A 33-year-old homeless woman has been living in an abandoned building and eating dried meat and bread from the dumpster behind a delicatessen. She smokes cigarettes "bummed" from others. She presents at a free clinic with bleeding under the skin, particularly around hair follicles, and bruises on her arms and legs. She is irritable, clinically depressed, and fatigued with general muscle weakness. Her gums are bleeding, swollen, purple, and spongy, with several loose teeth. She has an infected toe, which may be broken. She is afebrile, a glucose finger-stick is normal, and the urine dipstick shows no sugar, protein, or ketones. You suspect a vitamin deficiency. What might be the underlying mechanism for this patient's symptoms?

Question

Quizplus · Accepted Answer

The patient's symptoms are indicative of scurvy, which is caused by vitamin C deficiency. Vitamin C is essential for the hydroxylation of proline and lysine residues in collagen synthesis. Without it, collagen helices are unstable, leading to the symptoms observed.

A 33-Year-Old Homeless Woman Has Been Living in an Abandoned