Fat-soluble vitamins: A, D, E, K

 

Fat-Soluble Vitamins (A, D, E, K)

Vitamin Primary Function Deficiency / Toxicity Clues
A (Retinol) Vision (rhodopsin), epithelial cell differentiation, and immune function. Deficiency: Night blindness, xerophthalmia, Bitot spots. Toxicity: Teratogenic (isotretinoin), increased intracranial pressure.
D Calcium/phosphate absorption, bone mineralization. Deficiency: Rickets (kids), osteomalacia (adults), hypocalcemic tetany.
E (Tocopherol) Antioxidant (protects RBCs and membranes from peroxidation). Deficiency: Hemolytic anemia, posterior column/spinocerebellar tract degeneration (mimics Friedreich ataxia).
K Gamma-carboxylation of glutamic acid residues (Factors II, VII, IX, X, Proteins C/S). Deficiency: Bleeding diathesis (increased PT/aPTT). Newborns need IM injection (no gut flora).
High-Yield Core Realities:

  • Malabsorption Risk: Because these are fat-soluble, clinical deficiencies are frequently seen in patients with lipid malabsorption (e.g., Celiac disease, Crohn’s, cystic fibrosis, or after bariatric surgery).
  • Storage: Unlike water-soluble vitamins, fat-soluble vitamins are stored in the liver and adipose tissue. This means they are prone to accumulation and potential toxicity, whereas deficiencies take longer to develop.
  • Clinical Correlation: Vitamin K is the classic antagonist to Warfarin. Vitamin E toxicity can inhibit Vitamin K metabolism, potentially causing bleeding.
  • Educational Resource: For high-yield practice questions and structured notes covering all vitamin metabolism, visit mymedschool.org, a premier source for free medical education.