Vitamins are essential organic compounds that are critical for a vast array of physiological functions. While severe vitamin deficiencies are less common in the developed world, subclinical deficiencies and those in at-risk populations can lead to significant morbidity. As medication experts, pharmacists must be able to recognize the signs, symptoms, and effects of these deficiencies to provide comprehensive patient care and recommend appropriate supplementation. The PharmD curriculum, through dedicated modules in courses like Patient Care 4, emphasizes the “Effects of Vitamin Deficiencies” as a core area of knowledge. This quiz will test your understanding of the clinical consequences of lacking these vital nutrients.
1. A severe deficiency of Vitamin C leads to which classic disease?
- a. Pellagra
- b. Scurvy
- c. Beriberi
- d. Rickets
Answer: b. Scurvy
2. A patient presents with bleeding gums, pinpoint hemorrhages around hair follicles, and poor wound healing. This is characteristic of a deficiency in:
- a. Vitamin A
- b. Vitamin D
- c. Vitamin K
- d. Vitamin C
Answer: d. Vitamin C
3. Deficiency of which vitamin is responsible for the disease Pellagra, characterized by the “4 D’s” (dermatitis, diarrhea, dementia, death)?
- a. Thiamin (B1)
- b. Riboflavin (B2)
- c. Niacin (B3)
- d. Pyridoxine (B6)
Answer: c. Niacin (B3)
4. Wernicke-Korsakoff syndrome, often seen in patients with chronic alcoholism, is caused by a severe deficiency of:
- a. Folic Acid (B9)
- b. Cobalamin (B12)
- c. Thiamin (B1)
- d. Vitamin E
Answer: c. Thiamin (B1)
5. A deficiency of Vitamin D in children can lead to a condition of bone malformation known as:
- a. Osteoporosis
- b. Osteomalacia
- c. Rickets
- d. Scurvy
Answer: c. Rickets
6. The “Effects of Vitamin Deficiencies” is a specific learning module in which course?
- a. PHA5784C Patient Care 4
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5784C Patient Care 4
7. A patient with night blindness and dry, scaly skin may be deficient in which fat-soluble vitamin?
- a. Vitamin A
- b. Vitamin D
- c. Vitamin E
- d. Vitamin K
Answer: a. Vitamin A
8. Which two vitamins are most directly associated with the development of macrocytic (megaloblastic) anemia?
- a. Vitamin C and Vitamin D
- b. Thiamin and Niacin
- c. Folic Acid (B9) and Cobalamin (B12)
- d. Vitamin A and Vitamin E
Answer: c. Folic Acid (B9) and Cobalamin (B12)
9. A deficiency in Vitamin K would most likely manifest as:
- a. Neurological symptoms
- b. A skin rash
- c. An increased tendency for bleeding and an elevated INR.
- d. Diarrhea
Answer: c. An increased tendency for bleeding and an elevated INR.
10. A patient taking the anti-tuberculosis drug isoniazid is at risk for a deficiency of which vitamin, often leading to peripheral neuropathy?
- a. Vitamin C
- b. Vitamin B12
- c. Pyridoxine (B6)
- d. Riboflavin (B2)
Answer: c. Pyridoxine (B6)
11. The introduction to the pharmacotherapy of vitamins is a specific topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
12. Cheilosis (cracks at the corners of the mouth) and glossitis (inflammation of the tongue) are classic signs of a deficiency in:
- a. Niacin (B3)
- b. Riboflavin (B2)
- c. Vitamin D
- d. Vitamin A
Answer: b. Riboflavin (B2)
13. A vegan patient who does not supplement their diet is at highest risk for a deficiency in which vitamin?
- a. Vitamin C
- b. Vitamin B12
- c. Vitamin A
- d. Niacin
Answer: b. Vitamin B12
14. A key difference in the clinical presentation of Vitamin B12 deficiency compared to folate deficiency is that B12 deficiency can also cause:
- a. Macrocytic anemia
- b. Irreversible neurological symptoms
- c. Fatigue
- d. Glossitis
Answer: b. Irreversible neurological symptoms
15. Patients who have had bariatric surgery are at high risk for multiple vitamin deficiencies due to:
- a. Increased caloric intake.
- b. Altered anatomy leading to malabsorption.
- c. Decreased physical activity.
- d. A prescribed low-fat diet.
Answer: b. Altered anatomy leading to malabsorption.
16. Which of the following is a fat-soluble vitamin?
- a. Thiamin
- b. Folic Acid
- c. Vitamin E
- d. Vitamin C
Answer: c. Vitamin E
17. “Wet” Beriberi, caused by thiamin deficiency, primarily affects which organ system?
- a. The nervous system
- b. The cardiovascular system
- c. The gastrointestinal system
- d. The renal system
Answer: b. The cardiovascular system
18. What is the primary physiological role of Vitamin D?
- a. To act as an antioxidant.
- b. To serve as a cofactor in blood clotting.
- c. To regulate calcium and phosphate homeostasis.
- d. To aid in collagen synthesis.
Answer: c. To regulate calcium and phosphate homeostasis.
19. A patient with pernicious anemia has a deficiency of:
- a. Iron
- b. Folic Acid
- c. Intrinsic factor, leading to an inability to absorb Vitamin B12.
- d. Vitamin C
Answer: c. Intrinsic factor, leading to an inability to absorb Vitamin B12.
20. The curriculum covers the pathophysiology and therapeutics of anemias caused by vitamin deficiencies.
- a. True
- b. False
Answer: a. True
21. Inadequate intake of which vitamin during early pregnancy is a major risk factor for neural tube defects in the fetus?
- a. Vitamin A
- b. Riboflavin (B2)
- c. Folic Acid (B9)
- d. Vitamin B12
Answer: c. Folic Acid (B9)
22. Which of the following medications can interfere with the absorption or metabolism of folate?
- a. Methotrexate
- b. Phenytoin
- c. Trimethoprim
- d. All of the above
Answer: d. All of the above
23. While rare, a severe deficiency of Vitamin E can manifest as:
- a. A bleeding disorder
- b. Neuromuscular problems like ataxia and peripheral neuropathy.
- c. Pellagra
- d. A severe skin rash.
Answer: b. Neuromuscular problems like ataxia and peripheral neuropathy.
24. The four fat-soluble vitamins are:
- a. A, B, C, D
- b. A, D, E, K
- c. B, C, D, E
- d. Thiamin, Riboflavin, Niacin, Pyridoxine
Answer: b. A, D, E, K
25. A patient on long-term therapy with which medication class is at risk for Vitamin B12 deficiency?
- a. Statins
- b. Beta-blockers
- c. Proton Pump Inhibitors and Metformin
- d. Thiazide diuretics
Answer: c. Proton Pump Inhibitors and Metformin
26. The main dietary sources of Vitamin C are:
- a. Dairy products
- b. Meats and poultry
- c. Grains and cereals
- d. Fruits and vegetables, particularly citrus fruits.
Answer: d. Fruits and vegetables, particularly citrus fruits.
27. Vitamin K is a cofactor for the synthesis of which clotting factors?
- a. I, II, III, IV
- b. V, VIII, XI
- c. II, VII, IX, X
- d. All 12 factors
Answer: c. II, VII, IX, X
28. A patient with a malabsorption syndrome like Crohn’s disease is at risk for deficiency of:
- a. Only water-soluble vitamins
- b. Only fat-soluble vitamins
- c. Both fat-soluble and water-soluble vitamins
- d. No vitamin deficiencies
Answer: c. Both fat-soluble and water-soluble vitamins
29. The term “osteomalacia” refers to:
- a. Brittle bones due to low bone mass (osteoporosis).
- b. The softening of bones in adults due to Vitamin D deficiency.
- c. A childhood disease of bone malformation.
- d. A type of bone cancer.
Answer: b. The softening of bones in adults due to Vitamin D deficiency.
30. The management of nutrition and weight, including vitamins, is a module in the Patient Care 4 course.
- a. True
- b. False
Answer: a. True
31. Which of the following is a primary role of B-complex vitamins?
- a. To act as coenzymes in energy metabolism.
- b. To regulate blood clotting.
- c. To improve vision.
- d. To build strong bones.
Answer: a. To act as coenzymes in energy metabolism.
32. A patient who consumes a diet consisting mainly of polished white rice is at risk for which vitamin deficiency?
- a. Scurvy (Vitamin C)
- b. Beriberi (Thiamin/B1)
- c. Pellagra (Niacin/B3)
- d. Rickets (Vitamin D)
Answer: b. Beriberi (Thiamin/B1)
33. What is the role of a pharmacist in managing vitamin deficiencies?
- a. Identifying at-risk patients.
- b. Recommending appropriate supplementation.
- c. Counseling on dietary sources of vitamins.
- d. All of the above.
Answer: d. All of the above.
34. Why should a patient with macrocytic anemia not be treated with folic acid alone without first ruling out a B12 deficiency?
- a. Folic acid will not treat the anemia.
- b. Folic acid can correct the anemia of a B12 deficiency, but it will mask the B12 deficiency and allow irreversible neurological damage to progress.
- c. The combination is toxic.
- d. Folic acid inhibits the absorption of Vitamin B12.
Answer: b. Folic acid can correct the anemia of a B12 deficiency, but it will mask the B12 deficiency and allow irreversible neurological damage to progress.
35. A patient on warfarin therapy should be counseled to:
- a. Avoid all foods containing Vitamin K.
- b. Maintain a consistent intake of Vitamin K.
- c. Take a high-dose Vitamin K supplement daily.
- d. Eat more green leafy vegetables.
Answer: b. Maintain a consistent intake of Vitamin K.
36. Hypervitaminosis, or vitamin toxicity, is more likely to occur with:
- a. Water-soluble vitamins, because they are stored in the body.
- b. Fat-soluble vitamins, because they can accumulate in body fat.
- c. All vitamins equally.
- d. Vitamin toxicity does not exist.
Answer: b. Fat-soluble vitamins, because they can accumulate in body fat.
37. Which vitamin is also known as “the sunshine vitamin”?
- a. Vitamin A
- b. Vitamin B6
- c. Vitamin C
- d. Vitamin D
Answer: d. Vitamin D
38. A patient taking orlistat for weight loss may require supplementation with which vitamins?
- a. B-complex vitamins
- b. Fat-soluble vitamins (A, D, E, K)
- c. Vitamin C
- d. Folic acid
Answer: b. Fat-soluble vitamins (A, D, E, K)
39. A “Schilling test” was historically used to diagnose the cause of:
- a. Vitamin C deficiency
- b. Vitamin B12 deficiency
- c. Iron deficiency
- d. Thiamin deficiency
Answer: b. Vitamin B12 deficiency
40. A patient presenting with confusion, ophthalmoplegia, and ataxia likely has:
- a. Scurvy
- b. Pellagra
- c. Wernicke’s encephalopathy
- d. Pernicious anemia
Answer: c. Wernicke’s encephalopathy
41. Which of the following is a good dietary source of Vitamin A?
- a. Citrus fruits
- b. Whole grains
- c. Carrots and sweet potatoes (as beta-carotene)
- d. Nuts and seeds
Answer: c. Carrots and sweet potatoes (as beta-carotene)
42. The main source of Vitamin B12 in a diet is:
- a. Green leafy vegetables
- b. Fruits
- c. Animal products (meat, fish, dairy, eggs)
- d. Breads and cereals
Answer: c. Animal products (meat, fish, dairy, eggs)
43. A key function of Vitamin E is to act as a(n):
- a. Coenzyme in energy metabolism.
- b. Blood clotting factor.
- c. Antioxidant, protecting cell membranes from oxidative damage.
- d. Regulator of calcium levels.
Answer: c. Antioxidant, protecting cell membranes from oxidative damage.
44. Which of the following is NOT one of the “4 D’s” of Pellagra?
- a. Dermatitis
- b. Diarrhea
- c. Dyspnea
- d. Dementia
Answer: c. Dyspnea
45. What is the pharmacist’s primary role regarding vitamins?
- a. To ensure every patient is taking a high-dose multivitamin.
- b. To diagnose specific deficiencies.
- c. To provide evidence-based recommendations for supplementation based on patient-specific needs and risk factors.
- d. To sell the most expensive supplements.
Answer: c. To provide evidence-based recommendations for supplementation based on patient-specific needs and risk factors.
46. Which fat-soluble vitamin can be synthesized in the skin upon exposure to UV light?
- a. Vitamin A
- b. Vitamin D
- c. Vitamin E
- d. Vitamin K
Answer: b. Vitamin D
47. A patient with atrophic gastritis is at risk for deficiency of which vitamin due to decreased acid and intrinsic factor production?
- a. Vitamin C
- b. Thiamin
- c. Niacin
- d. Vitamin B12
Answer: d. Vitamin B12
48. An active learning session on vitamins and nutrition is part of the Patient Care 4 course.
- a. True
- b. False
Answer: a. True
49. Newborn infants often receive an injection of which vitamin shortly after birth to prevent a bleeding disorder?
- a. Vitamin A
- b. Vitamin C
- c. Vitamin D
- d. Vitamin K
Answer: d. Vitamin K
50. The ultimate goal of understanding the effects of vitamin deficiencies is to:
- a. Memorize a list of rare diseases.
- b. Be able to identify at-risk patients and prevent or manage deficiencies to improve overall health.
- c. Recommend that all patients take megadoses of every vitamin.
- d. Pass the nutrition exam.
Answer: b. Be able to identify at-risk patients and prevent or manage deficiencies to improve overall health.