NBME 22 Vitamin E (NBME Answers)

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submitted by ∗someduck3(66)

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Fat soluble vitamins are A,D,E,K. So both D & E could be decreased in this pt. But you have to know that Vitamin E deficiency is associated with demyelination & has been associated with posterior column demyelination. Also Vit E can be given with Alzheimer patients as it helps with free radicals..?

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aesalmon I actually thought that the posterior column findings were likely due to B12 deficiency - "subactue combined degeneration", due to malabsorption, as we see in this pt (. Turns out vitamin E can also cause symptoms which look like subacute combined degeneration: https://www.ncbi.nlm.nih.gov/pubmed/9012278, as does Copper (TIL): https://www.ncbi.nlm.nih.gov/pubmed/15249607 +3

jooceman739 Vitamin E deficiency causes posterior column findings and hemolytic anemia :) +6

nwinkelmann The way I think about it is that essentially, vitamin E is an anti-oxidant. Vitamin E deficiency = LOTS of oxidation, i.e. free radicals, which are toxic to most cells in the body (particularly myelination and RBCs). That's why it can be used with Alzheimer's patients. +4

makinallkindzofgainz Vitamin E presents like B12 deficiency but without megaloblastic anemia +1

kevin B12 would also affect lateral corticospinal tracts, vit E doesn't to my knowledge (b12 deficiency would also present with hyperreflexia but E deficiency just romberg sign, loss of proprioception and touch, ataxia) +

abhishek021196 This Divine Intervention podcast mentions this very clearly - https://divineinterventionpodcasts.com/2019/10/12/divine-intervention-episode-168-usmle-step-1-rapid-review-series-11-integrated/ +