Question

A 32-year-old woman presents with a pins and needles sensation on the sides and the bottom of her feet, as well as severe burning sensation in the feet. The burning sensation manifests primarily at night. Examination reveals a profoundly cachectic but alert patient with atrophy of muscles of the leg. Examination of the eye indicates that she also has nystagmus. Further questioning reveals that she has a history of homelessness and chronic alcoholism. What vitamin deficiency is most commonly associated with chronic alcoholism?

1. Vitamin C
2. Vitamin B1
3. Niacin
4. Vitamin E
5. Vitamin B6

Answer 1

The woman's symptoms and history indicate a thiamine (vitamin B1) deficiency, which is the most common vitamin deficiency associated with chronic alcoholism and can lead to conditions like Beri-Beri and Wernicke's encephalopathy.

Step-by-step explanation:

The 32-year-old woman's symptoms, which include a pins and needles sensation on the sides and bottom of the feet, severe burning sensation in the feet, muscle atrophy, and nystagmus, combined with a history of homelessness and chronic alcoholism, strongly suggest a deficiency in thiamine, also known as vitamin B1. Chronic alcoholism is commonly associated with thiamine deficiency due to poor dietary intake, decreased absorption, and impaired utilization of thiamine in the body.

The clinical condition of thiamine deficiency is known as 'Beri-Beri', and in more acute cases, such as in alcoholics, it can lead to Wernicke's encephalopathy.

Thiamine deficiency can result in a variety of issues such as loss of appetite, polyneuritis, cardiovascular changes, muscle weakness, and neurological impairments. Addressing thiamine deficiency is crucial, especially in those suffering from chronic alcoholism, to prevent further complications and to begin the recovery of neurological and muscular functions.