Macronutrients, Vitamins, & Minerals

What are the 4 fat soluble vitamins?

A, D, E, K

How do fat soluble vitamins differ from water soluble vitamins?

- Require bile for digestion and absorption

- Travel through lymphatic system

- Many require transport proteins in bloodstream

- Excesses stored in liver and adipose tissue

- Not readily excreted (higher risk of toxicity)

What vitamin has these roles:

Vision and fetal eye development, bone growth, reproduction, cell division, immunity, healthy surface linings of the respiratory tract and mucous membranes?

A

What vitamin deficiency is the leading cause of preventable blindness in children?

A

These are causes of deficiency in what vitamin:

Night blindness, complete blindness, xerophthalmia, hyperkeratosis, poor bone growth

A

Hyperkeratosis can occur with deficiency in what vitamin?

A

These are toxicity causes of what vitamin?

retinol levels of >100, dry skin, nausea, hair loss, bone/muscle pain, and various other nonspecific signs/symptoms

A

What vitamin has these roles:

promotes intestinal absorption of Ca2+ and phosphate (bone growth and remodeling), modulates cell growth, neuromuscular and immune function, and reduces inflammation?

D

Deficiency of what vitamin can be due to these:

rickets (children)

osteomalacia (adults)

osteoporosis

D

These are contributing factors of what vitamin deficiency?

-Dark skin

-Inadequate intake

-Inadequate exposure to sunlight

-Breastfeeding without supplementation

- Malabsorption syndromes (CF, long term corticosteroid use)

D

What is the definition of vitamin D deficiency?

25(OH)D concentration of 12 to 20 ng/mL (30 to 50 nmol/L)

What vitamin toxicity is rare and usually from excessive supplementation and can result in hypercalcemia?

D

What vitamin has these roles:

antioxidant- protects the cell membrane from oxidation and destruction, free radical scavenger

E

What vitamin deficiency is rare and can cause neuromuscular disorders and hemolysis (destruction of RBCs)?

E

What vitamin can cause toxicity that is rare but leads to vit K deficiency and can increase bleeding risk?

E

These are the sources for what vitamin:

nuts, vegetable oils, green leavy vegetables, cereals?

E

What vitamin has these roles:

clotting and bone formation

K

What vitamin deficiency is common in newborns and can lead to bruising easily, mucosal bleeding, splinter hemorrhages, melena, hematuria?

K

What are some water soluble vitamins?

Vit C

Thiamin (B1)

Riboflavin (B2)

Pyridoxine (B6)

Folic Acid

What water soluble B vitamin is thiamin?

B1

What water soluble B vitamin is riboflavin?

B2

What water soluble B vitamin is Niacin?

B3

What water soluble B vitamin is pantothenic acid?

B5

What water soluble B vitamin is pyridoxine?

B6

What water soluble B vitamin is Biotin?

B7

What water soluble B vitamin is cobalamin?

B12

What water soluble B vitamin is folate?

B9

How are excess B vitamins excreted?

through the urine

What vitamin has a major role in energy?

B

What vitamin has a major role of:

- Carbohydrate and protein metabolism

- Nerve, muscle, heart fxn

- Required coenzyme to fuel myocardial contraction

B1, Thiamine

These are buzzwords associated with what vitamin?

Beriberi, Wernicke’s, Alcoholism/alcoholic

Thiamine B1

What vitamin deficiency:

infant and adults: megaloblastic anemia, beriberi

infants:

cardiomegaly, tachycardia, cyanosis

vomiting, high pitch cry, nystagmus, seizures

B1, Thiamine

What syndrome is seen in those with alcohol abuse

B1 (thiamine) deficiency?

Wernicke- Korsakoff syndrome

What two things make up Wernicke- Korsakoff syndrome often seen in thiamine deficiency?

wernickes encephalopathy + Korsakoff syndrome

What occurs with acute thiamine deficiency and pt will present with confusion, ophthalmoplegia, and ataxia?

wernickes encephalopathy

What occurs with chronic thiamine deficiency and pt will present with amnesia and/or confabulation?

korsakoff syndrome

These are causes of deficiency in what vitamin?

- HF - using loop diuretics

- Alcoholism

- Malabsorption & Inadequate intake

- Folate deficiency

Thiamine, B1

What vitamin has the roles of:

growth/development of healthy skin, eyes, tongue, nerve function, digestion, energy metabolism, migraines

riboflavin B2

Deficiency of what vitamin can cause these:

cheilosis, glossitis, sore throat, anemia, seborrheic dermatitis, newborns w/ jaundice

riboflavin B2

What vitamin has these roles:

energy metabolism, NAD &NADP = DNA repair, catabolic & anabolic rxns, antioxidant, high dose can lower cholesterol

niacin B3

What are the 4D's that can be due do deficiency in vitamin B3 = PELLEGRA (Niacin)?

diarrhea, dermatitis, dementia, death

What is vitamin B5?

pantothenic acid

These are the roles of what vitamin:

energy metabolism, RBC metabolism, nervous system and immune function, lymphoid health maintenance, etc.

Pyridoxine- B6

Deficiency of what vitamin can cause these:

- Sideroblastic anemia

- Nervous system dysfunction, seizures

- TB - taking isoniazid

- Dermatitis

- Cheilosis

- Glossitis

- Homocysteinemia

B6 pyridoixine

What vitamin has roles in protein synthesis, fatty acid synthesis (maintenance of hair, skin, and nail health), cell replication, and energy metabolism?

biotin B7

What vitamin has roles in cell replication, DNA and RNA synthesis, prevention of neural tube defects/birth defects?

folate, B9

Folate or folic acid:

occurs naturally in food

folate

Folate or folic acid:

synthetic form in supplements and fortified food

folic acid

What B vitamin deficiency can cause these:

-megaloblastic anemia

- NTDs, birth defects

- Elevated homocysteine levels = homocysteniemia

----> can in turn cause heart attack, stroke, mental retardation, aortic wall rupture, atherosclerosis, DVT

folate B9

What B vitamin has these roles:

DNA synthesis, CNS development/health, growth

B12, cobalamin

deficiency of what B vitamin can cause these:

- Pernicious anemia

- Neurologic symptoms

B12, cobalamin

FOLATE deficiency can mask _____ deficiency.

B12 deficiency

Who is at risk for vitamin B12, cobalamin deficiency?

elderly, malabsorption (Crohn's), Vegan diet

These are the roles of what vitamin:

- Antioxidant

- Collagen production wound healing

- Immune function

- Neurotransmitter production

- Protein metabolism

- Improves absorption of iron from plant-based foods

- Prevention of scurvy

vitamin C (ascorbic acid)

What is vitamin C?

ascorbic acid

Deficiency of what vitamin can lead to decreased immune response and/or scurvy?

vitamin C

What vitamin has these sources:

fruits and vegetables

C

Are these major or trace minerals?

calcium, phosphorous, chloride, magnesium, potassium, sodium, and sulfur

major

Are these major or trace minerals?

chromium, copper, fluoride, iodine, iron, manganese, molybdenum, selenium, and zinc

trace

What mineral is stored in bone & teeth where it supports their structure and function and also has these roles as well:

- vascular contraction

- vasodilation

- blood clotting

- muscle function

- nerve transmission

- intracellular signaling

- hormone secretion

Ca2+

What regulates calcium levels in the body?

parathyroid gland

When calcium levels are low --- how is PTH affected?

increases

When calcium levels are high--- how is PTH affected?

decreased

These are seen in hyper or hypo calcemia:

osteoporosis, chvosteks sign, traousseaus

hypocalcemia

These are seen in hyper or hypo calcemia:

hyperparathroidism, kidney stones

hypercalcemia

What mineral is has roles in the formation of bone and teeth, energy metabolism, part of phospholipids, transports AA and fatty acids, and acts as a buffer?

phosphorous

Hypo or hyper phosphatemia:

hyperparathyroidism, bone & intestinal disease

hypo

Hypo or hyper phosphatemia:

renal insufficiency

hyper

What is the most prevalent anion in the ECF?

CL-

What mineral has these roles:

- Fluid-electrolyte balance

- Blood pressure

- Acid-base balance

- Regulated by kidneys

Cl-

Hyper or hypo chloremia:

dehydration, cushing syndrome, severe diarrhea, respiratory acidosis, renal tubular acidosis

hyper

Hyper or hypo chloremia:

excessive vomiting, Addison's disease, respiratory alkalosis

hypo

What mineral has these roles:

- Energy production

- DNA synthesis

- Smooth muscle contraction (skeletal and cardio)

- BP and HR control

- Bone strengthening and repair

Mg2+

What Mg2+ issue causes Refeeding syndrome and malabsorption?

hypomagnesemia

What is a major cation in the ICF that is absorbed in the SI and regulated by the kidneys?

K+

What mineral has these roles:

- Maintains water balance, osmotic equilibrium, acid-base balance

-Regulates neuromuscular activity

-Determines membrane potentials

-Cell growth

-Glycogen storage

K+

hypo or hyper kalemia:

- Torsades de pointes

-Muscle weakness, cramping

-Vomiting

hypokalemia

hypo or hyper kalemia:

-Muscle weakness

-Paralysis

-Respiratory failure

-Arrhythmias/ECG changes

hyperkalemia

What mineral is a major cation of the ECF that is absorbed in the intestine and filtered by the kidneys?

Na2+

These are the roles of what mineral:

-Regulates extracellular and plasma volume

-Acid-base balance

-Neuromuscular fxn

Na2+

Hyper or hypo -natremia: hyperglycemia, SIADH, cardiac/renal/or hepatic failure

hyponatremia

Hyper or hypo -natremia: hypovolemia/isovolemic

hypernatremia

What mineral is absorbed in the SI, bound and transported by transferrin, and stored as ferritin?

Fe2+

What stabilizes the thyroid gland and is required to make thyroid hormones?

iodine

Deficiency of what mineral can cause:

- Developmental and cognitive delay, goiter, hypothyroidism

- Most common cause of preventable brain damage in the world

iodine

These are the sources for what mineral:

iodized salt, foods from the sea and grown in iodine rich soil

iodine

What is the term for substances that interfere with iodine use of thyroid hormone production?

goitrogen

What mineral has roles in immunity, wound healing, taste/smell, DNA synthesis, and growth/development?

zinc

Vegetarians are at risk for deficiency in what mineral?

zinc

What is a disorder of copper metabolism that can create a Kayser-Fleischer ring?

wilsons disease

What mineral has roles in preventing dental carries?

fluoride

What is the term for excess fluoride?

fluorosis

What is an autosomal recessive disorder of AA metabolism that usually presents after birth with vomiting, mental retardation, irritability, convulsions, eczema, and occurs in children with blonde and blue eyes?

PKU

What is the diagnosis of PKU?

urine with musty odor