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NBME 20 Answers

nbme20/Block 4/Question#37

A 16-year-old girl with cystic fibrosis is brought ...

Vitamin E

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submitted by dickass(26),

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.

dickass  and VitB12 neurologic symptoms are described on pg 518 +  

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

ergogenic22  Also corticalspinal tract symptoms are not seen, but dorsal column and spinocerebellar tracts are seen +1  
sinforslide  In this case, patient's CF also predisposes fat-soluble vitamin deficiency. +4  
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. +3