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A 40 year old man with Crohn disease is receiving hyperalimentation for the management of high output enterocutaneous fistula. After 3 weeks total perenteral nutrition, he develops perioral ulcerations with stomatitis, loss of hair, worsening erythema of the fistula wound in spite of aggressive wound care. His hemoglobin is 11.9 g/dL and his fasting glucose is 118 mg/dL. Patient is most likely deficient in what vitamin and why?

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The General Principles section of the USMLE covers these topics:
Biochemistry
Genetics
Microbiology
Pathology
Pharmacology


1. A 40 year old man with Crohn disease is receiving hyperalimentation for the management of high output enterocutaneous fistula. After 3 weeks total perenteral nutrition, he develops perioral ulcerations with stomatitis, loss of hair, worsening erythema of the fistula wound in spite of aggressive wound care. His hemoglobin is 11.9 g/dL and his fasting glucose is 118 mg/dL. Patient is most likely deficient in what vitamin and why?





 
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