Water-soluble vitamin deficiency and toxicity: B1-B7: Pathology review

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Questions

USMLE® Step 1 style questions USMLE

of complete

A 25-year-old woman comes to the clinic due to myalgia, loss of appetite and a skin rash.  She noticed a progressively worsening skin rash around her eyes, nose and mouth over the course of the last 4 weeks. She has not had a fever, and the rash is not painful or pruritic. Five months ago, she began an intense fitness regimen with a strict diet, which includes eating multiple egg whites everyday, as well as a protein shake every morning, in which she puts several raw eggs. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 20/min, and blood pressure is 125/85 mmHg. BMI is 19 kg/m2. Physical examination reveals macular patches around her eyes, nose and mouth. The physician suspects a nutritional deficiency. The cause of this patient’s symptoms is determined to be a vitamin deficiency that acts as a cofactor for the enzyme acetyl-CoA carboxylase. Which of the following additional biochemical processes uses the deficient vitamin as a cofactor? 

Summary

Water-soluble vitamin deficiencies are mainly caused by insufficient dietary intake and chronic alcohol abuse. Their toxicities or hypervitaminosis can be caused by excess intake of supplements, fortified foods, or vitamin derivative-containing medications, but this is rare. Various types of vitamin B deficiencies can result in distinct health issues. Vitamin B1, or thiamine deficiency can cause Wernicke encephalopathy and beriberi. Vitamin B2, or riboflavin, deficiency can lead to angular cheilosis, glossitis, and corneal neovascularization.

Vitamin B3, or niacin, deficiency can cause pellagra, which presents with diarrhea, dementia, and dermatitis. Vitamin B5, or pantothenic acid deficiency can cause enteritis, adrenal insufficiency, dermatitis, alopecia, and burning feet syndrome. � Vitamin B6, or pyridoxine deficiency can lead to peripheral neuropathy and sideroblastic anemia. Vitamin B7, or biotin, deficiency can cause alopecia, dermatitis, and enteritis.

Sources

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Elsevier

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