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What are the 3 main sources of vitamin D for humans?
- diet
- dietary supplements
- sunlight
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Which form of vitamin D is available by Rx?
D2
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What is the vitamin D metabolite that is monitored and used to determine a pt's vitamin D status?
25-hydroxyvitamin D
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What is the level of 25-hydroxyvitamin D that most experts define as vitamin D deficiency?
Less than 20 ng/ml
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List OTC strengths of Vitamin D3
400, 800, 1000, 2000 IU
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How much vitamin D is usually found in multivitamins?
400 IU
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What are other names for vitamin D2, D3, and rocaltrol?
- D2 = Ergocalciferol
- D3 = Cholecalciferol
- Rocaltrol = Calcitriol
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When a multivitamin product label say the product contains Vitamin D, which form of vitamin D is usually contained in the product?
D2
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List the prescription vitamin D products and strengths
- Vitamin D2 50,000 IU/capsule
- Vitamin D2 8,000 IU/ml liquid (Drisdol)
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Name a symptom of Vitamin D deficiency
muscle weakness
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List some diseases Vitamin D deficiency has been linked to
- cancer
- T1DM
- Crohn's Disease
- MS
- HTN
- CHF
- schizophrenia
- depression
- osteoporosis
- osteomalacia
- rickets
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List 3 natural food sources of vitamin D
- Fish (tuna, sardines, salmon)
- Egg yolk
- Mushrooms
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list 3 foods that are usually fortified with Vitamin D
Milk, OJ, yogurt, butter, margarine, cheese, breakfast cereal, infant formula
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List 5 scenarios that can cause Vitamin D deficiency
- breastfeeding
- use of sunscreen
- skin grafts
- liver failure
- chronic kidney disease
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List medications that cause Vitamin D deficiency
- anticonvulsants
- glucocorticoids
- HAART
- antirejection meds
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What is the usual treatment dose of Vitamin D2 for vitamin D deficiency for an adult? For an 8 yo child?
- 50,000 IU weekly for 8 weeks
- same for 8 y.o.
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What is the usual maintenance dose of Vitamin D to prevent deficiency in adults? For an 8 y.o. child?
- Adult - D2 50,000 IU Q 2-4 weeks or D3 800-1000 IU daily, sensible sun exposure
- Child - D3 400-1,000 IU daily
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How much vitamin D3 should lactating women ingest to ensure adequate levels for themselves and the breastfed infant?
D3 1000-2000 IU/day; 4000 IU qd is safe for up to 5 months
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Is a tanning bed effective at elevating vitamin D levels?
yes
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What is the goal 25-hydroxyvitamin D level for pts with chronic kidney disease and how often should it be monitored?
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How much sun exposure is "sensible sun exposure" to maintain adequate vitamin D levels?
5-30 minutes between 10 a.m. and 3 p.m. twice a week (depending on time of day, latitude, and skin pigmentation)
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What level of 25-hydroxyvitamin D is considered to be toxic?
> 150 ng/ml
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