A 72-year-old man undergoes a subtotal colectomy for a cecal perforation due to a sigmoid colon obstruction. He has had a prolonged recovery and has been on total parenteral nutrition (TPN) for 2 weeks postoperatively. After regaining bowel function, he experienced significant diarrhea. Examination of his abdominal wound demonstrates minimal granulation tissue. He complains that he has lost his taste for food. He also has increased hair loss and a new perioral pustular rash. Which of the following deficiencies does he most likely have?
Correct Answer: Zinc
Description: The patient has a zinc deficiency. Alopecia, poor wound healing, night blindness or photophobia, anosmia, neuritis, and skin rashes are all characteristic of patients with zinc deficiency, which often results in the setting of excessive diarrhea. Selenium deficiency is characterized by the development of a cardiomyopathy. Molybdenum deficiency is manifested by encephalopathy due to toxic accumulation of sulfur-containing amino acids. Chromium deficiency can occur in patients on long-term TPN and is characterized by difficult-to-control hyperglycemia and peripheral neuropathy and encephalopathy. Thiamine deficiency results in beriberi, which includes symptoms of encephalopathy and peripheral neuropathy; patients with beriberi can also develop cardiovascular symptoms and cardiac failure.
Category:
Anaesthesia
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