12-28-2008, 03:31 AM
A 66-year-old man has had numbness and tingling
in the hands and
feet for 2 weeks. He lives in a homeless shelter and
is well fed. He
has been treated for pulmonary tuberculosis for 4
months with
isoniazid, rifampin, ethambutol, and pyrazinamide. He
is compliant with his
medication regimen but continues to abuse alcohol.
His temperature is 37
C (98.6 F), blood pressure is 136/76 mm Hg, pulse is
72/min, and
respirations are 20/min. He is well nourished but
depressed and irritable.
There is decreased sensation to pain and touch in the
hands and feet in
a stocking-glove distribution. Which of the following
is the most
likely nutritional deficiency?
A
) Folic acid
B
) Niacin
C
) Vitamin A
D
) Vitamin B1 (thiamine)
E
) Vitamin B2 (riboflavin)
F
) Vitamin B6
G
) Vitamin B12 (cyanocobalamin)
H
) Vitamin C
I
) Vitamin D
J
) Vitamin E
K
) Vitamin K