Chapter 10: VITAMIN AND NUTRITIONAL DISORDERS

PEARL: For the vitamins and nutritional disorders sections, familiarize yourself with the proper names of vitamins, but know that the ABP has yet to institute their strict use. In general, they still tend to use “Vitamin E” instead of “Tocopherol.” Keep in mind that you are not dealing with one test-question writer, so there is room for variability. In this chapter, the terms likely to be used will be presented, followed by the less likely associated term in parentheses.

FAT-SOLUBLE VITAMINS

Fat-soluble vitamins include Vitamin A, Vitamin K, Vitamin E, and Vitamin D.

PEARL: Keep deficiencies of these particular vitamins in mind when dealing with any disease that is associated with malabsorption.

MNEMONIC: Use the word FAKED to remind you of the Fat-soluble vitamins of A, K, E and D.

VITAMIN A (AKA RETINOL)

• MNEMONIC: Vitamin A = Retinol. Have you ever heard of Retin-A®?
• DEFICIENCY can lead to Bitot’s spots on the eye and blindness.
• EXCESS can lead to PSEUDOTUMOR CEREBRI.
  • (DOUBLE TAKE) PSEUDOTUMOR CEREBRI (AKA IDIOPATHIC INTRACRANIAL HYPERTENSION or BENIGN INTRACRANIAL HYPERTENSION)The symptoms associated with increased intracranial pressure (ICP) predominate for Pseudotumor Cerebri (AKA Idiopathic Intracranial Hypertension or Benign Intracranial Hypertension). These include headache, nausea, vision changes, and bulging fontanelle. Late findings are papilledema and loss of vision. The disease is not benign, and although CT or MRI of the head will not show herniation, a lumbar puncture will show increased intracranial pressure. It can be associated with excessive vitamin A, isotretinoin, tetracycline, and thyroxine. Treatment may require acetazolamide, diuretics, and sometimes even a shunt or a surgical procedure to relieve pressure on the optic nerve.

• • • PEARL: PSEUDO-tumor. Don’t get confused by the word “tumor.” This condition is NOT associated with a mass.
    • MNEMONIC: (image)

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