A 45 year old woman has chronic watery diarrhea, episodic flushing, and a 6 month history of worsening confusion and hyperpigmented scaling on sun exposed areas of her hands and neck. Urine 5 HIAA is markedly elevated. Deficiency of which vitamin is most likely contributing to her rash and neuropsychiatric symptoms?

  1. A)Vitamin B1
  2. B)Vitamin B2
  3. C)Vitamin B12
  4. D)Vitamin B3GABARITO
  5. E)Vitamin B6

Explicação

Carcinoid syndrome can divert tryptophan toward serotonin synthesis, decreasing niacin production and causing pellagra. Niacin deficiency classically causes the three Ds: diarrhea, dermatitis, and dementia. The flushing and elevated 5 HIAA point to a serotonin... Ver explicação completa e trilha adaptativa →

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