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FIRST AID USMLE STEP 1 – VITAMINS EXAM STUDY GUIDE SOLUTIONS
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FIRST AID USMLE STEP 1 – VITAMINS EXAM STUDY GUIDE SOLUTIONS Vitamin A (retinol) - Function - ANSWER-Antioxidant; constituent of visual pigments (retinal); essential for normal differentiation of epithelial cells into specialized tissue (pancreatic cells, mucus- secreting cells); prevents squ...

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  • October 31, 2024
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  • 2024/2025
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©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




FIRST AID USMLE STEP 1 – VITAMINS

EXAM STUDY GUIDE SOLUTIONS


Vitamin A (retinol) - Function - ANSWER✔✔-Antioxidant; constituent of visual pigments (retinal);

essential for normal differentiation of epithelial cells into specialized tissue (pancreatic cells, mucus-

secreting cells); prevents squamous metaplasia. Used to treat measles and acute promyelocytic leukemia

(APL).


Vitamin A (retinol) - Deficiency - ANSWER✔✔-Night blindness (nyctalopia); dry, scaly skin (xerosis cutis);

corneal degeneration (keratomalacia); Bitot spots on conjunctiva; immunosuppression.


Vitamin A (retinol) - Excess - ANSWER✔✔-Acute toxicity—nausea, vomiting, vertigo, and blurred vision.

Chronic toxicity—alopecia, dry skin (eg, scaliness), hepatic toxicity and enlargement, arthralgias, and

pseudotumor cerebri. Teratogenic (cleft palate, cardiac abnormalities), therefore a ⊝ pregnancy test and

two forms of contraception are required before isotretinoin (vitamin A derivative) is prescribed.


Vitamin A (retinol) - Extra - ANSWER✔✔-Retinol is vitamin A, so think retin-A (used topically for wrinkles

and Acne). Found in liver and leafy vegetables. Use oral isotretinoin to treat severe cystic acne. Use all-

trans retinoic acid to treat acute promyelocytic leukemia. Isotretinoin is teratogenic.




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, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Vitamin B1 (thiamine) - Function - ANSWER✔✔-In thiamine pyrophosphate (TPP), a cofactor for several

dehydrogenase enzyme reactions: +Pyruvate dehydrogenase (links glycolysis to TCA cycle) +α-

ketoglutarate dehydrogenase (TCA cycle) +Transketolase (HMP shunt) +Branched-chain ketoacid

dehydrogenase


Vitamin B1 (thiamine) - Deficiency - ANSWER✔✔-Impaired glucose breakdown p ATP depletion

worsened by glucose infusion; highly aerobic tissues (eg, brain, heart) are affected first. In alcoholic or

malnourished patients, give thiamine before dextrose to reduce risk of precipitating Wernicke

encephalopathy. Diagnosis made by increase in RBC transketolase activity following vitamin B1

administration.


Vitamin B1 (thiamine) - Extra - ANSWER✔✔-Think ATP: α-ketoglutarate dehydrogenase, Transketolase,

and Pyruvate dehydrogenase. Spell beriberi as Ber1Ber1 to remember vitamin B1. Wernicke-Korsakoff

syndrome —confusion, ophthalmoplegia, ataxia (classic triad) + confabulation, personality change,

memory loss (permanent). Damage to medial dorsal nucleus of thalamus, mammillary bodies. Dry

beriberi —polyneuritis, symmetrical muscle wasting. Wet beriberi —high-output cardiac failure (dilated

cardiomyopathy), edema.


Vitamin B2 (riboflavin) - Function - ANSWER✔✔-Component of flavins FAD and FMN, used as cofactors in

redox reactions, eg, the succinate dehydrogenase reaction in the TCA cycle.


Vitamin B2 (riboflavin) - Deficiency - ANSWER✔✔-Cheilosis (inflammation of lips, scaling and fissures at

the corners of the mouth), Corneal vascularization.


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