A chronic alcoholic presenting with bleeding gums and petechiae is more likely to have deficiency of:
**Core Concept**
Vitamin C (ascorbic acid) deficiency leads to impaired collagen synthesis and increased risk of bleeding due to impaired vascular integrity. Ascorbic acid plays a crucial role in the hydroxylation of proline and lysine residues in collagen, essential for the formation of stable collagen fibers.
**Why the Correct Answer is Right**
The chronic alcoholic is more likely to have a deficiency of vitamin C due to poor dietary intake, impaired absorption, and increased demand for the vitamin. Vitamin C is water-soluble and cannot be stored in the body, making it essential to consume adequate amounts through the diet. In chronic alcoholics, the liver's ability to store and release vitamin C is impaired, leading to deficiency. Moreover, ethanol can directly impair the absorption of vitamin C from the gut.
**Why Each Wrong Option is Incorrect**
* **Option A:** Folate deficiency typically presents with megaloblastic anemia, neurological symptoms, and gastrointestinal disturbances, not bleeding gums and petechiae.
* **Option B:** Vitamin K deficiency is associated with impaired blood clotting, presenting with easy bruising, prolonged bleeding, and increased prothrombin time, not specifically bleeding gums and petechiae.
* **Option D:** Iron deficiency typically presents with microcytic anemia, fatigue, weakness, and decreased exercise tolerance, not specifically bleeding gums and petechiae.
**Clinical Pearl / High-Yield Fact**
Vitamin C deficiency is also known as scurvy, a disease characterized by impaired collagen synthesis, leading to bleeding gums, joint pain, and poor wound healing.
**Correct Answer: A. Vitamin C. Vitamin C deficiency.**