Biochemistry chapter
SubjectsBiochemistry
BIOCHEMISTRY

Micronutrients: Vitamins & Minerals

136 practice questions · 55 study notes
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Questions

QUESTION 41
Which vitamin D metabolite is formed by hepatic hydroxylation of cholecalciferol and released into the circulation bound to vitamin D–binding globulin?
QUESTION 42
What causes undermineralization of bones in children with vitamin D deficiency rickets?
QUESTION 43
What is the most important source of substituted folates for biosynthetic reactions?
QUESTION 44
Which active metabolite is produced by hydroxylation of ergocalciferol from fortified foods?
QUESTION 45
A patient with vitamin A deficiency has difficulty adapting to darkness. Reduced availability of which molecule directly limits initiation of the visual cycle?
QUESTION 46
Which renal modification of calcidiol produces the probably inactive metabolite 24,25-dihydroxyvitamin D?
QUESTION 47
An adult woman with little sunlight exposure develops bone demineralization after several pregnancies. Which vitamin D deficiency disorder best fits this presentation?
QUESTION 48
Which outcome was reported in placebo-controlled trials of folate supplementation, commonly combined with vitamins B6 and B12?
QUESTION 49
A person with preneoplastic colorectal polyps has a high folate intake. Which potential consequence of folate supplementation is described?
QUESTION 50
What is the earliest sign of vitamin A deficiency?
QUESTION 51
Even mild vitamin A deficiency increases susceptibility to infectious diseases through impairment of which stated vitamin A function?
QUESTION 52
A person consuming abnormally large amounts of uncooked egg white develops biotin deficiency. What mechanism explains this association?
QUESTION 53
Vitamin K-dependent postsynthetic carboxylation converts protein glutamate residues into which amino acid?
QUESTION 54
In many foods, biotin occurs as which compound that is released on proteolysis?
QUESTION 55
Which metabolic process is specifically assigned to acyl carrier protein in the description of pantothenic acid function?
QUESTION 56
Which amino acid combines with pantothenate to form pantetheine and supplies the —SH group of coenzyme A and acyl carrier protein?
QUESTION 57
Pantothenic acid participates in acyl group metabolism as which functional moiety of coenzyme A and acyl carrier protein?
QUESTION 58
How can sufficiently high dietary vitamin K as quinone sustain protein carboxylation in the presence of warfarin?
QUESTION 59
During an infection, circulating vitamin A decreases and immune responses deteriorate further. Which change explains this sequence?
QUESTION 60
Which laboratory procedure is an accepted index of thiamin nutritional status?
QUESTION 61
Which vitamin K conversion is blocked by warfarin, causing the substrate of that conversion to accumulate and be excreted?
QUESTION 62
Which folic acid supplementation regimen is stated to significantly reduce the incidence of spina bifida and other neural tube defects?
QUESTION 63
A diet supplies 100 μg of food folates and 100 μg of folic acid from food enrichment. What is the total intake expressed as dietary folate equivalents?
QUESTION 64
A patient with Hartnup disease develops pellagra despite an apparently adequate intake of tryptophan and niacin. Which defect explains the loss of tryptophan?
QUESTION 65
Which molecule supplies ADP-ribose for protein ADP-ribosylation and nucleoprotein polyADP-ribosylation involved in DNA repair?
QUESTION 66
Excessive intake of which mineral is stated to cause hypertension in susceptible people?
QUESTION 67
What mechanism links iron overload to free-radical formation?
QUESTION 68
What intracellular effect is mediated by cyclic ADP-ribose and nicotinic acid adenine dinucleotide formed from NAD in response to neurotransmitters and hormones?
QUESTION 69
Which pair of minerals is specifically cited as becoming deficient when foods originate from regions with deficient soil?
QUESTION 70
What is the active form of folic acid?
QUESTION 71
Which foods are identified as the main dietary sources of riboflavin?
QUESTION 72
A patient receiving nicotinic acid for hyperlipidemia develops flushing and skin irritation. Which vascular effect accounts for the flushing?
QUESTION 73
Which reaction converts flavin mononucleotide (FMN) to flavin adenine dinucleotide (FAD)?
QUESTION 74
Intakes of either nicotinic acid or nicotinamide exceeding which daily amount are stated to cause liver damage?
QUESTION 75
Why can overproduction of 5-hydroxytryptamine in carcinoid syndrome cause pellagra?
QUESTION 76
Which vitamin acts as a carrier of one-carbon units?
QUESTION 77
A patient with dietary vitamin deficiency has cheilosis, glossitis, and seborrhea. Which deficiency is associated with this combination?
QUESTION 78
What determines the endpoint of nutrient repletion in a depletion/repletion study?
QUESTION 79
How does excessive vitamin A impair vitamin D and thyroid hormone function?
QUESTION 80
How much dietary β-carotene corresponds to one retinol activity equivalent?
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Study notes

Learning objectives for vitamins and dietary minerals
This passage outlines the topics to be studied but does not explain their underlying mechanisms or provide specific clinical facts. →
Biochemical functions and deficiency syndromes of vitamins and minerals
Vitamins are organic nutrients needed in small quantities for biochemical functions. They generally cannot be synthesized by the body and therefore require dietary supply. →
Determining micronutrient requirements and reference intakes
Nutrient adequacy lies between intakes that cause deficiency and intakes that exceed metabolic capacity and cause toxicity. →
Definition of vitamins and exceptions to dietary dependence
Vitamins are defined by their small dietary requirement and their role in maintaining normal metabolic integrity, although some can be formed in the body. →
Vitamin A activity: retinoids and provitamin A carotenoids
Vitamin A activity comes from preformed retinoids and from plant carotenoids that can serve as vitamin A precursors. →
β-Carotene cleavage and measures of vitamin A activity
Vitamin A content can be expressed using retinol equivalents, retinol activity equivalents, or the older international-unit system. →
Vitamin A and the visual cycle
Retinaldehyde is the prosthetic group of light-sensitive opsin proteins and is essential for initiating vision. →
Retinoic acid receptors and interaction with vitamin D and thyroid hormone signaling
Vitamin A regulates cell differentiation and turnover. Its retinoic acid forms control gene transcription through nuclear receptors. →
Vitamin A deficiency: visual progression and impaired immunity
Vitamin A deficiency is described as the most important preventable cause of blindness and also compromises immune function. →
Vitamin A toxicity: mechanism and organ manifestations
Excessive vitamin A intake can overwhelm its limited metabolic and intracellular binding capacity, causing tissue injury. →
Vitamin D: endogenous synthesis, hormonal actions, and deficiency
Vitamin D is not strictly a vitamin because it can be synthesized in the skin, which supplies most vitamin D under most conditions. →
Cutaneous synthesis and seasonal variation of vitamin D
Ultraviolet exposure initiates vitamin D synthesis from a cholesterol-synthesis intermediate that accumulates in the skin. →
Vitamin D hydroxylation in the liver and kidney
Cholecalciferol from the skin or food undergoes two hydroxylations to generate active 1,25-dihydroxyvitamin D, or calcitriol. →
Calcitriol: feedback regulation and maintenance of plasma calcium
Vitamin D controls calcium homeostasis, while its metabolism responds to factors related to plasma calcium and phosphate concentrations. →
Potential benefits and source limitations of higher vitamin D intake
The passage describes growing evidence for benefits of higher vitamin D status beyond established reference intakes. →
Skeletal effects of vitamin D deficiency
Vitamin D deficiency impairs bone mineralization in children and causes bone demineralization in adults. →
Vitamin D excess and protection against sunlight-induced toxicity
Excess dietary vitamin D can cause toxicity, and some infants develop hypercalcemia even at relatively low intakes. →
Vitamin E: membrane functions, vitamer families, and potency
Vitamin E comprises tocopherols and tocotrienols with differing biological potencies; no unequivocal unique metabolic function has been established. →
Vitamin E antioxidant action and regeneration by vitamin C
Vitamin E is a major lipid-soluble antioxidant in cell membranes and plasma lipoproteins. →
Vitamin E deficiency: impaired absorption and membrane injury
The passage distinguishes experimental animal findings from human deficiency associated with impaired vitamin absorption or transport and inadequate reserves in premature infants. →
Vitamin K: dietary forms, bacterial sources, and antagonists
Vitamin K is required for synthesis of blood-clotting proteins. Its antagonists reduce coagulation, while its biologically active forms arise from dietary, bacterial, and synthetic sources. →
Vitamin K-dependent carboxylation and the effect of warfarin
Vitamin K supports postsynthetic modification of protein glutamate residues, and its recycling explains both warfarin action and vitamin K rescue. →
γ-Carboxyglutamate in blood-clotting proteins
γ-Carboxyglutamate residues support calcium binding and membrane attachment of several proteins in the blood-clotting system. →
Vitamin K–dependent calcium-binding proteins outside coagulation
Vitamin K–dependent carboxylation of glutamate also occurs in proteins associated with bone, kidney, and regulation of cellular development and survival. →
Thiamin coenzymes in metabolism and nerve conduction
Thiamin has a central role in energy-yielding metabolism, particularly carbohydrate metabolism. Its diphosphate and triphosphate forms have distinct functions. →
Thiamin deficiency: neurological, cardiac, and metabolic effects
Thiamin deficiency produces three distinct clinical syndromes and can impair pyruvate metabolism. →
Assessment of thiamin status by erythrocyte transketolase activation
Thiamin nutritional status can be assessed using an enzyme activation procedure in erythrocyte lysate. →
Riboflavin: coenzymes, synthesis and dietary sources
Riboflavin has a central role in energy-yielding metabolism through its contribution to flavin coenzymes. →
Flavin coenzymes in oxidoreduction and oxidant stress
Flavin coenzymes act as electron carriers in metabolic oxidation reactions; their reoxidation can generate oxidant species. →
Riboflavin deficiency: conservation, manifestations, and assessment
Riboflavin is centrally involved in lipid and carbohydrate metabolism. Its deficiency occurs in many countries but is not fatal because tissue riboflavin is efficiently conserved. →
Niacin: synthesis, active forms, and metabolic function
Niacin was identified during studies of pellagra. Its synthesis from tryptophan means that it is not strictly a vitamin. →
NAD-derived ADP-ribose in DNA repair and calcium signaling
In addition to its coenzyme role, NAD supplies ADP-ribose for protein modification and gives rise to compounds involved in intracellular signaling. →
Pellagra: nutritional basis and clinical progression
Pellagra is associated with deficiency of tryptophan and niacin. Either tryptophan or niacin can prevent or cure the disease. →
Pellagra despite adequate tryptophan and niacin intake
Disease-related defects in tryptophan handling or diversion of its metabolism can cause pellagra despite an apparently adequate dietary intake. →
Adverse effects of excessive niacin intake
The passage describes adverse effects associated with nicotinic acid used for hyperlipidemia and liver toxicity from excessive intake of either niacin form. →
Vitamin B6: coenzyme forms, metabolic roles, and deficiency
Vitamin B6 functions through pyridoxal phosphate in amino acid metabolism, glycogen metabolism, and regulation of steroid hormone action. →
Vitamin B6 assessment and toxicity; vitamin B12 sources and initial absorption
This passage describes functional assessment and excess intake of vitamin B6, then introduces vitamin B12 chemistry, dietary availability, and binding proteins. →
Vitamin B12 absorption, dependent enzymes, and deficiency
This passage continues the intestinal handling of vitamin B12 and explains biochemical and hematological consequences of deficiency. →
Pernicious anemia: intrinsic factor failure and spinal cord degeneration
The target passage continues the discussion of impaired vitamin B12 absorption in pernicious anemia and explains its irreversible spinal cord complication. →
Dietary folate forms and dietary folate equivalents
Foods contain several forms of folate with differing absorption, so intake is expressed using dietary folate equivalents. →
Tetrahydrofolate carriage of one-carbon units
Tetrahydrofolate carries one-carbon fragments at specific nitrogen positions for biosynthetic reactions. →
Folate metabolism in DNA synthesis and drug action
Folate-dependent thymidine synthesis and folate regeneration provide targets for cancer chemotherapy and antimicrobial drugs. →
Vitamin B12 deficiency and the folate trap
Methionine synthase connects folate metabolism with vitamin B12 function and helps maintain tissue tetrahydrofolate availability. →
Folate deficiency and megaloblastic anemia
Actual folic acid deficiency and functional folic acid deficiency caused by vitamin B12 deficiency affect rapidly dividing cells. →
Folate supplementation: neural tube defects, homocysteine, and cancer
Folate supplementation has established effects on neural tube defects and homocysteine, while cardiovascular and cancer outcomes require careful distinction. →
Potential risks of folic acid supplementation and food enrichment
Folic acid enrichment can prevent neural tube defects, but the passage identifies groups in whom high intake may create problems. →
Biotin availability and exceptional causes of deficiency
Biotin is widely available from foods and intestinal synthesis; the passage identifies unusual circumstances in which deficiency occurs. →
Biotin in carboxylation and cell-cycle regulation
Biotin serves as a carbon dioxide carrier in a small group of carboxylase reactions. →
Pantothenic acid in coenzyme A and acyl carrier protein
Pantothenic acid participates in acyl group metabolism through its incorporation into coenzyme A and acyl carrier protein. →
Species dependence of the vitamin C requirement
Vitamin C is a dietary vitamin only in species unable to synthesize it through the uronic acid pathway. →
Vitamin C in copper- and iron-containing hydroxylases
Ascorbate supports specific hydroxylase reactions and also acts as a reducing agent and oxygen radical quencher. →
Scurvy: manifestations of vitamin C deficiency
Vitamin C deficiency causes scurvy, with manifestations attributed to impaired collagen and catecholamine synthesis. →
Higher vitamin C intake: saturation and possible benefits
The passage distinguishes saturation of vitamin C metabolism from its effects within the gut and the limited evidence concerning the common cold. →
Mineral requirements, deficiency risks and toxicity
Minerals support physiologic and biochemical functions. Adequacy depends on dietary variety, geographic food sources and losses, while excessive intake can cause toxicity. →
Vitamins and minerals: metabolic functions and deficiency
Vitamins are organic nutrients with essential metabolic functions, required in small dietary amounts because the body cannot synthesize them. Mineral elements with bodily functions must also be supplied in the diet. →
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