NBME 20 Vitamin E (NBME Answers)

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nbme20/Block 4/Question#37 (reveal difficulty score)
A 16-year-old girl with cystic fibrosis is ...
Vitamin E 🔍 / 📺 / 🌳 / 📖
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submitted by ∗dickass(127)

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FA pg 70:

Vit E deficiency:

Neurologic presentation may appear similar to vitamin B12 deficiency, but without megaloblastic anemia, hypersegmented neutrophils, or serum methylmalonic acid levels.

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dickass and VitB12 neurologic symptoms are described on pg 518 +

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submitted by ∗jackie_chan(34)

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Cystic fibrosis patient --> consider fat soluble vitamin deficiencies Presentation is neurologic with ataxia, mostly likely Vit E

A deficiency- visual, infections D- calcium low K- bleeding, coagulopathy

Folic acid- anemia, not given B6- anemia also (heme synthesis defect/ALA synthase)

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submitted by ∗usmleuser007(464)

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Vitamin E deficiency is known to cause similar spinal defects as Vitamin B12 deficiency. However, anemia is not seen.

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ergogenic22 Also corticalspinal tract symptoms are not seen, but dorsal column and spinocerebellar tracts are seen +5

sinforslide In this case, patient's CF also predisposes fat-soluble vitamin deficiency. +9

breis FA pg 70 +

usmleuser007 Correction: Read more on this Vitamin-E deficiency can in fact cause anemia - hemolytic anemia. This is b/c VitE work as an anti-oxidant; and therefore with reduced anti-oxidation RBCs are more prone to oxidative injuries. +4

azharhu786 AMBOSS: Hemolytic anemia; increased fragility of erythrocytes and membrane breakdown are also caused by vitamin E. +1

kcyanide101 Just to add..... Vitamin E in excess can also be toxic as it inhibits Vitamin K, which increases risk if bleeding etc +

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