A 48-year-old man with severe alcohol use disorder and chronic malnutrition presents with a 3-month history of chronic diarrhea, irritability, and disorientation. Vital signs show BP 118/76, HR 92, RR 16, Temp 37.2°C. Physical examination reveals a sharply demarcated, photosensitive hyperpigmented rash on the neck and dorsal hands. Serum albumin is 2.8 g/dL. He denies neurological symptoms beyond disorientation. Deficiency of which vitamin most likely explains this clinical syndrome?
- A)Vitamin B12
- B)Riboflavin
- C)Vitamin D
- D)NiacinGABARITO
- E)Vitamin C
Explicação
This patient has pellagra due to niacin deficiency. The classic triad is dermatitis, diarrhea, and dementia, often in malnutrition, alcoholism, Hartnup disease, or carcinoid syndrome. Niacin is a precursor of NAD and NADP, which are central to oxidation reduct... Ver explicação completa e trilha adaptativa →