Question

A patient with chronic heart failure on high-dose furosemide is started on enteral nutrition for an inability to consume adequate oral nutrition. Despite a slow advancement to goal feeding rate, he suffers from electrolyte imbalance and peripheral neuritis. Deficiency of which vitamin should be suspected in the cause of his symptoms?

1: Thiamin
2: Vitamin B12
3: Folate
4: Riboflavin

Answer 1

Thiamin (vitamin B1) deficiency should be suspected in a patient with chronic heart failure on high-dose furosemide who is experiencing peripheral neuritis and electrolyte imbalance after the advancement to goal feeding with enteral nutrition.

Step-by-step explanation:

A patient with chronic heart failure on high-dose furosemide who has started on enteral nutrition and experiences peripheral neuritis and electrolyte imbalance might be suffering from a deficiency of Thiamin (vitamin B1). The symptoms described, including neuropathy and cardiovascular issues, are characteristic of thiamine deficiency, which leads to a condition known as Beri-Beri. Particularly considering the patient's high-dose diuretic use, which can lead to an increased excretion of thiamine, this vitamin deficiency should be suspected in the cause of his symptoms.