“Vitamins are organic substances which

cannot be synthesized within the body and

are essential for maintenance of normal

structure and function of cells”.

1. FAT-SOLUBLE: Vit A,D,E,K.

2. WATER –SOLUBLE: Vit C & B complex group.

VITAMINS

Retinol- transport form;

Retinol ester- storage form;

Retinal (aldehyde form)- visual pigment;

Retinoic acid

VITAMIN A forms:

Maintaining normal vision in reduced light. (Rhodopsin

in rods, iodopsins in cones).

Differentiation of specialized epithelial cells, mainly

mucous secreting cells. Def. leads to squamous

metaplasia.

Enhancing immunity to infections (measles)

Anti-oxidant

NXBK:

Night blindness: impaired vision in night

Xerophthalmia: Dry eyes, dryness of conjunctiva (xerosis).

Bitot spots: Small opaque plaques with keratin debris.

Keratomalacia: Erosion of roughened corneal surface with

softening and destruction of cornea and total blindness.

A. Night blindness

B. Xerophthalmia

C. Bitot spots

D. Keratomalacia

Which of the following is first sign of Vit A deficiency ?

Major function of Vit D: maintenance of normal plasma levels

of Calcium and Phosphorus.

Deficiency:

Rickets in growing children

Osteomalacia in adults

Hypocalcemic Tetany

Vit-D2:: Available in Food or Fortified form.

Vit-D3:: 7-Dehydrocholesterol in Skin converted in the

skin by UV light Exposure.

Vit D2 or Vit D3 must be made Biologically active

Activated in 2 process- Liver & Kidney.

1,25 (OH)2 Dehydrocholesterol is active.

Vitamin-D Terminologies

Inadequate synthesis/ dietary deficiency:

-inadequate sun exposure, poor intake.

Decreased absorption: Cholestatic liver ds, Pancreatic

insufficiency, Biliary tract obstruction, Small bowel ds.

Derangements in metabolism: diffuse liver ds, Advanced

renal ds.

Phosphate depletion: Antacid abuse.

PREDISPOSING FACTORS FOR DEFICIENCY:

Excess of unmineralised matrix.

Inadequate calcification of epiphyseal cartilage.

Overgrowth of epiphyseal cartilage due to inadequate

calcification.

Failure of cartilage cells to mature and disintegrate.

Weak/ poorly formed bones- microfractures, stress fractures.

Deformation of the skeleton.

RICKETS & OSTEOMALACIA:

HEAD: softened occipital bones become flattened

with inward buckling of parietal bones.

Squared appearance of the head.

CHEST: ‘ due to overgrowth of cartilage at

costochondral jn.

antr. Protrusion of the sternum-

weakened ribs subjected to pull by respiratory muscles.

due to inward pull at the margin of the

diaphragm.

Antioxidant property.

Inhibits formation of atheromas by reducing oxidation of

LDL.

Def: Neurological manifestations- absent tendon reflexes,

ataxia, loss of position and vibration sense, loss of pain

sensation, spinocerebellar degenaration, muscle

weakness-ophthalmoplagia.

Infertility.

Required for clotting factor synthesis & Post

translational modification :F-II, VII, IX, X: Protein C & S.

Def: Bleeding diathesis, hemorrhagic ds of newborn,

hematomas, hematuria, melena, ecchymosis, gum

bleedings.

Routine Prophylactic dose for newborns.

SCURVY:

Hemorrhages: Gingival swelling, bacterial periodontal

infections, subperiosteal hematomas, bleeding into joint

spaces, perifollicular, hyperkeratotic papular rash.

IMPAIRED WOUND HEALING: due to deranged collagen

synthesis.

Skeletal changes: soft bones, growth retardation.

A. Vitamin A

B. Vitamin B1

C. Vitamin C

D. Vitamin D

Perifollicular hemorrhages seen with deficiency of which of the following?

Wet Beriberi: edema due to heart failure

Dry Beriberi: CNS and PNS system involved::::-----

a) Korsakoff syndrome: Psychosis with confusion, loss of

memory.

b) Wernicke’s encephalopathy: mental confusion with

ophthalmoplagia, nystagmus and ataxia.

Cheliosis:

Glossitis: Magenta red tongue.

Interstitial keratitis

Scaly dermatitis

Erythroid hyperplasia of BM

PELLEGRA: 3 D’s

1. Dermatitis

2. Diarrhea

3. Dementia

Which of the following is not seen in Pellegra?

A. Dermatitis

B. Depression

C. Diarrhea

D. Dementia