Nutrition Flashcards
A 10yo with OCD and a restrictive diet presents with progressive fatigue, irritability and unsteady gait. She is a very picky eater, Only eating bagels, chips, and lettuce. On exam, she is pale, OP exam notable for smooth, swollen tongue, Romberg sign and clonus are present. She has diminished proprioception and decreased pinprick sensation in bilateral LE’s. Which is the most likely vitamin deficiency for this patient?
A) folic acid
B) B12
C) C
D) E
B. Only natural sources of vitamin b12 come from animal sources (milk, eggs, meat). Neurologic changes from deficiency include spinal cord degeneration (ataxia), peripheral neuropathy, and brain dysfunction (irritability, depression, anxiety, etc). B12 deficiency leads to increased levels of MMA which damages myelin and causes above symptoms.
Vitamin E deficiency can also cause similar Neuro changes but doesn’t cause glossitis. Folic acid can cause similar symptoms but her diet contains FA (lettuce). Vitamin C deficiency doesn’t cause Neuro symptoms.
