Water-soluble vitamin deficiency and toxicity Quiz: Ace Your Exams

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A 42-year-old man comes to the volunteer medical center of a large refugee camp with generalized fatigue and diarrhea over the past 2 days. He has also noticed increased hair loss in the last 2 months. He states he has had to frequently skip meals due to famine. Temperature is 37.0°C (98.6°F), pulse is 92/min, respirations are 20/min, and blood pressure is 135/85 mmHg. BMI is 18 kg/m2. He is alert, cooperative and oriented to time, place and person. Serum chemistry panel, complete blood count, and thyroid function tests are found to be normal. Further testing reveals a vitamin deficiency that leads to impaired production of coenzyme A and reduced fatty acid synthesis. Which of the following can be expected on further evaluation, considering the most likely diagnosis?

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