Vitamins and Minerals CNSC complete solution 2022/2023

Vitamins and Minerals CNSC complete solution 2022/2023Vitamin A (absorption, transport, storage) -exists as retinoids in animal tissue and carotenoids in plants -absorbed in upper small intestine -role/storage: transported by RBP and stored in liver Vit A s/s deficiencies and toxicities deficiencies: follicular hyperkeratosis, bitot's spots, xeropthalmia, night blindness, excessive bone deposition, impaired wound healing toxicities: pruritus, alopecia, conjuctivitis, cheilitis, ataxia, bone loss/hip fractures vit A (labs to test, and TPN dosing) serum retinol 1mg retinol or 3300 IU vitamin D (forms, absorption, storage) -ergocalciferol (d2) and cholecalciferol (d3) -absorbed in dodenum and distal small intestine -stored in liver, muscle, adipose tissue -kidenys transform it into active form (calcitriol) vit d functions 1. calcium homeostatis (maintains appropraite levels of serium calcium 2. nosocomial infection: helps fight infections vit d s/s deficiencies hypocalcemia, osteomalacia/osteoporosis vit d populations at risk elderly, no sun exposure, PN, liver/renal disease vit d (labs and TPN dosing) 25-hydroxy vitamin D 5 mcg/200IU cholecalciferol vit E (absorption, forms, storages) -jejunjum -tocopherols and tocotrienols -adipose tissue, muscle, liver vit E function antioxidant that maintains membrane integrity , anti-clotting, neuroprotective vit E s/s deficiencies neuronal degeneration, hemolytic anemia, increased platelet aggregation vit E populations at risk prolonged steatorrhea, crohn's disease, cystic fibrosis, compromised biliary function, resection of ileum vitamin K (synthesis, absorption, storage) synthesized by gut mircoflora, absorbed in the jejunum, no storage form in the body vit k s/s functions ts blood coagulation (decreases INR) 2. helps bone mineralization/calcium balance vit k deficiencies/populations at risk bone loss/fracture, bleeding/hemorrage fat malabsorption, IBS, antibiotic therapy, long-term PN without lipid emulsion vit k labs to test and TPN dosing INR, 150 mcg phylloquinone vit c (site of absorption) predominately ileum, with some via jejunum vit c functions 1. antioxidant 2. synthesis of collagen 3. enhance iron absorption in the intestines vit s/s deficiency and populations at risk -delayed wound healing, petechia, corkscrew hairs, bleeding gums, -alcoholics, pts who smoke tobacco, surgical and burn pts, hyperglycemia, chronic inflammatory pts -pts who have renal disease should avoid high intakes of vit C as it can precipitate oxalate formation vit c lab to test and TPN dosing -ascorbic acid -200 mg ascorbic acid Thiamin (absorption and transport) jejunum bound to albumin in the form of TPP thiamin functions energy transformation (carb metabolism) nerve conduction (helps form structure of nerve membranes) populations at risk for thiamin deficiency -chronic vomiting -malabsorption (alcohol abuse) -inadequate intake -increased demand (refeeding syndrome) -long term PN