vitamins and minerals

what are the fat soluble vitamins?

A, D, E, K

what do fat soluble vitamins require for digestion and absorption?

bile

what do fat soluble vitamins travel through?

lymphatic system

where are excess fat soluble vitamins stored?

liver and adipose tissue

are fat soluble vitamins readily excreted?

no, therefore it can build up to toxic levels

what is the role of vitamin A?

vision and fetal eye development

bone growth

reproduction

healthy surface linings

is vitamin A deficiency common or rare?

rare

what is the leading cause of preventable blindness in children?

vit A deficiency

what are signs and symptoms of vit A deficiency?

night blindness, complete blindness

xerophthalmia, hyperkeratosis

poor bone growth

what is vit A toxicity due to?

long term ingestion of excessive amounts of synthetic Vit A (10x the RDA)

what level of retinol causes vit A toxicity?

> 100 mcg/dL

what are signs and symptoms of vit A toxicity?

dry skin, nausea, hair loss, bone/muscle pain

what is the main source of retinol?

animal sources

what is the main source of carotenoids?

plant sources

what is the role of vit D?

absorption of calcium and phosphate

bone growth and remodeling

reduces inflammation

what conditions are due to vit D deficiency?

rickets

osteomalacia

osteoporosis

what are contributing factors to vit D deficiency?

dark skin

inadequate intake

inadequate exposure to sunlight

breastfeeding without supplementation

malabsorption syndromes

is vit D insufficiency common or rare?

common

what defines vit D insufficiency?

25 (OH)D concentration of 12-20 ng/mL

is vit D toxicity common or rare?

rare

what does vit D toxicity result from?

excessive supplementation

if vit D is high, what is the effect on calcium?

increases

what is the main source of vitamin D with no risk of toxicity?

direct sun exposure

what is the role of vit E?

antioxidant

what is the function of an antioxidant?

protects from oxidation and destruction

"free radical scavenger"

is vit E deficiency common or rare?

rare

is vit E toxicity common or rare?

rare

what would vit E toxicity lead to?

vit K deficiency

what would vit K deficiency result in?

significant bleeding risk due to clotting factor deficiencies

what is the most active form of vit E and the only form that meets human requirements?

alpha tocopherol

what is the role of vit K?

synthesis of clotting factors

bone formation

what are the vit K clotting factors?

2, 7, 9, 10

what is another name for factor II?

prothrombin

what is the main source of vit K?

green leafy vegetables

is vit K deficiency common or rare?

common - newborns

rare - adults

what can predispose people to vit K deficiency?

liver failure

abx use

high doses of vit E

Which of the following is a fat-soluble vitamin?

all of the above

3 multiple choice options

Clotting factors II, VII, IX, and X are synthesized in the liver - True or False?

True

Which vitamin promotes calcium absorption?

Vit D

3 multiple choice options

Deficiency in which vitamin may lead to night blindness?

Vit A

3 multiple choice options

what are the water soluble vitamins?

B vitamins

vit C

folic acid

what is the role of B vitamins?

vital coenzymes in energy metabolism (ATP)

RBC synthesis

what happens to excess B vitamins?

excreted in urine

what is vit B1?

thiamine

what is the role of thiamine (B1)?

carb and protein metabolism

nerve, muscle, heart function

coenzyme for myocardial contraction

what conditions are associated with thiamine (B1)?

beriberi

wernicke's

alcoholism

what conditions are associated with thiamine deficiency?

megaloblastic anemia

beriberi

wernicke korsakoff

what is infantile beriberi?

infantile cyanosis, nystagmus, and high pitched cry due to B1 deficiency

what is wernicke korsakoff?

wernicke's encephalopathy + korsakoff syndrome

due to B1 deficiency

what is wernicke's encephalopathy?

ACUTE

confusion

ophthalmoplegia

ataxia

what is korsakoff syndrome?

CHRONIC

amnesia

confabulation

what are causes of thiamine deficiency?

loop diuretics

alcoholisms

folate deficiency

malabsorption

what is vit B2?

riboflavin

what is the role of riboflavin (B2)?

energy metabolism, development of skin and nerves

what are signs and symptoms of riboflavin (B2) deficiency?

cheilosis, glossitis, seb derm

anemia

jaundice

what is vit B3?

niacin

what is the role of niacin (B3)?

energy metabolism (NAD and NADP)

antioxidant

what is needed for tryptophan conversion?

niacin

what is the main condition associated with niacin (B3) deficiency?

pellagra

what are the 4 D's of pellagra?

diarrhea

dermatitis

dementia

death

what is vit B5?

pantothenic acid

are vit B5 deficiency and toxicity common or rare?

rare

what is vit B6?

pyridoxine

what is the role of pyridoxine (B6)?

energy metabolism

RBC metabolism

needed for > 100 enzymes in protein metabolism

maintains health of lymphoid organs

blood glucose control

converts tryptophan to niacin

what conditions are associated with B6 deficiency?

sideroblastic anemia

homocysteinemia

dermatitis

what is vit B7?

biotin

what is the role of biotin (B7)?

hair, skin, nail health

protein and fatty acid synthesis

energy metabolism

what is vit B9?

folate

which vitamin naturally occurs in food?

folate

which vitamin can only be found synthetically in supplements and fortified food?

folic acid

which patient population needs folic acid supplementation?

pregnant women

what is the role of folate?

cell replication

DNA and RNA synthesis

prevention of neural tube defects

what conditions are associated with folate deficiency?

megaloblastic anemia

neural tube defects

homocysteniemia

which drugs put patients at risk for folate deficiency?

phenytoin

OCPs

methotrexate

trimethoprim

5-FU

what is vit B12?

cobalamin

what is the role of vit B12?

DNA synthesis

CNS development

what condition is most associated with cobalamin (B12) deficiency?

pernicious anemia

which vit deficiency can mask B12 deficiency?

folate (B9) deficiency

what is vit C?

ascorbic acid

what is the role of vit C?

antioxidant

collagen production

immune function

absorption of iron

what condition is mainly associated with vit C deficiency?

scurvy

what are signs and symptoms of scurvy?

fatigue, widespread connective tissue weakness, red/bleeding gums, dry skin, subungual hemorrhages

Excess water-soluble vitamins are excreted in the urine - True or False?

True

It is difficult to distinguish between deficiency of which of the following B vitamins?

Vitamin B12 & Folate (Vitamin B9)

3 multiple choice options

major minerals are big tools needed in large quantities by the body - so what is their main goal?

to keep everything running smoothly

what are examples of major minerals?

calcium, phosphorus, chloride, magnesium, potassium, sodium, sulfur

what are the key functions of major minerals?

bone health

nerve and muscle function

fluid balance

pH regulation

which major minerals would you focus on for a patient with bone health concerns?

calcium and phosphorus

trace minerals are the small but mighty tools needed in smaller amounts - so what is their main goal?

to fine tune for harmonious function between body systems

what are examples of trace minerals?

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

what are key functions of trace minerals?

metabolism regulation

immune support

antioxidant function

DNA synthesis

what are examples of ultra trace minerals?

silicon, vanadium, nickel, tin, cadmium, arsenic, aluminum, boron

what is the function of silicon?

connective tissue health

what is the function of boron?

bone health and hormone regulation

what is the function of nickel?

enzyme regulation

where is calcium stored?

bone and teeth

what are the functions of calcium?

support structure and function of bone and teeth

vasoconstriction and dilation

blood clotting

muscle and nerve function

hormone secretion

what regulates calcium levels in the body?

parathyroid hormone

if calcium is low, what is the effect on PTH?

increases to pull calcium from bones

what is the relationship between PTH and Ca?

inverse