Vitamin and Trace Mineral Deficiency and Excess
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Questions and Answers

What is the primary organ responsible for synthesizing vitamin D?

  • Kidneys
  • Skin (correct)
  • Intestines
  • Liver

    • Which vitamin D form is known to be derived from plant sources?

  • Vitamin D3 (Cholecalciferol)
  • Vitamin D2 (Ergocalciferol) (correct)
  • 7-Dehydrocholesterol
  • Calcitriol

    • What is the name of the condition characterized by vitamin D deficiency in children?

  • Beriberi
  • Scurvy
  • Osteoporosis
  • Rickets (correct)

    • What serum level is typically measured to assess vitamin D status?

    <p>25-dihydroxyvitamin D</p> Signup and view all the answers

    What deficiency can occur especially in newborns due to low vitamin K levels?

    <p>Hemorrhage</p> Signup and view all the answers

    Which two forms of vitamin K are recognized?

    <p>Vitamin K1 and K2</p> Signup and view all the answers

    What is the recommended treatment for vitamin D deficiency once normal plasma levels are achieved?

    <p>800 IU/d from food and supplements</p> Signup and view all the answers

    What risk factors contribute to developing vitamin D deficiency?

    <p>Old age and dark skin</p> Signup and view all the answers

    In which conditions is vitamin E deficiency commonly observed?

    <p>Prolonged malabsorption diseases</p> Signup and view all the answers

    Why are newborns particularly susceptible to vitamin K deficiency?

    <p>Low fat stores and liver immaturity</p> Signup and view all the answers

    What symptom is predominantly associated with Wernicke's encephalopathy?

    <p>Horizontal nystagmus</p> Signup and view all the answers

    Which vitamin deficiency is characterized by the 'four Ds'?

    <p>Vitamin B3 deficiency</p> Signup and view all the answers

    Which of the following is NOT a symptom of riboflavin deficiency?

    <p>Personality changes</p> Signup and view all the answers

    What is the primary treatment for severe thiamine deficiency?

    <p>Intravenous thiamine 200 mg three times daily</p> Signup and view all the answers

    What dietary source is the richest in riboflavin?

    <p>Milk</p> Signup and view all the answers

    Which amino acid can be converted into niacin?

    <p>Tryptophan</p> Signup and view all the answers

    Which vitamin is commonly referred to as Pyridoxine?

    <p>Vitamin B6</p> Signup and view all the answers

    What condition is also known as Burning Feet Syndrome?

    <p>Pantothenic acid deficiency</p> Signup and view all the answers

    What skin manifestation is specifically associated with pellagra due to niacin deficiency?

    <p>Casal’s Necklace</p> Signup and view all the answers

    What should be avoided when taking large amounts of vitamin C?

    <p>History of kidney stones</p> Signup and view all the answers

    What is the primary function of thiamine (Vitamin B1) in the body?

    <p>Decarboxylation of α-ketoacids</p> Signup and view all the answers

    Which population is at higher risk for thiamine deficiency due to prolonged hyperemesis gravidarum?

    <p>Pregnant women</p> Signup and view all the answers

    What is a common dietary cause of thiamine deficiency?

    <p>Heavy reliance on milled polished rice</p> Signup and view all the answers

    Which drug is known to inhibit intestinal thiamine transporters and increase the risk of deficiency?

    <p>Metformin</p> Signup and view all the answers

    What can long-term thiamine deficiency lead to in infants?

    <p>Infantile beriberi</p> Signup and view all the answers

    What are the two classifications of beriberi?

    <p>Wet and dry</p> Signup and view all the answers

    What is the most common symptom reported by patients suffering from beriberi?

    <p>Pain and paresthesia</p> Signup and view all the answers

    Which of the following conditions is NOT a primary cause of thiamine deficiency in Western countries?

    <p>High-fiber diets</p> Signup and view all the answers

    What cardiovascular symptoms characterize wet beriberi?

    <p>Heart enlargement and peripheral edema</p> Signup and view all the answers

    What factors contribute to thiamine deficiency absorption issues in the body?

    <p>Alcohol consumption</p> Signup and view all the answers

    What is the primary biochemical function of thiamine in the body?

    <p>It mediates the conversion of hexose and pentose phosphates.</p> Signup and view all the answers

    What symptom is specifically associated with wet beriberi?

    <p>High-output congestive heart failure.</p> Signup and view all the answers

    Which group of individuals is most likely to require thiamine replenishment?

    <p>Patients undergoing bariatric surgery.</p> Signup and view all the answers

    What is the most common cause of thiamine deficiency in Western populations?

    <p>Chronic illnesses such as cancer.</p> Signup and view all the answers

    Which condition can develop in breast-fed infants due to maternal thiamine deficiency?

    <p>Infantile beriberi.</p> Signup and view all the answers

    Which substance is known to inhibit the absorption of thiamine?

    <p>Alcohol.</p> Signup and view all the answers

    What is a significant dietary risk for developing thiamine deficiency?

    <p>Heavy reliance on milled polished rice.</p> Signup and view all the answers

    What is the classification of beriberi that is characterized predominantly by symptoms affecting the cardiovascular system?

    <p>Wet beriberi.</p> Signup and view all the answers

    Which condition can result from prolonged vitamin E deficiency?

    <p>Hemolytic anemia</p> Signup and view all the answers

    What is a function of vitamin K in the body?

    <p>Coagulating blood</p> Signup and view all the answers

    Which factor does NOT contribute to vitamin D deficiency?

    <p>High sunlight exposure</p> Signup and view all the answers

    What is the primary reason for administering vitamin K to newborns?

    <p>Preventing hemorrhagic disease</p> Signup and view all the answers

    What is the characteristic feature of rickets due to vitamin D deficiency?

    <p>Bone softening</p> Signup and view all the answers

    Which vitamin K deficiency symptom is particularly critical in infants?

    <p>Intracranial bleeding</p> Signup and view all the answers

    What are the two forms of vitamin E recognized?

    <p>Tocopherols and tocotrienols</p> Signup and view all the answers

    Which is the primary method used to assess vitamin D status in individuals?

    <p>25-dihydroxyvitamin D serum levels</p> Signup and view all the answers

    Which of the following describes a significant clinical manifestation of Wernicke's encephalopathy?

    <p>Horizontal nystagmus</p> Signup and view all the answers

    What deficiency is primarily associated with the development of Pellagra?

    <p>Vitamin B3</p> Signup and view all the answers

    What is a key feature of riboflavin deficiency?

    <p>Corneal vascularization</p> Signup and view all the answers

    What dietary source is best known for being rich in Vitamin B2?

    <p>Milk</p> Signup and view all the answers

    Which vitamin deficiency can lead to severe psychological changes such as depression and confusion?

    <p>Vitamin B6</p> Signup and view all the answers

    What is the treatment protocol for severe thiamine deficiency?

    <p>Thiamine administered intravenously</p> Signup and view all the answers

    In what population is Pellagra most commonly found?

    <p>Individuals on corn-based diets</p> Signup and view all the answers

    Which condition is characterized by both memory loss and confabulatory psychosis?

    <p>Wernicke-Korsakoff syndrome</p> Signup and view all the answers

    What major effect does notable Vitamin C supplementation have on susceptible individuals?

    <p>Higher chances of kidney stones</p> Signup and view all the answers

    Which vitamin is also referred to as Vitamin H?

    <p>Biotin</p> Signup and view all the answers

    Which symptom is associated with the advanced stages of Pellagra?

    <p>Casal’s Necklace</p> Signup and view all the answers

    What is a primary function of Vitamin B5, also known as Pantothenic acid?

    <p>Production of acetylcholine</p> Signup and view all the answers

    What is the primary manifestation of Vitamin A deficiency?

    <p>Xerophthalmia</p> Signup and view all the answers

    Which vitamin plays a role in drug metabolism and detoxification reactions?

    <p>Vitamin B2</p> Signup and view all the answers

    What is the main clinical implication of thiamine deficiency related to alcohol consumption?

    <p>Central nervous system manifestations</p> Signup and view all the answers

    Study Notes

    Vitamin B1 (Thiamine)

    • First identified B vitamin, crucial for energy metabolism.
    • Functions in decarboxylation of α-ketoacids and branched-chain amino acids.
    • Essential coenzyme for transketolase reaction in hexose and pentose phosphate conversion.
    • Deficiency common in populations relying on milled rice diets.
    • Alcohol consumption and chronic illnesses (e.g., cancer) are significant deficiency causes in Western nations.
    • Alcohol interferes with thiamine absorption and synthesis of its active form.
    • Vulnerable populations requiring thiamine replenishment: pregnant women with hyperemesis, individuals with anorexia, malnourished patients on parenteral glucose, post-bariatric surgery patients.
    • Metformin and Verapamil may inhibit intestinal thiamine transport, increasing deficiency risk.
    • Maternal thiamine deficiency can cause infantile beriberi.
    • Prolonged deficiency leads to beriberi, classified as wet or dry.
    • Wet beriberi exhibits cardiovascular symptoms: enlarged heart, tachycardia, heart failure, peripheral edema, peripheral neuritis.
    • Dry beriberi presents as symmetric peripheral neuropathy, primarily affecting motor and sensory function in legs.
    • Chronic thiamine deficiency in alcoholics can result in Wernicke's encephalopathy, characterized by horizontal nystagmus, ophthalmoplegia, cerebellar ataxia, and mental impairment.
    • Wernicke-Korsakoff syndrome indicates memory loss and confabulatory psychosis.
    • Treatment involves intravenous thiamine at 200 mg three times daily.

    Vitamin B2 (Riboflavin)

    • Known as riboflavin, vital for fat, carbohydrate, and protein metabolism.
    • Functions as respiratory coenzyme and electron donor, aiding in drug and steroid metabolism.
    • Deficiency manifests in mucocutaneous surfaces, corneal vascularization, anemia, and personality changes.
    • Major dietary sources include milk, dairy products, enriched breads, and cereals.

    Vitamin B3 (Niacin)

    • Referred to as niacin, encompassing nicotinic acid and nicotinamide.
    • Critical for redox reactions through NAD and NADP formation.
    • Tryptophan can be converted into niacin.
    • Niacin deficiency causes pellagra, prevalent in populations consuming corn-based diets.
    • IsoNIAZID, a structural analogue of niacin, can trigger pellagra.
    • Symptoms of pellagra: loss of appetite, weakness, abdominal pain, bright red glossitis, pigmented scaling skin rash.
    • Advanced pellagra may present as Casal's Necklace rash.
    • Recognized by the four Ds: Dermatitis, Diarrhea, Dementia, and Death.
    • Treatment consists of oral supplementation with 100–200 mg of nicotinamide or nicotinic acid three times daily for five days.
    • High doses of nicotinic acid (2g/day) used for cholesterol issues but lacking evidence for cardiovascular disease prevention.

    Vitamin B6 (Pyridoxine)

    • Known as pyridoxine, abundant in legumes, nuts, wheat bran, and meat.
    • Severe deficiency can lead to peripheral neuropathy and abnormal EEGs, alongside personality changes.
    • Isoniazid requires concurrent pyridoxine administration to prevent neuropathy.
    • Deficiency diagnosed by low plasma PLP values.

    Biotin (Vitamin B7)

    • Also called vitamin H, a water-soluble vitamin.
    • Avidin, a protein in egg whites, binds biotin, impeding its bioavailability.

    Vitamin B5 (Pantothenic Acid)

    • Known as pantothenic acid, deficiency linked to Burning Feet Syndrome observed in WWII prisoners.
    • Choline, a precursor for various vital compounds, plays roles in cell membranes and lipid metabolism.

    Vitamin A

    • Retinaldehyde is crucial for vision; retinoic acid aids growth and cell differentiation.
    • The liver stores ~90% of vitamin A, releasing retinol bound to retinol-binding protein.
    • Approximately 190 million preschool-age children have vitamin A deficiency, with >5 million showing ocular symptoms (xerophthalmia).
    • Bitot's spots are keratinized patches on the sclera due to vitamin A deficiency.
    • Children with measles should receive two 60-mg doses of vitamin A over two consecutive days.

    Vitamin D

    • Insufficiency may elevate risks for type 1 diabetes, cardiovascular disease, and brain dysfunction.
    • Skin is the primary source of vitamin D.
    • Vitamin D2 (ergocalciferol) is derived from plant sources and found in supplements.
    • Vitamin D status monitored via serum levels of 25-dihydroxyvitamin D.
    • Risk factors for deficiency include old age, lack of sun exposure, dark skin, fat malabsorption, and obesity.
    • Rickets is a classic manifestation of vitamin D deficiency.
    • Treatment involves oral administration of 50,000 IU/week for 6–8 weeks, followed by 800 IU/day for maintenance post-recovery.

    Vitamin E

    • Deficiency typically arises in severe malabsorption disorders like celiac disease or after gastrointestinal surgeries.

    Vitamin K

    • Exist in two forms: Vitamin K1 (phylloquinone) and Vitamin K2 (menaquinones).
    • Vitamin K deficiency leads to hemorrhage, primarily in newborns due to low fat stores and immature liver function.
    • Vitamin K is administered prophylactically at birth (0.5–1 mg IM).

    Vitamin B1 (Thiamine)

    • First identified B vitamin, crucial for energy metabolism.
    • Functions in decarboxylation of α-ketoacids and branched-chain amino acids.
    • Essential coenzyme for transketolase reaction in hexose and pentose phosphate conversion.
    • Deficiency common in populations relying on milled rice diets.
    • Alcohol consumption and chronic illnesses (e.g., cancer) are significant deficiency causes in Western nations.
    • Alcohol interferes with thiamine absorption and synthesis of its active form.
    • Vulnerable populations requiring thiamine replenishment: pregnant women with hyperemesis, individuals with anorexia, malnourished patients on parenteral glucose, post-bariatric surgery patients.
    • Metformin and Verapamil may inhibit intestinal thiamine transport, increasing deficiency risk.
    • Maternal thiamine deficiency can cause infantile beriberi.
    • Prolonged deficiency leads to beriberi, classified as wet or dry.
    • Wet beriberi exhibits cardiovascular symptoms: enlarged heart, tachycardia, heart failure, peripheral edema, peripheral neuritis.
    • Dry beriberi presents as symmetric peripheral neuropathy, primarily affecting motor and sensory function in legs.
    • Chronic thiamine deficiency in alcoholics can result in Wernicke's encephalopathy, characterized by horizontal nystagmus, ophthalmoplegia, cerebellar ataxia, and mental impairment.
    • Wernicke-Korsakoff syndrome indicates memory loss and confabulatory psychosis.
    • Treatment involves intravenous thiamine at 200 mg three times daily.

    Vitamin B2 (Riboflavin)

    • Known as riboflavin, vital for fat, carbohydrate, and protein metabolism.
    • Functions as respiratory coenzyme and electron donor, aiding in drug and steroid metabolism.
    • Deficiency manifests in mucocutaneous surfaces, corneal vascularization, anemia, and personality changes.
    • Major dietary sources include milk, dairy products, enriched breads, and cereals.

    Vitamin B3 (Niacin)

    • Referred to as niacin, encompassing nicotinic acid and nicotinamide.
    • Critical for redox reactions through NAD and NADP formation.
    • Tryptophan can be converted into niacin.
    • Niacin deficiency causes pellagra, prevalent in populations consuming corn-based diets.
    • IsoNIAZID, a structural analogue of niacin, can trigger pellagra.
    • Symptoms of pellagra: loss of appetite, weakness, abdominal pain, bright red glossitis, pigmented scaling skin rash.
    • Advanced pellagra may present as Casal's Necklace rash.
    • Recognized by the four Ds: Dermatitis, Diarrhea, Dementia, and Death.
    • Treatment consists of oral supplementation with 100–200 mg of nicotinamide or nicotinic acid three times daily for five days.
    • High doses of nicotinic acid (2g/day) used for cholesterol issues but lacking evidence for cardiovascular disease prevention.

    Vitamin B6 (Pyridoxine)

    • Known as pyridoxine, abundant in legumes, nuts, wheat bran, and meat.
    • Severe deficiency can lead to peripheral neuropathy and abnormal EEGs, alongside personality changes.
    • Isoniazid requires concurrent pyridoxine administration to prevent neuropathy.
    • Deficiency diagnosed by low plasma PLP values.

    Biotin (Vitamin B7)

    • Also called vitamin H, a water-soluble vitamin.
    • Avidin, a protein in egg whites, binds biotin, impeding its bioavailability.

    Vitamin B5 (Pantothenic Acid)

    • Known as pantothenic acid, deficiency linked to Burning Feet Syndrome observed in WWII prisoners.
    • Choline, a precursor for various vital compounds, plays roles in cell membranes and lipid metabolism.

    Vitamin A

    • Retinaldehyde is crucial for vision; retinoic acid aids growth and cell differentiation.
    • The liver stores ~90% of vitamin A, releasing retinol bound to retinol-binding protein.
    • Approximately 190 million preschool-age children have vitamin A deficiency, with >5 million showing ocular symptoms (xerophthalmia).
    • Bitot's spots are keratinized patches on the sclera due to vitamin A deficiency.
    • Children with measles should receive two 60-mg doses of vitamin A over two consecutive days.

    Vitamin D

    • Insufficiency may elevate risks for type 1 diabetes, cardiovascular disease, and brain dysfunction.
    • Skin is the primary source of vitamin D.
    • Vitamin D2 (ergocalciferol) is derived from plant sources and found in supplements.
    • Vitamin D status monitored via serum levels of 25-dihydroxyvitamin D.
    • Risk factors for deficiency include old age, lack of sun exposure, dark skin, fat malabsorption, and obesity.
    • Rickets is a classic manifestation of vitamin D deficiency.
    • Treatment involves oral administration of 50,000 IU/week for 6–8 weeks, followed by 800 IU/day for maintenance post-recovery.

    Vitamin E

    • Deficiency typically arises in severe malabsorption disorders like celiac disease or after gastrointestinal surgeries.

    Vitamin K

    • Exist in two forms: Vitamin K1 (phylloquinone) and Vitamin K2 (menaquinones).
    • Vitamin K deficiency leads to hemorrhage, primarily in newborns due to low fat stores and immature liver function.
    • Vitamin K is administered prophylactically at birth (0.5–1 mg IM).

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    Description

    Explore the essential role of Vitamin B1 (Thiamine) in energy metabolism and its functions in various biochemical reactions. Learn about the causes and effects of deficiency, including its impact on vulnerable populations and the relationship with alcohol consumption. Understand the clinical implications of prolonged deficiency and the occurrence of beriberi.

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