A 2-year-old boy who is primarily on a milk based diet presents with a history of swollen bleeding gums, lethargy and pain while moving limbs. Most likely diagnosis of this patient is:
**Core Concept**
Rickets is a disease caused by vitamin D deficiency, leading to softening of the bones in children, resulting in skeletal deformities.
**Why the Correct Answer is Right**
The patient's symptoms of swollen bleeding gums, lethargy, and pain while moving limbs are indicative of rickets. Vitamin D plays a crucial role in calcium absorption, and its deficiency impairs normal bone mineralization. This results in softening of the bones, leading to skeletal deformities, such as bowed legs and chest deformities in children. The patient's diet primarily consisting of milk, which is fortified with vitamin D, makes this diagnosis even more likely.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because scurvy is a disease caused by vitamin C deficiency, which primarily affects collagen synthesis and does not typically present with the symptoms described.
**Option B:** This option is incorrect because lead poisoning can cause a range of symptoms including abdominal pain, constipation, and encephalopathy, but does not typically present with swollen bleeding gums.
**Option C:** This option is incorrect because hypothyroidism can cause growth retardation, but does not typically present with the symptoms described.
**Clinical Pearl / High-Yield Fact**
Rickets is a classic example of a disease caused by a nutritional deficiency, and its symptoms can be prevented by ensuring adequate vitamin D levels in children, especially those on a milk-based diet.
**Correct Answer:** C. Rickets.