Podcast
Questions and Answers
A patient presents with bleeding gums, poor wound healing, and anemia. The patient's diet is severely deficient in fresh fruits and vegetables. Which of the following enzymatic reactions is most likely impaired in this patient due to their deficiency?
A patient presents with bleeding gums, poor wound healing, and anemia. The patient's diet is severely deficient in fresh fruits and vegetables. Which of the following enzymatic reactions is most likely impaired in this patient due to their deficiency?
- Hydroxylation of proline and lysine residues. (correct)
- Conversion of homocysteine to methionine.
- Methylation of cobalamin to its active form.
- Synthesis of tetrahydrofolic acid from folate.
A pregnant woman is found to have a folate deficiency during her first trimester. Which of the following is the most critical reason why folate supplementation is essential during this period?
A pregnant woman is found to have a folate deficiency during her first trimester. Which of the following is the most critical reason why folate supplementation is essential during this period?
- Folate prevents the accumulation of methylmalonic acid, which can cause neurological damage.
- Folate is required for the absorption of iron, preventing maternal anemia.
- Folate is essential for the synthesis of purines and pyrimidines, critical for DNA synthesis and cell division. (correct)
- Folate enhances the production of intrinsic factor, which is necessary for vitamin B12 absorption.
A patient presents with macrocytic anemia and neurological symptoms including peripheral neuropathy. Lab tests reveal elevated levels of homocysteine and methylmalonic acid. Which of the following describes the most likely cause of these findings?
A patient presents with macrocytic anemia and neurological symptoms including peripheral neuropathy. Lab tests reveal elevated levels of homocysteine and methylmalonic acid. Which of the following describes the most likely cause of these findings?
- Folate deficiency due to malabsorption in the jejunum.
- Vitamin C deficiency affecting iron absorption and collagen synthesis.
- Vitamin B12 deficiency due to impaired absorption in the terminal ileum. (correct)
- Combined deficiency of iron and vitamin B6 affecting heme synthesis.
A researcher is studying the effects of nutrient deficiencies on erythrocyte development. Which combination of deficiencies would result in macrocytic anemia with hypersegmented neutrophils and an increased mean corpuscular volume (MCV)?
A researcher is studying the effects of nutrient deficiencies on erythrocyte development. Which combination of deficiencies would result in macrocytic anemia with hypersegmented neutrophils and an increased mean corpuscular volume (MCV)?
A patient with a history of strict veganism presents with numbness and tingling in their extremities, fatigue, and cognitive difficulties. A blood test reveals macrocytic anemia. Which of the following is the most appropriate initial treatment?
A patient with a history of strict veganism presents with numbness and tingling in their extremities, fatigue, and cognitive difficulties. A blood test reveals macrocytic anemia. Which of the following is the most appropriate initial treatment?
A patient is diagnosed with scurvy. Which of the following best explains the underlying mechanism leading to the characteristic symptoms of this condition?
A patient is diagnosed with scurvy. Which of the following best explains the underlying mechanism leading to the characteristic symptoms of this condition?
A patient presents with a history of chronic alcohol abuse. Lab results indicate macrocytic anemia and elevated homocysteine levels. Supplementation with which vitamin is most likely to improve these findings?
A patient presents with a history of chronic alcohol abuse. Lab results indicate macrocytic anemia and elevated homocysteine levels. Supplementation with which vitamin is most likely to improve these findings?
Following a partial gastrectomy, a patient develops neurological symptoms alongside macrocytic anemia. Which of the following mechanisms is most likely responsible for these complications?
Following a partial gastrectomy, a patient develops neurological symptoms alongside macrocytic anemia. Which of the following mechanisms is most likely responsible for these complications?
A newborn is diagnosed with spina bifida. Which maternal deficiency during pregnancy is most likely associated with this condition, and what biochemical process is most affected by this deficiency?
A newborn is diagnosed with spina bifida. Which maternal deficiency during pregnancy is most likely associated with this condition, and what biochemical process is most affected by this deficiency?
A patient with a history of Crohn's disease presents with symptoms of peripheral neuropathy and macrocytic anemia. Which of the following malabsorption issues is most likely contributing to the patient's condition?
A patient with a history of Crohn's disease presents with symptoms of peripheral neuropathy and macrocytic anemia. Which of the following malabsorption issues is most likely contributing to the patient's condition?
Flashcards
Vitamin C Main Roles
Vitamin C Main Roles
Accelerates hydroxylation, collagen production, antioxidant, promotes osteoblasts, modulates immune response, neurotransmitter synthesis, and chelates iron for absorption.
Vitamin C Deficiency Symptoms
Vitamin C Deficiency Symptoms
Scurvy, anemia, poor wound healing, and decreased osteoblast stimulation.
Folate (Vitamin B9)
Folate (Vitamin B9)
Vegetables and fortified foods; active form is tetrahydrofolic acid (THF); main role is DNA production.
Folate Deficiency Symptoms
Folate Deficiency Symptoms
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Vitamin B12 (Cobalamin)
Vitamin B12 (Cobalamin)
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Vitamin B12 Deficiency Symptoms
Vitamin B12 Deficiency Symptoms
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Folate Deficiency Recap
Folate Deficiency Recap
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Vitamin B12 Deficiency Recap
Vitamin B12 Deficiency Recap
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Neural Tube Defects
Neural Tube Defects
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Prevent Neural Tube Defects
Prevent Neural Tube Defects
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Study Notes
Vitamin C (Ascorbic Acid)
- Found in citrus fruits, strawberries, bell peppers, and green leafy vegetables
- Essential for hydroxylation of proline and lysine in collagen synthesis, thus crucial for connective tissue, blood vessels, and skin
- Acts as a powerful antioxidant, neutralizing free radicals and reactive oxygen species
- Enhances the absorption of non-heme iron by reducing iron to a more absorbable form
- Modulates the immune system, enhancing the function of immune cells
- Deficiency leads to scurvy, characterized by bleeding gums, bruising, poor wound healing, and weakness due to impaired collagen production
- Deficiency reduces iron absorption, potentially leading to anemia
- Deficiency impairs bone mineralization and increases the risk of fractures due to its role in osteoblast function
- Excessive intake can cause gastrointestinal disturbances like diarrhea and nausea, and may increase the risk of kidney stones in susceptible individuals due to increased oxalate excretion
Folate (Vitamin B9)
- Abundant in leafy green vegetables, legumes, citrus fruits, and fortified cereals
- Essential for the synthesis of purines and pyrimidines, the building blocks of DNA and RNA
- Needed for dTMP (thymidine monophosphate) synthesis, which is vital for DNA replication
- Involved in transferring methyl groups in biochemical reactions, regulating gene expression, DNA repair, and neurotransmitter synthesis
- Deficiency leads to macrocytic, megaloblastic anemia due to impaired DNA synthesis, resulting in large, immature red blood cells
- Deficiency leads to elevated homocysteine levels, increasing the risk of cardiovascular diseases
- Deficiency during pregnancy can cause neural tube defects like spina bifida and anencephaly
- Excessive intake can mask a vitamin B12 deficiency, delaying diagnosis and potentially leading to neurological damage
Vitamin B12 (Cobalamin)
- Found exclusively in animal products such as meat, fish, poultry, eggs, and dairy products
- Acts as a cofactor in DNA synthesis, particularly in the conversion of homocysteine to methionine
- Acts as a cofactor for methylmalonyl-CoA mutase, an enzyme involved in the metabolism of odd-chain fatty acids and certain amino acids
- Deficiency leads to macrocytic, megaloblastic anemia due to impaired DNA synthesis
- Deficiency is uniquely associated with neurological symptoms like peripheral neuropathy, demyelination, and cognitive impairment
- Deficiency leads to elevated homocysteine and methylmalonic acid levels
- Has distinguishing neurological symptoms, such as subacute combined degeneration of the spinal cord, which leads to numbness, weakness, and gait disturbances.
- Toxicity is extremely rare due to the body's ability to store large amounts, especially in the liver
Key Differences Between Folate and Vitamin B12 Deficiency
- Folate deficiency can cause macrocytic anemia with hypersegmented neutrophils and increased homocysteine, but no neurological symptoms
- Vitamin B12 deficiency can cause macrocytic anemia with hypersegmented neutrophils, neurological symptoms, increased homocysteine, and increased methylmalonic acid
Neural Tube Defects and Prevention
- Neural tube defects like spina bifida and anencephaly can be prevented with folic acid supplementation in early pregnancy
- Folic acid supplementation beginning before conception and continuing during the first trimester significantly reduces the risk of these congenital defects
Trace Elements
- Essential for physiological processes but only needed in minute amounts
- Examples: iron, zinc, copper, iodine, and selenium
- Deficiencies or toxicities can lead to severe health issues
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