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  1. #1
    BioPatel is offline Member
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    hemorrhages around hair follicles and splinter hemorrhages

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    A 53-year-old alcoholic man is picked up by the police and taken to an emergency department, where the staff notices that he has multiple lesions that appear to be bruises over his body. On questioning, the man states that he was not beaten up, and physical examination establishes that these are actually ecchymoses rather than true bruises. Minute hemorrhages around hair follicles and splinter hemorrhages in the nail beds are also noted. Deficiency of which of the following nutrients would most likely produce these findings?

    A. Calcium
    B. Iron
    C. Vitamin B12
    D. Vitamin C
    E. Vitamin D

  2. #2
    Asclepius1's Avatar
    Asclepius1 is offline Ultimate Member 537 points
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    D?

  3. #3
    BioPatel is offline Member
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    The correct answer is D. The patient described suffers from scurvy, due to a deficiency of dietary vitamin C. Absence of vitamin C leads to impaired hydroxylation of proline residues in nascent procollagen chains, leading to weakness of blood vessel walls. Clinically, the deficiency syndrome is characterized by perifollicular hemorrhages, fragmentation of hairs, purpura, ecchymoses, splinter hemorrhages, and hemorrhages into muscle. In patients with normal dentition, gum changes (swelling, bleeding, loosening of teeth) are also noted. Without supplementation with vitamin C, death may eventually occur.

    Calcium (choice A) and vitamin D (choice E) deficiencies can cause bone disease.

    Iron deficiency (choice B) can cause microcytic anemia.

    Vitamin B12 deficiency (choice C) can cause megaloblastic anemia.

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    VictorRose is offline Newbie 510 points
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    Hi there,
    Splinter hemorrhages look like thin, red to reddish-brown lines of blood under the nails. They run in the direction of nail growth.
    They are named splinter hemorrhages because they look like a splinter under the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails.
    I think it’s a vitamin C deficiency that initially, red, thickened and raised bumps appear around the hair follicles. However for more information it would be better to seek good professional advice.
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