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NBME 20 Answers

nbme20/Block 4/Question#10

A 65-year-old woman who has a 25-year history of ...

Hydroxylation of proline

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There is an abnormally decreased function of the hydroxylation of proline because the 2nd stage in collagen synthesis (hydroxylation of specific proline and lysine residues) requires vitamin C. Since this patient has Scurvy (vit. C deficiency), this process is unable to occur.

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submitted by hayayah(525),

She has a vitamin C deficiency. Scurvy features swollen gums, easy bruising, petechiae, perifollicular and subperiosteal hemorrhages.

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submitted by lynn(0),

FA19, pg 69 - perifollicular and subperiosteal hemorrhages, pg 674 specifically lists mucosal bleeding