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Old 08-12-2011
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Correct Answer Alcoholic with shoulder wound

A 69 year old alcoholic male presents to the ER with a shoulder wound that is not healing well. On PE, numberous ecchymosses are noted on posterior aspect of his legs & thighs. Skin evaluation reveals minute hemorrhages around hair follicles & splinter hemorrhages in nail beds. Lab examination is remarkable for a Hemoglobin of 10 (n 14-18 g/dL). Therapy should consist of -

A) Factor VIII
B) Iron
C) Vitamin B12
D) Vitamin C
E) Vitamin K
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Old 08-12-2011
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E) Vitamin K
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Old 08-12-2011
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vitamin C
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Old 08-12-2011
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Yes, I agree.. Vit C

It'll strengthen collagen, as well as increasing Iron absorption from Duodenum.

"Killing two birds with 1 stone"
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vit C deficiency
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d) Vit C deficiency
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follicular hemmorrhage is Vit C...
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vitamin C ...
and we can further differentiate it clinically from vitamin k by B.T which is increase in vit c deificiency while p.t is increased in vit k deficiency
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Quote:
Originally Posted by Hope2Pass View Post
A 69 year old alcoholic male presents to the ER with a shoulder wound that is not healing well. On PE, numberous ecchymosses are noted on posterior aspect of his legs & thighs. Skin evaluation reveals minute hemorrhages around hair follicles & splinter hemorrhages in nail beds. Lab examination is remarkable for a Hemoglobin of 10 (n 14-18 g/dL). Therapy should consist of -

A) Factor VIII
B) Iron
C) Vitamin B12
D) Vitamin C
E) Vitamin K
D) Vitamin C
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Old 08-13-2011
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Correct Answer D) Vitamin C

The correct answer is D) Vitamin C.

Explanation -

The patient in this vignette has signs and symptoms consistent with a deficiency of Vitamin C. Vitamin C must be consumed in the diet and is abundantly found in fruits & vegetables. Deficiencies of Vit C are rare in developed countries but can be a concern in those with inconsistent eating patterns - elderly, alcoholics (as in this case) and persons who live alone.

Vitamin C deficiency results in Scurvy, characterized by hemorrhages, subperiosteal hematomas, bleeding into joint spaces, gingival swelling, secondary periodontal infection, anemia, hyperkeratotic papular rashes, impaired wound healing & weakened immune response to local infections.

Vitamin C is needed for activatino of prolyl & lysyl hydroxylase precursors, both of which are necessary in collagen hydroxylation. Therefore, in Vitamin C deficiency the quantity & quality of collagen produced is dramatically impaired.
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