B1 thiamine | In thiamine pyrophosphate (TPP) a cofactor for:
| At malnutrition or alcoholism (secondary malnutrition and malabsorption) Impaired glucose breakdown leading to ATP depletion, so first organs affected are the brain and heart (highly aerobic tissues). Wernicke-Korsakoff syndrome. Wernicke:
Korsakoff:
Beriberi: § wet beriberi (high output HF, dilated cardiomyopathy, edema) § dry beriberi (polyneuritis, symmetrical muscle atrophy) mnemonic: ber1ber1 |
B2 riboflavin | Cofactor in oxidation and reduction (FADH2) | 2 Cs:
mnemonic: riboFlavin = FAD, FMN= 2 ATP |
B3 niacin |
*excess: facial flushing (seen at pharmacological doses of treating hyperlipidemia) | 3 Ds of pellagra:
Severe deficiency caused by: 1. Hartnup’s disease (decreased tryptophan absorption) 2. Malignant carcinoid syndrome (increased tryptophan metabolism) 3. INH (decreased B6) |
B5 pantothenate | Cofactor for acyl transfers and FA synthase |
|
B6 pyridoxine | · Required for synthesis of B3 from tryptophan · Converted to pyridoxal phosphate, a cofactor for: « transamination (eg: ALT, AST) « DC reactions « Glycogen phosphorylase « Cystathione synthesis « Heme synthesis | § Convulsions § Hyperirritability § Peripheral neuropathy § Sideroblastic anemias Deficiency can be caused by INH and OCPs. |
B12 cobalamin | · Cofactor for homocysteine methyltransferase and methylmalonyl COA mutase (transfers CH3 group as methylcobalamin) | § Macrocytic, megaloblastic anemia § Hypersegmented PMNs § Neuro symptoms such as paresthesias, subacute combined degeneration (abnormal myelin) o Only vitamin stored (in liver). Other vitamin Bs are flushed out of the system o Deficiency due to: à Pure vegan diet à Sprue à Enteritis à Diphyllobothrium latum à Lack of intrinsic factor (gastric bypass, pernicious anemia) à Absence of terminal ileum (Chron’s) |
Wednesday 16 June 2010
vitamin B
to a med student, knowing their B1, 2, 3, 6, 12 is as intrinsic as a preschooler knowing their A, B, Cs. sometimes the difference between an A grade and a B grade, is getting the right vitamin B type.
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