • Chronic alcohol abuse
    • Pregnancy

Biotin (Vitamin B7) Deficiency

  • Form: Oral (OTC)
  • Symptoms:
    • Dermatitis around eyes, nose and mouth
    • Conjunctivitis
    • Alopecia
    • Changes in mental status
    • Lethargy
    • Hallucinations
    • "Pins and needles"

Folic Acid (Vitamin B9) Deficiency

  • Forms: Oral (OTC), injection (RX)
  • Symptoms:
    • Malabsorptive syndromes
    • Weight loss surgery
    • Severe malnutrition
    • Chronic alcohol use
    • Infants fed exclusively goat milk
  • Prevention: Important for preventing neural tube defects and for women of childbearing age.

Cobalamin (Vitamin B12) Deficiency

  • Forms: Sublingual/Oral (OTC), injection/nasal spray (Prescription)
  • Symptoms:
    • Vegan/vegetarian diet
    • Weight loss surgery
    • Malabsorption

Ascorbic Acid (Vitamin C) Deficiency

  • Forms: Oral (OTC), injection (RX)
  • Symptoms:
    • Scurvy
  • Causes:
    • Major cause of mortality in famine/malnourishment
    • Poor diet lacking fruits/vegetables

Vitamin D Deficiency

  • Sources:
    • UV sunlight
  • Deficiency Causes:
    • Low sun exposure
    • People over 70
  • Toxicity:
    • Excessive supplementation-high doses
    • Leads to poisoning in children
    • Long-term use of high doses can cause iron overload and multiple organ damage.

Vitamin E Deficiency

  • Dietary Sources:
    • Wheat germ, sunflower oil, almonds, hazelnuts, green leafy vegetables, tomato products, pumpkin, sweet potato

Vitamin K Deficiency

  • Symptoms:
    • Excessive bleeding
    • Stomach pains
    • Bone defects
  • Interactions:
    • Warfarin antagonists reducing anticoagulant effect

Calcium

  • Forms: Acetate, Carbonate, Citrate, Gluconate (oral), Acetate (injection)
  • Dosage Recommendations:
    • 500mg elemental calcium at once MAX
  • Recommended Sources:
    • 8 ounces of milk = 300 mg
    • 6 ounces of yogurt = 300 mg
    • 1 ounce of cheese = 200 mg
    • Add 250mg of calcium for non-dairy sources

Iron

  • Forms: Fumarate, gluconate, sulfate (oral)
  • Interactions:
    • Fe and zinc interfere with absorption
    • PPI can decrease iron absorption
  • Toxicity:
    • Leads to poisoning

Potassium and Sodium

  • Forms:
    • Potassim: Gluconate (oral)
    • Sodium: Acetate, Chloride, Citrate, Gluconate, Phosphate
    • Drug Interations

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