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Questions and Answers
A patient presents with bleeding gums, epistaxis, and spongy swollen gums. Which vitamin deficiency is MOST likely the cause, and what other signs might be present to differentiate it from other conditions?
A patient presents with bleeding gums, epistaxis, and spongy swollen gums. Which vitamin deficiency is MOST likely the cause, and what other signs might be present to differentiate it from other conditions?
- Vitamin C deficiency; presence of bilateral lesions at the corners of the mouth and dermatitis could help rule out other conditions.
- Vitamin K deficiency; neurological symptoms such as seizures would be more prominent in Vitamin K deficiency.
- Vitamin B12 deficiency; megaloblastic anemia and neurological symptoms would be expected.
- Vitamin C deficiency; retinal hemorrhages and impaired wound healing could differentiate it from other bleeding disorders. (correct)
A patient taking Isoniazid develops glossitis, seborrhea, and peripheral neuropathy. Which vitamin supplementation would be MOST appropriate, and what is the rationale behind this intervention?
A patient taking Isoniazid develops glossitis, seborrhea, and peripheral neuropathy. Which vitamin supplementation would be MOST appropriate, and what is the rationale behind this intervention?
- Vitamin B1 (Thiamine), as Isoniazid increases thiamine excretion, resulting in neurological and dermatological manifestations.
- Vitamin B12 (Cobalamin), because Isoniazid inhibits the co-enzyme production with DNA formation with myelin.
- Vitamin B6 (Pyridoxine), as Isoniazid is an antagonist to Vitamin B6, potentially causing deficiency symptoms. (correct)
- Vitamin B3 (Niacin), as Isoniazid is known to interfere with niacin absorption, leading to pellagra-like symptoms.
A patient presents with night blindness and is diagnosed with Vitamin A deficiency. What is the underlying mechanism connecting Vitamin A to night vision, and how does this manifest at a cellular level?
A patient presents with night blindness and is diagnosed with Vitamin A deficiency. What is the underlying mechanism connecting Vitamin A to night vision, and how does this manifest at a cellular level?
- Vitamin A is metabolized into retinol which is necessary for function of the cones. Defiency leads to impaired adaptation.
- Vitamin A is a precursor to retinal, which combines with opsin to form rhodopsin; deficiency impairs the regeneration of rhodopsin after exposure to light. (correct)
- Vitamin A acts as a coenzyme in the retina, enhancing the sensitivity of retinal ganglion cells to light; deficiency affects the processing and transmission of visual signals.
- Vitamin A is required for the synthesis of rhodopsin, a pigment in rod cells that is essential for vision in low-light conditions. Deficiency leads to impaired function of cone cells.
A patient with a history of chronic anticonvulsant use is found to have osteomalacia. How do anticonvulsants contribute to bone disorders, and what specific intervention should be considered in managing this patient?
A patient with a history of chronic anticonvulsant use is found to have osteomalacia. How do anticonvulsants contribute to bone disorders, and what specific intervention should be considered in managing this patient?
A patient on warfarin is newly prescribed a high dose of antibiotics for a severe infection. Which vitamin is MOST affected, and what is the potential interaction between the high-dose antibiotics and warfarin?
A patient on warfarin is newly prescribed a high dose of antibiotics for a severe infection. Which vitamin is MOST affected, and what is the potential interaction between the high-dose antibiotics and warfarin?
Flashcards
What are Vitamins?
What are Vitamins?
Organic substances required in small amounts for metabolic processes, often not synthesized in the body.
How are vitamins classified?
How are vitamins classified?
Classified as either water-soluble (like Vitamin C and B-complex) or fat-soluble (A, D, E, K).
What causes Vitamin Deficiency?
What causes Vitamin Deficiency?
Can result from inadequate diet, increased requirements, or malabsorption issues such as cystic fibrosis.
Vitamin C Deficiency Symptoms
Vitamin C Deficiency Symptoms
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Vitamin A Toxicity/Deficiency
Vitamin A Toxicity/Deficiency
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Study Notes
- Vitamins are organic substances which are required in small amounts for metabolic processes.
- Most vitamins aren't synthesized in the body or are synthesized in small or insufficient quantities.
- Vitamins are classified into fat-soluble or water-soluble types.
- A synthetic solubilized version of Vitamin E exists.
Vitamin Classifications
- Water-soluble and Fat-soluble vitamins are the two main categories.
- Water-soluble vitamins include non-B-complex and B-complex vitamins.
- Ascorbic acids or vitamin C are non-B-complex vitamins.
- B-complex vitamins include energy releasing and hematopoietic vitamins as well as other.
- Thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), biotin, and pantothenic acid, are energy-releasing vitamins.
- Folic acid and vitamin B12 are examples of hematopoietic vitamins.
- Pyridoxine (vitamin B6), pyridoxal, and pyridoxamine are other B-complex vitamins.
- Fat-soluble vitamins include Vitamin A (retinol, B-carotenes), Vitamin D (cholecalciferol), Vitamin K (phylloquinones, menaquinones), and Vitamin E (tocopherols).
Vitamin Deficiency
- Insufficient dietary intake can lead to vitamin deficiency.
- Increased bodily requirements as a result of pregnancy, disease diagnosis or drugs, can result in vitamin deficiency.
- Malabsorption because of drugs and diseases like cystic fibrosis can result in vitamin deficiency.
Vitamin C Properties
- Vitamin C is actively absorbed in the GIT (gastrointestinal tract).
- It enhances iron absorption.
- It aids in the biosynthesis of collagen proteoglycans, ECF(extracellular fluid) in tooth, bone, and capillary endothelium.
- It also has roles with ADH (Antidiuretic hormone) and oxytocin, adrenal steroids, mitochondrial electron transport chain and activation of fatty acids, and P450 enzyme.
- The recommended daily allowance is 75mg.
- Gum bleeding, nosebleeds (epistaxis), blood in urine (haematuria), and retinal hemorrhages indicate a vitamin C deficiency in adults.
- Infants may experience subperiosteal bleeding and haemarthrosis.
- Common symptoms include wound healing or osteoporosis.
- Some consider the therapeutic use of vitamin C for renal calculi controversial.
B1 Properties
- B1, also known as thiamine, is actively absorbed from the GIT.
- It is involved in carbohydrate catabolism and anabolism.
- Beri-Beri can be caused by a vitamin B1 deficiency.
- Beri-Beri can either be wet or dry.
B2 Properties
- B2, also known as riboflavin, is passively absorbed from the GIT.
- It helps in biosynthesis through the use of cofactor for glutathione reductase.
- Ariboflavinosis and cheilosis may be caused by a deficiency of B2.
- May also cause stomatitis and lesions at mucocutaneous tissues.
- In some cases, magenta colored tongue, corneal vascularization and RBC (red blood cell) aplasia.
B3 Properties
- B3 can be synthesized in humans and is found in plant and animal sources.
- It functions are cofactors and a component in NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate.
- Deficiency might result in skin abrasion, skin ulcer problems and dementia, as well as hyperlipidemia.
B6 Properties
- B6, also known as pyridoxine, is passively diffused into the GIT.
- Functions as a co-factor for transaminase.
- The recommended daily allowance is 2mg.
- Glossitis, seborrhea, seizures, peripheral neuropathy can be caused by a B6 deficiency.
- Therapeutic uses include anti-TB treatments at 50mg per day.
- Is used with caution in those with Parkinson's and when the cause is lead, chloramphenicol, or is idiopathic in sideroblastic anaemia
- Treat with pyridoxine in cases of PTS (50-100mg).
B12 Properties
- B12 is actively absorbed by active transport.
- It is an enzyme in the formation of DNA (deoxyribonucleic acid) and other proteins such as myelin.
- Problems with the GIT and blood can occur if deficient.
- Can result in nerve degeneration and bone marrow problems.
- The recommended daily allowance is 6 μg.
- Used to treat neuropathies and anaemia.
Vitamin A Properties
- Primarily absorbed as retinol esters and stored within the liver.
- Is a cofactor for carbohydrate anabolism, microsomal drug metabolism, and an essential component for the retinal pigment rhodopsin.
- The recommended daily allowance is 700-900 µg.
- Night blindness occurs if deficient and leads to keratomalacia
- Steatorrhea, Ichthyosis, acne, and cystic fibrosis can be teated with vitamin A
- Toxicities can include hypovitaminosis that leads to RBC and nerve damage.
- Hypervitaminosis increases anti-clotting and liver abnormalities.
- High dosages can blur vision and increase cranial pressure.
- Is not recommended if pregnant.
Vitamin D Properties
- Is activated by sun, bile is needed to be absorbed.
- Is excreted as active metabolites from the kidney
- The recommended daily allowance is 5-10µg.
- Rickets and Osteomalacia are signs of deficiency.
- Malabsorption and chronic liver disease can be treated with it.
- Used in conjunction with anticonvulsants to treat renal osteodystrophy and osteoporosis, a chronic liver disease and hypoparathyroidism
- ADR may lead too hypercalcemia.
Vitamin E Properties
- It is absorbed from the intestine through lymph.
- It is excreted in the bile and urine
- Acts as an an antioxidant and protects RBCs (red blood cells) against hemolysis.
- The recommended daily allowance is 15mg.
- Deficiency will result in hemolytic anaemia and neurological syndrome.
- Interacts with anticoalgulants and antiplatelets like Simvastatin and Niacin
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