Vitamins and Minerals

1. Biochemistry Quiz
Department of Biochemistry

2. Round -1
Case studies

3. Team A
A 30-month-old female child whose growth rate has been in the
lower 10th percentile over the last year presents with:
oChronic nonproductive cough, and
odiarrhea with foul-smelling stools.
oShe is diagnosed as having cystic fibrosis.

4. Team A
For which of the following vitamins is this child most likely to be at
risk of deficiency?
oAscorbic acid (vitamin C)
oVitamin D
oThiamine (vitamin B1)
oRetinol (vitamin A)
oRiboflavin (vitamin B2)

6. Correct Answer
Retinol (vitamin A). Because cystic fibrosis leads to
pancreatic damage and diminution of the ability to
secrete HCO3 ions and pancreatic digestive enzymes
with the result that fat and protein are absorbed
poorly.
Lipid malabsorption reduces the absorption of fat
soluble vitamins.

8. Team B

9. Team B
A 71-year-old man had a 3 week history of :
• weakness,
• polyuria,
• intense thirst,
• difficulty in speaking and understanding commands,
• staggering walk,
• confusion and
• a weight loss of 10 kgs.

10. Team B
• For one month he took 200,000
units of vitamin D each day
because he had severe
osteoarthritis.
• His plasma calcium was 3.38
mmol/L(13.5 mg/dl)

11. What is the most probable
diagnosis?
• Diabetes mellitus
• Diabetes insipidus
• Hypervitaminosis D
• Vitamin D deficiency
• Renal failure

13. Answer
• It is a case of vitamin D toxicity.
• Vitamin D toxicity results from taking excessive amounts.
• Because synthesis of 1,25(OH)2D (the most active metabolite
of vitamin D) is tightly regulated, vitamin D toxicity usually
occurs only if excessive doses (prescription or megavitamin)
are taken.
• Marked hypercalcemia commonly causes symptoms.
• Anorexia, nausea, and vomiting can develop, often followed by
polyuria, polydipsia, weakness, nervousness, pruritus, and
eventually renal failure.

14. Team C

15. Team C
• A 32- year- old male reported to emergency with active bleeding
from nose.
• History revealed that he had been on Orlistat for weight
reduction from the past two years.
• He had started Orlistat without the advice of any practitioner
and had lost nearly 20 kg of body weight .

16. Team C
• There was no history of hypertension, bleeding disorder or any
other medical illness.
• No such bleeding episode occurred in the past.
• There was no abnormality detected upon local examination of
nose.
• What is the relationship between Orlistat and epistaxis?

17. Team C
• Vitamin K deficiency
• Deficiency of clotting factors
• Platelet dysfunction
• Auto immune hemorrhagic disease
• Vitamin C deficiency

18. Epistaxis

19. Correct answer
• Vitamin K deficiency
• Orlistat inhibits pancreatic lipase.
• Fat maldigestion and absorption.
• Impaired absorption of fat soluble vitamins
• Vit K deficiency more common due to inadequate storage in
liver.

20. Round 2
Name the disease

21. Team A

22. Team A
• Hemolytic anemia
• Neurological deficits
• Muscle cramps

24. Answer
• Vitamin K deficiency

25. Team B

26. Team B
• Visual disturbances
• Growth failure
• Recurrent infections

28. Answer
• Vitamin A deficiency

29. Team C

30. Team C
• Fragile bones
• Muscle weakness
• Easy fractures

32. Answer
• Vitamin D deficiency

33. Round 3
Visual interpretation

34. Team A

35. The displayed picture shows the
outcome of deficiency of a
vitamin.
Name the vitamin, state the
diagnosis and state the
functional forms of this vitamin.
Team A

37. • Xerophthalmia, vitamin A deficiency
• Retinal. Retinol and retinoic acid

38. Team B

39. Team B
Name the vitamin, deformity and
three additional findings in this
disease.

41. Answer
• Vitamin D
• Rickets
• Frontal bossing, knocked knee, pigeon chest

42. Team C

43. Team C
Deficiency of which vitamin
might get precipitated in early
stages of obstructive jaundice
and why?

45. Answer
• Vitamin K deficiency
• Obstruction to the outflow of bile
• Bile is needed for absorption of fat soluble vitamins
• Vitamin K is stored in inadequate amounts in liver

46. Round 4
Laboratory interpretations

47. Team A

48. Team A
• A 3 –year-old girl was brought for consultation. The mother
stated that the child began walking at the age of 27 months.
• Laboratory Investigation report was as follows:
• Serum Ca: normal,
• PO4- low
• Alkaline Phosphatase: mildly increased and
• X-Ray studies revealed- “cupping" of the distal radius and distal
femur, widening of the epiphysis and angular deformities.

50. Answer
• Vitamin D deficiency

51. Team B

52. Team B
A 50 year female reports to medical OPD. Her lab report shows :
▪ Calcitriol levels –High
▪ Alkaline phosphatase –High
▪ Serum 1,25(OH)2D –Low
▪ Urinary calcium- Low
▪ Serum PTH-high

54. Answer
• Vitamin D deficiency

55. Team C

56. Team C
• A 10-day-old boy was admitted with new-onset focal seizures.
Laboratory investigations revealed:
• Normal renal function and electrolytes,
• Hypocalcemia (total calcium 1.80 mmol/L [normal 1.96 mmol/L to
2.66 mmol/L]
• Low ionized calcium 0.82 mmol/L [normal 1.14 mmol/L to 1.29
mmol/L]) a
• Hyperphosphatemia 3.30 mmol/L (normal 1.62 mmol/L to 3.10
mmol/L).
• Low 25-hydroxy vitamin D level of 13 mmol/L (normal 27 mmol/L
to 110 mmol/L),

58. Answer
• Vitamin D deficiency

59. Round 5
Historical perspective of vitamins

60. Team A

61. Team A
• Rickets, the bone disease caused by vitamin D deficiency, was
known in antiquity and was described in detail by ?

63. Answer
• F. Glisson in 1650

64. Team B

65. Team B
• Name the scientists' who discovered vitamin E ?

67. Answer
• In 1922 at the University of California in Berkeley, Dr. Herbert
M. Evans, a research physician, and his assistant, Katherine S.
Bishop "discovered" vitamin E.

68. Team C

69. Team C
• Name the scientist who discovered vitamin K ?

71. Answer
• Vitamin K was first discovered in 1929 by Henrik Dam who was
studying the role of cholesterol by depriving chickens of
cholesterol in their diet. He subsequently observed a
particular vitamin extract from these chickens in relation to
blood coagulation

72. Round 6
Enzymology

73. One word answers

74. Team A
• The enzyme that catalyzes the change in location of the
functional group from one position to another within a
compound is called ???

76. Answer
• Mutases

77. Team B

78. Team B
• The enzymes which catalyze the transfer of reducing
equivalents/groups other than reducing equivalents are called
???

80. Answer
• Transferases

81. Team C

82. Team C
• Tightly integrated into the enzyme structure by covalent or
non-covalent forces ????

84. Answer
• Prosthetic group

85. Round 7
• Multiple choice questions

86. Team A
Any of the following processes except one are involved at
the active site of an enzyme to accelerate the rate of
reaction-
a) Catalysis by Bond Strain
b) Catalysis by Proximity and Orientation
c) Non covalent catalysis
d) Acid base catalysis

88. Answer
• Non covalent catalysis

89. Team B

90. Team B
Which statement out of the followings is incorrect about the
effect of increasing temperature on enzyme activity-
a) Raising the temperature increases the kinetic energy of
molecules
b) A ten degree Centigrade rise in temperature will increase the
activity of most enzymes by 50 to 100%.
c) Most animal enzymes rapidly become denatured at
temperatures above 40oC
d) Storage of enzymes at 5°C or below is generally not suitable.

92. Answer
• d) Storage of enzymes at 5°C or below is generally not suitable.

93. Team C

94. Team C
One out of the following enzymes has absolute specificity
for its substrate; choose the correct option-
a) Urease
b) Carboxy peptidase
c) Pancreatic lipase
d)Lipoprotein lipase

96. Answer
• A) Urease

97. Round 8
Case studies

98. Team A
• A 60-year-old was brought to medical emergency complaining
of chest pain.
• After initial laboratory workup and ECG, he was diagnosed with
Acute Myocardial infarction, and admitted for further
observation and treatment.
• He was prescribed with Tissue plasminogen activator(TPA).

99. Team A (contd.)
• Tissue plasminogen activator(TPA) cleaves plasminogen to
plasmin. It has the ability to dissolve clots. It catalyzes cleavage
of bonds by water.
• What might be the class of this enzyme ?

100. Team B
• An 8-year-old boy has been admitted to the pediatric ward.
There is history of periodic vomiting, developmental retardation
and intolerance to protein. The child has been diagnosed with
Propionic acidemia, caused due to deficiency of Propionic acid
carboxylase. The said enzyme catalyzes condensation of
propionic acid with carbon dioxide.
• What might be the class of the enzyme ?

101. Team C
• A 5 –year-old child has bee diagnosed with Glycogen storage
disease. Physical examination revealed growth retardation, and
hepatomegaly. Laboratory investigation confirm the deficiency
oh Phosphorylase kinase. The enzyme catalyzes
phosphorylation of phosphorylase enzyme using ATP as the
donor of phosphate.
• What might be the class of enzyme ?

102. Round 9
Graphical interpretation

103. Graphical
interpretations
• What is the
interpretation from this
picture ?
Team A

105. Answer
• Effect of substrate concentration

106. Team B
• What is Km ?
• What is its significance ?

107. Team C
• What is the Optimum pH of
pepsin and Amylase ?

108. Round 10
Spot questions

109. Team B
• What are the characteristics of an active site ?

110. Team C
• Give one example each of the mechanisms involved at the
active site .