Question

A 45-year-old man presents with fatigue and hair loss that began about 2 weeks ago. His past medical history is significant for alcoholism and type II diabetes mellitus. He states that over the past 2 weeks, he has begun feeling more and more tired, and he has noticed that he was losing much more hair than usual. He denies pain, nausea, vomiting, fever, and chills; he states that he had been in his usual state of health until 2 weeks ago. He also denies recent illness and travel. He states that he now gets tired after very minimal activity and has poor wound healing. He admits that his diet is poor and that he does not control his blood glucose very well.

Physical examination reveals a thin, frail man in no acute distress. He has an ulcerous lesion on his left heel that is draining but does not appear to be infected. Blood work including urinalysis, CBC, and WBC were within normal limits.

What deficiency does this patient most likely have?

1. Niacin
2. Zinc
3. Folate
4. Vitamin B-12
5. Vitamin B-1

Answer 1

The patient's symptoms, including poor wound healing, hair loss, and fatigue, in the context of a poor diet and poorly controlled diabetes, suggest that he is most likely suffering from a zinc deficiency.

Step-by-step explanation:

The patient in the scenario is likely suffering from a zinc deficiency. Zinc is essential for maintaining a healthy immune system and plays a critical role in wound healing, cell growth, and hair growth. The patient's symptoms, including fatigue, hair loss, and poor wound healing, are consistent with zinc deficiency, especially in the context of a poor diet and poorly controlled diabetes, which can affect nutrient absorption. Additionally, given his history of alcoholism, this could further predispose him to nutritional deficiencies because alcohol can interfere with the absorption of zinc and other vital nutrients.