A 42-year-old man presents with bilateral pitting pedal oedema, breathlessness, and a high-volume pulse with wide pulse pressure. Echocardiography shows a dilated heart with high-output failure. He consumes a diet predominantly of polished white rice and reports heavy alcohol intake. The most likely underlying deficiency is:
- A Thiamine ✓
- B Riboflavin
- C Pyridoxine
- D Pantothenic acid
Correct answer: A. Thiamine
Explanation
High-output cardiac failure with oedema in a polished-rice eater is wet beriberi due to thiamine (vitamin B1) deficiency. Thiamine is required for pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase, so carbohydrate loading worsens the state. Riboflavin deficiency causes angular stomatitis and glossitis, not cardiac failure. Pyridoxine deficiency causes sideroblastic anaemia and neuropathy.
Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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