An elderly bachelor living alone presents with bleeding gums, perifollicular haemorrhages, coiled 'corkscrew' hairs, and poor wound healing of a leg ulcer of three months' duration. His diet consists almost entirely of bread and tea. The most appropriate diagnosis is:

• A Vitamin A deficiency
• B Scurvy ✓
• C Kwashiorkor
• D Zinc deficiency

Explanation

The triad of bleeding gums, perifollicular haemorrhage with corkscrew hairs, and delayed wound healing in a diet lacking fruit and vegetables is classical scurvy from vitamin C deficiency. Vitamin C is needed for hydroxylation of proline and lysine in collagen synthesis. Vitamin A deficiency gives follicular hyperkeratosis without bleeding, and zinc deficiency impairs healing but does not cause gum haemorrhage.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.